“Understanding Pain: Unravelling the physiology, assessment, and management of pain through South African stories” is an open access pain textbook edited by Romy Parker and Jocelyn Park-Ross.
The book was funded by an IASP Developing Countries Education Grant and published in early August 2024 by the University of Cape Town Libraries. The book is freely available for use and sharing here: https://openbooks.uct.ac.za/uct/catalog/book/52
Unravelling the complexity of pain
The editors of this book recognised the need to translate the current pain science and evidence-informed paincare practices into our culturally-diverse and resource-constrained South African context where the majority of the population depends on a public healthcare system that is accessed via primary care structures.
In addition, as an open access book packed full of other free online resources, it is a real gift to the South African pain community and has value for other similar settings across Africa.
The book is divided into 6 sections – each with relevant contributions from an interdisciplinary team of authors, such as physiotherapists, anaesthetists and surgeons; as well as people living with pain:
- Section 1: The nuts and bolts of pain – covering the basic pain science and overarching principles for assessing and treating it.
- Section 2: Managing pain at the primary level of care – suggesting guidelines on managing common painful conditions presenting in primary care settings (e.g. low back pain, Fibromyalgia and Osteoarthritis)
- Section 3: Chronic pain – describing the paradigm shift needed in managing pain that persists and becomes complex (e.g. CRPS, chronic pelvic pain).
- Section 4: Prehospital and emergency pain – offering guidelines for managing the range of pain aetiologies necessitating emergency care (e.g. burns).
- Section 5: Perioperative pain management – considering the multiple factors influencing the pain experienced in relation to surgery (e.g. joint replacements, phantom limb pain)
- Section 6: Useful Resources – packed full of print-ready resources, like assessments and charts.
Weaving the science with stories
Pain is not just a symptom that can be rated by severity; or a phenomenon to be studied by scientists; or an incidence to be reported in scary statistics. It is a distressing whole-person experience that is best conveyed through the stories of the people living with it and then faced in partnership with a competent and caring team of healthcare practitioners.
So, whilst “Understanding pain” does not skimp on the science, it does anchor it to case studies – the stories of real people living with pain in our unique South African context – and always recommends a team-based approach.
With obvious empathy and epistemic humility, the team of authors has not just succeeded in unravelling the ‘knotty’ complexity of pain and its management but have then creatively woven the guiding principles and practical application threads together with the stories of South Africans living with pain – crafting ‘ready-to-wear’ gear for any healthcare professional or student in our South African context.
Balancing theory with practical pointers
“Understanding pain” manages to avoid being too theoretical or overly reductionist by offering guiding principles as well as a structured approach to assessment of the underlying mechanisms and biopsychosocial contributors to the pain experience.
It then gives enough breadth of knowledge to address most challenges across the continuum of pain but also dives to appropriate depth when exploring specific conditions, such as Fibromyalgia, Complex Regional Pain Syndrome and others. The extensive reference list at the end of each section invites curious readers to go even deeper!
In addition to the fascinating pain science and deeply personal stories, what makes this book engaging and easy-to-read is the simple language; clearly delineated sections; brightly-coloured illustrations; and clever literary devices used to expand upon or focus in on key information.
A resource for all healthcare practitioners and students
Any healthcare student or practitioner, feeling overwhelmed by the complexity of pain and concern for those living with it, can read this book to update their pain science knowledge, upskill in pain management and develop core communication skills for partnering with people in pain.
