1. 2017;20;E257-E268Prevalence of Specific Types of Pain Diagnoses in a Sample of United States Adults
   Retrospective Review
   Promila Pagadala, PhD, Jichun Xie, PhD, Beth Parente, MHS, Aladine A. Elsamadicy, BE, Syed Mohammed Qasim Hussaini, MS, Siyun Yang, MS, Jing L. Han, BA, Kelly Ryan Murphy, BS, and Shivanand P. Lad, MD, PhD.

BACKGROUND: Patients with pain conditions place significant demands on health care services globally. Health economists have reported the annual economic cost of pain in the United States as high as $635 billion. A common challenge in treating patients suffering from chronic pain conditions is accurate diagnosis and treatment.

OBJECTIVE: The aim of this study was to determine the modern-day prevalence of individual types of pain diagnoses in adults.

STUDY DESIGN: Retrospective analysis of Truven MarketScan® Commercial and Medicare Supplemental database.

SETTING: United States patient population with a pain diagnoses from 2000 to 2012.

METHODS: Multivariate analysis was used to determine the individual prevalence of specific types of pain diagnoses over a 13-year period. Patients: We grouped the 6,575,999 patients with ICD-9 pain diagnoses into pain groupings.

RESULTS: We determined the prevalence of pain groupings as back pain (74.7%), chronic pain (10.4%), complex regional pain syndrome (1.2%), degenerative spine disease (63.6%), limb pain (50.0%), neuritis/radiculitis (52.8%), and post-laminectomy syndrome (14.8%).

LIMITATIONS: Retrospective and non-randomized study, with a patient cohort that is weighted towards recent years and commercial insurance. Coding discrepancies that are recorded and collected for patients.

CONCLUSIONS: The demographic differences and similarities within the subgroups highlighted the concept that pain diagnoses should be considered as separate, but related entities. The present study helps us to better understand the frequency of specific pain diagnoses, and directs future studies to appropriately focus on pain diagnoses based on prevalence. This will allow increased understanding of the variation in pain diagnoses and prevent over-generalization in studies examining pain patients to more accurately reflect the varied subtypes and their economic impact.
Duke University Institutional Review Board Protocol: 00053624

Key words: Pain diagnoses, CRPS, neuritis, radiculitis, limb pain, degenerative spine disease, back pain, chronic pain, post-laminectomy pain, prevalence, MarketScan