Review: Explain Pain by David S. Butler and Lorimer Moseley

Authors David Butler and Lorimer Moseley take complex scientific information and turn it into an easy to read but still totally enlightening introduction to the science of pain. Using thoughtful analogies and illustrations without medical jargon, the authors’ style is refreshingly accessible, but never condescending. It really does explain pain. I hope that by understanding our pain better, we will all be better able to cope with it.

The embedded video is an audio recording of part of the book. I am including it, and the review below, to help you decide if you want to purchase the book. Its very expensive at $74.06, and I am afraid that is just too high a price to pay for a book for most people. If I could put every page free on this site I would. I think it is that important. So check your library? Tell your doc to buy a few copies and lend them out? Demand a kindle version? Buy it from Amazon and then sell it back later?

The authors have provided us with another good option, the Explain Pain Ebook downloadable as a pdf for only $35.00, a significant savings for the minor hassle of printing it out.

Demystifying the causes of Pain

The authors state 4 aims of this book: 1) to assist health professionals to help their patients, 2) to enable people in pain to understand better what is happening to them, 3) to help people in pain make choices about their pain management, and 4) to describe modern management models and management essentials for overcoming pain (5).

One of these management essentials is education and understanding, and Butler and Moseley take on part of that educational task. They start by pointing out that the pain we experience is not necessarily related to the damage in our bodies. They explain this with the example of a paper cut. How can such a tiny amount of damage cause that awful sting? (12-13). The authors go on to explain how changes in the body, even because of an injury, may or may not be perceived as a threat by the brain (14-17). But if there is pain, then the brain has decided a threat is present, and this can happen even if the original injury has healed.

A book that explains both pain symptoms and pain treatments

Explain Pain then delves into the anatomy of pain and the changes in the body that can make the pain signal more intense. For example, pain is a normal feeling in the body, but sometimes there are changes in the processes that create the sensation of pain, and these alterations may tell the brain that there is more danger to the body than is actually present (73-74). The result is of course more pain, but not more danger to the body!

So can we somehow turn off these altered signals? How do our thoughts and feelings relate to the experience of pain? The authors tell us there is no single answer to the pain problem, but there are lots of things we can do to help ourselves. Understanding pain and moving our bodies in healthful ways are two of the tools we can use to cope (108). If we understand the inner workings of pain, and the way our brains handle perceived threats, we are moving in the right direction. I also think we are taking some of of our fears out of the pain experience.

Butler and Moseley also refer to “educated movement,” which they discuss in detail with sample exercises for both the brain and the body. The general idea is that with movement we can re-establish the brain’s understanding of how we feel things (sensory function) and how we do things (motor function) (108). You really need to examine the book on this subject, however. I cannot justly summarize their content in only a few sentences.

There is also a section on making decisions about your pain management. The authors explain different approaches to pain in healthcare, and suggest guidelines for making decisions regarding your care. For another resource on making healthcare decisions, see my post on the American Pain Foundation.

Every page of this book has something new to offer the person with pain. It is a “must-read” for anyone who struggles with chronic pain.

Explain Pain is published by the Neuro Orthapaedic Institute, an independent, international group of physical therapists “dedicated to quality education and resource distribution.”

CRPS / RSD a better life is a blog that mixes personal reflections with the science of pain as presented in this book. The site is full on interesting posts and information.