Episode Details

Pain is probably the oldest problem in medicine. It’s the way our bodies tell us that something is wrong here.

But pain has long been considered a symptom. So when medicine can’t find what’s wrong, or when medicine can’t fix the pain, well, that’s usually the end of the story. And that’s left a lot of people with chronic pain suffering in silence.

In this episode, we learn why pain is one of the great mysteries of medicine - one of the most challenging conditions to diagnose, to measure, and to treat successfully.

We explore why the worthy effort to bring pain into the light inadvertently created what may be the most devastating social crisis (ahem, opioid epidemic) of the last century.

And we look at a new pain medicine - Journavx - which is not approved for chronic pain (yet) but has a lot of people hoping for a path to peace without addiction.

Sources for this episode

[1]  "Wrestling With Pain:" John J. Bonica, MD. Autobiography (1987) The International Symposium on Pain Analgesia: Dr. John J. Bonica recounts his life as a "wrestling match" against medical indifference to establish the multidisciplinary approach to pain therapy. 

[2] Oral History Interview with John J. Bonica (1993) John C. Liebeskind History of Pain Collection: John Bonica is widely regarded as the founding father of pain management.

[3] International Symposium on Pain (1974) Raven Press: Proceedings from the first major international meeting on pain research and management.

[4] Individual Differences in Pain: Understanding the Mosaic that Makes Pain Personal (2017) PAIN: Explains how biological, psychological, and social factors shape personal pain experiences.

[5] Chronic Pain: What Does It Mean? A Review on the Use of the Term Chronic Pain in Clinical Practice (2021) Journal of Pain Research: "Chronic pain" is a semantically inaccurate and potentially misleading clinical label because it overemphasizes duration while failing to account for biopsychosocial factors.

[6] Prevalence of Depression and Anxiety in Chronic Pain (2025) JAMA: Systematic review and meta-analysis showing high rates of depression and anxiety among adults with chronic pain.

[7]  Improving Outcomes of Analgesic Treatment: Is Education Enough? (1990) Annals of Internal Medicine: The persistent undertreatment of pain is rooted in a historical medical focus on physical lesions over subjective symptoms. 

[8]  Pain as the 5th Vital Sign Toolkit (2000) The Veterans Health Administration: A comprehensive guide developed by the Veterans Health Administration (VHA) to institutionalize a standardized, system-wide approach to managing patient discomfort.

[9] A Capsule History of Pain Management (2003) JAMA: Historical overview of approaches to managing pain, from ancient remedies to modern treatments.

[10] Bridging Old and New in Pain Medicine: An Historical Review (2023) Cureus: Historical review linking t