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Pain: The Science of Suffering
Pain is one of medicine's greatest mysteries. When farmer John Mitson caught his hand in a baler, he cut off his trapped hand and carried it to a neighbor. "Sheer survival and logic" was how he described it. "And strangely, I didn't feel any pain." How can this be? We're taught that pain is a warning message to be heeded at all costs, yet it can switch off in the most agonizing circumstances or switch on for no apparent reason. Many scientists, philosophers, and laypeople imagine pain to operate like a rigid, simple signaling system, as if a particular injury generates a fixed amount of pain that simply gets transmitted to the brain; yet this mechanistic model is woefully lacking in the face of the surprising facts about what people and animals do and experience when their bodies are damaged.
Patrick Wall looks at these questions and sets his scientific account in a broad context, interweaving it with a wealth of fascinating and sometimes disturbing historical detail, such as famous characters who derived pleasure from pain, the unexpected reactions of injured people, the role of endorphins, and the power of placebo. He covers cures of pain, ranging from drugs and surgery, through relaxation techniques and exercise, to acupuncture, electrical nerve stimulation, and herbalism.
Pain involves our state of mind, our social mores and beliefs, and our personal experiences and expectations. Stepping beyond the famous neurologic gate-control theory for which he is known, Wall shows that pain is a matter of behavior and its manifestation differs among individuals, situations, and cultures. "The way we deal with pain is an expression of individuality."
Patrick Wall looks at these questions and sets his scientific account in a broad context, interweaving it with a wealth of fascinating and sometimes disturbing historical detail, such as famous characters who derived pleasure from pain, the unexpected reactions of injured people, the role of endorphins, and the power of placebo. He covers cures of pain, ranging from drugs and surgery, through relaxation techniques and exercise, to acupuncture, electrical nerve stimulation, and herbalism.
Pain involves our state of mind, our social mores and beliefs, and our personal experiences and expectations. Stepping beyond the famous neurologic gate-control theory for which he is known, Wall shows that pain is a matter of behavior and its manifestation differs among individuals, situations, and cultures. "The way we deal with pain is an expression of individuality."
196 pages, Kindle Edition
First published January 1, 1999
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April 17, 2022
When I was about 7.5 months pregnant I went back to the UK. I went to see about breathing techniques in labour. The very rude lady told me I was too late for the classes and anyway I'd been been breathing since birth so I didn't need to learn it. I asked what she taught. She said distraction techniques. Concentrate on breathing and believe it will take the pain away. She said it worked better if you involved your husband, if you have one. As I said, very rude lady.
Skip to * if you want to know a fantastic way to deal with pain without reading the rest of the review (TL;DR syndrome).
The author says that people having their blood taken or injections feel considerably less pain if they imagine they are some tropical beach with the sound of the waves and coconut trees shading the sun like where I live. He said that the first thing to do with pain is to take away the stress, stress contributes to pain. Sedatives, family, pets, anything that helps you relax is a good thing. And not to refuse sleeping pills if they are prescribed until you can sleep well on your own.
I now have a very detailed understanding from the cellular level up to the moaning and groaning of what pain is, and how to treat it, or better prevent it. But not all pain is treatable. I'm glad I learned that distraction techniques, placebos, acupuncture and hypnosis all work to some degree. All stimulate endorphins, the natural opiates the body produces although how is not known. None have a scientific base, or at least not yet.
__________
Notes on reading the book. The author has a lovely name for those scientists he thinks are dickheads, "classical thinkers".
Wall talks about heroes in every culture who bear pain. Of initiation rites, whether hazing or Masaii that are about bearing pain stoically - making it meritworthy in itself. Women who undergo 'natural' childbirth are considered more praiseworthy than those who have painkillers which is really, really sad. I had an epidural and was able to participate in my son's birth after hours of being lost in a miasma of pain. He then goes on to discuss Jesus suffering on the cross and how a person suffering can identify with suffering as Jesus did and also feel they can be part of the Kingdom of Heaven.
