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How a founder’s vision became IASP IASP returns to Italy 1st World Congress on Pain Florence 1975
14th World Congress on Pain Milan 2012
June 2012 Volume 1, Issue 1
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International Association for the Study of Pain® 111 Queen Anne Ave. N., Suite 501 Seattle, WA 98109-4955 USA Telephone: +1 206-283-0311 Fax: +1 206-283-9403 Email: iaspdesk@iasp-pain.org www.iasp-pain.org Newsletter Advisory Board Editor-in-Chief: Beverly Collett (UK) Huda Huijer Abu-Saad (Lebanon) Antoon de Laat (Belgium) Michael Nicholas (Australia) Graciela Rovner (Sweden) Yasuo Sugiura (Japan) Kathy Kreiter Executive Director
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insight
Features How a founder’s vision became IASP.............7 by John Loeser
IASP returns to Italy...........12
Karen Smaalders Director of Marketing, Communications, and Membership Published biannually and distributed by the International Association for the Study of Pain Copyright 2012, International Association for the Study of Pain IASP Insight is published in June and December. Please contact the IASP Secretariat for more information on submissions or email Insight@IASP-pain.org. The International Association for the Study of Pain is a not-for-profit, tax-exempt organization, incorporated in Washington, D.C., in May 1974 (ID no. 237416302). IASP is recognized by the World Health Organization as a Non-Governmental Organization (NGO) affiliate. Timely topics in pain research and treatment have been selected for publication, but the information provided and opinions expressed have not involved any verification of the findings, conclusions, and opinions by IASP®. Thus, opinions expressed in IASP Insight do not necessarily reflect those of the Association or the Officers or Councilors. No responsibility is assumed by the Association for any injury or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instruction, or ideas contained in the material herein. Because of rapid advances in the medical sciences, the publisher recommends independent verification of diagnoses and drug dosages. For permission to reprint articles, please contact IASP.
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Organizing the first IASP Pain Management Camp............16 by Pongparadee Chaudakshetrin
Departments Noteworthy...........................3
Dear Reader, Since the early days of IASP, the Association has always had a printed newsletter. When IASP changed to an e-news format, some of you may have missed the printed version. In addition, so much of what IASP and our membership do cannot easily be shared in short articles. As a result, we decided to launch IASP insight, a biannual news magazine that will feature indepth articles about IASP-related events, history, IASP members involved in research and other activities, and chapter news. This is a trial project that we hope to continue if we receive positive feedback from all of you. Historic changes are about to take place as the IASP office moves to Washington, D.C., after nearly 40 years of residence in Seattle. As there are many new members who may not be that familiar with the history of IASP, the main article of this first issue focuses on the Association’s founder, John J. Bonica, and his vision of IASP. Some of the many old photographs show him at the 1st World Congress of Pain in Florence, Italy, in 1975. These photos also highlight the fact that the IASP will return to Italy in August for the 14th World Congress on Pain. You will get the first impressions of the upcoming meeting in Milan through the summaries by Drs. Troels Jensen and Frank Keefe, who were invited to give the distinguished lectures this year.
Inside insight........................3 IASP reports........................4 Trainee spotlight .................11 Granting relief.....................16 Chapter news....................23
This first issue also has a summary of the very successful IASP Pain Management Camp that was held in Thailand last year, and chapter news from Latin America and the United Kingdom. Two young Bonica scholars, Laura Stone and Lucie Low, are also in the spotlight. I would like to thank Beverly Collett, the editorin-chief of this magazine, and her team, for the enthusiasm with which they have produced this new publication of IASP. I hope you will enjoy it! Looking forward to seeing you all in Milan in August.
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Eija Kalso, MD, DMEdSci President of IASP
Noteworthy
Inside insight
Our first issue! Our new publication, IASP insight, features the efforts of IASP members around the world whose work supports and promotes the IASP mission. The member magazine is under the direction of Editor-in-Chief Beverly Collett, MBBS (UK) and Newsletter Advisory Board members Huda Huijer Abu-Saad, RN, PhD (Lebanon), Antoon de Laat, DentSci (Belgium), Michael Nicholas, PhD (Australia), Graciela Rovner, BSc, MSc (Sweden), and Yasuo Sugiura, MD, PhD (Japan). The magazine will be sent to IASP members twice each year, and is also available to read online at www.iasp-pain.org/Insight. Please send comments, submissions, and queries to Insight@iasp-pain.org.
IASP Past President and founding member John D. Loeser, MD (USA), takes a look back at the origins of IASP in our inaugural issue, exploring how and why founder John J. Bonica started an international, multidisciplinary association to study pain. From the first International Symposium on Pain in 1973 to the Association’s first Congress in 1975, the Association quadrupled in size. The chart below looks at some of the differences between 1975 (the first full year of incorporation) and 2012, as IASP makes plans to return to Italy for the 14th World Congress on Pain in August.
IASP: then and now 1975
2012
IASP offices to relocate The IASP offices will be moving to Washington, D.C., by the end of 2012. In March, the IASP Council approved purchase of an office space on H Street in downtown Washington, D.C. The move from Seattle, Washington, to the East Coast of the United States will diversify IASP’s investments, strengthen its financial standing, and provide a more international setting to help the Association realize its strategic goals. Detailed information about the move will be announced in the December issue of IASP insight.
Honorary Members announced IASP congratulates five new Honorary Members who have made outstanding contributions in the field of pain. Pongparadee Chaudakshetrin, MD (Thailand), Jonathan Dostrovsky, PhD (Canada), Kathleen Foley, MD (USA), Ji-Sheng Han, MD (China), and Olaitan Alice Soyannwo, MBBS, MMed (Nigeria), will be honored on Thursday, August 30, 2012, at the General Assembly of the 14th World Congress on Pain in Milan, Italy.
Mark your calendars! 14th World Congress on Pain.......................August 27-31, 2012 Global Year Against Visceral Pain launch.........October 22, 2012
World Congress 1st World 14th World on Pain Congress on Pain Congress on Pain Location
Florence, Italy
Milan, Italy
Attendance
750+
6,000*
Delegate Countries
23
110*
Membership
1,445
8,000
Dues (regular)
$25 ($105**)
$40 - $200
SIGs
0
19
Chapters
7
88
Programs and Activities
IASP Newsletter, PAIN, Membership Directory
IASP e-Newsletter, PAIN, IASP Press books, Annual Report, Grants and Fellowships, Research Symposium, SIGs, Website, Online Membership Directory, Discussion Forums, IASP insight
Coming soon from IASP Press! Several new books will be published soon by IASP Press. The following new volumes will be available at the Congress: Pain Comorbidities: Understanding and Treating the Complex Patient, edited by Maria Adele Giamberardino and Troels Staehelin Jensen (June 30) The Phenomenon of Pain by Serge Marchand (July 15) Pain 2012: Refresher Courses, 14th World Congress on Pain, edited by Irene Tracey (August 27) Pick up your copy in Milan at the IASP booth or order online at www.iasp-pain.org/Books.
Secretariat Staff 1
17
Headquarters
Washington, D.C.***
*anticipated
Seattle ** adjusted for inflation
***by end of 2012
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IASP reports
Pain education initiatives move ahead
based on the IASP Core Curriculum, were to be (a) feasible for any health science faculty/school, regardless of region; and (b) a baseline/ guide for prelicensure pain content development. Final versions of seven pain curriculum outlines for dentistry, medicine, nursing, occupational therapy, pharmacy, physical therapy, and psychology are now undergoing final approval by Council.
by Judy Watt-Watson and Philip Siddall
The Interprofessional Pain Outline Group completed the first five phases of this project during 2010–2012. This process has included extensive discussion by email of each of the four main components of the Core Curriculum until consensus was reached on foundational pain content that was complete, clear, and relevant to all professions (Phases 1–2). The interprofessional draft has been cross-referenced with the revised uniprofessional drafts to ensure that all common priorities were included (Phase 3). Phase 4 involved considerable discussion by the total Working Group before the draft was circulated to the IASP Education SIG membership for input (Phase 5). Sixty-one responses were received from a variety of countries and a good mix of professions and are being considered by the Education Initiatives Working group. The final draft will be submitted to Council for approval (Phase 6).
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lthough pain education has been identified as a strategy to improve ineffective pain management practices [5], recent evidence supports the continuing lack of pain content in health science curricula, particularly for students in their first professional program (prelicensure/undergraduate/entry-to-practice) [2,4,7]. IASP recognized the need to facilitate educational initiatives through its establishment of the Education Initiatives Working Group in 2010. The Toronto International Pain Education Satellite Symposium accepted in conjunction with the 13th World Congress on Pain was a first; over 90 participants from 12 countries helped to crystallize previous efforts to establish the IASP Pain Education Special Interest Group (Education SIG), approved in Montréal in September 2010. The IASP Education Initiatives Working Group (Chair P. Siddall) met first in London, England, in June 2010 to decide project priorities based on an extensive needs assessment and a previous IASP membership survey of priorities. Work has focused on four projects, including: (a) the Education SIG that has now been established (Chair E. Carr); (b) an Interprofessional Pain Education Outline (Chair J. Watt-Watson); (c) an e-based Pain Resource site (co-Chairs G. Ochoa, M. Pitcher); and (d) establishing an endorsements process (Chair J. Ballantyne). This article describes the work related to the development of the Interprofessional Pain Curriculum Outline.
