A thorough study of pain is presented in Pain: The Culture and Science of Pain by Connie Faltynek PhD. Looking back at history, the author examines how pain was perceived and treated. She also examines the various medications and alternative treatments currently available. Faltynek explores the many advancements on the horizon in pain management. Additionally, ingrained biases, cultural perspectives, and the complexity of treating pain are discussed. Here is the book's chapter breakdown.

Contents

Introduction

Chapter 1: What is Pain? A Primer

Types of Pain

Mechanisms of Pain Transmission

PAIN: It is All in Your Head!

Impact of Emotions and Thoughts on Pain Sensation

Conclusion

Chapter 2: Pain and Pain Relief Prior to the 19th Century

Ancient Western World

Early Christian Era

Middle Ages

16th, 17th, and 18th Centuries

Historical Views About Pain in the Muslim and Jewish Worlds

Conclusion

Chapter 3: Pain and Pain Relief in the 19th and 20th Century

Early 19th Century

Discovery of Anesthesia in the Mid-19th Century

Conflict Between Religion and Advances in Medicine in the 19th Century

Emergence of "Faith Cure" and the Christian Science Church

Conflict Between Religious Views and Pain Relief Continued in the 20th Century

Gender Bias in Pain Relief

Rise in Use of Opioids for Pain Relief

Pain Relief in the Latter Part of the 20th Century

Conclusion

Chapter 4: Pain in Animals

Historical Views Regarding Animal Pain

Surgical and Post-Surgical Pain in Animals in the 20th Century

Management of Painful Diseases and Conditions in Animals in the 20th Century

Pain Control in Animals in the 21st Century

Conclusion

Section II. Treatment of Pain Today

Chapter 5: Pain and Pain Relief in the 21st Century

Management of Acute Pain in Hospitals

Chronic Pain

Pain Management in Infants and Children

Diminished Emphasis on Pain Relief in the 21st Century

Lack of Availability of Strong Pain-Relieving Medications Worldwide

Racial Disparities in Pain Management in the United States

Pain Can Not be Measured Objectively

Reluctance of Patients to Use Pain-Relieving Medications

Limited Pain Education Contributes to Unrelieved Pain

Conclusion

Chapter 6: How Good Are Current Medications in Relieving Pain?

Medications for Non-Neuropathic Pain

Medications for Neuropathic Pain

Medications for Migraine

Other Pain Medications

Conclusion

Chapter 7: Prescription Opioids: Essential Medications for Pain Relief or Evil Drugs?

Short-Term Use of Opioids to Relieve Severe Acute Pain

Opioids: Important Drugs for Acute Pain, But What About Chronic Pain?

Current Opioid Crisis

How Great Are the Risks of Taking Opioids for Pain Relief?

"Opiophobia"

Balancing Risks vs Pain-Relieving Benefits of Prescription Opioids

The Criminalization Model and the War on Drugs

Abuse-Deterrent Opioid Products

Urgent Need to Expand Treatment for Those Addicted to Opioids

Conclusion

Chapter 8: Recent Research to Identify New Pain Medications

101 Modern Drug Discovery

Marijuana/Cannabis

Capsaicin Receptor

Sodium Channels

Nerve Growth Factor

Recent Opioid Research

Other Ongoing Research

Why So Little Progress

Conclusion

Chapter 9: Alternative Methods to Manage Pain

Spinal Manipulation and Exercise

Acupuncture

Electrical Stimulation

Nerve Ablation

Psychological Methods to Relieve Pain

The Placebo Effect

Conclusion

Chapter 10: The Future of Pain Management

Attempts to Reduce Opioid Abuse

Use of Naloxone to Prevent Deaths from Opioid Overdoses

Is There a "Magic Bullet" Waiting to be Discovered?

Barriers to Use of Alternative Methods to Relieve Pain

Efforts to Develop Objective Measures of Pain

The Future of Brain Imaging in Pain Management

Role of Genetics in Pain and Pain Relief

Conclusion: There is Hope for the Future!

My goal is to highlight key points throughout the book that I found to be particularly insightful, helpful, or eye-opening. Due to the large number of highlights throughout the book, I will have to pick and choose what to share.

Low threshold nerve fibers, known as Aβ fibers, cause a non-painful sensation. High threshold nerve fibers, called Aδ and C fibers, generate pain.

In physical terms, pain is the result of defined processes. Pain sensations can be affected by one's thoughts and emotional state.