It put me in mind of Mother Theresa. Sanctification through suffering. A very Christian concept. She said that pain and suffering were gifts from God and were a purification from sin. This is why she denied those she gave shelter if not succour to, any medications or treatment. (Also she diverted funds meant for these among other things, see Christopher Hitchens's The Missionary Position: Mother Teresa in Theory and Practice. But karma got Mother Theresa. The day she died she should have been the headline of all the newsites and papers in the world but instead she got a small column way down the page. Princess Diana died that day too.
I watched a documentary last night on pain and those who were born without the ability to feel it. In one family a grandmother had broken her ankle and went to the doctor about the shape of it. He told her she had broken it twice before, she had no idea! Her granddaughter said she got blisters in her mouth because when her coffee was too hot she didn't know. Thelife span of those who cannot feel pain is often shortened, they suffer so many injuries without noticing and children might put themselves in harm's way - jumping off walls - because they can do it and not suffer, and their friends can't.
The documentary was also about those who are born with or acquire a condition of intractable pain without any discernable cause.
I kind of have a problem of extreme sensitivity. This can be an advantage but often isn't. Stub my toe or get a cat scratch, an injection, or someone bumping into me and it is painful enough to make me cry out. My doctor had an interesting way around this. I don't like general anaesthetics as my father had a triple bypass and was totally conscious and in pain the whole time but unable to move a muscle to tell anyone. So my doctor would give me a tranquilizer to relax me, then ketamine, a club drug that sends you somewhere else entirely different, to a lovely world filled with music for me, so I wouldn't even be aware of my surroundings, and then a nerve block at the site of the procedure.
Towards the end being sewn up I would wake up and feel delicious and want to go back into the trip and ask for more, always refused. That ended when my doctor retired. It's now forbidden in the hospital. Shame really. It was nice to wake up from a procedure having enjoyed it thoroughly. After the operation though, I would need major painkillers, and sometimes laser treatment for local pain for weeks.
A lawyer friend had such bad pain that he once collapsed on my kitchen floor. He went from doctor to doctor and hospital to hospital eventually ending up in Johns Hopkins for a week of tests. At the end of the week they told him they would do a small procedure and he could go home. He was surprised, he thought it would be major treatment. They injected alcohol around the nerves in his spine that were causing the problem. Drunk they didn't operate (who does?) and within minutes he was pain free.... so simple.
*A pharmacist told me that the best way to treat pain was with one acetaminophen and one ibuprofen and some caffeine as a catalyst. The NSAID attacks the pain at the site of the inflammation and the other works on the pain receptors on the brain, so you are hitting the pain from two different angles. And because the drugs are metabolised in completely different organs in the body you can take them twice as often (ie if you would take 2 ibuprofen every 8 hours, now you are only taking one, you can do it every 4). Works too.
Original review 22 July 2017.
Rewritten 5 May 2018
Rerewritten 17 April 2022 One of these days I will have said all I want to say about Pain.
Skip to * if you want to know a fantastic way to deal with pain without reading the rest of the review (TL;DR syndrome).
The author says that people having their blood taken or injections feel considerably less pain if they imagine they are some tropical beach with the sound of the waves and coconut trees shading the sun like where I live. He said that the first thing to do with pain is to take away the stress, stress contributes to pain. Sedatives, family, pets, anything that helps you relax is a good thing. And not to refuse sleeping pills if they are prescribed until you can sleep well on your own.
I now have a very detailed understanding from the cellular level up to the moaning and groaning of what pain is, and how to treat it, or better prevent it. But not all pain is treatable. I'm glad I learned that distraction techniques, placebos, acupuncture and hypnosis all work to some degree. All stimulate endorphins, the natural opiates the body produces although how is not known. None have a scientific base, or at least not yet.
__________
Notes on reading the book. The author has a lovely name for those scientists he thinks are dickheads, "classical thinkers".
Wall talks about heroes in every culture who bear pain. Of initiation rites, whether hazing or Masaii that are about bearing pain stoically - making it meritworthy in itself. Women who undergo 'natural' childbirth are considered more praiseworthy than those who have painkillers which is really, really sad. I had an epidural and was able to participate in my son's birth after hours of being lost in a miasma of pain. He then goes on to discuss Jesus suffering on the cross and how a person suffering can identify with suffering as Jesus did and also feel they can be part of the Kingdom of Heaven.
