Chronic pain as a human rights issue: setting an agenda for preventative action

Abstract

Background: Historically, chronic pain has been viewed primarily as a medical issue, and research has been focused on the individual and predominantly on pain sufferers in high-income countries. Objectives: This article argues the need for a broader understanding of the context of chronic pain and its complex aetiologies and maintenance. It is suggested that the interaction between chronic pain and social context has been inadequately explored. Methods: A single case study is used of a man living in a violent urban environment in South Africa accessing a pain clinic at a tertiary hospital. Following the case-study approach, as used in the chronic traumatic stress field by Kaminer et al., the case material is utilised to develop an argument for a new research agenda. Results: Analysis of the case material demonstrates the complex interplay between bodily and psychological experiences, with chronic pain being contextually maintained and exacerbated by very difficult life circumstances, ongoing violence, and marginalisation. Conclusions: It is suggested that a research agenda be developed which explores the links between chronic pain and ongoing chronic traumatisation in contexts of continuous violence, oppression, and disempowerment – common features of much of the contemporary majority world.

Towards Health Equity for People Experiencing Chronic Pain and Social Marginalization

“…And I kinda get thrown around by both of them because I'm not either one. (LGBTQ2S [1][2][3][4][5][6][7][8][9][10][11] Similarly, newcomers' experiences varied with their status governed by legislation related to immigrants and refugees, the bene ts to which they were variously entitled, and their experiences with related processes. For example, one newcomer attributed her experiences of chronic pain with the social isolation she experienced as a refugee.…”

How Indonesians Cope with Chronic Pain: Does Seeking Help and Comfort from God Work?

“…Living in urban settings increases the level of stress and burnout (Maly & Vallerand, 2018), so it leads to a greater need to release the burden and pain through positive religious coping. Frenkel and Swartz (2017) explained that chronic pain is often experienced as disabling, affecting people's ability to work, and their perception of their place in the fast-paced urban life. However, when people believe that there are things beyond their control, leaving some of the burdens to God brings more peace as well as acceptance of the condition and decreases the negative perception of pain experienced (Tarjoman & Borji, 2019).…”

Towards health equity for people experiencing chronic pain and social marginalization

“…This intersects with multiple stigmas related to race and ethnicity, class, gender, sexual orientation, mental health, and substance use, among other forms [ 16 – 19 ]. Thus, chronic pain becomes more than a health issue—it should be viewed as an issue of equity and justice associated with social contexts of discrimination and structural violence [ 20 ], reflective of the way in which societies are organized to create harm and maintain racism, poverty, and other disadvantages [ 21 ]. While physical trauma in the form of injury and surgical interventions represents the major cause of pain, social trauma resulting from experiences and impacts of racism and colonization [ 22 , 23 ], the stigma and lack of responses for mental health issues [ 24 ], misogyny and intimate partner violence [ 25 ], the current drug overdose public health crisis [ 26 ] [ 27 ], and the ongoing crises of homelessness and poverty [ 28 ], among other challenges, contribute substantially to experiences of living with pain.…”