Visualizing Global Chronic Pain

Abstract

Conservative estimates suggest that chronic pain affects over one and a half billion people, or 20% of the world’s population.1 Pain is the most common reason that patients seek medical care,2 and pain is an independent risk factor for increased mortality.3 The negative consequences of chronic pain are exacerbated by social determinants of health. Low socioeconomic status is directly correlated with increased rates of chronic pain. In addition, numerous other risk factors, such as comorbid psychological disease, are far more prevalent in these environments.4 Offered here is a visual depiction of chronic pain and its sequelae in the global health setting. The authors are resident physicians with an interest in pain management, and both contributed to this visualization of long-standing pain. During their training, the authors have interacted with patients living with chronic, untreated, or undertreated pain in a variety of settings, and this experience has informed the creation of this artwork. The image (Figure) was designed in collaboration with OpenAI, a non-profit artificial intelligence (AI) research laboratory seeking to promote safe, free-to-use AI content. The authors provided this AI system with several prompts, including “chronic pain” and “global pain,” and after some trial and error, this image was created. Several elements of the art were subsequently adjusted by the authors.Figure.: Artistic rendition of pain around the world.Featured in this image is a man seeming to carry the weight of the entire world on his shoulders, his body slumping under its pressure, which is representative of his unabating pain. We parallel this work with the classic image of Atlas and the globe. In Greek mythology, Atlas was commanded by Zeus to lift the earth on his shoulders for all of eternity. Here, we depict a nondescript man, shirtless, struggling, and stooped beneath the globe’s weight, to depict the burden of chronic pain worldwide. There are several other symbols of pain throughout the image. For example, the man’s skin is erythematous, perhaps harshly sunburned, or otherwise aching, which is representative of the intensity of his suffering. The grey, ominous skies and a myriad of dark, foreboding clouds further add to the solemn nature of the image and underscore the man’s plight. The figure in the center is presented over the African continent, and to the lower right, although somewhat abstract, is an elephant, among several baobab trees, deciduous foliage indigenous to savannah environments, which further alludes to the impact of untreated chronic pain in a global context. The consequences of chronic pain are often overlooked and underappreciated. We seek to call attention to the significant suffering that chronic pain causes across the globe. E

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