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Last Updated: Wednesday, 17 March, 2004, 02:40 GMT
Many people not treated for pain
Many people suffer from chronic pain
At least half of patients in Europe with muscle or joint pain are not receiving treatment, research suggests.

Researchers surveyed almost 6,000 people with musculoskeletal pain and almost 1,500 doctors in eight European countries.

Their results suggest as many as 50m Europeans endure chronic pain without getting medical help.

The research, by the Arthritis Action Group, is published in the journal Annals of the Rheumatic Diseases.

It found management of musculoskeletal pain differed little across all eight countries.

Patients fail to get proper treatment for their pain due to a lack of open communication and understanding between physicians and their patients.
Professor Anthony Woolf
However, while family doctors felt that they were managing the condition well, patients did not always feel the same way.

Around one in four of those with musculoskeletal pain said they did not seek medical help for it.

This was despite the fact that up to 75% of those surveyed suffered from pain on a constant or daily basis - to the extent that it limited routine activities.

Those that do seek help often wait several months or years before doing so.

However, around half of patients who had consulted a doctor about it said they were not currently being treated for their pain.

The doctors, on the other hand, said that they offered all patients some form of treatment - and virtually all of them said they were trying to improve the patients' quality of life.

Drug risks

Painkillers such as aspirin, known as NSAIDS, are the drugs most commonly prescribed to combat chronic pain.

However, most doctors said they were concerned that the drugs could have a bad effect on the digestive system if used over a long period.

German doctors were more likely to recommend exercise, physiotherapy, herbal medicine and acupuncture to their patients than any other doctors in Europe.

The survey indicates that most patients had found out about their condition from the media, friends and family, or physiotherapists - rather than from their doctor.

Only up to one in three patients said that the doctor had been their source of information.

And many patients were poorly informed about the risks and benefits of treatment.

Only half of patients in Sweden, Ireland, Germany, France and the UK, were aware that NSAIDs have side effects, for example.

Fears of addiction and over-reliance on medication were relatively common among both patients and doctors.

The researchers argue that patients are not being provided with sufficient information to help them effectively manage their problems.

Under-estimate the problem

They argue that the discrepancy in the views of doctors and patients may be due, in part, to the fact that family doctors generally under-estimate the impact or severity of patients' pain and consequent disability and psychological distress.

People who took part in the survey came from the UK, France, Germany, Spain, Ireland, Sweden, Italy, and Switzerland.

In the UK, self management programmes for arthritis have been available for some time and are now being expanded to other chronic conditions through the Expert Patient Programme.

Researcher Professor Anthony Woolf, of the Royal Cornwall Hospitals Trust, Truro, told BBC News Online patients and physicians do not spend enough time discussing the benefits and risks of medication.

He said part of the problem was the perception that arthritis and other musculoskeletal disorders affect only elderly people.

He said: "Patients fail to get proper treatment for their pain due to a lack of open communication and understanding between physicians and their patients.

"This lack of communication is also why doctors have a more rosy view of the situation than it appears to be in reality."

Phil Gray, chief executive of the Chartered Society of Physiotherapy, called for more initiatives to give patients direct access to physiotherapists, who were ideally placed to provide relief from musculoskeletal pain.

"Direct access initiatives save hours of valuable GP time and ensure that patients receive fast and effective treatment.

"We now want to see the necessary changes made to enable the expansion of direct access services."

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