It put me in mind of Mother Theresa. Sanctification through suffering. A very Christian concept. She said that pain and suffering were gifts from God and were a purification from sin. This is why she denied those she gave shelter if not succour to, any medications or treatment. (Also she diverted funds meant for these among other things, see Christopher Hitchens's The Missionary Position: Mother Teresa in Theory and Practice. But karma got Mother Theresa. The day she died she should have been the headline of all the newsites and papers in the world but instead she got a small column way down the page. Princess Diana died that day too.
I watched a documentary last night on pain and those who were born without the ability to feel it. In one family a grandmother had broken her ankle and went to the doctor about the shape of it. He told her she had broken it twice before, she had no idea! Her granddaughter said she got blisters in her mouth because when her coffee was too hot she didn't know. Thelife span of those who cannot feel pain is often shortened, they suffer so many injuries without noticing and children might put themselves in harm's way - jumping off walls - because they can do it and not suffer, and their friends can't.
The documentary was also about those who are born with or acquire a condition of intractable pain without any discernable cause.
I kind of have a problem of extreme sensitivity. This can be an advantage but often isn't. Stub my toe or get a cat scratch, an injection, or someone bumping into me and it is painful enough to make me cry out. My doctor had an interesting way around this. I don't like general anaesthetics as my father had a triple bypass and was totally conscious and in pain the whole time but unable to move a muscle to tell anyone. So my doctor would give me a tranquilizer to relax me, then ketamine, a club drug that sends you somewhere else entirely different, to a lovely world filled with music for me, so I wouldn't even be aware of my surroundings, and then a nerve block at the site of the procedure.
Towards the end being sewn up I would wake up and feel delicious and want to go back into the trip and ask for more, always refused. That ended when my doctor retired. It's now forbidden in the hospital. Shame really. It was nice to wake up from a procedure having enjoyed it thoroughly. After the operation though, I would need major painkillers, and sometimes laser treatment for local pain for weeks.
A lawyer friend had such bad pain that he once collapsed on my kitchen floor. He went from doctor to doctor and hospital to hospital eventually ending up in Johns Hopkins for a week of tests. At the end of the week they told him they would do a small procedure and he could go home. He was surprised, he thought it would be major treatment. They injected alcohol around the nerves in his spine that were causing the problem. Drunk they didn't operate (who does?) and within minutes he was pain free.... so simple.
*A pharmacist told me that the best way to treat pain was with one acetaminophen and one ibuprofen and some caffeine as a catalyst. The NSAID attacks the pain at the site of the inflammation and the other works on the pain receptors on the brain, so you are hitting the pain from two different angles. And because the drugs are metabolised in completely different organs in the body you can take them twice as often (ie if you would take 2 ibuprofen every 8 hours, now you are only taking one, you can do it every 4). Works too.
Original review 22 July 2017.
Rewritten 5 May 2018
Rerewritten 17 April 2022 One of these days I will have said all I want to say about Pain.
February 24, 2020
I don't know why I was really curious about this book. As Wall writes, pain is usually a topic people want to steer clear from. However, despite how unpleasant the subject matter is, this book is really fascinating!
What I adored about this book is that it's truly interdisciplinary in the best way. Wall dips his fingers into philosophy when he discusses the connection between body and mind. He brings up research from anthropology to talk about the various cultural responses to pain. He talks about neurobiology and how pain works through the nerves. There's also a bit of neuroscience as he discusses the actual impact of pain in the brain. It all works together and it's fantastic when a subject is discussed through various disciplines.
What's the underlying message here? Wall claims that pain is related to the response we think is appropriate. That is, the way we respond to pain is closely related to what we assume the pain is. He talks about how pain can be better if the person knows what will happen, if they are treated as an active member of their recovery.
