Chronic pain — why science has scant succour for one in five people

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Chronic pain — why science has scant succour for one in five people
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A physician calls on the medical system to contextualize and personalize the treatment of pain.

). He reports the finding that physicians are five times less likely to prescribe opioids to Black children with acute appendicitis than to white children with the condition. A section on gender explores the history of pain management during childbirth, including the misogynist and white-supremacist origins of the natural-childbirth movement, and a rousing endorsement of the epidural. In general, women experience more pain than men, and are more sensitive to it.

This conclusion seems overly rosy. Exercise is “entirely safe” for people with chronic pain, Warraich writes — it brought him relief, although it was excruciating at first. But exercise is not like a pill. A person has to find the right kind, which might take trial and error, along with guidance from the right physical therapist or trainer, which costs money and time and requires access. It’s going to take a lot to roll that out to one-fifth of the world’s population.

Pain resists easy categorization. It has a vast array of causes, in a vast array of bodies and minds. The assurance that whole categories of treatments will or won’t work for everyone is puzzling for a book that calls on the medical system to treat pain in a more contextualized and personalized way.

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