Member News
Pain curriculum outlines The IASP Education Initiatives Working Group (with 17 members) selected by Council is representative of diverse professions and geographical regions. Prior needs assessments had identified an interprofessional pain curriculum outline as a priority, and subsequent scoping exercises produced few results. Therefore a subgroup was directed to develop an interprofessional pain curriculum outline based on the IASP Core Curriculum. Concurrently, pain experts were asked by Council to revise their profession-specific curricula outlines in an effort coordinated by Watt-Watson. All uni- and interprofessional outlines,
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The Interprofessional Pain Curriculum Outline provides basic pain topics common to all professions but does not replace the uniprofessional curricula that include additional depth in content required by each individual profession and discipline. The outline is to be used with health science students who are in their first professional program to provide shared opportunities to learn together (e.g., dentistry, medicine, nursing, occupational therapy, pharmacy, physical therapy, psychology, and social work). It provides a guide that can be implemented in a variety of ways considering the professions involved and regional needs.
Why an interprofessional curriculum outline? “Interprofessional” is a recent term for a concept that needed to be distinguished from intraprofessional (e.g., within medical departments such as surgery, anesthesia, or neurology). Interprofessional education (IPE) has been defined as two or more professions learning from and about each other to improve collaboration and the quality of patient care [3,8]. Research evidence for IPE supports positive health outcomes for patients and health systems through collaborative teams [8]. For health care professionals to collaborate in meeting patients’ needs, they must understand each other’s roles and expertise. This understanding is the foundation for valuing and respecting others’ contributions to the management of complex problems, such as persistent pain.
Members of the IASP Education Initiatives Working Group met in London to develop a strategic plan.
Interprofessional education fosters this understanding through small groups working together on a project, unlike multiprofessional education, which is usually delivered in a didactic lecture format presented to a large group with minimal interaction. An interprofessional pain curriculum provides a common basis for different professions to learn the same language, to gain a basic understanding of pain mechanisms, and to master major biopsychosocial concepts important to all. Effective pain management can be complex, requiring collaborative approaches that exceed the expertise of any one profession. Collaborative competencies include recognizing and respecting the roles, responsibilities, and competence of others in relation to one’s own, and knowing when, where, and how to involve these other professionals [1]. Interprofessional group opportunities allow students to learn of each other’s expertise, both shared and unique, which is essential to interprofessional and/ or multiprofessional pain management. Working as a team to plan, manage, and monitor care (interprofessional) and communicating/ coordinating care from individual health care professionals (multiprofessional) results in more effective patient outcomes. The recent World Health Organization document [8] on interprofessional education suggests that collaborative practice involves an interprofessional team with multiple health professionals from different backgrounds who can work together with patients, families, caregivers, and communities to deliver the highest quality of care (p. 7). The Interprofessional Pain Curriculum Outline aims to provide interprofessional learning opportunities for students to understand and appreciate the expertise of professions other than their own. Comprehensive pain assessment and management is multidimensional and requires collaboration among health professionals. Interprofessional pain education can be successful when it reflects real world practices and is integrated early in the educational experience [6].
References [1] Barr H, Freeth D, Hammick M, Koppel I, Reeves S. Evaluations of interprofessional education: a United Kingdom review for health and social care. London: United Kingdom Centre for the Advancement of Interprofessional Education with the British Educational Research Association; 2000. [2] Briggs E, Carr ECJ, Whittaker M. Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom. Eur J Pain 2011;15:789–95. [3] Centre for the Advancement of Interprofessional Education. Interprofessional education: a definition. London: United Kingdom Centre for the Advancement of Interprofessional Education (CAIPE); 1997. [4] Mezei L, Murinson B. Pain education in North American medical schools. J Pain 2011;12:1199–208. [5] Sessle B. Incoming president’s address: looking back, looking forward. In: Devor M, Rowbotham MC, Wiesenfeld-Hallin Z, editors. Proceedings of the 9th World Congress on Pain. Seattle: IASP Press; 2000. p. 9-18. [6] Watt-Watson J, Hunter J, Pennefather P, Librach L, Raman-Wilms L, Schreiber M, Stinson J, Dao T, Lax L, Gordon A, Mock D. An integrated undergraduate curriculum, based on IASP curricula, for six health science faculties. Pain 2004;110:140–8. [7] Watt-Watson J, McGillion M, Hunter J, Choiniere M, Clark AJ, Dewar A, Johnston C, Lynch M, Morley-Forster P, Moulin D, Thie N, von Baeyer CL, Webber K. A survey of prelicensure pain curricula in health science faculties in Canadian universities. Pain Res Manag 2009;14:439–44. [8] World Health Organization. World Health Organization framework for action on interprofessional education and collaborative practice. Available at: http://www.who.int/hrh/resources/framework_action/en/. Accessed April 26, 2012.
Philip Siddall, MBBS, PhD (Australia), Chair, is Associate Professor of Pain Education at the University of Sydney in Australia. Judy Watt-Watson, RN, MSc, PhD (Canada), is Professor Emerita at the University of Toronto Lawrence S. Bloomberg Faculty of Nursing and Executive Director of the University’s Centre for Advanced Studies in Professional Practice.
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How a founder’s vision became IASP by John Loeser
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he end of World War II created a burst of energy characterized by the redevelopment of the nations devastated by war and was followed by the growth of a peacetime economy. This led to major changes in the worldview held by scientists and clinicians. Advances in the treatment of diseases, typified by the development of antibiotics, antipsychotics, and many types of other drugs, better anesthesia, and new surgical treatments, produced optimism about the eventual control of many of the diseases afflicting humankind. In the United States, academic medical centers developed, strongly supported by the burgeoning National Institutes of Health. Money poured into new facilities and led to the rapid expansion of research activities. With the dawn of jet airplane travel, a new international community of researchers and clinicians blossomed. Before the days of the Internet, face-to-face meetings were the only basis for this new internationalism. In this heady environment, John J. Bonica, MD, first spread his wings to soar over the world of anesthesia and pain. He developed his international reputation and interpersonal skills as Secretary of the World Federation of Anesthesiologists. He traveled extensively for this organization and believed strongly in its federated status. He knew anesthesiologists from all over the world, facilitated by his ability to converse in Italian, Spanish, and a bit of Portuguese.
Member News
John Bonica welcomes attendees at the 1st World Congress on Pain in Florence while (seated from L-R) Florence Mayor Elio Gabbuggiani, SPC Chair Denise Albe-Fessard, and LAC Chair Paolo Procacci listen.
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The University of Washington School of Medicine (UWSOM) was founded in 1946, admitted its first class the following year, and rapidly expanded its departments and programs in the following decade. The original chairpersons were almost all established academicians from schools in the Eastern United States. Anesthesiology was a division of the Department of Surgery, and the specialty was not held in much repute. By 1960, the UWSOM decided to invest in this new specialty and make it a separate department. After a national search, John J. Bonica was selected to be the founding chair. He had established a private practice group in Tacoma, just south of Seattle and adjacent to Madigan Army Medical Center, where he had served during WWII. In addition to providing operating room anesthesia in Tacoma, Bonica had established a pain clinic, staffed voluntarily by his colleagues. Like most of the other chairpersons of his era at the UWSOM, Bonica was a man of vision and determination to achieve his goals. Within a few years he had built a stellar clinical department, obtained research funding from the National Institutes of Health (NIH), and established a very well-respected residency program. He was carefully following developments not just in anesthesiology, but especially in pain, which was one of his foremost interests. He ascribed his devotion to pain to his experiences as an anesthesiologist with wounded soldiers during WWII and to a life-threatening experience his wife had during childbirth. He recruited to the UWSOM basic scientists and clinicians who shared his desire to improve both research and clinical management in pain. Both in Tacoma and at the UWSOM, Bonica was observed to sleep very little and to have boundless energy. Indeed, he had single-handedly authored his magnum opus, The Management of Pain, while in private practice in Tacoma, by writing several hours each night after he returned Aaron Ganz, Ed Driscall, John Bonica, and from his workday Seymore Kreshover meet at the 1973 at the hospital. International Pain Symposium in Issaquah, U.S. I was a resident in Neurological Surgery at the UWSOM from 1962 to 1967 and attended the pain clinic sessions with one of my attending surgeons, Lowell E. White Jr., who had cofounded the University of Washington Multidisciplinary Pain Clinic with Bonica and Dorothy Crowley, RN, in 1960. After two years in the U.S. Army, I returned to the Department of Neurological Surgery in 1969 and became its neurosurgical representative to the pain clinic. My relationship with Bonica began in this era. I was, to put it succinctly, one of his foot soldiers. Luckily, he was not really my boss; I often counted my blessings in that respect!
The Scientific Program Committee for IASP’s 1st World Congress meets in Paris, France, 1973.
Louisa Jones No discussion of the origins of the IASP can be possible without highlighting this remarkable woman. Louisa Jones was hired by Bonica as his Editor for Research Publications in 1967 and proved to be able to work with him, a trait that was not shared by all of those hired by his department. Her duties were exclusively editorial in the early years of her employment at the UWSOM. She worked behind the scenes on manuscripts and was not a public figure at all. IASP would change all of this! More about Jones will follow later in this narrative.
The beginnings of IASP In 1972, Bonica believed that the time had come to hold an international meeting of pain clinicians and researchers. He discussed this plan with members of the pain clinic, who supported the idea and agreed to help. The Dean of the UWSOM, Robert Van Citters, agreed to sponsor the proposed meeting and provided limited start-up funds. Bonica also solicited funds from drug and device manufacturers, and the NIH (National Institute of General Medical Sciences, National Institute of Dental Research, and National Institute of Arthritis and Musculoskeletal and Skin Diseases). These monies made it possible to rent a meeting site and provide room and board for the invitees. Bonica called upon colleagues both at the UWSOM and throughout the world to help him select the invitees. Informal meetings of pain clinic faculty were held to discuss potential invitees and suggest people whom Bonica might not know because of their specialties or research activities. For example, I was responsible for identifying appropriate neurosurgeons, and Bill Fordyce located psychologists. Bonica obviously had a sense for what was happening in the scientific and practicing communities, for almost everyone he invited chose to attend. As the meeting was being put together by Seattle people, it was obvious that it had to be held in our area. Bonica wanted to structure the meeting so that there was time for informal interactions as well as formal lectures and workshops. He worried that there were too many distractions in Seattle itself, and hit upon the brilliant idea of holding the meeting in a former nunnery that had been converted to an educational center about half an hour east of Seattle. This lovely site, Providence Heights, had no access to public transportation, and taxis were costly, as participants realized when they
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How a founder’s vision became IASP came there from the airport. Most of the attendees were at Providence Heights 24 hours each day. Many new relationships were created by the close and closed environment of the meeting site.