I liked the chapter where he talked about different cultures. It reminded me of how, in my seminar before working in an American summer camp, they gave us a lecture about how Israelis tend to react to pain by shrugging it off while Americans are more used to be given attention and how that impacts the way Israelis work with children (because yeah, if a child falls and I see they're okay, my response is really going to be something like, "you're fine!").
All in all, if you'd like to know more about how pain works, this is a good book, I believe. If you're interested in seeing a broad view of a subject, this is also a nice thing to read.
What I'm Taking With Me
- Reading the descriptions of diseases was like, "oh no, I have experienced a headache, what if I have cancer", "I think I feel short of breath right now, what if this is a heart attack?"
- This idea that pain is not just a sensation but also comes with a desire to get rid of it.
- And really, when we think about dualism and all of that, pain is something that impacts your mind as well as your body. I'd rant about this more but I have a 2000 word essay to write now so I should keep my ranting energy for that.
Uni Adventures:
- I know I'm finally at home here because (a) two uni guards know my name and (b) a friend from the dorms told me "you know, when I first saw you, I thought you're this really quiet introvert but you're literally the loudest person I know".
- I actually met up with friends this week, it feels like a miracle, I forgot that I actually do enjoy hanging out with people.
- So I've experienced failing an exam and yeah, it's sad but also, I feel like I absolutely understand why and that I'm going to be able to make it through. Or I just have an unhealthy amount of faith in myself, despite this.
- In my essay for Comparative Politics, I'm tempted to write about racism in the states again (guys, did you know that the us government has consistently created voter policies that harm the ability of black people to vote? it's a literal strategy and it makes me sick) but I feel like at this point, my TA is just going to be like, "Roni, please, there are other problems in the world, are you able to write an essay without talking about racism in the states?".
- We talked to a guy who had been involved in built the security fence around the West Bank as well as Oslo and Camp David peace procedures. It was so fascinating but the thing that I want to remember the most from it all was him saying that just like the Berlin wall fell, that wall is also going to and that when it does, he wants to be the first to knock it down.
- On other interesting things that happened this week, I had a long conversation with a Jewish Dane and in the beginning of the conversation, he said he isn't religious at all. Then throughout the conversation, he told me about how he helps run the Jewish organization at his university, that he's going to be working as a Jewish tour guide and teacher, that he helps organize Jewish sport competitions. At this point, I was like, "you seem awfully connected to your Jewishness for someone who's not religious" and it led to such a great conversation about culture vs faith.
- You know that bit in Harry Potter when Snape assigns an essay about werewolves in the hopes that the class will recognize Lupin is one? That's exactly what the essays in politics are like. It feels like such a dystopian idea and then you look around and you see the polarization and the crisis manufacturing and realize that democracy backsliding is a very real problem.
- I'm going to have to eventually pick one subject to do more credits and like, there's a very real fear that it'll be politics and not philosophy. Or maybe I'll surprise myself and everyone around me and do economics (let's be real, that'll never happen because if I end up as an economist, I will feel like I have literally failed at life).
What I adored about this book is that it's truly interdisciplinary in the best way. Wall dips his fingers into philosophy when he discusses the connection between body and mind. He brings up research from anthropology to talk about the various cultural responses to pain. He talks about neurobiology and how pain works through the nerves. There's also a bit of neuroscience as he discusses the actual impact of pain in the brain. It all works together and it's fantastic when a subject is discussed through various disciplines.
What's the underlying message here? Wall claims that pain is related to the response we think is appropriate. That is, the way we respond to pain is closely related to what we assume the pain is. He talks about how pain can be better if the person knows what will happen, if they are treated as an active member of their recovery.
I liked the chapter where he talked about different cultures. It reminded me of how, in my seminar before working in an American summer camp, they gave us a lecture about how Israelis tend to react to pain by shrugging it off while Americans are more used to be given attention and how that impacts the way Israelis work with children (because yeah, if a child falls and I see they're okay, my response is really going to be something like, "you're fine!").
All in all, if you'd like to know more about how pain works, this is a good book, I believe. If you're interested in seeing a broad view of a subject, this is also a nice thing to read.
