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.

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changes to the brain and spinal cord, many doctors and patients still labor under misguided cultural notions and outdated scientific dogmas that prevent proper treatment, to devastating effect.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.

'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

Up to 35% of adults suffer from chronic pain, and a substantial number of these patients are admitted to hospitals every year. A major concern of these patients is whether the pain will be adequately controlled during hospitalization. these patients are more likely to have poor pain control and may experience an exacerbation of their co-exisitng chronic pain condition during hospital admission. Adequate pain control is directly related to clinical outcomes, length of hospital stay, and patient satisfaction. A considerable body of evidence demonstrates the medical, social, and economic benefits of satisfactory inpatient pain control. Currently, there are limited pain control guidelines to address this challenging inpatient population. In fact, there are no guidelines outlinign best practices for postoperative pain control in patients with chronic pain. The complex nature of chronic pain and a dearth of publications addressing the concerns of these patients make the creation of relevant guidelines difficult. The goal of this book is to equip clinicians to provide safe and effective management of hospitalized patients with co-existing chronic pain. Each chapter addresses a particular clinical question and is written by an expert in the field. Chapters describe basic principles and specific clinical situations commonly encountered during the care of patients with co-existing chronic pain in hospital settings.

Needless Suffering offers a sociological examination of a complex medical problem: chronic pain and the inability of doctors and other health professionals to understand and manage it in their patients. People in pain, writes Dr. David Nagel, are the poor of the medical world. Like the poor, they are stigmatized and left at the mercy of powerful social actors who tend to work in their own self-interest, frequently at the expense of those they propose to serve. This leaves those who suffer with little control over their own destinies and creates a dysfunctional status quo that harms instead of helps. Drawing on his own experience witnessing his mother's chronic pain and numerous clinical stories from over thirty years' expertise as a pain management specialist, Nagel looks first at patients, their families, and their doctors (usually not trained in pain management), and then broadens his canvas to elaborate a pain power structure that includes the entire healthcare community, insurers, lawyers, government regulators, employers, politicians, law enforcement agencies, and painkilling drugs. Concluding with concrete reforms to create more effective and compassionate pain care, this book is designed for pain patients and their families, healthcare providers, legislators and other public policymakers, judges, personal injury and other attorneys, insurers, government regulators, law enforcement personnel, and health care businesspeople.