Inside Chronic Pain

"With Lous Heshusius as a guide, pain patients can learn much about the perils of a modern health-care odyssey. Health professionals can learn how an articulate middle-class female white patient thinks (with all that thinking entails) when her world is irreversibly altered by pain. She does not promise happy endings. Chronic pain is like that. From the rare intersection in this text between patient narrative and physician response, however, readers may construct a dialogue on pain in our time that cannot fail to bring plentiful opportunities for personal insight and professional enlightenment."—from the Foreword by David B. Morris Chronic pain, which affects 70 million people in the United States alone—more than diabetes, cancer, and heart disease combined—is a major public health issue that remains poorly understood both within the health care system and by those closest to the people it afflicts. This book examines the experience of pain in ways that could significantly improve how patients and practitioners deal with pain. It is the first volume of a new collection of titles within the acclaimed Culture and Politics of Health Care Work series called How Patients Think, intended to give voice to the concerns of patients about their own medical care and the formulation of health policy. Since surviving a near-fatal car accident, Lous Heshusius has suffered from chronic pain for more than a decade, forcing her to give up her career as a professor of education. Inside Chronic Pain, based in part on the pain journal Heshusius keeps, is a stunning memoir of a life lived in constant pain as well as an insightful and often critical account of the inadequacies of the health care system—from physicians to hospitals and health insurance companies—to understand chronic pain and treat those who suffer from it. Through her own frequently frustrating experiences, she shows how health care providers often ignore, deny, or incorrectly treat chronic pain at immense cost to both the patient and the health care system. She also offers cogent suggestions on improving the quality and outcome of chronic pain care and management, using her encounters with exceptional medical professionals as models. Inside Chronic Pain deals with pain's dramatic and destructive effects on one's sense of self and identity. It chronicles the chaos that takes place, the paralyzing effect of severe pain, the changes in personality that ensue, and the corrosive effects of severe pain on the ability to attend to day-to-day tasks. It describes how one's social life falls apart and isolation takes over. It also relates moments of happiness and beauty and describes how rooting the self in the present is crucial in managing pain. A unique feature of Inside Chronic Pain is the clinical commentary by Dr. Scott M. Fishman, president of the American Pain Foundation. Fishman has long tried to improve the lives of patients like Heshusius. His medical perspective on her very human narrative will help physicians and other clinicians better understand and treat patients with chronic pain.

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.

This book covers a range of topics, from the cause and identity of pain, to pain relief management. Starting from the mechanism of pain, it continues to pain management techniques such as nerve blocks, drugs (pain killers), noninvasive manipulations psychological techniques and electric management, before describing the management of various painful conditions such as headaches, back pain, extremities pain, post-herpetic pain or complex regional pain syndrome. It also provides the format of case reports which can be used to explain management options. A novel feature of the book is that it provides additional insights into how clinicians involve patients in treating their own pain through guided self-assessment and self-management. Recent studies have revealed that pain is not only a biological alarm that warns of disease, but can also be the disease itself, or the catalyst of a vicious circle of pain and disease. Providing rapid pain relief is often effective in sparking the rapid recovery from various diseases. This book offers the perfect guide for all clinicians, not only those working at pain clinics but all those who have to treat patients who are in pain.

Chronic pain, which affects 70 million people in the United States alone-more than diabetes, cancer, and heart disease combined-is a major public health issue that remains poorly understood both within the health care system and by those closest to the people it afflicts. This book examines the experience of pain in ways that could significantly improve how patients and practitioners deal with pain. It is the first volume of a new collection of titles within the acclaimed Culture and Politics of Health Care Work series called How Patients Think, intended to give voice to the concerns of patients about their own medical care and the formulation of health policy. Since surviving a near-fatal car accident, Lous Heshusius has suffered from chronic pain for more than a decade, forcing her to give up her career as a professor of education. Inside Chronic Pain, based in part on the pain journal Heshusius keeps, is a stunning memoir of a life lived in constant pain as well as an insightful and often critical account of the inadequacies of the health care system-from physicians to hospitals and health insurance companies-to understand chronic pain and treat those who suffer from it. Through her own frequently frustrating experiences, she shows how health care providers often ignore, deny, or incorrectly treat chronic pain at immense cost to both the patient and the health care system. She also offers cogent suggestions on improving the quality and outcome of chronic pain care and management, using her encounters with exceptional medical professionals as models. Inside Chronic Pain deals with pain's dramatic and destructive effects on one's sense of self and identity. It chronicles the chaos that takes place, the paralyzing effect of severe pain, the changes in personality that ensue, and the corrosive effects of severe pain on the ability to attend to day-to-day tasks. It describes how one's social life falls apart and isolation takes over. It also relates moments of happiness and beauty and describes how rooting the self in the present is crucial in managing pain. A unique feature of Inside Chronic Pain is the clinical commentary by Dr. Scott M. Fishman, president of the American Pain Foundation. Fishman has long tried to improve the lives of patients like Heshusius. His medical perspective on her very human narrative will help physicians and other clinicians better understand and treat patients with chronic pain.