The First International Symposium on Pain This fabulous five-and-a-half-day event was held May 21–26, 1973, in Issaquah, Washington. There were 339 attendees, of whom 102 delivered presentations. Another 237 delegates came to listen and have informal discussions with the presenters. There were 75 participants from the UWSOM. In total, 70% of those present were from outside the Seattle area. Clinicians and researchers from 13 countries were in attendance. Bonica had already arranged to publish the proceedings with a small New York City scientific firm, Raven Press, and their Acquisitions Editor, Virginia Martin, was also present. The meeting started with breakfast and ended with after dinner symposia each evening. The first three days were devoted to basic and clinical science; the last two and a half days focused on diagnosis and therapy of pain. Discussions were held after each topical session; the highlights were included in the proceedings volume. It was a thrilling yet exhausting experience, which served as the nexus for relationships that crossed disciplinary and geographic barriers. Of course, the Melzack-Wall Gate Theory had been published eight years earlier, and both Ron Melzack and Pat Wall were in attendance and constantly engaged in debates. Melzack showed a movie of an African doctor trepanning the skull of a headache sufferer with a sharp rock. An attendee at the meeting was so stressed by the blood and gore that he fainted and fell from his bench onto the floor. That was when the world of pain realized for the first time the value of having a neurosurgeon in the audience! I remember well the excitement of being among famous researchers and clinicians who were actually willing to talk with younger, unknown attendees. Many of the friendships that I made at that meeting have persisted for almost 40 years, due to our shared interests in the abolition of pain and the pursuit of pleasure.
before we met again. Bonica would edit the proceedings book to be published by Raven Press. Denise Albe-Fessard agreed to be the Scientific Program Committee Chairperson for the Florence meeting, and Paolo Procacci was the Local Arrangements Committee Chair. Everyone who participated in the meeting recognized that the newlyfounded Association was John Bonica’s baby. All that was left after Issaquah was to make it all happen, and that is largely a Louisa Jones story. In the final paragraph of his preface to the symposium volume, Bonica expressed his “very special thanks and utmost appreciation” to Jones for “efficiently carrying out literally the hundreds of details and procedures inherent in planning, coordinating and running such a large meeting.” All of the attendees agreed with his assessment! Jones tells the story of going to Bonica’s office after the Issaquah meeting and asking him what was to happen to enable the growth and development of the proposed International Association for the Study of Pain. He replied: “You handle it.” And thus our Association was put into good hands, and it flourished, to no small degree because of her skills and devotion to our cause. Bonica continued to pay her salary from Department of Anesthesiology funds, although she devoted increasing amounts of her time to launching IASP. Membership records had to be established, the agreed-upon initial dues of $25 per year had to be collected and recorded, the proceedings book edited, plans for the 1975 First World Congress of Pain developed and implemented, governance of the Association established, and the journal, Pain, launched. Jones had a hand in every one of these activities, and every one of them was successful.
Member News
At the end of the meeting, Bonica moderated a session to discuss plans for the future. It was generally agreed that the International Symposium on Pain had been a great success; there was unanimous approval to move ahead with the founding of an international multidisciplinary research John Bonica greets Basil Finer in the Palazzo Dei Congressi, 1975. and clinical association. Bonica agreed to work on the mechanics for this project. Wall agreed to be the editor of a new journal, Pain. The group To govern the Association before it was established legally, Bonica agreed to have the first meeting of the International Association for formed a Council Pro Tem made up of Bonica, Fink, Ward, Patton, the Study of Pain in Florence, Italy, in September 1975. Participants Loeser from the UWSOM, and Wall. The five Seattleites met a few volunteered for the many, many tasks that had to be accomplished times, conducted business mainly by telephone, but got the Association
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The 1977 Council meeting launched. Formal incorporation occurred in was held in Igls, Austria, near May 1974 in Washington, D.C. The bylaws Innsbruck. This was the first of the World Federation of Anesthesiologists of many subsequent Council were used as a model for the proposed meetings to be held in conjunction IASP bylaws. A contract with Elsevier was with a national chapter meeting, finalized to publish the journal, Pain, with a plan that facilitated the Wall as editor-in-chief, and the first issue development of our chapters and was published in January 1975. By the end provided an opportunity for Council of 1974, we had 652 members from 42 and local members to interact. countries. This doubling of the number of By the time of this meeting, IASP attendees at the Issaquah meeting indicated had developed to the point that the interest in pain throughout the international we could afford to pay Jones and medical and research community. We were her support staff and were not concerned about how to grow IASP at the as dependent upon the largesse time that many national chapters were being John Bonica (left), and his wife Emma Bonica (far right) enjoy the of Bonica and the University of formed, as we did not wish to lose control 1975 Congress reception with delegates from South America. Washington. We implemented over the organization by having it balkanized. a plan to permit membership from currency-controlled countries, an We agreed that the focus of our efforts should be on IASP itself and not on important step in gaining members from behind the Iron Curtain and in national chapters until we had built a strong organization. There was little the developing world. Excitement was growing about the Second World question that IASP was John Bonica’s organization in these early days. Congress that was to be held in Montreal in 1978. Indeed, we worried The Council Pro Tem served until the First World Congress on Pain was that the number of registrants would exceed the capacity of the meeting held in Florence, Italy, September 5–8, 1975. site and available hotels! For the attendees at that Council meeting, Igls was a spectacular site. Procacci took many of us on a tour of the town The success of Bonica’s plan to have an international and and determined the date of construction of the buildings by the type of interdisciplinary society devoted to the study of pain and its treatment shutters on their windows; as each house had a small sign with its date of was proven by the First World Congress on Pain. Eight hundred construction, his accuracy was astounding. Many of us went hiking in the registrants heard 265 presentations. Albe-Fessard and her colleagues Alps. It was there that my wife and I got to know Bill and Cox Noordenbos; had met twice in the interval to construct a solid program for the we spent a few extra days with them in Innsbruck and we were taught Congress. Procacci chaired the Local Arrangements Committee, and how to drink our single malt Scotch “neat”—the only proper way according the social events were superb. The opening reception was in Palazzo to Bill, who had received his medical training in Edinburgh. He was a great Vecchio and seemed to many of us to be a reincarnation of the times man, an original thinker, a lovable person in every way. IASP brought me of the Medici. Florence was a magnificent meeting site and a wonderful into contact with many like him, but none better. symbol of what IASP could aspire to in the coming years. Many superb lectures were a real highlight, as the breadth of the pain world was demonstrated by both scientists and clinicians. Of course, the major items of business were the approval of the bylaws and the election of the first IASP Council. Albe-Fessard was elected as President, and Bonica as President-elect. Seven regional vice-presidents, 14 Councilors, a Secretary (Raymond Fink), and a Treasurer (Louisa Jones) were also elected. The idea of regional vice-presidents was later abandoned, as it was not a workable concept. It was decided that Council would meet annually, and the first Council meeting was scheduled for Milan in 1976. Policies were established to foster the growth of the Association: recruiting members, supporting the journal Pain and other publications for members, and financial prudence, including paying only for tourist fares for councilors to attend meetings and trying to keep the administrative costs as low as possible. This proved to be another of The Palazzo Vecchio housed the Welcome Reception for the 1975 Congress. Jones’s areas of brilliance, as the costs of running IASP were remarkably low during her entire tenure, even though the services to members We next gathered together in Montreal in 1978 for the Second World and support of all of our activities were first class. Having our own Congress on Pain. Over 1,100 attendees benefited from the work of the administrative support team and not hiring professional management Scientific Program Committee, chaired by John Liebeskind, and the Local served us well under her leadership.
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The fourth Congress was supposed to be in Mexico, but events in that country made it impossible to plan for our large multinational group; therefore, the fourth Congress was held in Seattle. This was a real homecoming celebration for those of us based in Seattle who had worked so hard to get the Association launched. The weather for the entire week in September was fabulous, and the Congress was a great success in all respects. A special lecture in honor of Bonica was established. By that time IASP had 2,500 members, reasonable financial reserves, and a cadre of researchers and clinicians who were devoted to the Association. Jones and two assistants accomplished all of the support work.
John Bonica addresses the delegates at the 1981 Edinburgh Congress.
Arrangements Committee, chaired by Melzack. For the first time, we had poster sessions and breakfast sessions; both were very popular. We introduced the first honorary members to the members. This tradition has been carried forward to the present date and permits the Association to recognize those who have made a special contribution to our organization and to the world of pain. Several important committees had become operative by this time: perhaps none more important than the Subcommittee on Taxonomy, chaired by Harold Merskey. This group generated the definitions and taxonomy that brought stability to pain research and diagnosis. Manfred Zimmerman chaired the Committee on Research that soon thereafter published Guidelines on Ethical Standards for Pain Research on Animals, another important product of IASP. By the end of this year, our membership reached 1550, we completely funded our administrative activities, and Pain was widely recognized as the premier journal in our field, thanks to Wall’s editorial leadership and our members’ willingness to submit their work to our journal. At the General Assembly, Bonica became President, Ainsley Iggo was elected President-elect, and Albe-Fessard became Past President. The Third World Congress on Pain was held in Edinburgh in 1981 with Ulf Lindblom as the Scientific Program Committee chair and Iggo as the Local Arrangements chair. The venue was the University of Edinburgh; the 1,665 attendees were housed all around the city, and university housing was obtained for those with limited budgets. The program of providing financial assistance for attendees who needed help to come to the meeting was initiated and subsequently significantly expanded. At this meeting, Melzack was chosen to be President-elect. IASP had grown rapidly, had a presence throughout the world, and was rapidly developing new educational and scientific publications and projects.
