Confronting Pain at Its Core

Back pain March 3, 2020 By: Keith Skillman, CAE

An initiative by the International Association for the Study of Pain illustrates the protective nature of many associations’ work. In concert with the ASAE centennial, the ASAE Research Foundation is researching associations’ other societal impacts on public protection, education, workforce, and the economy.

Imagine for a moment what life is like for an individual with chronic, debilitating back pain. Lost work. Doctor visits. Significant health implications, such as mental and behavioral conditions like depression and anxiety. Unreimbursed medical expenses. For the estimated 116 million Americans affected by chronic pain of one kind or another, it’s a daily reality.

Moreover, according to the Centers for Disease Control and Prevention, patients with chronic pain experience up to 70 percent greater mortality risk, and the estimated annual cost of treating chronic pain in the United States alone is $635 billion.

And yet—despite the sometimes crippling impact on individuals and even their workplaces and communities—until recently, chronic pain was not systematically recognized as a discrete diagnosis. The situation has left patients with limited treatment and insurance options, complicating the work of researchers in quantifying the prevalence and burden of pain, and limiting opportunities for clinicians to develop evidence-based and cost-effective treatments.


Today—thanks to extensive, scientifically rigorous work of the members of the International Association for the Study of Pain, experts in the field, and nearly 100 partner organizations—chronic back pain and other forms of chronic pain are discretely recognized and classified into one of seven categories:

  • chronic primary pain
  • chronic cancer pain
  • chronic post-traumatic and post-surgical pain
  • chronic neuropathic pain
  • chronic headache and orofacial pain
  • chronic visceral pain
  • chronic musculoskeletal pain

In May 2019, the World Health Assembly approved the classification, ICD-11, and the new diagnoses will take effect worldwide for health reporting in January 2022. What’s the significance? Among other things, formal recognition of chronic pain as a stand-alone disease means:

  • Chronic pain is now noted as requiring special consideration and treatments, enabling physicians to more proactively treat patients and potentially offset long-term costs.
  • Chronic pain sufferers and their healthcare teams can track pain as a diagnosis or co-diagnosis in an underlying disease.
  • Critical data such as cost information, treatments, and societal impact of pain will be made more readily accessible—possibly enabling better measurement and reduction of the burden of pain without undue burden on government agencies.

The Foundation’s Research

The IASP example is one of many from ASAE Research Foundation work that will be highlighted and further detailed throughout the ASAE centennial this year and beyond. The foundation’s research is focused on association initiatives that have positively changed society, specifically in areas relating to safety, education, and economic and workforce development.

Throughout 2020, ASAE and the ASAE Research Foundation will tell the stories of these association efforts and share the lessons gleaned by associations representing wide-ranging industries and professions and addressing specific problems and needs.

Keith Skillman, CAE

Keith Skillman, CAE, based in Lawrence, Kansas, writes about associations and their work.