This book is an extension of my 1992 book entitled The Social Context of Chronic Pain Sufferers. Many ideas nominally explored there are elaborated in this volume, which is an attempt to fill a major gap in the chronic pain literature. Although there has been a virtual flood of new works on the medical and psychological aspects of chronic pain, such enthusiasm is somewhat muted in relation to the social environment of the patient. Although there is universal recognitionamongpain expertsthat biological, psychological,and socialfactors influence the experience ofpain, the social component (forreasons that are - clear) has failed to attract much attention. Theneed forabook focusedonsocialrelationsisobvious.Thepatientisnot merelyacarrierof symptoms.Thereis alargesocialrealityinthe background of each patient; that reality can have multidimensional consequences, from the way pain is perceivedto seriousfinancialhardshipand other sourcesof stress, c- plicating treatment, management, and, ultimately, the prognosis. Clinicians rec- nize the value of incorporating the social dimension in the overall evaluation and treatment of the patient. This book attempts to accomplish that task.
In order to achieve that objective, this volume addresses many important e- ments inthepatient'ssocial environment-the mostsignificantbeingthefamily. Beyond the family, for a vast majority of patients, work represents a major source of economic security and self-esteem. Job loss, common in this population and a major cause of much personal and family distress, needs critical examination.