Epidemiology of Chronic Pain
Linda LeResche University of Washington
Michael Von Korff Center for Health Studies-- Group Health Cooperative of Puget Sound
Epidemiology is defined as the study of distribution, determinants, and natural history of disease in populations ( Lillienfeld & Lillienfeld, 1980). This definition embodies the three important perspectives of epidemiology: the population perspective, the environmental perspective, and the developmental perspective. We have elaborated the implications of these perspectives for research and treatment of chronic pain elsewhere ( Dworkin, Von Korff, & LeResche, 1992). Here we provide a brief review.
Much of this book is written from the perspective of clinicians who treat patients with chronic pain. Such pain patients, often seen in tertiary care centers, certainly experience a great deal of suffering and interference with social roles associated with their pain; they also account for significant health care costs and disability. However, as a group these patients represent only a small fraction of persons in the population who experience pain, or even persistent pain. Thus, inferences about pain generated from the study of this highly selected group of patients may not be useful, and may even be misleading, in terms of developing an understanding of the etiology and natural history of acute, recurrent, and chronic pain conditions ( Fields, 1987).