Why chronic pain is often overlooked as part of disability – and what can help

In Australia, one in five people live with chronic pain, which is defined as pain that lasts longer than three months. This rate is significantly higher among people with disabilities. However, the relationship between disability and chronic pain is often misunderstood, even for those who are enrolled in the National Disability Insurance Scheme (NDIS). Many people with chronic pain struggle to receive adequate support for their condition, despite the profound impact it has on their functioning and overall wellbeing.

Chronic pain is more than just an uncomfortable sensation. It can have a devastating effect on various aspects of a person's life, including relationships, work, financial stability, mental health, and overall quality of life. People with chronic pain face a higher risk of unemployment and depression compared to those without pain. The severity of pain experienced by an individual depends on factors such as age, sex, relationships, social connections, and cultural background.

To qualify for NDIS support, individuals must demonstrate that their impairment reduces their ability to perform everyday tasks, such as self-care, mobility, communication, and participating in social activities. However, chronic pain alone is generally not enough to meet the eligibility criteria for NDIS support, unless it can be proven to significantly impact a person's functional capacity.

Disentangling the impact of chronic pain from other impairments can also be challenging, as pain can both arise from and contribute to long-term health conditions and disabilities.

The upcoming changes to NDIS funding could make it even more difficult for people with chronic pain to access the support they need. To be eligible for NDIS services and supports, individuals will need to have "undertaken all appropriate treatment" for their condition and have it assessed as likely to be permanent. However, there is uncertainty regarding what treatments are considered "appropriate" for chronic pain related to specific impairments and whether all such treatments would need to be tried before someone can access the NDIS.

Additionally, NDIS participants may only access supports that directly address needs arising from an NDIS-recognized diagnosis or impairment, which may not reflect the interconnected ways disability and chronic pain affect a person's life.

For those who are not eligible for the NDIS, support options are limited. Medicare-subsidised allied health services through a GP chronic condition management plan offer five visits per year, but this covers a limited range of allied health professionals and may incur out-of-pocket expenses. Some individuals may pay for these services entirely or receive partial rebates through private health insurance or workers' compensation schemes.

However, practical support with daily tasks, such as personal care or household chores, is rarely affordable for those without NDIS funding.

To address the challenges faced by people with chronic pain and disabilities, better coordination between various service systems is needed. This includes collaboration between Medicare, private health insurance, and the NDIS, as well as increased support for individuals with complex needs. Some people may require healthcare, while others may need assistance with community access, mobility, or personal care to participate in social life and employment and maintain their physical and mental wellbeing.