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The author explores the changing rhetoric of pain medicine and how this rhetoric ultimately shapes the health-care community's understanding of what pain medicine is, how the medicine should be practiced and regulated, and how practitioner-patient relationships are best managed. -- Dust jacket.
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.
Examines OxyContin, the so-called miracle prescription drug that swept the nation but led to overdoes and addiction, providing a look at the multi-billion-dollar pain managment business, its excesses and its abuses.
From neurobiology to public policy, examines the chronic pain crisis, which is a major national health concern, discussing the latest scientific discoveries and advances in treatments and providing a sensible plan of action.
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.
"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. MorrisChronic 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.
Acupuncture Treatment for Musculoskeletal Pain covers the basics of acupuncture theory and explains the precepts of Eastern medicine. The text is written for orthopaedic surgeons, anesthesiologists and rehabilitation medicine specialists, and will aid them in their diagnosis and treatment of musculoskeletal pain -- both acute and chronic -- as well as arthritis. Readers of the text will progress on a journey through healing that will serve as a useful adjunct to the procedures and medications currently in use. The author breaks the subject down into three sections: Basics of Acupuncture, Acupuncture Treatment of the Muscoloskeletal Acupuncture Points and Indications, and Special Techniques.
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.
NPR Best Book of 2019 A bioethicist’s eloquent and riveting memoir of opioid dependence and withdrawal—a harrowing personal reckoning and clarion call for change not only for government but medicine itself, revealing the lack of crucial resources and structures to handle this insidious nationwide epidemic. Travis Rieder’s terrifying journey down the rabbit hole of opioid dependence began with a motorcycle accident in 2015. Enduring half a dozen surgeries, the drugs he received were both miraculous and essential to his recovery. But his most profound suffering came several months later when he went into acute opioid withdrawal while following his physician’s orders. Over the course of four excruciating weeks, Rieder learned what it means to be “dope sick”—the physical and mental agony caused by opioid dependence. Clueless how to manage his opioid taper, Travis’s doctors suggested he go back on the drugs and try again later. Yet returning to pills out of fear of withdrawal is one route to full-blown addiction. Instead, Rieder continued the painful process of weaning himself. Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system. In Pain is not only a gripping personal account of dependence, but a groundbreaking exploration of the intractable causes of America’s opioid problem and their implications for resolving the crisis. Rieder makes clear that the opioid crisis exists against a backdrop of real, debilitating pain—and that anyone can fall victim to this epidemic.