Comprehensive Canadian survey reveals significant gaps in treating Paradigm of

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Comprehensive Canadian survey reveals significant gaps in

treating " Paradigm of Pain "

http://www.medadnews.com/News/Index.cfm?articleid=499255

Chronic pain sufferers identify sleep and psychological impacts that

affect everyday life often not recognized or treated

A new Canadian survey reveals startling data about the gap in the

treatment and management of chronic pain in Canada (i). The data

indicates chronic pain sufferers experience psychological symptoms

such as anxiety and depression and report that their condition

affects their ability to sleep. When they speak to their health care

professionals, patients often do not receive treatment for these

other conditions.

" This new data reveals the enormous impact that pain has on the

lives of Canadians and confirms that there is a mental and emotional

component that exacerbates the physical symptoms of pain, " says Dr.

Sullivan, PhD, Department of Psychology, McGill University,

Montreal. " This confirms what we have been experiencing in our work

with pain patients. There must be more emphasis on recognizing and

effectively treating all aspects of pain experienced by patients -

the physical pain component along with sleep and psychological

symptoms. " This relationship between pain, sleep and psychological

symptoms is sometimes referred to as the " Paradigm of Pain " .

Approximately 6,200 Canadians responded to the -Decima on-line

survey completed for Pfizer Canada during October 2007. From the

group of initial respondents about 1,100 identified they suffered

from some form of chronic pain. One-third of chronic pain sufferers

report that they regularly suffer from at least one symptom of

chronic pain. Among those who have been regularly suffering from two

or more symptoms for more than six months, half (47%) have not been

diagnosed and only one in four (25%) have neither been diagnosed

with a disease nor are they receiving any treatment at all for their

symptoms.

Pain often cited as interfering with sleep

Among chronic pain sufferers in Canada, approximately four in ten

(38%) experience fatigue regularly or always as a result of their

condition and one in three (36%) experience trouble falling or

staying asleep. While more than half of these chronic pain sufferers

have spoken with their health care professionals about their fatigue

and inability to sleep, few were prescribed medication for the

condition. " It is no surprise to those of us who work with these

patients that only four in ten indicate having spoken to their

doctor about their anxiety and among those, only one in four

indicate being prescribed medication or other treatments, " says Dr.

Genge, Montreal Neurological Hospital. Dr. Genge treats

patients with a variety of pain conditions.

Two in three sufferers experience anxiety, feelings of despair

Chronic pain can have a significant impact on a person's daily

functioning and quality of life. In addition to the physical

symptoms of pain, two in three chronic pain sufferers experience

anxiety about their condition and those who take medication for

their pain are twice as likely to report being 'always'

or 'regularly' worried about their condition than those not taking

medication. A large number of chronic pain sufferers experience

feelings of despair and hopelessness. " The data confirms sleep

interference can be a direct result of and can further exacerbate

chronic pain and psychological symptoms. And the psychological

symptoms can have the same effect on pain and sleep, " says Dr.

Sullivan. Among those Canadians who have been regularly suffering

from two or more chronic pain symptoms for more than six months,

half (47%) have no diagnoses but are taking prescribed or over-the-

counter medication while one in four (25%) have neither been

diagnosed with a disease nor are they receiving any treatment at

all. The symptoms most often noted by those who responded included:

<< - Temporary numbness or muscle weakness; - Painful tingling or

numbness or muscle weakness; - Sharp, stabbing or burning pains; -

Painful sensations of cold or heat; and - Painful sensitivity to

touch. >>

Neuropathic pain or 'nerve' pain was the most frequently diagnosed

neuropathic disease followed by multiple sclerosis and other pain

conditions such as diabetic, post-shingles and post-stroke

neuropathies. It is estimated that as many as 2.2 million Canadians

live with some form neuropathic pain(ii); a disease that is often

under-diagnosed and under-treated.

LYRICA® now approved for the treatment of central neuropathic pain

In 2005, LYRICA (pregabalin) became the first treatment approved for

the management of neuropathic pain associated with diabetic

peripheral neuropathy (DPN) and postherpetic neuralgia (PHN). LYRICA

is now the first agent approved, with conditions, for use in the

management of central neuropathic pain (CNeP), nerve pain associated

with conditions such as spinal cord injury (SCI), stroke, multiple

sclerosis and Parkinson's disease. Central neuropathic pain results

from a primary lesion or dysfunction in the nervous system (i.e.,

brain, brainstem and spinal cord). LYRICA is marketed by Pfizer

Canada Inc. The approval of LYRICA for use in central neuropathic

pain was based on a trial in spinal cord injury pain. This type of

pain is generally treatment resistant with low levels of response to

traditional neuropathic medications and opioids. This SCI study is

the largest trial ever conducted in such a difficult to treat

population. Benefits were significant across all measures including

pain reduction, pain related sleep difficulties & anxiety, as well

as the patients' overall impression of change. The safety of LYRICA

has been established in almost 9,000 patients (controlled and

uncontrolled studies). LYRICA has a favourable safety profile. The

most commonly observed adverse events ((greater than or equal to) 5%

and twice the rate of that seen in placebo) in pregabalin-treated

patients in pre-marketing studies were: dizziness, somnolence,

peripheral oedema, and dry mouth. Adverse events were usually mild

to moderate in intensity.