What I'm Taking With Me
- Reading the descriptions of diseases was like, "oh no, I have experienced a headache, what if I have cancer", "I think I feel short of breath right now, what if this is a heart attack?"
- This idea that pain is not just a sensation but also comes with a desire to get rid of it.
- And really, when we think about dualism and all of that, pain is something that impacts your mind as well as your body. I'd rant about this more but I have a 2000 word essay to write now so I should keep my ranting energy for that.
Uni Adventures:
- I know I'm finally at home here because (a) two uni guards know my name and (b) a friend from the dorms told me "you know, when I first saw you, I thought you're this really quiet introvert but you're literally the loudest person I know".
- I actually met up with friends this week, it feels like a miracle, I forgot that I actually do enjoy hanging out with people.
- So I've experienced failing an exam and yeah, it's sad but also, I feel like I absolutely understand why and that I'm going to be able to make it through. Or I just have an unhealthy amount of faith in myself, despite this.
- In my essay for Comparative Politics, I'm tempted to write about racism in the states again (guys, did you know that the us government has consistently created voter policies that harm the ability of black people to vote? it's a literal strategy and it makes me sick) but I feel like at this point, my TA is just going to be like, "Roni, please, there are other problems in the world, are you able to write an essay without talking about racism in the states?".
- We talked to a guy who had been involved in built the security fence around the West Bank as well as Oslo and Camp David peace procedures. It was so fascinating but the thing that I want to remember the most from it all was him saying that just like the Berlin wall fell, that wall is also going to and that when it does, he wants to be the first to knock it down.
- On other interesting things that happened this week, I had a long conversation with a Jewish Dane and in the beginning of the conversation, he said he isn't religious at all. Then throughout the conversation, he told me about how he helps run the Jewish organization at his university, that he's going to be working as a Jewish tour guide and teacher, that he helps organize Jewish sport competitions. At this point, I was like, "you seem awfully connected to your Jewishness for someone who's not religious" and it led to such a great conversation about culture vs faith.
- You know that bit in Harry Potter when Snape assigns an essay about werewolves in the hopes that the class will recognize Lupin is one? That's exactly what the essays in politics are like. It feels like such a dystopian idea and then you look around and you see the polarization and the crisis manufacturing and realize that democracy backsliding is a very real problem.
- I'm going to have to eventually pick one subject to do more credits and like, there's a very real fear that it'll be politics and not philosophy. Or maybe I'll surprise myself and everyone around me and do economics (let's be real, that'll never happen because if I end up as an economist, I will feel like I have literally failed at life).
December 27, 2008
This book is not a self-help or pain healing book, and as there are so many of those, this book sets itself apart by looking closely at the causes and consequences of pain. It deals with questions like, how does the time lapse (if any) between injury and onset of pain, play into how the body deals with the pain? Wall delves into endorphin response, the placebo effect, shame and embarassment. He also looks at how pain is handled emotionally and physically, internally and externally - between pain with an overt cause, and pain without overt cause. What factors, in addition to overt injury, produce pain and modulate its intensity? How and what do we learn about and from pain?
In all, this is a uniquely well-rounded book that is only hindered by its length. Each chapter could be a book in itself and the space dedicated to each topic is limited. While it challenges many common misconceptions about pain sensation etc., it can't entirely do those challenges justice. This is the only reason I'd give it 4 stars instead of 5 - it was a tough call.
The first chapter deals with "Private Pain and Public Display," studying some of the most extreme cases of pain sensation, including emergency rooms, torture and masochism. From the data cited, Wall asserts that the amount of pain and the amount of injury are not "tightly related" (as anyone who's worked in an ER or Urgent Care facility can confirm.)
"The public display of pain has the purpose of informing others of the patient's needs whereas the private suffering assesses the meaning and consequences of the patient's own miserable state."
From the chapter, "The Philosophy of Pain," Wall takes on notions of mind/body duality and sensation to say that, "Unlike Russell's ideal of a passive input analyzed by an active brain, there are signs that brain activity controls the input. This does not mean that the entire outside world is a hallucination, but it does mean that our senses include active participation of mind and body."
