The costs of chronic pain and subsequent disability in the United States are and will continue to be a major socioeconomic problem until appropriate, cost-effective algorithms for management are created and implemented. Chronic, unrelieved pain is not only a major drain on scarce health care resources, but also it is the cause of needless suffering of millions of people worldwide. Approximately 30% of the general population of the United States suffers from chronic pain.<sup>10 Bonica J.J. Chronic non-cancer pain  Lancaster, UK: MTP Press (1987). 

Cliccare qui per andare alla sezione Riferimenti</sup> In a study of the general population of Michigan, The Michigan Pain Study, it was found that one in five adults, or about 1.2 million people, in Michigan suffer from some form of chronic, ongoing, or recurring pain.<sup>49 Michigan Pain Study: EPIC/MRA 4710 W. Saginaw Hwy. Lansing, MI 48917=2601, 1997

Cliccare qui per andare alla sezione Riferimenti</sup> In the workplace, pain was responsible for 400,000 workers, or 12% of the Michigan work force, failing to show up for work at some point during 1997. Of those surveyed, 35% missed more than 20 days of work in the same year. In a 1992 study on the dollar impact on 12 diverse and large U.S. businesses, disability cost these businesses an average of $2500 per employee.<sup>15 Chelius J., Galvin D., Owens P. Disability: It’s more expensive than you think Business Health 1992 ;  10 : 80

Cliccare qui per andare alla sezione Riferimenti</sup>

Besides these dollar costs to society and economy, there are direct costs of chronic pain to patients and their families, including loss of job, loss of income, loss of savings and security, loss of insurance, and loss of self-esteem. The Michigan Pain Study surveyed 1500 Michigan residents who were 18 years of age and older to determine the severity of the chronic pain problem, how people cope, access to treatment, and the effectiveness of available pain care. Of the 1.2 million people in Michigan who suffer from chronic pain, 42% say pain has affected their relationships with spouses, family members, and fellow workers. Forty-eight percent experience depression; 18% have overdosed on pain medication; and 10%, about 120,000 people, have contemplated suicide. Looking for relief from pain has led to 5% of chronic pain sufferers in this population (representing approximately 60,000 adults) to drink alcohol, including 18% who admit to overdosing on their medications. These figures paint a gloomy and compelling picture of the true costs of chronic, unrelieved pain to society.

The consequences of intractable pain, in respect to both its impact on society and its emotional and physical price exacted on patients and their families, are staggering; finding a solution should be a high priority for governmental agencies, health care intermediaries, and health care workers. Abandoning patients when less costly and less invasive interventions do not work to relieve pain and suffering is not acceptable. This article presents the argument that interventional pain management is appropriate for patients suffering from chronic unrelieved pain and, based on efficacy reports in the literature, is justifiable. These invasive therapies do relieve pain and suffering and, in fact, are cost-effective when one looks at the alternatives.