Smerteboken – fra vondt til bedre

Harald Breivik

doi:10.1515/sjpain-2019-2014

Article Publicly Available

Smerteboken – fra vondt til bedre

Harald Breivik

Published/Copyright: July 29, 2019

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From the journal Scandinavian Journal of Pain Volume 19 Issue 4

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Aas Audun Smerteboken – fra vondt til bedre Dreyers Forlag Oslo 2018 978-82-8265-449-4 306 pages

This is a well-written important book about pain, of interest to patients and clinicians of all types and specialties practicing medicine. It is written in the Norwegian language that can be read and understood by many of the 30 million inhabitants in the five Nordic countries.

This is a story about pain and its understanding and management from older, even biblical times, through Decartes’ descriptions of pain transmission from toes to brain, about nitrous oxide, diethyl ether and chloroform, the barriers to obstetric pain relief, to modern time seeing the pendulum of opioid use swinging from too liberal use about a century ago, to a period with fanatical obstruction to clinical use – even in dying cancer-patients, to another period of uncritical marketing and “liberal” prescribing of potent opioids, because “pain relief is a human right”, to present-day strict guidelines warning that opioids should generally not be prescribed for chronic pain – due to its nasty adverse effects.

Audun Aas writes well about the scientific discoveries by Pat Wall and Ron Melzack – the fathers of “the pain gate theory”, and about John Bonica, the anaesthesiologist who realized that injections of local anaesthetics could relieve acute pain but that his chronic pain patients needed other health care specialists, the psychologist Bill Fordyce and the neurosurgeon John Loeser in particular, and created the first multi-professional pain clinic, model for a global “movement”, the foundation of the International Association of Pain and major progress in multimodal rehabilitation av chronic pain patients.

He writes with insight and up-to-date knowledge of the development and present-day understanding of sensory, affective, and cognitive aspects of the experience of pain and how we can help our patients better tolerate, accept, and have an appropriate quality of life, in spite of health conditions with persistent or recurring pain as a burdening symptom.

The book contains entertaining and well written chapters on sex-differences, genetics, allostasis and post-traumatic stress disorder, neuropathies with or without pain, fibromyalgia, mindfulness and cognitive behavioural therapy. His book contains illustrative case stories, statements with humour and point (e.g. “When I get a headache, I take two aspirins and keep away from children, just like the bottle says”; “If Hell was a medical condition, it would not be unlike CRPS”, citing Nathan Rudin of John Hopkins University).

He clearly has long experience in treating children, adolescents, adults, as well as elderly patients with difficult pain conditions. Chapters dealing with the “difficult opioids” are well balanced. This is a book describing the long experience of a well-read, wise pain-clinician able to write clearly, educational and with humour. It deserves an English-language version for the benefit of many more than his Nordic readership.

Published Online: 2019-07-29

Published in Print: 2019-10-25

Articles in the same Issue

https://doi.org/10.1515/sjpain-2019-2014