The following chapter, "The Body Detects, the Brain Reacts," takes on pain as it affects the nervous system specifically. For many readers this may well be the driest chapter in the book - but it is well worth the read.
The next chapter takes us back to the "Whole Body", challenging the common focus on "conscious awareness of pain" in isolation of all other associated events. Wall begins this discussion with William James' proposal that "some of our emotions were an awareness of our general body reactions to an event, rather than to the event itself." This idea, for Wall, opens the possibility that that pain is a syndrome that joins together a coincident group of signs and symptoms rather than a single phenomenon.
This leads neatly into Chapter 5: The "Normal" Pain response. Here he discusses his idea that "we fear the onset of private pain and doubt our ability to endure it with dignity in our public display." Pain response, pain thresholds - across gender, genetics, cultural stereotypes all factor into how we feel we should deal with pain (the internal and external factors of pain.)
Wall then draws the distinction (in internal sensation/emotion and external factors) between "Pain with Obvious Causes" and "Pain without a Cause". This may well be the heart of the book for sufferers of chronic pain conditions like fibromyalgia, myofascial pain etc. - which he takes in turn.
In Chapter 8, Wall discusses how treatments work and how the medical field has evolved in it's treatment of pain conditions - from medicines to surgery to whole person treatments. While wrapping up this chapter, Wall empathizes the importance of the patient's belief that the treatment will work for the ultimate success of the therapy. This, of course, leads directly to Wall's more controversial chapter on "The Placebo Response."
For Chapters 10 and 11, Wall brings all the information, theories and phenomena back to "Your Pain (10) and "Other People's Pain." These chapters not only wrap up the material in previous chapters, but also looks into the process of pain - especially a pain syndrome over time, and its consequences. "Other People's Pain" takes a summary of previous information and ties it with advice and insight geared for the caregivers in everything from first aid to the professionals and the education they receive.
In all, this is a uniquely well-rounded book that is only hindered by its length. Each chapter could be a book in itself and the space dedicated to each topic is limited. While it challenges many common misconceptions about pain sensation etc., it can't entirely do those challenges justice. This is the only reason I'd give it 4 stars instead of 5 - it was a tough call.
The first chapter deals with "Private Pain and Public Display," studying some of the most extreme cases of pain sensation, including emergency rooms, torture and masochism. From the data cited, Wall asserts that the amount of pain and the amount of injury are not "tightly related" (as anyone who's worked in an ER or Urgent Care facility can confirm.)
"The public display of pain has the purpose of informing others of the patient's needs whereas the private suffering assesses the meaning and consequences of the patient's own miserable state."
From the chapter, "The Philosophy of Pain," Wall takes on notions of mind/body duality and sensation to say that, "Unlike Russell's ideal of a passive input analyzed by an active brain, there are signs that brain activity controls the input. This does not mean that the entire outside world is a hallucination, but it does mean that our senses include active participation of mind and body."
The following chapter, "The Body Detects, the Brain Reacts," takes on pain as it affects the nervous system specifically. For many readers this may well be the driest chapter in the book - but it is well worth the read.
The next chapter takes us back to the "Whole Body", challenging the common focus on "conscious awareness of pain" in isolation of all other associated events. Wall begins this discussion with William James' proposal that "some of our emotions were an awareness of our general body reactions to an event, rather than to the event itself." This idea, for Wall, opens the possibility that that pain is a syndrome that joins together a coincident group of signs and symptoms rather than a single phenomenon.
This leads neatly into Chapter 5: The "Normal" Pain response. Here he discusses his idea that "we fear the onset of private pain and doubt our ability to endure it with dignity in our public display." Pain response, pain thresholds - across gender, genetics, cultural stereotypes all factor into how we feel we should deal with pain (the internal and external factors of pain.)
Wall then draws the distinction (in internal sensation/emotion and external factors) between "Pain with Obvious Causes" and "Pain without a Cause". This may well be the heart of the book for sufferers of chronic pain conditions like fibromyalgia, myofascial pain etc. - which he takes in turn.
