The occurrence and impact of generalized pain

A major problem with estimating the impact of chronic generalized pain is t hat the term remains undefined. It appears to encompass several distinct cl inical entities, including rheumatoid arthritis and fibromyalgia, which can exist alone or together in a given individual. Nonetheless, chronic genera lized pain appears to have a sizable impact on both the individual and soci ety. Although little is known about causal relationships, demographic risk factors for chronic generalized pain are female sex, age in the forties and fifties, lower income, lower education, and being divorced or separated. C hronic generalized pain affects the individual in several ways, including p hysical and psychological distress, losses of function, quality of life, em ployment and income, and prolonged litigation for many. Its impact on socie ty includes increased utilization of health care resources, loss of work pr oductivity, disability and insurance costs, costs of litigation and social policy. Future research into the impact of chronic generalized pain must be gin by defining this term in a way that is both valid in construct and conv enient to use. Research is also warranted to develop and validate diagnosti c tools that may better distinguish various subsets of chronic generalized pain, both to better understand the pathological processes involved and to allow for estimates of the relative contribution of each subset to societal costs.