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The efforts of many, many people made IASP a success from its earliest days. Certainly the key figures were Bonica and Jones at the start, and both remained important in the Association until their retirement years later. We became a group of friends who shared a mission. Some worked hardest for the establishment of their regional or national chapter. Others devoted most of their time to IASP itself. Others undertook arduous research to develop our knowledge base. The list is long, so I cannot possibly give everyone the credit that they deserve. In my mind the early IASP standouts were, in addition to Bonica and Jones, Harold Merskey, Ron Melzack, Pat Wall, Ron Dubner, Howard Fields, Jean-Marie Besson, Paolo Procacci, Fausto Molina, Denise Albe-Fessard, Bill Noordenbos, Kathy Foley, John Liebeskind, Ulf Lindblom, Manfred Zimmerman, and Sir Michael Bond. What a wonderful experience it was to work with these great people as well as the many others who contributed to the success of the International Association for the Study of Pain. Without authorization to do so, I speak for all of them: We did it!
Additional resources Bond, MR, Dubner R, Jones LE, Meldrum MI. The history of the IASP: progress in pain since 1975. In: Merskey H, Loeser JD, Dubner R, editors. The paths of pain. Seattle: IASP Press; 2005. Bonica JJ, editor. Advances in neurology, Vol. 4. New York: Raven Press; 1974. p. vii–x. Jones L. First steps: the early years of IASP, 1973–1984. Seattle: IASP Press; 2010. The John C. Liebeskind History of Pain Collection at the Louise M. Darling Biomedical Library, University of California, Los Angeles (minutes of IASP Council meetings and papers of John J. Bonica)
John D. Loeser, MD, is Professor Emeritus at the Departments of Neurological Surgery and Anesthesia and Pain Medicine, University of Washington, Seattle, USA. He is a founding member of IASP and served as President from 1993 to 1996.
Trainee spotlight
Bonica scholars Each year, IASP awards the John J. Bonica Trainee Fellowship to an exceptional trainee in the early stages of his or her career who is interested in pursuing either clinical or basic science research in the field of pain. IASP’s first Bonica scholar, Laura Stone (above) and one of the most recent recipients, Lucie Low (below), now both researchers at McGill University, Canada, share their stories.
Laura Stone, PhD
Lucie Low, PhD
n 1998 I had the honor of being the first recipient of the John J. Bonica Trainee Fellowship. Dr. Bonica was a pioneer in the interdisciplinary approach to pain management and founder of the International Association for the Study of Pain.
was lucky enough to be awarded the John J. Bonica Trainee Fellowship in 2008, when I was in my final year at University College London, UK. The fellowship has made quite a difference to my professional life and enabled me to move to Canada and experience life in vibrant, exciting Montréal!
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Consistent with Dr. Bonica’s interdisciplinary philosophy, the fellowship allows trainees to pursue training outside of their institutions and outside of their primary field of research. Prior to applying for the fellowship, my graduate research was focused on using behavioral and immunohistochemical methods to investigate interactions between opioids and other classes of analgesic drugs. Encouraged by my PhD mentors Drs. George Wilcox and Robert Elde, I pursued the opportunity to study electrophysiology at the Vollum Institute in Portland, Oregon, USA, as part of a joint appointment in the laboratories of Drs. Ed McCleskey and John Williams. With the support of the Bonica fellowship, I was able to expand my research expertise through the acquisition of new techniques, my knowledge base through exposure to new ideas, and my professional skills through relationships with new colleagues and collaborators. In my current position in the Faculty of Dentistry and the Alan Edwards Centre for Research on Pain at McGill University, in Montréal, Canada, my research interests have expanded from a primary emphasis on neuropharmacology to include translational research on low back pain. Our current studies utilize both human subjects and animal models and incorporate diverse methods ranging from brain imaging to epigenetic analysis. As a mentor, I strongly support interdisciplinary approaches and encourage trainees to expand their own expertise through outside collaborations. The John J. Bonica Training Fellowship helped me to develop the skills and perspective necessary to conduct interdisciplinary pain research. I am grateful to have benefited from this unique opportunity.
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Since arriving here at McGill University to work with Catherine M. Bushnell, PhD, I have learned a huge amount. My project explores the possible neuroprotective effects of environmental enrichment on the long-term effects of chronic neuropathic pain. We have planned a longitudinal study using animal pain models and will be monitoring pain-related changes in behavior (both sensory and cognitive) and in the brain (using MRI). We think environmental enrichment might be a useful animal model of the biopsychosocial interventions that can help human chronic pain patients, and the results from the animal studies could help inform the clinical treatment of patients in the future. We hope to start seeing some exciting results within the next few months. I was lucky enough to be in Montréal at the time of the 13th World Congress on Pain. This is always a fun, busy, and fascinating week, and attending with all my new friends and colleagues from Montréal, as well as introducing friends and colleagues from the UK to the city, felt really special. The highlight of the week was the Trainees’ Reception from the club on the roof of the tallest building in Montréal – I was very proud to be able to call this my new hometown. For my career, this award has been invaluable. I’ve been learning new techniques and skills, and increasing my depth of knowledge in techniques I already knew. I’ve also improved upon those crucial “soft skills’” such as project and time management. It felt like a real vote of faith from IASP to receive the John J. Bonica Trainee Fellowship, and I gratefully thank IASP for its support. I hope to live up to the reputation of the fellowship’s namesake.
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14th World Congress on Pain®
IASP returns to Italy
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hirty-seven years after the 1st World Congress on Pain in Florence, IASP returns to northern Italy this summer for the 14th World Congress on Pain in Milan. Many times larger than the initial gathering of 750 attendees in 1975, today’s Congress remains the leading pain-related conference covering all aspects of pain research and pain management. Instrumental to the success of the Milan Congress are the Scientific Program Committee, chaired by Irene Tracey, PhD (UK), and the Local Arrangements Committee (LAC), chaired by Paolo Marchettini, MD (Italy). The anticipated 6,000 attendees of this year’s Congress will see the result of these committees’ hard work as they take part in five stimulating days of activities, including 15 plenary lectures, 70 topical workshops featuring three to four speakers each, a busy exhibition hall with dozens of exhibitors and 2,000 poster presentations, and social events featuring the best in Italian hospitality and entertainment. Those who come early may also choose among 19 refresher courses on Monday, August 27, one of 16 Special Interest Group (SIG)-sponsored Satellite Symposia on Sunday, August 26, or a variety of membersponsored symposia prior to the Congress. IASP will offer a total of 18 Continuing Medical Education (CME) credits for plenaries and workshops, and up to seven additional CME credits for the optional refresher courses. In addition, CME credits may be available for symposia depending on the sponsor.
August 27-31, 2012 From the first gathering onward, the wide range of plenary and workshop topics at the World Congress on Pain has reflected the multidisciplinary interests of IASP’s membership, thanks to the vision of IASP founder John J. Bonica. One journalist covering the 1975 Congress praised the unexpectedly large attendance (nearly double what organizers expected) and the many facets of chronic pain discussed by professionals from various disciplines, from anesthesiology and neuroscience to psychology and dentistry. Lecture and presentation topics from the first Congress included central pain pathways, pain measurement, peripheral blocks and pain control, spinal cord mechanisms, acupuncture, hypnosis, sociologic aspects of pain, narcotic analgesics, cancer pain, psychological factors in pain, and central nervous system stimulation. Today’s Congress offerings are just as diverse, with plenaries on such topics as neuropathic pain, psychosocial interventions for managing pain in older adults, brain imaging of pain, cancer pain, complex persistent pain conditions, migraine headache and light, and stress and visceral pain. Delegates from 23 countries came to Florence in 1975, and today networking with colleagues from around the world continues to be a Congress highlight. The Welcome Reception on Monday evening, from 17:00 to 19:00 in the South Hall of the Milano Convention Centre, marks the official opening of the Congress. The LAC plans to highlight the entertainment and cuisine of the different regions of Italy, with a focus on the northern, central and southern areas of the nation.
1975 Welcome Reception, Palazzo Vecchio
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Milano Convention Centre
Trainees will have a unique opportunity to network with a handful of distinguished pain mentors during the Trainee Networking Reception, while enjoying some of Italy’s culture and hospitality. This year’s reception takes place at the famous La Triennale di Milano, a showcase for modern decorative and industrial arts, allowing attendees to tour the museum’s newest galleries for this trainee-only event. IASP worked with its local meetings partner to develop a series of optional tours designed for spouses and other accompanying guests. All registered accompanying guests will receive a ticket for Milan’s Hop On Hop Off City Bus Tour, good for at least two days. Guests may also purchase tickets for a series of other sight-seeing tours, bringing them to places such as Lake Como, Bergamo, the Last Supper, Sforza Castle, and La Scala.
