(HealthDay)— Of the 50 million Americans living with chronic pain, the pain is so bad for 20 million that it keeps them from doing the daily activities of life, researchers say.

According to a report from the U.S. Centers for Disease Control and Prevention, chronic pain and high-impact chronic pain are more common among women, older adults, the poor, people previously employed, those with public health insurance or living in rural areas.

Not only is chronic pain widespread, it lies at the root of the opioid epidemic, said Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Conn.

“Potentially overlooked is the crisis that precipitated the opioid crisis—the high prevalence of chronic pain in need of relief,” he said.

The CDC report is a reminder that an epidemic of chronic pain existed before it was compounded by an epidemic of opioid misuse, explained Katz, who was not involved with the new study.

Chronic pain must be prevented more often and treated with compassion, effectiveness and safety once it begins, he added. “Efforts to limit the harms of opioid analgesics cannot result in neglect of patients’ pain,” Katz said.

Coping with chronic pain and high-impact chronic pain are associated with restrictions in mobility and daily activities, opioid dependence, anxiety, depression and a poor quality of life, according to the study authors.

In addition to the suffering of millions of citizens, chronic pain costs an estimated $560 billion each year in medical expenses, lost productivity and disability programs, the researchers said.

In light of these problems, mainstream medicine must embrace valid approaches to pain management other than drugs, Katz suggested.

“This is already an established objective among those dedicated to state-of-the-art pain management, but it must become the routine standard of care,” he said.

Care must be more holistic and patient-oriented, Katz stressed.

A prescription for an opioid is a quick, easy response from a busy doctor. “But the patient in pain might improve with better sleep, stress reduction and relief of loneliness,” Katz said.

Dr. Mark Bicket, an assistant professor of anesthesiology at Johns Hopkins University in Baltimore, said that effective pain management needs to be a team effort. “Appropriate treatment for chronic pain involves more than just medicines,” he explained.

Managing chronic pain effectively involves a group that includes doctors, physical therapists and others, and activities like yoga or meditation, Bicket said.

And non-narcotic painkillers—such as Aleve or Tylenol—may be just as effective in controlling chronic pain. Typically, a combination of a painkiller and exercise or physical therapy is the most effective way to manage chronic pain, he said.

“If you are living with chronic pain, you are not alone,” Bicket said. “And you deserve to have a discussion about the different options to treat your pain.”

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