Profiles of pain in Mississippi: results from the Southern Pain Prevalence Study.

OBJECTIVES: To estimate the prevalence, intensity, frequency, and origins of pain in Mississippi residents and explore the social and cultural aspects of pain and pain management by measuring the impacts of pain on everyday life as well as respondents' beliefs and attitudes toward pain.

STUDY DESIGN: Cross-sectional survey of Mississippi adults.

SUMMARY OF BACKGROUND DATA: Data from previous population surveys and clinical studies indicate that pain is a pervasive part of everyday life. The prevalence, intensity and frequency of reported pain is substantial throughout these studies. The literature documents large and profound consequences of pain both for individual lives and for society. The data also suggest that beliefs and attitudes rooted in the social and cultural context of society may help explain how pain is managed or endured.

METHODS: Telephone interviews with a representative sample (random digit dialing) of 604 Mississippi adults were conducted utilizing a computer-assisted telephone interviewing system. The cooperation rate was 94.8% (5.2 % refusal). The Code of Standards and Ethics for Survey Research rate was 67.4% and the maximum sampling error was +/- 4.0% (95% confidence interval). The Mississippi survey data represent a subset of the data obtained in the six-state Southern Pain Prevalence Study.

RESULTS: The pain prevalence rate was estimated to be 37% of the overall Mississippi sample: 9% of the sample reported severe pain on at least a monthly basis; 16% reported moderate pain; and 12% reported mild pain. Among those reporting pain, a majority (52%) experienced pain on a daily basis. The most commonly reported origins of pain were back pain (49%), leg and knee pain (41%), and shoulder.and arm pain (20%). Respondents also reported that both moderate and severe pain had substantial negative impacts on multiple facets of everyday life, including interference with sleep (84%), recreational/leisure activities (78%), ability to work (68%), sexual relations (43%), and relationships with others (36%). Mental health impacts for respondents with moderate to severe pain on at least a monthly basis included increased feelings of anxiety (66%), self-reported depression (63%), and loneliness (46%). When responding to questions regarding beliefs and attitudes about pain and pain management, the majority of respondents (62%) considered pain to be a normal part of everyday life. Many respondents felt that medicine should be saved until the pain becomes worse (55%), and a substantial number of respondents felt that good patients do not complain about pain to their doctors (22%).

CONCLUSIONS: This study expands the body of knowledge about the prevalence of pain in Mississippi, suggesting that approximately one-third of the state's adults are affected by pain on at least a monthly basis. Most of this pain is moderate to severe and quite frequent--occurring daily for the majority of pain sufferers. The study also illuminates social and cultural dimensions of pain, revealing that a) the presence of pain negatively affects almost every facet of life, from sleep and work to relationships, leisure activities, and mental health, and b) respondents attitudes and beliefs are often at variance with modern approaches to pain management. Knowledge gained could have critical implications for understanding patients and the treatment of pain.