Roman Emperor Marcus Aurelius in 170-180 CE wrote a treatise entitled Meditations. He wrote, "If you suffer pain becasue of some external cause, what troubles you is not the thing but your decision about it, and this is in your power to wipe out at once. Whosoever therefore is not himself indifferent to pain..., which Univeral Nature employs indifferently, plainly commits sin."

In the 1980s, newborns undergoing surgery received only minimal anesthesia and were not treated for pain afterwards.

The late Margo McCaffery was a pioneer within the Pain Management Nursing field in the United States in the later part of the 20th century. She stated, "Pain is whatever the experiencing person says it is and exists whenever he says it does."

Pain was designated as the fifth vital sign by the American Pain Society in 1996. There were four vital signs: pulse rate, respiration rate, temperature, and blood pressure.

Disagreements between patient reports of pain and those assessed by clinicians often lead to questions about the existence of pain.

Unrelieved pain persists despite significant advancements in many fields of medicine. Pain science lags behind most medical conditions. Pain is rarely adequately relieved, whether it is chronic or acute.

There are two broad types of pain: neuropathic pain and non-neuropathic pain.

With regard to opioids the author states, "I would argue that it is extremely reckless to deny prescription opioids to patients with severe pain that has not been relieved by other medications or alternative methods."

Why are pain medication studies limited? Patients have different types of pain, different types of pain can vary in response to a particular medication, pain is complex, and pain is highly individualized. What works for one person may not work for another with a similar type of pain.

It is important to make the distinction between drug abuse, drug dependency, and drug addiction.

Opiophobia - excessive fear of prescrition opioids.

The only truly new pain medications with a novel mechanism of action are the CGRP antogonists approved for migraines.

The FDA approved Olinvyk in August 2020. In a hospital or clinic setting, it is used as a short-term IV treatment for moderate to severe pain. The oral compound TRV734 has been entered into clinical trials, but it is currently being used to suppress withdrawal symptoms associated with opioid use.

Among the alternative methods of managing pain are chiropractic, exercise, massage, acupuncture, meditation, behavioral modification, and electrical stimulation.

A variety of research is being conducted and new treatments are on the horizon, including brain imaging, genetic testing, personalized treatments, and new medications.

Pain: The Culture and Science of Pain is an excellent book. The book would be beneficial to medical professionals, chronic pain sufferers, those with loved ones suffering from chronic pain, and anyone interested in learning more about pain. As someone who suffers from chronic pain, I learned a great deal from this book. This is definitely a book I'd recommend.

Super informative!

Thank You to Connie Faltynek and The Paper House, for the digital ARC provided through NetGalley in exchange for an honest review!

A really good look at the markers of pain and why we experience pain and what we can do about it. It was fairly dry and I struggled to stay paying attention though, could have also been how poorly it was formatted in the arc, though.

I received this from the publisher for a review. I was drawn to this book as I suffer from chronic pain and have for the last 18 years. I also have several auto immune disorders that contribute to the pain. One thing that I very much enjoyed in this book was that the author did not write above my head, in other words it was very easy for everyone who would want to read this, to understand. There was no long run on medical jargon, which I found very refreshing. The author had written this originally many years ago and has taken the time to update this as situations and treatments have advanced throughout the years. Personally I really appreciated the time and effort the author put into writing this in a way that did not blame the person in pain or contribute to the stigmas that typically surround chronic pain. This has different chapters explaining acute and chronic pain, treatments, how the world / medical community perceives chronic pain and treatments. I think this is an excellent book for people starting out on their pain journey, medical professionals and pain caregivers.

"Pain" by Connie Faltynek is a raw and compelling exploration of the human experience. Faltynek weaves together a tapestry of emotions, taking readers on a journey through the highs and lows of life's challenges. Her writing is both poignant and relatable, making it impossible not to connect with the characters and their struggles.

The author doesn't shy away from the discomfort of pain but rather embraces it as an integral part of the human condition. Faltynek's prose is like a balm, soothing the wounds while gently urging readers to confront and understand their own pain. The narrative is beautifully nuanced, filled with moments of resilience, vulnerability, and ultimately, hope.

What sets "Pain" apart is Faltynek's ability to capture the universal aspects of suffering, making it a book that transcends personal experiences. It's a poignant reminder that pain, in its various forms, is something we all share and navigate in our own ways.

In this slim yet powerful volume, Connie Faltynek has crafted a work that resonates deeply, offering solace and a sense of camaraderie to anyone who has grappled with life's inevitable hardships. "Pain" is not just a book; it's a compassionate companion on the journey through the complexities of existence.