More than 20 percent of patients with chronic pain do not seek physician care for their pain, according to a report.

“We need to get over what for many people appeared to be the ‘don’t ask, don’t tell’ mentality about chronic pain,” Dr. Barbara P. Yawn from Olmsted Medical Center, Rochester, Minnesota told Reuters Health.

Among 3575 individuals who responded to a mailed questionnaire, 2302 reported having chronic pain and 2221 answered relevant questions. The investigators found that 497 of these patients (22.4 percent) said that they had not informed their doctors about their pain.

Of these silent pain sufferers, 70.6 percent had moderate or severe pain, 48.9 percent had pain for eight days or more per month, and 40.6 percent met both of these criteria.

About one quarter of them reported at least moderate interference with general activity and sleep, the results indicate. Vocal pain sufferers were more likely to report interference with general activity and sleep.

The survey showed that 78.9 percent of the silent sufferers used over-the-counter pain medications (compared with 56.3 percent of vocal sufferers), but only 5 percent used prescribed pain medications (compared with 35.2 percent of vocal sufferers).

Silent sufferers made fewer health care visits per year than their vocal counterparts (5.2 vs 8.6), the report indicates.

Educational and employment status had little impact on whether patients were silent or vocal about their pain. Men were more likely to be silent than women, the investigators say, and younger patients were more likely to be silent than older patients.

“I think we need to reassure our patients (probably by example) that we will listen to concerns about chronic pain and take those concerns seriously,” Yawn said, and “that we do have alternatives to the ‘stronger’ pain medications that can cause side effects and have the potential for addiction.”

“I think it is important to determine if the chronic pain is interfering with work, play, or sleep and if it is, try to help,” Yawn commented. “We also need to know when patients are able to deal with the pain on their own and don’t need us-but I would prefer they have the confidence to ask us when it is interfering with activities they want to do.”

SOURCE: Mayo Clinic Proceedings, February 2006.