As the Pain Management Collaboratory and its partners focus on nonpharmacological approaches to pain management and other comorbid conditions, it is important to understand how pain has been understood and treated throughout documented human history. Scroll through this time line to see the era’s philosophy on pain, and the treatments, if any.
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
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
