Encyclopedic in scope, this book on chronic pain also tells the personal story of the author, a Boston-based, nationally syndicated health columnist.
When she developed chronic neck pain, Foreman’s savvy medical background and reporter’s skills were little help. She suffered the same stigmatizing it’s-all-in-your-head reaction that many chronic pain patients (especially women) experience. Finally, an MRI scan showed the arthritis, bone spurs and sliding vertebrae of her cervical spine that caused her agony. Foreman spent five years interviewing experts, reviewing the literature and talking to patients to summarize what America is doing about pain. The answer? Not much—despite a 2011 report by the Institute of Medicine of the National Academies of Science revealing that 100 million Americans live in chronic pain. Foreman cites the report, noting also that medical schools barely touch the subject of pain. She then lays out the anatomy and physiology of pain perception. She debunks myths about women’s greater tolerance of pain and infants’ lack of feelings of pain. She provides an especially solid chapter on mind-body interactions, discussing the placebo effect, the relationship between pain and depression, and alleviation techniques like meditation and cognitive behavioral therapy. Then it’s on to treatments. Government, health provider and cultural dictates that inhibit the use of opioids or, in the case of government, even allow research on marijuana, get the drubbings they deserve. (It’s important to note, however, that opioids provide limited relief for chronic pain.) As for other approaches (drug and nondrug), Foreman discusses benefits and risks and cites multiple clinical trials, some pro, some con, for each treatment. She also extols the benefits of exercise: There’s good evidence that it helps for low back pain, arthritis and fibromyalgia.
Foreman’s text underscores the fact that pain really is an extraordinarily complex phenomenon that requires more research. If we continue head-in-the-sand policies, we will remain a nation in pain.