Saturday, May 6, 2023

Opinion Today: The despair fueling America’s chronic pain

Millions are suffering in ways that lead to addiction, sorrow and a tangle of other pathologies. Why?

Chronic pain is not just a result of car accidents and workplace injuries but is also linked to troubled childhoods, loneliness, job insecurity and a hundred other pressures on working families.

Bobbie Wert in her bedroom with a heating pad, which she uses along with pillows when her pain gets bad.Ricardo Nagaoka for The New York Times
Author Headshot

By Nicholas Kristof

Opinion Columnist

One of the mysteries of America is why so many people are in pain.

Neck pain! Back pain! Hip pain! Knee pain! Perhaps 50 million Americans suffer from chronic pain, and the problem seems to be getting worse even as workplace injuries go down. In other countries it's mostly older people who report pain, which makes some sense since their bodies are beyond warranty, but in the United States it's the middle-aged who suffer most, especially in the working class. So what's going on?

For a column about chronic pain, I interviewed a woman named Bobbie Wert who has been wracked by stomach pain since she was a young girl. Doctors poked and prodded and occasionally operated to remove bits and pieces, but none of this helped — and Wert eventually understood that the problem probably wasn't her uterus or bladder. "It was trauma," she said.

Physical and sexual abuse had whirled around her when she was young, and it may be that it put the brain on a hair-trigger alarm system that periodically went haywire. The mechanisms aren't fully understood, but it is clear that chronic pain sometimes originates in the brain rather than in the body part that hurts; phantom pain from an amputated limb is one example.

I decided to write about chronic pain not just because so many suffer from it, but also because there is a growing amount of helpful research into how to ease it. This many people don't need to suffer.

This essay is the first in an occasional series I'll be writing about the interwoven crises affecting working-class Americans and, more important, how we can address these challenges. The series, "How America Heals," will explore education, health, homelessness, loneliness, addiction and more.

The series arises from a deeply personal place. As I wrote in my last book, more than a quarter of my childhood classmates on my old No. 6 bus have died from drugs, alcohol or suicide. Sometimes these friends confided in me about their chronic pain, and at the time I wondered if they were malingering; in retrospect, I don't think they were. This series is a way to highlight these problems across America and explore how we can heal together.

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