A Comparison of Chronic Pain Prevalence in Japan, Thailand, and Myanmar

Background: Pain has been regarded as important in the improvement of quality of life (QOL). Inthe advanced countries of Europe and the North America, a number of large-scale epidemiologicalsurveys on pain, particularly chronic pain, have thus been performed in general populations.However, few epidemiological surveys of chronic pain have been reported from developingcountries, and no surveys appear to have examined chronic pain in the least developed countries.Objectives: To compare the incidence of chronic pain in Asian countries, using Japan as anadvanced country, Thailand as a developing country, and Myanmar as one of the least developedcountries.Study Design: Cross-sectional study in 4 hospitals.Setting: A university hospital and a general hospital in Japan, a university hospital in Thailand,and a general hospital in Myanmar.Methods: Patients were 1,000 nursing staff working in Japan, 448 nursing staff working inThailand, and 405 nursing staff working in Myanmar. The survey was performed by requestingall nursing staff to anonymously answer the questionnaire. Data were used to calculate chronicpain prevalence, pain site, presence or absence of consultation with doctors, methods of handlingpain other than consultation with doctors, and whether pain was controlled for each country. Theresults were then compared between countries.Results: The prevalence of chronic pain in Myanmar was 5.9%, which was significantly lower (P< 0.01) than in Japan (17.5%) or Thailand (19.9%). The most frequent pain sites were the lowerback, head, and shoulders in Japan, and the shoulders, ankle, upper back, and head in Thailand,whereas in Myanmar, no clear certain tendencies were observed. The most frequent method forhandling pain other than consultation with doctors was over-the-counter drugs in Japan, massagein Thailand, and relaxation therapy (meditation) in Myanmar.Limitations: Limitations of this study were the cross-sectional design study, the smallnumber of hospitals included, the limitation of patients to nursing staff, and the omission fromthe questionnaire of questions regarding body height and weight, working situation, familybackground, trauma history, sports activity history, smoking history, psychological/character tests,QOL, and pain levels of patients.Conclusion: The prevalence of chronic pain was significantly lower in Myanmar than in Japan orThailand. With regard to the site and treatment of chronic pain, no clear tendencies were observedbetween countries, suggesting that frequency and the character of chronic pain differ from countyto country around the world.Key words: Chronic pain, epidemiology, prevalence, low back pain, shoulder pain, ankle pain,headache, developing countries, least developed countries