In Chapter 8, Wall discusses how treatments work and how the medical field has evolved in it's treatment of pain conditions - from medicines to surgery to whole person treatments. While wrapping up this chapter, Wall empathizes the importance of the patient's belief that the treatment will work for the ultimate success of the therapy. This, of course, leads directly to Wall's more controversial chapter on "The Placebo Response."
For Chapters 10 and 11, Wall brings all the information, theories and phenomena back to "Your Pain (10) and "Other People's Pain." These chapters not only wrap up the material in previous chapters, but also looks into the process of pain - especially a pain syndrome over time, and its consequences. "Other People's Pain" takes a summary of previous information and ties it with advice and insight geared for the caregivers in everything from first aid to the professionals and the education they receive.
November 23, 2007
Pain: The Science of Suffering is the complete title of this book. Written by a physician, but easily digestible by the layperson. Comprehensive and enlightening. (Charlotte, I want this back!)
addendum: Fixed title (it's good to be a librarian!) AND happily welcomed the return of this book by the kind Charlotte, who put it in the mail for me (something I myself am terrible at doing - the lines at these NYC post offices are off-puttingly horrific!). Thanks, friend.
addendum: Fixed title (it's good to be a librarian!) AND happily welcomed the return of this book by the kind Charlotte, who put it in the mail for me (something I myself am terrible at doing - the lines at these NYC post offices are off-puttingly horrific!). Thanks, friend.
February 7, 2020
It was interesting to read a book about pain written by an expert who is also a cancer patient who suffers as he writes about suffering, so professionally.
December 26, 2018
If you're anything like me, you've been looking for a book about the phenomenology, physiology, psychology, and treatment of pain, one written by a medical doctor and researcher who has personal insight into the nature of pain and suffering. "Pain: The Science of Suffering", by Patrick Wall, is such a book. It's a thorough, intelligent, low-key, and compassionate take on the state of pain management in our society.
Wall is decidedly *not* a purveyor of get-pain-free-quick schemes, nor is he the sort of MD who says it's all in your mind. On the contrary, he practices medicine in this field, is skeptical of a lot of what experts and non-experts say, and most of all he has a serious chronic pain condition that gives him the special sort of insight. By reading this book, at the very least, you might find some of your experiences validated by Wall. While this book seems intended for a well-read general reader, my suspicion is that health care providers of all stripes will also benefit from this resource.
Wall is decidedly *not* a purveyor of get-pain-free-quick schemes, nor is he the sort of MD who says it's all in your mind. On the contrary, he practices medicine in this field, is skeptical of a lot of what experts and non-experts say, and most of all he has a serious chronic pain condition that gives him the special sort of insight. By reading this book, at the very least, you might find some of your experiences validated by Wall. While this book seems intended for a well-read general reader, my suspicion is that health care providers of all stripes will also benefit from this resource.
June 25, 2013
Downloaded this as a reference for a research paper I was doing on Phantom Limb Pain and ended up being fascinated with it and couldn't put it down. Read the whole book and was impressed.
December 1, 2023
Neither a self help or guidance book, but it already illustrates enough details if you feel a gap between anecdotal self-helps and your actual curiosity. I really like how this book talks about how we sensors the pain, especially the 3 types of neurons that responds differently on different timescales. I learnt that why sometimes distraction works for ignoring the pain and why sometimes it doesn't work.
Also, the phantom pain is also an interesting concept. It is interesting to learn that there is a hypothesis that most of lower back pain are not associated with actual body injure, just signals processing wrong.
Anecdotal self-help books like to summary everything in one or two sentences, providing a working model without letting you know when the model stops working. This book, in contrast, doesn't give you simple take-away messages, but helps (at least me) developing my understanding how to perceive pains.
Honestly, I shall give 5 stars to this book, but, perhaps due to my poor English reading skills, I only think I understand no more than 15% in the book. So I give it a 4 stars in case I might over-recommend it.
Also, the phantom pain is also an interesting concept. It is interesting to learn that there is a hypothesis that most of lower back pain are not associated with actual body injure, just signals processing wrong.
