Sixty-six percent scored their pain intensity at moderate (5–7), and 34% at severe (8–10); 46% had constant pain, 56% intermittent; 49% had suffered pain for 2–15 years; and 21% had been diagnosed with depression due to the pain. Sixty-one percent were unable or less able to work outside the home, 19% had lost a job, and 13% had changed jobs due to their pain. Forty percent had inadequate pain management and less than 2% were seeing a pain management specialist.In the United States, chronic pain has been estimated to occur in approximately 35% of the population, with approximately 50 million Americans experiencing partial or total disability as a consequence. According to the Institute of Medicine, there are about 116 million Americans living with chronic pain, which suggests that approximately half of American adults have some chronic pain condition. The Mayday Fund estimate of 70 million Americans with chronic pain is slightly more conservative. In an internet study, the prevalence of chronic pain in the United States was calculated to be 30.7% of the population: 34.3% for women and 26.7% for men.In Canada it is estimated that approximately 1 in 5 Canadians live with chronic pain and half of those people have lived with chronic pain for 10 years or longer. Chronic pain in Canada also occurs more and is more severe in women and Canadas Indigenous communities. Outcomes
Sleep disturbance, and insomnia due to medication and illness symptoms are often experienced by those with chronic pain.
Folic acid supplements are also recommended for some cases of thalassemia. Evaluation and Diagnosis
In theory, the three most common microcytic anemias (iron deficiency anemia, anemia of chronic disease, and thalassemia) can be differentiated by their red blood cell (RBC) morphologies. Anemia of chronic disease shows unremarkable RBCs, iron deficiency shows anisocytosis, anisochromia and elliptocytosis, and thalassemias demonstrate target cells and coarse basophilic stippling. In practice, though elliptocytes and anisocytosis are often seen in thalassemia and target cells occasionally in iron deficiency. All three may show unremarkable RBC morphology. Basophilic stippling is one morphologic finding of thalassemia which does not appear in iron deficiency or anemia of chronic disease. The patient should be in an ethnically at-risk group and the diagnosis is not confirmed without a confirmatory method such as hemoglobin HPLC, H body staining, molecular testing or another reliable method. Coarse basophilic stippling occurs in other cases as seen in Table 1.As IDA and ACD can often be confused, it is important to evaluate their laboratory parameters. IDA is associated with low hemoglobin, ferritin, transferrin saturation, and MCV. It is also associated with a normal C-reactive protein and high transferrin. ACD is associated as well with low hemoglobin but ferritin may be normal-high, and transferrin saturation, transferrin, and MCV may be low-normal. An additional difference between IDA and ACD is that ACD is often associated with high C-reactive protein. See also
Hypochromic anemia

References
External links

Emedicine on chronic anemia