Piazza Del Duomo
Arco della Pace
While the accompanying guests are enjoying the sights of Milan and the Lombardy region, Congress delegates may focus on this year’s remarkable scientific program. Each day, the Congress will start with Plenary Sessions highlighting several themes for each day. For example, the lecture by Patrick Mantyh, PhD (US), “Cancer Pain: From Mechanism to Therapy,” will kick off the Congress on Tuesday morning. Later in the day, several posters and topical workshops will be featured on the same topic. Themes include such topics as opioids, genetics of pain, and psychosocial interventions (Wednesday), neuropathic pain, brain imaging, and visceral pain (Thursday), and headache, glia and pain, and pain treatments (Friday). Registrants may plan out their day using the online itinerary planner, which helps organize attendees’ choices among the many plenary sessions, poster discussions, and topical workshops. To view this year’s program, register for the Congress, or plan your Congress itinerary, visit www.iasp-pain.org/Milan.
Galleria Vittorio Emanuele II
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14th World Congress on Pain®
Distinguished lectures highlight Congress awards In 1984, IASP created the John J. Bonica Distinguished Lecture Award named in honor of the founder of IASP. Presented to an IASP member who has made a major contribution to pain research or pain therapy, this year’s lecture will be delivered by Troels S. Jensen, MD, DMSc (Demark). In 2005, the IASP Council created the John D. Loeser Distinguished Lecture Award, named after the founding member for his many decades of dedication to the promotion of pain education and research. The award, bestowed this year on Frank Keefe, PhD (USA), recognizes work that gives new perspectives to understanding the experiences of pain and opens the door to future reductions in suffering. IASP’s President selects both distinguished lecture award winners.
Neuropathic Pain: Is It an Entity? by Troels S. Jensen
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ince the days of the Swedish biolologist and physician Carl von Linné, scientists have had a passion for systematic classification in an attempt to understand the chaotic nature surrounding us. This desire to group phenomena in nature is also shared by the medical community, including those interested in pain. Differences in how somatosensory information is processed in experimental nerve injury and in inflamed tissue as suggested by basic scientists has been adopted by clinicians who tend to classify their patients as having neuropathic or inflammatory types of pain, and those pains that do not have such features are called idiopathic. The lack of a gold standard for what is and what is not neuropathic pain raises the question whether such a jump from basic science to the clinic is justified. The risk of classifying subjective phenomena such as pain is that we may force patients into a spin of academic terms, which neither reflect the underlying pain-generating mechanisms nor guide the management of pain. Neuropathic pain is a term used by scientists and clinicians—but not by patients—to describe and categorize pain conditions caused either by lesions or by diseases of the normal somatosensory system. Neuropathic pains represent a series of heterogeneous conditions, which neither share a specific anatomical location nor a specific cause. Lesions may be anywhere from the peripheral receptor to the cerebral cortex, and the underlying disease may vary from mechanical constriction of nerves to stroke lesions disrupting the somatosensory system. With such diversity in presentation is it then permissible to talk about neuropathic pain as an entity? The immediate answer is: Probably not. There is no such entity as a single disease called neuropathic pain. It is a spectrum of disorders that apparently share common features,
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which may qualify them to be grouped. But in order to be meaningful such a grouping of disorders should reflect a certain pathophysiology, symptomatology, clinical presentation, treatment, or prognosis, which distinguishes them from other types of pain. A mechanism-based classification of pain disorders has been a mantra for the last two decades, but we are still awaiting its implementation. A major obstacle for a mechanism-based classification is that we only have a vague idea about how neuropathic symptoms translate into mechanisms and vice versa. Currently the clinician in the evaluation of patients suspected of having neuropathic pains are faced with the dilemmas that patients report symptoms, not mechanisms, and in the individual patient several symptoms may be present, each caused by separate mechanisms. Moreover, one mechanism can cause different symptoms. John J. Bonica— the eminent clinician he was—insisted on always listening to the patient and studying his or her pain before making any assumptions about underlying mechanisms. The current interest in associating subjective symptoms and soft neurological signs in painful and non-painful nervous system diseases and disorders with structural, molecular, genetic, and functional biomarkers may represent a new way to understand how pain is generated. This may eventually get us to a point where we can treat the individual patient because we now understand the mechanism for his or her pain. Troels S. Jensen, MD, DMSc, is a professor of neurology and Director of the Danish Pain Research Center at Aarhus University Hospital, Denmark. He was a former President of IASP.
Psychosocial Interventions for Managing Pain in Older Adults: Outcomes and Implications for Clinical Practice by Francis (Frank) Keefe ith heightened recognition of the importance of assessing pain in older adults has come growing interest in novel approaches to managing pain in older adults. This presentation highlights recent clinical and research efforts focused on psychosocial approaches to managing pain in older adults suffering from persistent pain. The presentation is divided into three parts.
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In the first part, a rationale is provided for utilizing psychosocial interventions with older adults. A biopsychosocial model for understanding pain and pain behavior in older adults will be presented. This model acknowledges and highlights the role that biomedical variables can play in the pain experience (e.g., variables such as extreme frailty, sensory problems, cognitive impairments, comorbid medical and comorbid pain problems). The model also highlights the important of psychological variables (e.g., depression, personality, coping, self-efficacy, and pain acceptance) and how they are influenced by and in turn influence biomedical variables. Finally, the model underscores the role that socio-environmental variables (e.g.,
social support, pain communication, as well as critical, solicitous, and supportive partner/caregiver responses to pain) play in shaping pain and pain-related behaviors in older adults. In the second part of the presentation, a number of psychosocial protocols currently being used in managing pain in older adults will be described. The protocols to be reviewed include cognitive-behavior therapy protocols (e.g., systematic training in pain coping skills), emotional disclosure protocols (e.g., privately writing about difficult and stressful talks that one has not shared with others), acceptance based protocols (e.g., mindfulness-based stress reduction and yoga-based interventions), and couples-based approaches (such as partner-assisted training in pain coping skills and couples interventions where the focus is on couples communication and problem solving efforts). These protocols will be critically analyzed. For each protocol, this analysis will include a consideration of outcome data emerging from controlled treatment outcome studies, a discussion of protocol strengths and limitations, and a review of key issues for future clinical and research efforts. Part three of the presentation identifies new opportunities for psychosocial pain management interventions in older adults. The rationale, treatment
approaches, and results of recent studies focusing on psychosocial approaches for treating older adults who have pain and comorbid conditions (e.g., obesity, depression) will be described and critically reviewed. These recent studies underscore the potential benefits of multicomponent interventions (e.g., combining pain coping skills training with lifestyle behavioral weight management for obese patients with osteoarthritic knee pain) in managing pain that occurs in the context of comorbid conditions. In addition, new technologies for enhancing the dissemination of psychosocial interventions (web-based and telephone interactive voice response methods) will be discussed. Although it is generally assumed that older adults are wary and resistant to the use of newer technologies for delivering psychosocial intervention, recent research has questioned this assumption. We will consider ways that technology-based psychosocial interventions can be tailored to meet the preferences of older adults. Finally, novel ways to integrate psychosocial interventions into the health care systems in which most persons with persistent pain are treated will be described. Francis (Frank) Keefe, PhD, is professor of psychology and neuroscience at Duke University, U.S.
Award
Topic/field of work
Winner
Presentation of award
John J. Bonica Distinguished Lecture
“Neuropathic Pain: Is it an Entity?”
Troels Staehelin Jensen, MD, DMSc (Denmark)
8:30 Thursday, August 30, 2012 Gold Room
John D. Loeser Distinguished Lecture
“Psychosocial Interventions for Managing Pain in Older Adults: Outcomes and Implications for Clinical Practice”
Francis (Frank) Keefe, PhD (USA)
14:00 Wednesday, August 29, 2012 Gold Room
Ronald Melzack Lecture
“Brain Imaging of Pain”
Luis Garcia-Larrea, MD, PhD (France)
14:00 Thursday, August 30, 2012 Gold Room
Ronald Dubner Research Prize
Discovering brain mechanisms of acute and chronic pain
David Seminowicz, PhD (USA)
8:30 Tuesday, August 28, 2012 Gold Room
Award for Excellence in Developing Countries for Basic Science
Pain pathophysiology, descending pain modulation, central and peripheral actions of opioid and NSAIDS, tolerance to analgesics, neuropathic pain, cancer-induced pain, pain and analgesia
Victor Tortorici, PhD (Venezuela)
14:00 Tuesday, August 28, 2012 Gold Room
Award for Excellence in Developing Countries for Clinical Science
Cancer pain management and palliative care, onco-anaesthesia
Sushma Bhatnagar, MD (India)
14:00 Thursday, August 30, 2012 Gold Room
Ulf Lindblom Young Investigator Award for Clinical Science
Biopsychosocial models to improve prevention and treatment of chronic musculoskeletal pain
Steven George, PT, PhD (USA)
8:30 Wednesday, August 29, 2012 Gold Room
Patrick Wall Young Investigator Award for Basic Science
Functional significance of the brain responses triggered by sudden and intense sensory stimuli in humans
Giandomenico Iannetti, MD, PhD (UK)
8:30 Friday, August 31, 2012 Gold Room
Philip A. Spiegel IASP Congress Trainee Scholarship
Neuroscience, specifically addressing the molecular mechanisms of neuropathic pain
Dina Juarez-Salinas, BS, PhD student at University of California, San Francisco (USA)
8:30 Tuesday, August 28, 2012 Gold Room
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Granting relief
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groundbreaking mirror therapy training project, introduced in Vietnam in December 2011 as a collaboration between Beth Darnall, PhD, of Oregon Health and Science University (USA) and Moira Judith Mann, co-founder of the End the Pain Project (ETPP), expanded to Cambodia this year. Joining forces with Do Than Huy, MSC, MA, Chief of Anesthesiology, Can Tho University, and Tuan Ahn Nguyen, MMed, of University Medical Center in Ho Chi Minh City, Darnall and Mann secured funding from the IASP under the Initiative for Improving Pain Education in Developing Countries. The IASP grant funded mirror therapy training to physicians, trauma workers, physical therapists, prosthetists, and allied health professionals in Vietnam.
