1. 2013;16;603-608A Comparison of Chronic Pain Prevalence in Japan, Thailand, and Myanmar
   Cross-Sectional Study
   Toshihiko Sakakibara, MD, Zhuo Wang, MD, Permsak Paholpak, MD, Weerachai Kosuwon, MD, Myint Oo, MD, and Yuichi Kasai, MD.

BACKGROUND: Pain has been regarded as important in the improvement of quality of life (QOL). In the advanced countries of Europe and the North America, a number of large-scale epidemiological surveys on pain, particularly chronic pain, have thus been performed in general populations. However, few epidemiological surveys of chronic pain have been reported from developing countries, and no surveys appear to have examined chronic pain in the least developed countries.

OBJECTIVES: To compare the incidence of chronic pain in Asian countries, using Japan as an advanced country, Thailand as a developing country, and Myanmar as one of the least developed countries.

STUDY DESIGN: Cross-sectional study in 4 hospitals.

SETTING: A university hospital and a general hospital in Japan, a university hospital in Thailand, and a general hospital in Myanmar.

METHODS: Patients were 1,000 nursing staff working in Japan, 448 nursing staff working in Thailand, and 405 nursing staff working in Myanmar. The survey was performed by requesting all nursing staff to anonymously answer the questionnaire. Data were used to calculate chronic pain prevalence, pain site, presence or absence of consultation with doctors, methods of handling pain other than consultation with doctors, and whether pain was controlled for each country. The results were then compared between countries.

RESULTS: The prevalence of chronic pain in Myanmar was 5.9%, which was significantly lower (P < 0.01) than in Japan (17.5%) or Thailand (19.9%). The most frequent pain sites were the lower back, head, and shoulders in Japan, and the shoulders, ankle, upper back, and head in Thailand, whereas in Myanmar, no clear certain tendencies were observed. The most frequent method for handling pain other than consultation with doctors was over-the-counter drugs in Japan, massage in Thailand, and relaxation therapy (meditation) in Myanmar.

LIMITATIONS: Limitations of this study were the cross-sectional design study, the small number of hospitals included, the limitation of patients to nursing staff, and the omission from the questionnaire of questions regarding body height and weight, working situation, family background, trauma history, sports activity history, smoking history, psychological/character tests, QOL, and pain levels of patients.

CONCLUSION: The prevalence of chronic pain was significantly lower in Myanmar than in Japan or Thailand. With regard to the site and treatment of chronic pain, no clear tendencies were observed between countries, suggesting that frequency and the character of chronic pain differ from county to country around the world.