The Politics Of Pain Medicine

Exploring the medical rhetoric surrounding pain medicine, the author chronicles the work of interdisciplinary pain management specialists to found a new science of pain and a new approach to pain medicine grounded in a more comprehensive biospychosocial model. His analysis shows how these materials shape the healthcare community's understanding of what pain medicine is, how the medicine should be practiced and regulated, and how practitioner-patient relationships are best managed.

Pain touches sensitive nerves in American liberalism, conservatism, and political life. In this history of American political culture, Keith Wailoo examines how pain has defined the line between liberals and conservatives from just after World War II to the present. From disabling pain to end-of-life pain to fetal pain, the battle over whose pain is real and who deserves relief has created stark ideological divisions at the bedside, in politics, and in the courts. Beginning with the return of soldiers after World War II and fierce medical and political disagreements about whether pain constitutes a true disability, Wailoo explores the 1960s rise of an expansive liberal pain standard along with the emerging conviction that subjective pain was real, disabling, and compensable. These concepts were attacked during the Reagan era, when a conservative backlash led to diminished disability aid and an expanding role of courts as arbiters in the politicized struggle to define pain. New fronts in pain politics opened nationwide as advocates for death with dignity insisted that end-of-life pain warranted full relief, while the religious right mobilized around fetal pain. The book ends with the 2003 OxyContin arrest of conservative talk show host Rush Limbaugh, a cautionary tale about deregulation and the widening gaps between the overmedicated and the undertreated.

Chronic pain is a medical mystery, debilitating to patients and a source of frustration for practitioners. It often eludes both cause and cure and serves as a reminder of how much further we have to go in unlocking the secrets of the body. A new field of pain medicine has evolved from this landscape, one that intersects with dozens of disciplines and subspecialties ranging from psychology and physiology to anesthesia and chiropractic medicine. Over the past three decades, researchers, policy makers, and practitioners have struggled to define this complex and often contentious field as they work to establish standards while navigating some of the most challenging philosophical issues of Western science. In The Politics of Pain Medicine: A Rhetorical-Ontological Inquiry, S. Scott Graham offers a rich and detailed exploration of the medical rhetoric surrounding pain medicine. Graham chronicles the work of interdisciplinary pain management specialists to found a new science of pain and a new approach to pain medicine grounded in a more comprehensive biospychosocial model. His insightful analysis demonstrates how these materials ultimately shape the healthcare community’s understanding of what pain medicine is, how the medicine should be practiced and regulated, and how practitioner-patient relationships are best managed. It is a fascinating, novel examination of one of the most vexing issues in contemporary medicine.

'European Pain Management' provides a review of the organization of pain care in the 37 member countries, providing the first authoritative summary, description, and coordinated challenge establishing the authority of pain centres in Europe

Each of us will know physical pain in our lives, but none of us knows when it will come or how long it will stay. Today as much as 10 percent of the population of the United States suffers from chronic pain. It is more widespread, misdiagnosed, and undertreated than any major disease. While recent research has shown that pain produces pathological changes to the brain and spinal cord, many doctors and patients still labor under misguided cultural notions and outdated scientific dogmas that prevent proper treatment, to devastating effect. In The Pain Chronicles, a singular and deeply humane work, Melanie Thernstrom traces conceptions of pain throughout the ages—from ancient Babylonian pain-banishing spells to modern brain imaging—to reveal the elusive, mysterious nature of pain itself. Interweaving first-person reflections on her own battle with chronic pain, incisive reportage from leading-edge pain clinics and medical research, and insights from a wide range of disciplines—science, history, religion, philosophy, anthropology, literature, and art—Thernstrom shows that when dealing with pain we are neither as advanced as we imagine nor as helpless as we may fear. Both a personal meditation and an intellectual exploration, The Pain Chronicles illuminates and makes sense of the all-too-human experience of pain—and confronts with extraordinary grace and empathy its peculiar traits, its harrowing effects, and its various antidotes.

Pain Medicine approaches the management of common chronic pain conditions using a unique interdisciplinary approach focusing on multiple facets of patients' clinical presentations. The comprehensive discussions in each chapter are centered on a vignette that mimics a fairly typical case presentation. In addition to detailed classical descriptions of the epidemiology, pathophysiology, prognosis, and confounding psychosocial factors of each disease entity, the text provides various interdisciplinary management approaches. The case-based approach illustrates key clinical points and demonstrates how practitioners from a variety of disciplines can work together to deliver optimal patient care. The ACGME criteria for fellowship training in Pain Medicine calls for an interdisciplinary approach, with required training and exposure to the fields of Anesthesiology, Neurology, Psychiatry, and Physical Medicine & Rehabilitation. As this trend is occurring in private pain clinics and practices as well as in academic institutions, there is a need for a volume which integrates the approaches of the various disciplines into a coherent whole to guide clinicians and trainees in the interdisciplinary management of pain. With each chapter authored by respected experts in the key specialties involved with pain management, Pain Medicine is a highly applicable clinical reference for practitioners, an excellent anchor text for fellows and residents in training, and a thorough review for initial board certification as well as maintenance of certification exams.