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Bouth Vorn lost his leg while farming in Cambodia.
Moira Judith Mann photo
The need for phantom pain care is great in Vietnam, the country with the highest prevalence of amputation, primarily due to ongoing land mine disasters and motorbike accidents. Pain care is also severely limited in Vietnam due to limited resources. As such, mirror therapy offers an inexpensive and accessible solution to phantom pain experienced by 80 percent of amputees. Simple, non-invasive mirror therapy procedures can be taught to amputees in just 30 minutes by a trained professional, so that home self-treatment is possible at little or no cost.
photo
Vietnam
Participants received mirror therapy research and clinical didactics delivered by Darnall in a PowerPoint presentation and training manuals. Mann and Darnall conducted demonstrations with volunteer amputees as part of the three-hour workshops. Workshop content also encompassed discussion of potential complications and contraindications for mirror an from Hien Nguyen Xu k cover. oc bl ra therapy with an emphasis Fa a es tri Vietnam on connecting patients with proper referral and support. Support included supplementary tools for managing phantom limb pain such as the HeathSaaS internet portal for health care professionals and/or patients to enter the results of their mirror therapy and Farabloc, an electromagnetic fieldblocking material for use where mirror therapy cannot be of aid. Chantel Gorton
by Moira Judith Mann
Moira Judith Mann photo
Vietnam mirror therapy project expands to Cambodia
Under the IASP initiative, three mirror therapy training and certification workshops were delivered in cities spanning the length of Vietnam: Can Tho, co-sponsored by the International Obstetrics Hospital, Phuong Chau; Dong Ha, co-sponsored by the Quang Tri Department of Health; and Hanoi, co-sponsored by the Vietnamese Training Center for Orthopedic Technologists (VIETCOT). Travel costs for participants were paid by the IASP grant.
Song Sit instructs a physiotherapist in mirror therapy movements.
Vietnam outcomes One hundred and six workshop participants received certificates of completion. Participant satisfaction ratings for the workshops were high (94%). T-test analyses showed a significantly greater likelihood to use mirror therapy with future patients. Accredited VIETCOT foreign student participants will spread mirror therapy training to such countries as Bangladesh and Khajikistan. Dong Ha volunteer land mine victim, Thiet Nguyen Xuan, was aided by mirror therapy for fingers blown off and by continuous use of Farabloc for pain in his missing feet.
Cambodia
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ann continued on to Phnom Penh, meeting with two members of the staff of Veterans International Cambodia (VIC), Sit Song, Physical Therapy Clinical Mentor, and Tokyo Bak, Country Representative. She scheduled a series of mirror therapy workshops for staff of VIC rehabilitation clinics in Kuen Khleang on the outskirts of Phnom Penh, Kratie, and Prey Veng over a ten-day period, along with a workshop for the Physiotherapist Department of Calmette Hospital, Phnom Penh. Once accredited, these Cambodian professionals could then provide training for other trainers and direct mirror therapy for landmine victims and other amputees who suffered phantom limb pain. Freeing these amputees of phantom limb pain dovetails with VIC’s goal for amputees to lead active and productive fulfilling lives.
assisted movements. After 20 minutes of concentrating on the mirror image of his intact leg, Barang reported that he no longer felt an itch in the sole of his phantom foot. Song explained the schedule for selfadministered mirror therapy and gave Barang a graphic sheet with brief instructions in Khmer to follow for thirty days in addition to the loan of an unbreakable leg mirror. In the second half of the workshop, the physiotherapists and prosthetists set up individual table-top mirrors, and as they went through simple motion exercises, they experienced sensations produced by concentrating on mirror images of their arms and hands. This exercise reinforces the practitioner’s ability to empathize with the process so as to effectively guide the amputee through the movements routine in front of the mirror. Thirty-six Cambodian physiotherapists and prosthetists who participated in the workshops received Certificates of Completion. After the Prey Veng workshop ended, health care workers visited the rural home of Bouth Vorn, a 53-year-old who had stepped on a land mine while farming seven years ago, losing a leg above the knee. At least two times a week he experienced disrupted sleep from severe tingling pain in his phantom large toe that spread to his stump. Vorn was skeptical about the value of mirror therapy, but agreed to try the technique. Guided by Song, it did not take long before he reported the tingling pain he was feeling in his phantom big toe had receded. He continues the therapy at home with telephone supervision.
Cambodia outcomes On a previous visit to Cambodia in 2009 for ETPP, Mann conducted a mirror therapy workshop with VIC physiotherapists. As part of its mandate, ETPP supplied VIC with portable table-top mirrors for upperarm therapy and unbreakable plastic mirrors suitable for lower-limb therapy in 2010. The first part of the workshops involved volunteer amputees with phantom limb pain. At the Prey Veng Clinic, Khuonh Barang, a young man who lost his leg above the knee six months ago in a road accident, was guided through a mirror therapy session. Phantom pain manifested in the toes and sole of his missing foot. Song, pre-trained in 2009, instructed the gathered physiotherapists in initial
Thirty-six accredited physiotherapists will extend their knowledge of mirror therapy to other Cambodia physiotherapists as part of their clinic routines. At the 12th Physical Therapy National Congress of Cambodia in December 2012, to be attended by approximately 100 physiotherapists, Song, as a Congress Organizer, will focus on mirror therapy in clinical presentations. Six volunteer amputees experienced some reduction of phantom pain during the demonstrations. Moira Judith Mann, an independent documentary producer and photographer, is cofounder of End the Pain Project, dedicated to global reduction of phantom limb suffering for amputees.
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Organizing the first
IASP Pain Management Camp
by Pongparadee Chaudakshetrin With the goals of improving Southeast Asian clinicians’ knowledge of pain management, fostering collaboration among local pain practitioners, and raising the level of care for Asian pain patients, IASP members organized a highly successful IASP Pain Management Camp in Thailand in May 2011. Pongparadee Chaudakshetrin tells the story of developing an educational camp that enriched the knowledge and experience of 28 clinicians from 13 Southeast Asian countries.
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his pilot pain education project received support from IASP as well as the Association of South-East Asian Pain Societies (ASEAPS), Thai Association for the Study of Pain (TASP), and Mahidol University, Thailand. The idea to organize a pain camp arose two years earlier in ASEAPs’ biennial scientific congress in Bali, Indonesia. Participants attending the IASP reception from Laos, Myanmar, Vietnam, Bhutan, Mongolia, and Cambodia expressed a common goal to address their countries’ unmet needs in pain management. Inspired by the European Pain School held annually in Siena, Italy, the group decided that ASEAPS should organize a “summer school” with intensive pain management training in conjunction with its 2011 scientific meeting in Bangkok. A task force led by Immediate Past President of ASEAPS and IASP Council Member Cynthia Goh, MBBS, PhD (Singapore), and IASP Liaison for Southeast Asia Troels S. Jensen, MD, PhD (Denmark), worked on the concept for this “summer school” which, if successful, would be held not only in Asia, but in other parts of the developing world, including Africa and South America. The task force decided to link the school to the congress planned for the region so that participants and faculties could join the congress as delegates and speakers.
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IASP Pain Management Camp May 1-5, 2011 Thailand Objectives To improve knowledge of pain mechanisms, diagnosis, and management in Asian countries. To enhance pain infrastructure and collaboration in the Asian countries. Course directors Cynthia Goh, MBBS, PhD (Singapore) Pongparadee Chaudakshetrin, MD, FFPMANZCA (Thailand) IASP faculty Allen Finley, MD, FRCPC, FAAP (Canada) Troels Staehelin Jensen, MD, PhD (Denmark) Eija Kalso, MD, DMedSci (Finland) Michael R. Bond, MD, PhD (UK) Anthony Dickenson, PhD (UK) Regional faculty Andi Husni Tanra, MD, PhD (Indonesia) M.R. Rajagopal, MD (India) Ramani Vijayan, FFARCS, FANZCA (Malaysia) Mary Cardosa, MBBS (Malaysia) Jocelyn C. Que, MD, MMed (Philippines) Pradit Prateepavanich, MD (Thailand) Anan Srikiatkhachorn, MD (Thailand) Chuthamanee Suthisisang, MD (Thailand) Waraporn Waikakul, MD (Thailand) Phanomporn Vanichanon, DDS, MS (Thailand) Sahattaya Paiboonworachat, MD, PhD (Thailand)
Course directors and faculty To plan the camp, organizers met several times for lengthy discussions to reach consensus as they explored a long list of topics and concepts for the camp (for details, visit www.iasp-pain.org/Insight). Many people were instrumental to the camp’s success, including IASP Past President Gerald F. Gebhart, PhD (USA), IASP President Eija Anneli Kalso, MD, DMedSci (Finland), the Pain Camp task force, including Jensen, Goh, and Michael M. Bond, MD, PhD (UK), and contributing educators and Thai faculty members who initiated the idea and contributed much effort to bring the education concepts to reality.
Course objectives The Pain Management Camp targeted doctors and other health care allies who plan to be pain practitioners, trainers, leaders, or even champions of pain management in their respective countries. The interactive nature of the residential camp stimulated discussion relevant to the real-life situation of participants. Organizers found it challenging to create a curriculum that had something for everyone since the spectrum of pain knowledge was very wide, ranging from those who run pain clinics in their own countries to those with little experience in pain management. Moreover, the degree of difficulties and shortage of resources such as drugs and opioid availability was so diversified that organizers encouraged experience-sharing from faculty and participants to allow participants to learn from one another. The effectiveness of the collaborations and strength of the contributions of experienced IASP faculty and regional faculty enhanced the faculty teamwork. This was a critical factor, along with the generous IASP financial support, in the success of the Pain Camp.
