A Nation in Pain: Healing Our Biggest Health Problem

“A Nation in Pain: Healing Our Biggest Health Problem” – Judy Foreman’s groundbreaking book on the problem of pain in America | A Review | Health Rising’s Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Forums

This is a lengthy review covering a selection of what Ms. Foreman wrote in her book.

“I will argue that lack of adequate pain control is one of the most urgent health problems in America.” Judy Foreman

The pain had come out of nowhere. At fifty she was a successful woman in a great relationship who swam competitively. She hadn’t experienced any injury, yet the burning, stabbing pain running from the back of her neck to her shoulder was driving her nuts. 

She hadn’t known such pain was even possible. The slightest mistake – the slightest move in the wrong direction – could leave her gasping with pain. Simply changing from a sitting position on the bed to lying down was excruciating.

An MRI found near-herniated discs, spondylolisthesis, bone spurs, and arthritis in her neck.

The bad news was that no one seemed to be able to do anything about it.

Her introduction to pain relief in the world of medicine was so shattering that it prompted her to do something she’d never done before – write a book – “A Nation in Pain: Healing Our Biggest Health Problem”.

A Nation in Pain

Some are medical professionals whose whose disillusionment with the medical system is, if anything, greater because they expected so much more.

All were shocked by how little help they received from their colleagues, and how quickly they felt abandoned.

Yet chronic pain costs the U.S. more than heart disease, cancer, and diabetes combined. Chronic – not acute– pain accounts for over 40 percent of all emergency room visits.

Since the path to chronic pain invariable begins with acute pain, it’s vital that doctors treat acute pain appropriately – but only about half of people undergoing surgery feel they get satisfactory pain relief.

The Meaning of Pain

Any suggestion that we might be inadvertently adding to our pain is upsetting.Why would anyone want to add to their pain?

The answer is that no one consciously wants to but that our brain is structured makes it almost inevitable.

It turns out that chronic pain is such a fundamental process that it affects everything from her brain to her neck to her behavior and while behavioral modification didn’t cure her it did help.

The truth is that an emotional response comes baked in with pain in humans. The part of the brain (the anterior cingulate) that processes pain signals also happens to regulate our emotions. Pain – the fundamental sensation that it is – not surprisingly has a strong emotional component and learning how to deal with that component successfully can be quite helpful.

The Opioid Wars

In “The Opioid Wars I and II” Foreman takes on a crisis the medical profession is generating all on its own.

…That story highlights the two opioid epidemics Foreman believes exist; the one you hear about in the news – the abuse of opioid drugs by people – and the epidemic of untreated pain caused in part by the restrictions put on opioid use.

The federal response to the IOM report’s staggering findings of pain in the U.S. appears to have consisted of an agreement to tracking pain research funding and creating two committees with miniscule budgets and no authority. The fact that single most expensive “disease” in the U.S. does not have an Institute or even a Center devoted to its study at the NIH is beyond weird.

The NIH is composed of 27 Institutes and Centers including Institutes on the Eye, Aging, Alcohol Abuse, Biomedical Engineering, Childhood Health, Deafness, Drug Abuse, Environmental Health, Minority Health, Nursing Research, etc. – but no Institute on Pain.

People in pain have to take responsibility for their inaction as well. A White House Petition to implement a National Pain Strategy collared an embarrassing 11,000 of the needed 100,000 signatures to have the White House respond. Just this month, on the other hand, a petition asking the DEA to reconsider its designation of Kratom as an illegal substance quickly reached 132,000 signatures.  

That demonstrated that the need is out there but the political will to take on chronic pain as a stand alone issue is not. Until the pain community comes together like the AIDS groups did and the chronic fatigue syndrome (ME/CFS) community is starting to, the changes needed may not occur.

The review provides extensive excerpts from her book.

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One thought on “A Nation in Pain: Healing Our Biggest Health Problem

  1. david becker

    Judy Foreman failed to dig deep enough to the meta issues and the very core of what made pain care so poor in America. She followed folks like Myra Christopher and the APS and thought just more professionalism was the answer. She was a naive realist who failed to see how deep the political moral economic and social issues were. In point of fact i told her- but like most certaintists she believes were all free to be as wrong as we want to be- just like our pain care system.
    Im glad to see that some people get it when it comes to understanding the depths of the problem in pain care-but most of them are stuck in quicksand of hopelessness-and i get stuck sometimes, too. There are no quick fixes to transforming our Kafkaesque pain care system. And more research, more input from the APS or AAPM is as stupid as it can get. We need a revolution in our pain care system-anyone who calls for less then that i dare say doesnt care much for people in pain. They will accuse me of the naive realism they are guilty of-and ill tell them they have made a Brave NEw World of Pain Care that is as dehumaniing as it gets.

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