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Why All This Pain?

Peter Abaci

Peter Abaci, MD, is the Medical Director of the nationally recognized Bay Area Pain and Wellness Center, located in Los Gatos, California. A widely respected expert on chronic pain management and a highly successful chronic pain sufferer, he is the author of Take Charge of Your Chronic Pain: The Latest Research, Cutting-Edge Tools, and Alternative Treatments for Feeling Better.

If you suffer from chronic pain, then you are now in the company of 116 million other Americans according to a recent report by the Institute of Medicine. This is by far the largest number that has been assigned to the chronic pain community since I started practicing some fifteen years ago, and with so many now affected this suggests that we are in the middle of a chronic pain epidemic. Chronic pain should now be considered one of the major chronic diseases of our modern society, along with things like heart disease and diabetes.

This brings me to the million dollar question of why? In other words, why is the incidence of chronic pain on the rise and now affecting so many people?

I think we can find some of the answers if we look carefully at the changes that have occurred in our society during this same time period. Such changes, spurred by the evolution of technology, have had a big impact on lifestyle behaviors. For starters, we move less and we move differently than our previous generations. Innovations like cars, computers, and cell phones mean more of us can live and work in a primarily sedentary fashion. As a result, we burn fewer calories each day and we don’t use many of the muscles that we used to need for survival resulting in wholesale changes to our bodies.

Computers were not a regular part of peoples’ lives until the 1990s. Our bodies were not made to sit and work on a keyboard all day long, yet that is precisely what many of us now do. This ultimately has a big impact on the muscles and joints that support our necks, shoulders, and backs, and at the same time requires very little input from our lower halves. This also requires us to be indoors more, which means more of us are now vitamin D deficient (also a risk factor for chronic pain).

Diets have also changed over the last few decades. We eat more processed foods containing products with high-fructose corn syrup and trans fats, while consuming less fruits, vegetables, and whole-grains. Such dietary changes mean consuming more harmful pro-inflammatory food products and an overall increase in calorie consumption compared to past generations.

The end result of all of these changes is that people are getting larger and larger. At one time, the obesity rate in the U.S. was relatively low, but it has recently shot up to 30% and is projected to hit 50% by 2030 according to a recent article in the Lancet. Even small increases in body weight can cause big increases in force exerted onto the spine and knee joints, and that translates into more degeneration and more pain. On top of that, abdominal fat cells have been found to increase the secretion of inflammatory mediators.

A number of recent studies have shown strong correlations between chronic pain and lifestyle factors like obesity and smoking. If people have been smoking for decades, then why would smoking all of a sudden be associated with chronic pain? I think this has to do with our increased longevity. Certain lifestyle habits may not have a big impact on how we feel in middle age, but could have a big impact on our quality of life as we grow older.

As more of us continue to live longer, it becomes imperative that we adopt strategies to diminish the impact pain can have on the quality of our lives. If we want to successfully fight this rise in chronic pain, then we need to look at how technological changes have directly led to lifestyle shifts and find ways to offset or counter-balance these changes so we can all have a better chance of feeling well at any age.

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