Ranjan Roy

Preface

It is difficult to imagine a clinician addressing the management of a chronic pain patient without the dimensions discussed in this book. Last week we received a written referral to see a man who suffers with low back pain. Today he entered the office, hobbling slowly, with a pained expression and sad demeanor. He began to relate a history of frustrations surrounding his disability. These include the failure of the long list of specialists to cure him, his troubles with his pension cheques, and his inability to function as a father and husband. While he was speaking, his wife, who had accompanied him to the interview, was seen to avert her head and begin to cry. Turning the attention to her we learned that she had been injured in an automobile accident, was also suffering with constant pain, and was similarly disabled. Further inquiry revealed that their only relative was a 13 year old son. The description they gave about their son reflected failure at school, withdrawal from friends, and emotional distress resulting in part from the parents’ almost total reliance on the boy. The referral had said "chronic back pain"; the presentation reflected an entanglement of psychosocial issues.
The need for addressing psychosocial dimensions in the management of chronic pain was highlighted in a previous book published by Williams and Wikins in 1982 (Roy, R., and Tunks, E. (Ed) Chronic Pain: Psychosocial Factors in Rehabilitation).That original project was initiated through the enthusiasm and energy of Ranjan Roy. Dr. John Basmajian also played a large part in making that book possible.
Knowledge is an active thing, growing through its application and through interaction with knowledgeable colleagues. In this way therefore we have been stimulated by the recent developments regarding psychosocial issues in rehabilitation of chronic pain patients. We have turned to colleagues well-known and experienced researchers and clinicians, for the fresh perspectives in this new book. Moreover, this book offers us the privilege of continuing the dialogue with you, the reader, because you also are our colleague, sharing our commitment to this perspective of rehabilitation.
We therefore wish to thank all of our colleagues who have contributed to this work, for the knowledge and perspectives of the present, and for the advances of the future.

ELDON TUNKS
ANTHONY BELLISSIMO
RANJAN ROY