The conception of “pain” between rheumatology and medical anthropology: a new way of conceiving pain

Abstract

In this brief article we have to start looking at the patient as a person and at the complexity of the situation he or she is handing over to us. After setting some coordinates on medical anthropology, we will try to understand how it can be of help to the rheumatologist, what new perspectives arise from the dialogue between these two disciplines. Medical Anthropology shows how every individual in every social context perceives, interprets, and deals with illness and health in a manner closely linked to personal experience and the socio-cultural environment of which he or she is a part; it recovers the old holistic paradigm of ancient and primitive and folk medicine, the reunification of soul and body, the global study of the person. In this perspective, the issue of pain emerges, particularly in rheumatology (we have to consider that in Italy there are about 4 million patients with arthrosis, the most widespread chronic degenerative rheumatic disease, about 400,000 those with rheumatoid arthritis, and at least 600,000 who are affected by other diseases of great clinical relevance, such as psoriatic arthritis, ankylosing spondylitis, lupus and scleroderma). Starting from the assumption that man is not a machine, nor is his pain the result of a series of mechanisms, we could assume that between man and his pain there is the ambivalence of the relationship that unites man to the world. Pain affects man’s identity, often shattering it, thus becoming the disease to be cured. In this perspective, it can never be considered as something good, something that adds to a person's life. Pain, therefore, being a multiple reality, needs to be inserted in the relationship that the subject has with himself, the socio-cultural uses that he has assimilated, elements from which the physician cannot prescind.

Keywords

• pain
• rheumatologist
• medical anthropology