Pain camp admission It was initially decided that the course would have about 30 diverse participants, of which 25 candidates would receive an IASP scholarship and five would be self-subsidized. Invitation letters for nominations were sent to specific IASP chapters, medical associations, teaching institutes, hospitals, or respected members within the field. Camp organizers targeted health care graduates whose day-to-day work includes the management of patients with pain or the teaching of pain topics. Prospective attendees were trainees or experts who treat pain in such fields as anesthesiology, neurology, rehabilitation medicine, orthopedic surgery, and palliative medicine, including family physicians, nurses, pharmacists, physiotherapists, and other allied health professionals. Priority was given to individuals working for provincial hospitals or
those with limited access to major pain centers. Other criteria included affliliation with a university, general or tertiary care center, hospital, or training program, or a role in training these professionals within the country of residence. Applicants who were members of local IASP chapters received priority. A total of 60 applications were received from 17 countries. Sixteen participants were selected from targeted countries including Vietnam, Cambodia, Laos, Myanmar, Sri Lanka, Bangladesh, Bhutan, and Mongolia based on the predefined criteria, recommendations, qualifications, and English language skills, and who had not received a similar IASP award in the past three years. There were 10 participants from five ASEAPS countries, including Philippines, Indonesia, Malaysia, Singapore, and Thailand, who were partially subsidized by their country chapters. Visit www.iasp-pain.org/ Insight for applicant demographics.
Structure and timeframe The five-day camp employed various methodologies, including didactic talks and lectures, case presentations and sharing by course participants, role play, review of articles, daily team assignments, and observation of clinical programs at a nearby pain clinic and a massage school. The Pain Management Camp course was divided into two sections: 3-day residential course 1½-day lecture course held in conjunction with a refresher course at the ASEAPS Congress meeting The residential course, held at Salaya Pavilion Hotel & Training Center within the campus of Mahidol University, covered essential elements in pain topics relevant to “day-to-day clinical practice” including: Essential mechanisms of pain What is the clinical value of the biopsychosocial model of pain and how do we use it? Communication with the pain patient (pain assessment with role play) Assessing a chronic pain patient The difference between acute and chronic pain The prevention of chronic pain after surgery and trauma Chronic low back pain The differences and similarities of cancer pain with other types of pain Common clinical manifestations of neuropathic pain Pain management: pharmacological and nonpharmacological How to use opioids for pain control Place of pain interventions Case management
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Pain management camp The various teaching methods comprised didactic talks and lectures, open discussion, role play (history taking and evaluating a pain patient), and a video and live patient demonstration (a man with postherpetic neuralgia, and a girl with chronic neuropathic pain). Participants divided into teams for learning exercises with collaborative course work and group discussion. Daily assignments focused on case management for low back pain and other acute, chronic, and cancer pain situations based on attendees’ experiences. The course also included a visit to a university-based pain management clinic, where participants attended a demonstration of a chronic pain patient’s management. After group assignment presentations concluded on the third day, the faculty elaborated on pain therapy topics and “Pharmacological Management of Pain” by discussing how to select medications and carry out a critical analysis of new pain medications. In addition, this course also provided a discussion on nonpharmacological treatments and the roles of complementary medicine. To provide insight on this topic, students visited WatPo Thai Traditional Medical School to learn and experience the effects of Thai traditional massage.
program rating of 4.38. Nearly 28 percent of the participants said the course covered all of the topics that they need to be familiar with to manage pain patients in their practice while almost 68 percent said the course covered most of the topics. Along a similar topic, about 55.5 percent said the course completely met their expectations, while 44.5 percent said the course mostly met their expectations. All of the participants said this course will have an influence on their future work and career.
Faculty evaluations Course evaluations collected from 11 faculty members including one neurologist, five anesthesiologists, one physical and rehabilitation specialist, one dentist, two palliative care medicine physicians, one psychiatrist, and one neurosurgeon had an overall ranking of 4.8. All respondents agreed that the course should become a recurring program.
Visit www.iasp-pain.org/Insight to view additional information online about the Pain Management Camp, including: Planning the camp (discussion topics for planning the camp) Demographic information for applicants and attendees ASEAPS newsletter
Social program In order to promote collaboration and networking, sponsored participants were asked to share their room and participants from the same country were asked to separate. Bringing participants and faculty together outside the classroom was one of the major benefits of the social program. After class in the first evening, the faculty and participants toured Mahidol University by tram. This complimentary evening with a relaxed atmosphere provided an interesting time to explore the campus together and for participants to get to know each other better, establishing relationships that continued for the remainder of the school.
Program course evaluations To evaluate the program course, participants filled out evaluation forms that rated the program on a scale of 1 to 5 from poor to excellent. With 22 responding, the program course received 4.5 on average for duration, program scheduling, curriculum, opportunity for interaction with peers, quality of course content, accommodation, and logistics, with an overall
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Measuring success As a result of this pain camp, participants were motivated to learn more, and many have sought further training. Two anesthesiologists were awarded a one-year fellowship training in Bangkok funded jointly by IASP and World Federation of Societies of Anaesthesiologists (WFSA); one is now involved in training in Singapore General Hospital. Other signs of success: A Bhutanese nurse is currently pursuing her PhD in pain management in Australia, while several others are now trainers for pain management in their countries, or have started providing pain service in their local hospitals. Based on the success of the first camp, ASEAPS organizers agreed that a similar educational course program should be part of the next Congress, scheduled for Singapore in 2013. Pongparadee Chaudakshetrin, MD, is Associate Professor at Mahidol University International College in Bangkok, Thailand. She will be awarded IASP Honorary Member status at the 2012 World Congress on Pain.
Chapter news Latin America Asociación Boliviana del Dolor (ABD) Great leaders, huge growth by Marco Antonio Narváez Tamayo, MD, President It is gratifying to look back and review the result of productive efforts of individuals who look for better days for their pain patients and society. The Board of ABD in 2011 developed a tremendous recruitment and educational effort and are now seeing some of their goals achieved. Argentina Chapter officers, from left: President Jorge Vivé, Past President Eduardo Marchevsky, Treasurer Pablo Graff, and General Secretary Sergio Czerwonko.
Multicomponent, multilevel, multidisciplinary, multi-professional, and multicultural…pain is such a multifaceted field! This creates challenges, but also a stimulating source of enrichment. For our inaugural issue, we feature a milestone summit in the UK, and the latest achievements of some of our Latin American chapters. In the future, Chapter news will feature many other countries and endeavors, giving us the opportunity to learn from other cultures and gain new perspectives and strategies. These pages will be a place to meet, to interact, and to become inspired by your colleagues throughout the world. Please share with us in a dynamic way your chapter’s successes and challenges. A stronger network will enable us all to grow. Write to us at insight@iasp-pain.org so that others may hear of ideas and activities that they may be able to adopt in their own countries. We look forward to sharing your stories!
Asociación Argentina para del Dolor Oldest chapter, new efforts by Jorge Vivé, MD, President
Argentina is the oldest chapter of IASP in Latin America, formed not long after IASP in 1974. As in other areas of Latin America, the recognition of the treatment of pain as a independent medical specialty is one of the most recurrent subjects of discussion. Diverse efforts continue in this regard, including courses and collaborative activities with other specialties. AAED created a committee in conjunction with the Academia Nacional de Medicina with the objective of obtaining recognition for pain. The AAED Actualization in Pain Treatment is a permanent postgraduate online educational program. This group of courses provides information for physicians who have little access to educational institutions. The initial four 12-week courses provide three hours per week of quality up-to-date information of multidisciplinary origin with different faculty to transcend the vision of each specialty and provide a transdisciplinary approach to treatment.
One of the Chapter’s newest programs is the first Bolivian journal of pain. Available free of charge and with national circulation, it is aimed at medical and health professionals and captures the progress of pain research. Another key development for the promotion of pain management is ABD’s newly created website: www.dolor-bolivia.org.bo – which is open for all our Spanishspeaking friends and to those interested in knowing different realities than what they see in their own countries. The chapter’s recent membership growth reflects the genuine commitment, dedication, and hard work of leadership benefiting from: a) the strong link with health care leaders in Bolivia, b) the interesting scientific calendar of multidisciplinary lectures reaching all members, c) the strategic alliance with the pharmaceutical industry, and d) incorporating the results of a recent membership survey in our plans and programs. Last, but not least, the Bolivian chapter can proudly say that after an effort of national integration in the areas of pain, ABD members represent professionals from the five most important cities of our beloved Bolivia. With the satisfaction of accomplishment and joy of better days for our society, affectionate greeting to all our fellow friends in the IASP that passionately work to decrease the pain burden worldwide.
Asociación Cubana para El Estudio Y Tratamiento Del Dolor (ACETD) Doing a lot with a little by Jorge L. Yera Nadal, MD, President The Cuban Association for the Study and Treatment of Pain is a relatively new chapter (2005) with few members, yet the activities are many: courses on pharmacology and interventional techniques, as well as pain symposia on a variety of topics and an annual colloquy of experts on the Global Year Against Pain. In Cuba the study and treatment of pain is part of four years of study in anesthesiology and reanimation. Once graduated as a specialist in anesthesiology, a doctor may be devoted solely to the treatment of pain and work in public service. The Cuban health system provides analgesic drugs and non-invasive techniques, and with intensive
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efforts it is possible to carry out some interventional techniques. Available economic resources don’t allow adequate supplies to existing pain centers to provide 11 million citizens with the services they need to alleviate pain.
Asociación Paraguaya para el Estudio y Tratamiento del Dolor (APETD)
ACETD is working on a basic and clinical approach to pain in a multidisciplinary way. The Drug Research and Development Center implemented the Experimental Laboratory of Neuropharmacology with special attention to neuropathic pain to create a place for our young postgraduates to initiate basic pain education. In 2012 the Brazil-Cuba Collaborative Research began with the Faculty of Medicine of Ribeirão Preto of the University of São Paulo (USP) and distinguished professor Sergio H. Ferreira. Cuba hopes to make more and closer relationships with Latin American chapters to help formulate educational plans for pain specialists in Cuba and the rest of Latin America.
