Dupuytren's contracture is an abnormal thickening and tightening of the normally elastic tissue beneath the skin of the palm and fingers. This tissue is called fascia. The fascia contains strands of fibers, like cords, that run from the palm upward into the fingers. In Dupuytren's contracture, these cords tighten, or contract, causing the fingers to curl forward. In severe cases, it can lead to crippling hand deformities.
But for almost everyone, pain is what matters. "It's pain that brings people into the doctor's office," says Penney Cowan, executive director of the American Chronic Pain Association. "It's pain that they want treated."
Pain has emerged as a devastating public health problem. According to the American Chronic Pain Association, pain is the No. 1 cause of adult disability in the U.S. At least one out of six people live with chronic pain.
Putting a Dollar Sign on Debilitating Pain
Yet estimates for the economic impact of pain vary. A 2003 study published in The Journal of the American Medical Association put the cost at $61.2 billion per year. But that's only the money drained from U.S. businesses because of productivity lost from employees in pain. It only included arthritis, back pain, headache, and other musculoskeletal pain; other kinds of chronic pain were excluded.
And while looking at pain's bottom line is important, no price can be put on the enormous suffering it causes.
"The costs are incalculable," says Christopher L. Edwards, PhD, assistant professor of psychiatry at Duke University School of Medicine. "How do you estimate the value of lost self-worth? How do you estimate the loss of family, friends, and a sense of accomplishment?"
What is causing all of this pain -- and cost? For the most part, it's the usual suspects:
And studies show the incidence of pain seems about the same among age groups. What changes is the type of pain.
For example, people in their 20s and 30s are more likely to suffer from debilitating headaches. The incidence of back pain peaks in middle age. The elderly often face arthritis and other painful conditions, like shingles. What unites these groups is the pain itself -- and the hidden costs that can change lives.