Ancient Times

1500-1300 BC

Ancient Cultures

Pain outside of visible injury caused by demons or evil spirits

Classical Period

Pain caused by an imbalance of the four humors

Pre-Inca cultures use coca plant leaves for pain remedies

Opium used for pain relief in Egypt, India, China, and other ancient cultures

Aside from opium or mandrake drugs, application of hot/cold therapies, blood letting, and herbal remedies applied for pain

Hippocrates acknowledges usefulness in opium for treating pain

460 BC

400 BC

300BC

300 BC

Early Imperial Era

The heart senses pain, not the brain

Middle Ages

Pain was a punishment from god(s), with healing of it left to mortals

Acupuncture first recorded in Chinese medical text

Electric fish used for headaches, arthritis, and other pains in Egypt, Rome, Greece

Documented use of narcotics for painful operations

First book of drug formulations introduced by Nikolaus of Salerno. More than half of the formulas are related to pain remedies

50 AD

Late Antiquity

Central nervous system detects pain, signaling an underlying disease that needs to be addressed to alleviate pain

1200 - 1300 AD

1150 AD

1300to1600

circa 1350

Age of Exploration

Western Culture viewed medical treatments coming from the East as related to the devil

Renaissance — Enlightenment

Pain is inevitable and a sign of life

Europeans mix narcotic substances with herbs and apply to sponge for inhalation or directly to wounds for pain relief

Dutch physician
Willem ten Rhijne first westerner to learn
acupuncture

Rhijne publishes essay on practical uses of acupuncture for pain relief

Laudanum
(mixture of opium and liquor)
introduced by Thomas Sydenham

1670s

1683

1680

1800s

1848

Late Industrial Era

Pain can be minimized and/or relieved

Second Industrial Revolution

Diagnostic tests developed for specific ailments; clinicians dismiss chronic pain as a sign of mental disease

Dentist
William T.G. Morton gives public demonstration of ether inhalation as a surgical anesthetic

1820-1830

1870s

1864

1846

British Obstetrician James Young Simpson proposes use of chloroform for pain in childbirth and surgery

Morphine industrially produced in Germany and the United States

S. Weir Mitchell and colleagues at Turner’s Lane Military Hospital, focus clinical research on phantom limb pain, regionalized pain, chronic pain, and neurological diseases

Physicians issue concerns over morphine becoming addictive

1920s

1947

Early to Mid-Twentieth Century

People reporting unexplained chronic pain not well understood, and they were often thought to be delusional or seeking drugs.

Psychotherapy or neurosurgery are the recommended options for pain relief

1950s

1953

1920s

William Livingston establishes a research-based pain clinic in U.S.

French obstetrician Ferdinand Lamaze develops the Lamaze method for developing pain management skills during childbirth

The Management of Pain, by Dr. John Bonica,
is the first comprehensive text book on pain treatment options around the world

Present

1970

1965

circa 1960s

Pain is both a psychological and physiological problem

Wilbert Fordyce introduces operant conditioning and other behavioral psychological approaches to chronic pain treatment

Ronald Melzack and Patrick D. Wall introduce the gate control theory of pain in "Pain Mechanisms: A New Theory," which influenced how clinicians treated and discussed pain w/patients

1990s

2017

Health community recognizes the need for a more alternative treatments to pharmacology for
pain relief

Pain Management Collaboratory
begins studies on non-pharmacological approaches to pain management

Information Era

Pain is individualized and can be helped through a multi-modal, personalized plan; need for research to determine best approaches

circa 1972

Pain is more than simply a symptom of disease (mental or physical)

Sources

R. Sabatowski, D. Schafer, S. M. Kasper, H. Brunsch and L. Radbruch, “ Pain Treatment: A Historical Overview”, Current Pharmaceutical Design (2004) 10: 701. https://doi.org/10.2174/1381612043452974

Meldrum ML. A Capsule History of Pain Management. JAMA. 2003;290(18):2470–2475. doi:10.1001/jama.290.18.2470

Roberts CS. Weir Mitchell of Philadelphia. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Available from: https://www.ncbi.nlm.nih.gov/books/NBK715/

Ramey, D. and Buell, P. D. (2004), A true history of acupuncture. Focus on Alternative and Complementary Therapies, 9: 269-273. doi:10.1211/fact.2004.00244

Katz, Joel, and Brittany N Rosenbloom. “The golden anniversary of Melzack and Wall’s gate control theory of pain: Celebrating 50 years of pain research and management.” Pain research & management vol. 20,6 (2015): 285-6. doi:10.1155/2015/865487