This comprehensive review covers the full and latest array of interventional techniques for managing chronic pain. Chapters are grouped by specific treatment modalities that include spinal interventional techniques, nonspinal and peripheral nerve blocks, sympathetic interventional techniques, soft tissue and joint injections, and implantables. Practical step-by-step and evidence-based guidance is given to each approach in order to improve the clinician's understanding. Innovative and timely, Essentials of Interventional Techniques in Managing Chronic Pain is a critical resource for anesthesiologists, neurologists, and rehabilitation and pain physicians.

It is only natural for someone in pain to attend to the body part that hurts. Yet this book tells the story of persistent pain having negative effects on brain function. The contributors, all leading experts in their respective fields of pain electrophysiology, brain imaging, and animal models of pain, strive to synthesize compelling and, in some ways, connected hypotheses with regard to pain-related changes in the brain. Together, they contribute their clinical, academic, and theoretical expertise in a comprehensive overview that attempts to define the broader philosophical context of pain (disentangling sensical from nonsensical claims), list the changes known to take place in the brains of individuals with chronic pain and animal models of pain, address the possible causes and mechanisms underlying these changes, and detail the techniques and analytical methods at our disposal to "visualize" and study these changes. Philosophical and social concepts of pain; testimonials of chronic-pain patients Clinical data from pain patients’ brains Advances in noninvasive brain imaging for pain patients Combining theoretical and empirical approaches to the analysis of pain-related brain function Manipulation of brain function in animal models Emerging neurotechnology principles for pain diagnostics and therapeutics

Dr. John E. Sarno's groundbreaking research on TMS (Tension Myoneural Syndrome) reveals how stress and other psychological factors can cause back pain-and how you can be pain free without drugs, exercise, or surgery. Dr. Sarno's program has helped thousands of patients find relief from chronic back conditions. In this New York Times bestseller, Dr. Sarno teaches you how to identify stress and other psychological factors that cause back pain and demonstrates how to heal yourself--without drugs, surgery or exercise. Find out: Why self-motivated and successful people are prone to Tension Myoneural Syndrome (TMS) How anxiety and repressed anger trigger muscle spasms How people condition themselves to accept back pain as inevitable With case histories and the results of in-depth mind-body research, Dr. Sarno reveals how you can recognize the emotional roots of your TMS and sever the connections between mental and physical pain...and start recovering from back pain today.

Some people suffer from chronic, debilitating disorders for which no conventional treatment brings relief. Can marijuana ease their symptoms? Would it be breaking the law to turn to marijuana as a medication? There are few sources of objective, scientifically sound advice for people in this situation. Most books about marijuana and medicine attempt to promote the views of advocates or opponents. To fill the gap between these extremes, authors Alison Mack and Janet Joy have extracted critical findings from a recent Institute of Medicine study on this important issue, interpreting them for a general audience. Marijuana As Medicine? provides patientsâ€"as well as the people who care for themâ€"with a foundation for making decisions about their own health care. This empowering volume examines several key points, including: Whether marijuana can relieve a variety of symptoms, including pain, muscle spasticity, nausea, and appetite loss. The dangers of smoking marijuana, as well as the effects of its active chemical components on the immune system and on psychological health. The potential use of marijuana-based medications on symptoms of AIDS, cancer, multiple sclerosis, and several other specific disorders, in comparison with existing treatments. Marijuana As Medicine? introduces readers to the active compounds in marijuana. These include the principal ingredient in Marinol, a legal medication. The authors also discuss the prospects for developing other drugs derived from marijuana's active ingredients. In addition to providing an up-to-date review of the science behind the medical marijuana debate, Mack and Joy also answer common questions about the legal status of marijuana, explaining the conflict between state and federal law regarding its medical use. Intended primarily as an aid to patients and caregivers, this book objectively presents critical information so that it can be used to make responsible health care decisions. Marijuana As Medicine? will also be a valuable resource for policymakers, health care providers, patient counselors, medical faculty and studentsâ€"in short, anyone who wants to learn more about this important issue.