Lives of 300,000 marred by pain  
Severe enough for them to take an average of 36 days' MC a year
By Salma Khalik, Health Correspondent

MORE than 300,000 adults here are living in pain severe enough to affect their work a large-scale study on chronic pain has found.

They take an average of 36 days' medical leave a year to deal with pain that can range from crippling backache and joint pain to headache and arthritis.

But it seems that fewer people here report prolonged and constant suffering compared to those in other developed countries.

They form 8.7 per cent of adults here, lower than the more than 10 per cent elsewhere. One in five adults in Europe, for example, complains of chronic pain. In Hong Kong, the proportion is 11 per cent.

Chronic pain is defined as pain that occurs in three months out of six.

On a scale of one to 10, a pain would be rated four or more.

The study involved interviews with more than 4,000 people and was published in the Annals, the journal of the Academy of Medicine, last month.

The two specialists who conducted the study believe the warm climate here has something to do with the low rate.

Dr Yeo Sow Nam, a pain specialist in private practice, said certain pain conditions are more common in cold climates". The cold could make joints ache more.

He added: "Interestingly, Mediterranean countries like Italy and Spain have less pain prevalence than the colder Scandinavian countries like Norway."

The other doctor involved in the study, anaesthetist Tay Kwang Hui, a consultant at the National University Hospital also cited Singapore's relatively young population and a cultural bias in being stoic about pain.

The study found some ethnic differences in reporting chronic pain. It was the highest among Indians (11 per cent) followed by Chinese (8.7 per cent) and Malays (6.4) per cent. Similar ethnic differences are seen in Malaysia, said Dr Tay.

Dr Tan Kian Hian, director of Singapore General Hospital's (SGH's) Pain Management Centre, agreed that chronic pain might be under-reported here since Asians "may not be as vocal as people in the Western populations".

He added: "It is not uncommon to see patients in Singapore who have put up with severe pain for a prolonged period of time before seeking treatment.

We need to educate our population ...... not to suffer in silence."

Back pain is the most common form of pain often the result of a slipped disc. SGH's orthopaedic department treated 10,000 patients for spinal problems and another 10,000 for knee pain last year. Its spokesman said the number has been increasing at about 5 per cent a year.

The elderly are the biggest group of pain sufferers, with one in five people aged 65 and older complaining of being in pain. The doctors say ageing causes wear and tear in their bodies.

But young people who exercise without care can suffer as much as the old. Miss Danielle Goh was only 18 years old when she was diagnosed with a prolapsed disc and degeneration of two of her lumbar vertebrae.

Doctors think it could have been caused by too much active dancing.Hardly a day passed without her twirling on the dance floor.

Now 30, she recalls that initially, the pain would surface every few weeks.

"I felt excruciating pain sitting, lying down, standing, moving, and even when not moving. I could hardly move, and feared going to the bathroom as getting down and up from the seat was a feat."

After 12 years of strengthening her lower back with regular swimming, her pain episodes are now less frequent.

The study predicted that in 20 years time Singapore would have more than 500,000 chronic pain sufferers.

Since it affects older people more, it concluded that unless this trend was slowed down, it could stand in the way of the Government's plans to increase the working age to 65 years and beyond.