New Book, Documentary on the 'Painful Truth' of Chronic Pain

Pauline Anderson

September 16, 2015

Chronic pain is one of the most complex medical conditions of modern times. It is also among the most common. One in three Americans suffer from chronic pain, or pain lasting longer than 12 weeks, not including children or cancer patients. As the population ages and cancer treatments boost the number of survivors living with pain, the problem will likely get worse.

It is in this context that noted pain specialist Lynn Webster, MD, vice president of scientific affairs at PRA Health Science, Salt Lake City, Utah, and past president of the American Academy of Pain Medicine, wrote a personal account of treating patients in pain and has coproduced a documentary on the topic.

The book, The Painful Truth: What Chronic Pain is Really Like and Why it Matters to Each of Us (Webster Media, LLC), chronicles the heart-wrenching stories of nine of his patients. Among them is Carolyn Tuft, who lost part of her right shoulder and suffered damage to her right lung and brachial nerves when a gunman randomly shot her at the Trolley Square Mall in Salt Lake City, Utah, in 2007. Among other victims was her 15-year old daughter, who died in her arms.

Giving Voice

"I wanted to create a voice for people in pain," Dr Webster told Medscape Medical News. "They are often ignored, denigrated, treated as if they're a subclass of society and are often thought of as being addicts. I don't believe people understand the amount of suffering, or the lack of humanity, that goes on."

Dr Webster not only documents the individual struggles of these patients but also highlights the challenges physicians face in trying to adequately treat their patients who cope daily with pain.

"I talk about how difficult it is for us to treat chronic pain," particularly with constraints involved in the use of opioids, said Dr Webster. "I don't think there's any medical condition that is more complex than chronic pain, because we're usually dealing not only with physical problems but also with mental problems, family problems, and financial problems."

Dr Webster also notes the failures of the healthcare system to adequately address the plight of patients with chronic pain and includes what he calls "a call to action."

"We need to have a cultural transformation to improve the lives of chronic pain patients," he said. "All people who experience pain should write their senator and ask for more research dollars from the National Institutes of Health to find better, safer, and more effective therapies."

Dr Webster has worked in the pain management field for more than 30 years. He is board certified in anesthesiology and pain medicine and is certified in addiction medicine.

The number of Americans experiencing chronic pain is on the rise, partly because people are living longer, Dr Webster said. "As we get older, the more likely we are to have chronic arthritic pain and spinal pain. One of two Americans who live long enough will have significant back pain," which is often due to arthritis and is untreatable and very disabling.

Such situations can be compounded by being overweight, he added. This, he said, may lead to diabetes and to diabetic peripheral neuropathy.

Add other chronic illnesses, surgeries to treat those conditions, and patients surviving cancer and you've got a growing population that is dealing with sometimes unbearable pain.

Perhaps the most painful conditions involve the trigeminal nerve ― for example, neuralgia or severe migraines. For patients with these conditions the rate of suicide is three times that of other chronic pain sufferers, who in turn have a two to three times higher rate of suicide than the general population, Dr Webster said.

"There's plenty of evidence showing that some people are unable to tolerate the pain," especially if it is continuous, said Dr Webster. "It's such a burden that at some point, they just give up; they can't keep up the fight."

Pain researchers now understand that in many cases, pain is not just an early symptom of disease. "Too often, it actually becomes a disease itself and can be as malignant as any cancer."

In addition to writing the book, Dr Webster helped produce and fund a 1-hour documentary on chronic pain. He recruited an Emmy Award–winning journalist to write the script and identified national sources and topics to cover in the documentary.

Riveting Project

Medscape Medical News asked Steven D. Passik, PhD, vice president, clinical research and advocacy, Millennium Health, San Diego, California, who is a psychologist and addiction specialist familiar with the project, to comment on the book and documentary.

They are "riveting" and "heartfelt," he said. "They help shed light on the complexity of pain management and the very individual and diverse ways that people with chronic pain suffer, survive, and ultimately succumb to or overcome their difficulties."

The way chronic pain patients are often treated suggests that they are "dismissed," and they are subjected to various forms of stigma, said Dr Passik. To top it off, everyone seems to have advice on how these patients should behave and how they should and should not be treated.

The book and documentary are "extremely relevant and timely," Dr Passik said. Society is reevaluating pain treatment and developing policies to address the safe use of opioids in the face of a national epidemic of opioid misuse, abuse, diversion, and overdose, he said.

"But as dire as the epidemic is, it's important still to understand the tremendously diverse needs of this population of 70 million individuals and take into consideration the intended and unintended consequences of any actions we ultimately take."

Dr Webster's new work is a reminder that, as with those suffering any medical condition, people in pain "need to be appreciated and understood as individuals," said Dr Passik. "They need their healthcare providers, policy makers, and all other stakeholders to be educated, skillful, and compassionate and willing to leave behind dogma and preconceptions."

The book was released September 1. The documentary will air on public television in the fall (details on dates and network are still to be determined). Other viewing applications, such as through the Web and apps, are also in the works, said Dr Webster.


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