Anecdotal self-help books like to summary everything in one or two sentences, providing a working model without letting you know when the model stops working. This book, in contrast, doesn't give you simple take-away messages, but helps (at least me) developing my understanding how to perceive pains.
Honestly, I shall give 5 stars to this book, but, perhaps due to my poor English reading skills, I only think I understand no more than 15% in the book. So I give it a 4 stars in case I might over-recommend it.
August 15, 2021
What is pain? We all know the answer, don't we? Actually, we don't
Patrick Wall explains what pain is, how it occurs, and how it can be managed.
I love to know how things work, and pain is no exception. This book tells us how pain varies amongst people, societies and situations. How pain was misunderstood by the ancients, and by more modern physicians. It also takes us through the things which can affect it, from depression and anxiety, to the placebo effect and narcotics.
The main thing I have learned from this book is that pain is a sensation similar to hunger or tiredness - a call to action for our bodies which demands appropriate attention but can be ignored if more urgent (or interesting) matters come to mind.
A good book for anybody who wants to understand pain, especially if they suffer from it. Recommended for those who just like to know things too.
Patrick Wall explains what pain is, how it occurs, and how it can be managed.
I love to know how things work, and pain is no exception. This book tells us how pain varies amongst people, societies and situations. How pain was misunderstood by the ancients, and by more modern physicians. It also takes us through the things which can affect it, from depression and anxiety, to the placebo effect and narcotics.
The main thing I have learned from this book is that pain is a sensation similar to hunger or tiredness - a call to action for our bodies which demands appropriate attention but can be ignored if more urgent (or interesting) matters come to mind.
A good book for anybody who wants to understand pain, especially if they suffer from it. Recommended for those who just like to know things too.
June 11, 2020
Patrick Wall, a neurologist and neuroscientist, was one of the great pain researchers of the 20th century and sadly passed away two years after this first published. "Pain: The Science of Suffering" is long out of print unfortunately. I was lucky enough to find it at a second had book store or a book sale. It is an excellent book. Wall has a knack for putting the scientific into clear, readable language, without making it sound paternalistic, or making the reader feel stupid. If you're looking for more than a basic introduction into pain, this is a great book.
July 12, 2022
Yleistajuinen tutkielma kivusta ilmiönä, sen monista syistä, seurauksista ja myös kokemukseen liittyvistä mysteereistä. Kiehtovaa ja yllättävän sujuvaa luettavaa. Toki teos on jo yli parikymmentä vuotta vanha, joten uusia askelia kivun ymmärtämisessä on varmasti (toivottavasti) jo otettu, mutta Wall käsittelee silti kiinnostavasti kivun fyysisiä ja psyykkisiä vaikutuksia sekä kokijaan että tämän lähiympäristöön.
April 27, 2023
Huh. Not what I was expecting. More about the intellectual concepts of pain. He's got a chapter on pain and religion, pain and philosophy, pain and psychology....He seems very smart but is not a good writer in terms of explaining concepts to lay people. Quite often I had to read and reread sentences to understand his point. It's a short book, under 200 pages, so I decided to bite the bullet and keep reading instead of DNF. I wish I'd cut my losses and stopped reading.
December 6, 2018
I knew this would be an interesting book to read and I’m not disappointed. Apart from one chapter that provides in-depth physiology of pain, a layman can easily enjoy and understand the rest of the book without much fundamental/prior knowledge.
November 16, 2018
Interesting book, bit focused on the medical aspect of pain. For medicine professionals mostly.
Read
December 6, 2025Dnf, couldn't stay interested
August 18, 2008
This book needed to be cut some, but was really interesting.
November 9, 2009
Pain research is where it's at right now! I'm going to try to take a class on chronic pain next semester, this book is GREAT. He developed the spindles theory which fascinates me to no end.
June 9, 2011
A bit to hard for my little brain I think. Interesting but a bit heavy going.
March 17, 2016
Most of what's there is good, but it's surprisingly short and a decent chunk of it is a review of high school anatomy.
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