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COST OF PAIN AND SLEEP INTERACTIONS

In terms of general medical demand, a painrelated problem motivates one patient in five to consult a family physician.86 In the 2000-2001 period, according to a Canadian survey, three out of four patients with chronic pain visited a family general physician and approximately one in five chronic pain patients received care from a chiropractor, physiotherapist, and/or ‘alternative’ health care provider.10 In Finland, chronic pain patients have two times more contacts with health care professionals than controls without pain, and health care system use is 25% higher.9 An Australian study (n = 17 543 individuals; telephone interviews) revealed that individuals with chronic pain were more frequent users of the health care system (incidence rate ratio of at least twofold) than patients with no pain and no disability.53

Frequencies of primary care visits were 12-17 times higher, hospital admission 2.6 times higher and emergency visits 5.0 times higher in individuals with pain-related disability (interference with daily activities) than patients with pain and no disability. In Sweden, the incidence of patients using physical therapy is at 7.2% and the rate of using alternative care is at 5.9%.87 According to a Statistics Canada survey, 20% of chronic pain patients visit a chiropractor, alternative, or physical therapist to obtain some pain relief; this rate is two to three times more frequent than that of individuals without pain.10 For one-third of the 43% of patients using complementary and alternative medicines for peripheral neuropathies, as mentioned above, the motive was inadequate pain control by conventional health care.85 It is important to reiterate that 40% of chronic pain patients do not feel that they receive adequate treatment for their pain condition and 70% feel that they do not receive adequate support from society.9,10