More suffering chronic pain

Madam Neo Soo Lan suffered from facial nerve pain until a general practitioner referred her to Dr Tan Kian Hian, director of the SGH pain management centre. He prescribed drugs which eased the pain.
Madam Neo Soo Lan suffered from facial nerve pain until a general practitioner referred her to Dr Tan Kian Hian, director of the SGH pain management centre. He prescribed drugs which eased the pain. PHOTO: GIN TAY FOR THE STRAITS TIMES

Hospitals report rise in patients seeking help amid greater awareness of availability of pain clinics

Thousands of people here suffer from chronic pain and the numbers are going up.

Two of the biggest restructured hospitals here are seeing a rise in the number of patients seeking help for various types of chronic pain.

The number of clinic sessions doctors run just to see such patients has also increased.

At National University Hospital (NUH), doctors have noted an increase of 50 to 60 per cent, compared with three years ago.

They now see more than 2,000 patients a year and have increased pain management clinic sessions from six a week in 2012 to almost double that number this year.

At Singapore General Hospital (SGH), the increase over the past three years is about 30 per cent and the hospital now sees more than 6,000 patients a year.

Last year, five more pain specialists joined the existing four at SGH's pain management centre to help with the growing patient load.

Fortunately, doctors have many tools to deal with pain.

"There are many things that we do that have been easing patients' pains.

"These include medication, injections and surgery," said Dr Tan Kian Hian, who is director of the SGH pain management centre as well as a senior consultant in the department of anaesthesiology.

For those who have tried various treatments and still cannot work or engage in daily or recreational activities, there is now cognitive behavioural therapy.

Among the reasons for the increased numbers are the greater awareness of the availability of pain clinics among both doctors and patients, and more doctors specialising in the area.

There are also more resources allocated to patients who have chronic pain.

The ageing population is another important reason for the increase in number of pain patients.

By 2030, one in five people in Singapore will be aged over 65, or 900,000 people.

With many surveys showing chronic pain to affect about 20 per cent of the population, there will be about 180,000 elderly people living with chronic pain by that time.

Most common age-related pains are in back, neck

The most common types of pain associated with age are that of the back and neck, due to degenerative conditions of the spine.

There are also other musculoskeletal pains, such as at the hip, or knee pain, said Dr James Tan, senior consultant at the pain management clinic and department of anaesthesia in NUH.

Musculoskeletal pain can affect up to 44 per cent of the population.

Then there is cancer and nerve pain - also linked to age.

Doctors estimate that 60 per cent of new cancer cases involve those aged 60 and above.

Nerve pain can have many root causes, including diabetes and shingles, or may be a result of surgery.

One of the worst nerve pains is trigeminal neuralgia, or facial pain, said Dr Tan Kian Hian.

A light touch could set off jolts of excruciating pain that feel like sharp, stabbing electric shocks.

Patients often avoid food and drink rather than suffer the pain. This causes weight loss and, in serious cases, malnutrition.

At SGH, about 800 patients seek treatment for nerve pain every year. Doctors have seen a 10 per cent rise in such patients over the past five years. Of these, about 80 patients have trigeminal neuralgia.

One such patient is Madam Neo Soo Lan, 72, whose facial nerve pain started in 2008.

Her symptoms started with dental pain. It quickly escalated and the pain was so bad that when it came on, she could not open her mouth and it would wake her up from sleep. She could not even bear to feel wind on her face.

She saw many doctors over six months but no one could give her a clear diagnosis. "I lost a lot of weight and lived in fear of the pain coming on," said the housewife and grandmother of seven.

Finally, a general practitioner referred her to Dr Tan at SGH, who prescribed drugs which helped to ease the pain.

Madam Neo now takes an anti-seizure drug once a day. She is also monitored regularly for possible side effects.

"Pain, when allowed to persist for a period of time, can become a chronic disease, leading to changes in the nervous system. Seeking early treatment and appropriate management is important," said Dr Tan.

A version of this article appeared in the print edition of The Straits Times on July 14, 2015, with the headline 'More suffering chronic pain'. Print Edition | Subscribe