The medicalization of chronic pain

Abstract

This paper presents an initial analysis of the medicalization of chronic pain, focusing on the definitions and treatment of chronic pain in recent decades. We identify several factors that contributed to this medicalization including the emergence of the gate control theory of pain, medical advocates for pain treatment and speciality training, the development of multidisciplinary pain clinics, the emergence of professional pain associations, extended medical treatments, and governmental decisions and support. The increased attention to chronic pain as a discrete medical category and innovations in chronic pain treatment have contributed to the medicalization of chronic pain in ways that suggest there may be benefits to society and pain sufferers, in contrast to many other cases of medicalization.

Where Movements Matter: Examining Unintended Consequences of the Pain Management Movement in Medical, Criminal Justice, and Public Health Fields

“…Pain management advocates helped to medicalize chronic pain by pulling it under the medical purview, decoupling it from specific diseases, altering the legal and regulatory environment of pain treatment, and allaying physicians' fears about prescribing powerful narcotics. Contrary to the historical treatment of pain as a symptom of some underlying condition, chronic pain became a distinct medical category, diagnosed as pain from disease, injury, or unknown causes (Conrad and Munoz ). Movement consequences took place on numerous fronts, facilitating change in law/regulation, science, markets, and professions while establishing a strong field of SMOs oriented toward pain management.…”

“…Several movements converged or worked in parallel to advocate for effective pain treatment, including hospice and palliative care activists who advocated for humane pain treatment at the end of life (Neumann 2016;Krisman-Scott 2003), cancer activists who promoted the use of narcotics to relieve cancer patients' suffering (Seymour, Clark, and Winslow 2005), holistic activists concerned with interdisciplinary approaches to pain (Conrad and Muñoz 2010), and pharmaceutical activists seeking to encourage providers to use opioid treatment for noncancer patients (Lyman 2013). Activism in each of these areas helped to change the culture of pain management.…”

“…We then conducted cited reference searches on these books to identify works that corroborated or contradicted their accounts and that provided comprehensive analyses of more recent time periods (e.g., Wailoo ; Libby ). Finally, we selected texts with a distinct sociological perspective on pain and addiction (e.g., Goode ; Conrad and Muñoz ; Conrad and Schneider ). We conducted cited reference searches of these texts to identify other relevant research on these topics.…”

“…In the context of shifting attitudes toward narcotics throughout the twentieth century, the pain management movement mobilized at a time when scientific shifts helped the medical community to reconceptualize pain and ushered in new forms of pain treatment. The movement operated largely inside professional fields, creating social movement organizations to advocate for more effective pain treatment and working to designate pain treatment as a medical subspecialty (Wailoo ; Conrad and Muñoz ; Meier ). However, the movement also maintained an alliance with drug companies who were developing new products that they hoped to market widely for pain treatment (Wailoo ; Meier ).…”

Medical and Familial Claims to Long-Term Care: Institutional Gaps and Shifting Jurisdictions

“…. This includes alcoholism(Gusfield 1986), hyperkinesis(Conrad and Schneider 1992), sex addiction(Irvine 1995), homosexuality(Greenberg 1990), chronic pain(Conrad and Muñoz 2010), and fetal alcohol syndrome(Armstrong 2003), among others(Conrad 1992). My claim that medicine has "no ready solution" to these problems does not mean that solutions have not been offered.…”