Asociación Paraguaya para el Estudio y Tratamiento del Dolor (APETD), IASP’s Paraguay Chapter, set out to perform bimonthly scientific conferences with different themes in the nation’s capital. In October 2011, the Paraguayan First Congress of Pain increased interest in pain, kicking off a series of scientific activities of various medical societies with the participation and support of APETD.
Asociación Mexicana para el Estudio y Tratamiento del Dolor (AMETD) Rising to the challenge by Margarita E. Araujo Navarrete, MD, President During the last 32 years, the number of members of the Mexican Association for the Study of Pain, a multidisciplinary association, has increased consistently. However we have challenges trying to ameliorate the pain care services for our 100 million inhabitants due to the particular characteristics of each state of Mexico with inherent inequality, and cultural and educational diversity. During the next few years we are committed to manage pain efficiently, and focus on the quality of assessment and diagnosis. It is necessary to change the attitude of those who believe that pain is a consequence that must be simply accepted as the result of disease, age, or unavoidable circumstances. Pain must have a prevalent place and must take a high priority in the efforts in which the entire health care team is involved to deliver the best possible service for the patient, the family, and society.
Asociación Istmeña para el Estudio del Dolor (AIPED) Panamá Spreading the love by Eka Perez-Franco, DDS, MS, ABOP, President AIPED held monthly educational meetings, inviting health practitioners with different backgrounds and professions interested in pain topics, in order to disseminate pain education around the country, to talk about IASP, and to define the Chapter’s purpose. AIPED members have participated in different association and organization medical meetings and round tables in order to promote education on pain diagnosis and interdisciplinary management. In the future we hope to have more pain clinics around the country and more colleagues “in love” with pain management.
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A focus on education by Graciela Elizeche, MD, President
APETD’s ongoing educational project aims to increase the quality of life of people with pain by providing a comprehensive response to the effective relief of suffering. The classes, for students, residents, physicians, and health professionals in general, will focus on providing the updated theories, diagnosis and assessment of pain, and multidisciplinary management to health professionals in major cities. Other areas of focus are the challenges of implementing research programs in pain, curricula for undergraduate and graduate programs, and ways to strengthen alliances nationally and internationally.
Asociación Venezolana para el Estudio del Dolor (AVED) A huge, productive chapter! by Eloymar Rivero, MD, President Besides activities such as scientific congresses and medical education events in many cities and nearby countries, AVED produces manuals and books on pain with recommendations for acute and chronic pain conditions for free distribution or at very low cost for its members. Using evidence-based medical criteria, we gathered consensus opinions to create two publications: First Guide of Clinical Practice for the Treatment of Acute Postoperative Pain and Practical Guide for Diagnosis and Treatment of Neuropathic Pain. For 2012, AVED has organized a very busy schedule of conferences, among others the VII Venezuelan Congress on Pain scheduled in Caracas on July 18-20, 2012. Last year, the Venezuela Chapter Executive Board collaborated with authorities responsible for public health policies to plan the launch of two important campaigns: “Pain as the Fifth Vital Sign” and “Hospitals Without Pain.” These campaigns aim to induce important changes in the way patients are treated, particularly in public hospitals, and should aid the endeavor to influence medical school curricula to include an updated selection of pain topics. AVED is thankful for the profound efforts and unrestricted dedication of its members, including Dr. Victor Tortorici, Chair of the Caracas Congress Scientific Program Committee, who will receive the 2012 IASP Award for Excellence in Pain Research in Developing Countries at the Milan Congress (see page 15).
Chapter news UK Summit tackles chronic pain An estimated 7.8 million people are affected by persistent pain in the United Kingdom, many of whom are denied the benefit of appropriate management and improved outcomes due to uneven commissioning of services and a lack of national directives and resourcing. In an effort to address some of these issues, a Pain Summit was held in Westminster, London, on November 22, 2011. This report is provided by the Pain Summit Steering Committee.
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rganized by the British Pain Society, the Chronic Pain Policy Coalition (CPPC), Royal College of General Practitioners, and the Faculty of Pain Medicine, the Pain Summit was the first joint event of patients, health care professionals and commissioners in England to examine current pain service provision and develop innovative strategies for commissioning services in the future. The day consisted of plenary sessions featuring leading figures in health care, academia, patient groups, and policy-making addressing over 150 delegates, and parallel workshop sessions to formulate preliminary recommendations. Senior national figures across the Government and health service addressed the audience, including Earl Howe, the Parliamentary under-Secretary of State at the Department of Health (Quality), and Professor Sir Bruce Keogh, Medical Director of the National Health Service in England. Both said the Government recognized the enormous burden of pain on both individuals and society and acknowledged that little had improved since the issue was brought to national attention three years ago by then Chief Medical Officer, Sir Liam Donaldson.
Sir Bruce highlighted the recent National Pain Audit, conducted by Dr Foster Limited and the British Pain Society, which revealed that while 64% of pain clinics in England claimed to satisfy the criteria for multidisciplinary care as per international recommendations, only 40% could provide the staffing evidence to support this claim.
Health professionals and patients provided some of the most moving contributions of the day, including this statement from a 17-year-old with complex regional pain syndrome who described her experiences since developing the condition: “Living with pain has had a considerable impact on my life. I don’t think that there is any doubt that my life would have taken a different route if I hadn’t developed pain. Pain has diverted my path away from sport and becoming an athlete. It has made me more aware of the little things in life and I try not to take the little things, like walking for example, for granted. Pain does limit how much I can do the things I really love but, more than anything, I try not to let it define me. I try to define it.” The Summit also touched on the relationship between pain and employment with a presentation from Professor Dame Carol Black, the National Director for Health and Work. Dame Carol highlighted that according to research conducted in 2006, three of the top 10 health problems that prevent people from working relate to pain (back/neck pain, other chronic pain, and arthritis). She emphasized that in order to help people living with pain stay in, or return to work, there needs to be collaboration between the government, health care professionals, employers, and employees. The day concluded with a suggested five-point plan for the improvement of pain services in England: 1. Undertake a burden of disease analysis to be able to describe the scale of the problem 2. Ensure that chronic pain is seen as a “high street disease” (common) in the eyes of the public and the media 3. Embed chronic pain within at least one NHS performance framework and ideally, more 4. Showcase centers of excellence 5. Achieve universal use of pain scoring as a clinical metric in the same way as blood pressure is regularly recorded A preliminary report and more information on the Summit is available on the Pain Summit website: www.painsummit.org.uk. Pain Summit Steering Committee Richard Langford, MBBS, FRCA, FFPMRCA President, British Pain Society David Rowbotham, MB ChB Dean, Faculty of Pain Medicine, Royal College of Anaesthetists Martin Johnson¸ MB ChB Clinical Champion for Pain, Royal College of General Practitioners Beverly Collett, MBBS, FFPMRCA Chair, Chronic Pain Policy Coalition
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The Latest Word on Pain Pain Comorbidities: Understanding and Treating the Complex Patient
Pain Comorbidities Understanding and Treating the Complex Patient D
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edited by Maria Adele Giamberardino and Troels Staehelin Jensen. ISBN: 978-0-93109292-3, paper.
Maria Adele Giamberardino, MD, and Troels Staehelin Jensen, MD, PhD Editors
The enon Phenom of
Pain chand
by Serge Mar
Irene tracey, Editor
Pain 2012
RefResheR CouRses 14th World Congress on Pain
The Phenomenon of Pain by Serge Marchand. ISBN 978-0-93109291-6, paper.
Pain 2012 RefResheR CouRses
Pain 2012: Refresher Courses, 14th World Congress on Pain edited by Irene Tracey. ISBN 978-0-93109293-0, paper.
Irene tracey, Editor
The occurrence of multiple, concomitant medical conditions is very common and is becoming increasingly more frequent as the population ages. Pain Comorbidities provides a contemporary understanding of the nature, modalities of diagnosis, and treatment of complex clinical situations involving multiple concurrent diseases and their influence on the experience of pain. Important attention is paid to therapeutic aspects of the comorbid patient, ranging from the role of the multidisciplinary pain clinic and of pharmacological treatment—with particular emphasis on antidepressants—to the role of physical training and rehabilitation and of a psychological management approach. Price: US$85.00 (IASP Members: US$70.00) Publication date: June 30, 2012
The Phenomenon of Pain clearly describes the physiological and psychological mechanisms involved in the development and persistence of pain. Serge Marchand provides practical details on treatment methods, outlining pharmacological as well as nonpharmacological options and presenting a case for an interdisciplinary approach. This adaptation of the original French version helps the reader understand the various factors surrounding the complex phenomenon of pain. Price: US$70.00 (IASP Members: $55.00) Publication date: July 15, 2012
An informative collection of articles by noted experts that gathers in one place current information about the study and management of pain throughout the world. Edited by Irene Tracey, Pain 2012 brings together the presentations that these experts will give at the refresher courses that precede the biennial World Congress on Pain in Milan, Italy, in August 2012. These articles are published in one book for use at the refresher courses, as well as for medical researchers and clinicians who want an overview of contemporary pain research and management. Price: US$40.00 Publication date: August 27, 2012
InternatIonal assoCIatIon for the study of PaIn
IASP Press®
To get your copy, go to the IASP Bookstore on the IASP website at www.iasp-pain.org/books. See the website for more information, or contact the International Association for the Study of Pain at books@iasp-pain.org or call +1.206.283.0311.
International Association for the Study of Pain®