Managing Pain is a Systems Problem

This book offers a clinically grounded and thought provoking examination of chronic pain as a complex disease of the nervous system rather than a simple symptom of tissue injury. Drawing on more than five decades of experience in anaesthesia and pain medicine, the book explains how neuroplastic and nociplastic changes can drive persistent pain, even after apparent healing. Building on the author’s earlier clinical work, it extends the discussion from individual treatment to broader systems of care. Moving beyond individual treatment approaches, Managing Pain is a Systems Problem How Medicine, Policy and Education Fail—and How They Can Do Better explores how healthcare systems, policy frameworks, and compensation structures shape patient outcomes. It critically examines fragmented care, over medicalisation, procedural dependence, and medication-related harm, while highlighting how institutions can unintentionally contribute to long-term disability. Through detailed clinical narratives, the text reveals the human impact of these systemic failures and the importance of coordinated, multidisciplinary care. At its core, the book advocates for a more integrated, humane model of pain management. It brings together clinical medicine, rehabilitation, psychology, ethics, and public health to provide practical guidance for clinicians, trainees, and decision-makers. Emphasizing functional restoration, patient education, and collaborative care, this volume calls for meaningful reform in how chronic pain is understood, treated, and supported across modern healthcare systems.