Richard S. Weiner, Ph.D
Former Executive Director – deceased
American Association of Pain Management

“I finally stopped dog-earring the pages because I was dog-earring all of them.”

Pain Pandemic is one book that should not have had to be written. Dr. Goodley will convince you that Medicine’s Fundamental Flaw is so obvious and pervasive that it is almost inconceivable that it took a century and a professional life’s effort to prove it so powerfully.

Dr. Goodley’s pilgrimage is captivating, sometimes infuriating and always educational. It is the story of a titanic struggle between truth and institutional power in which he always sides with patients in pain and through them validates what he contends.

Nothing about this book is remote. It is deeply personal from Dr. Goodley to his reader. It is passionate, and there is anger here that is only another expression of the love and compassion that drives this man to make things right.

Dr. Goodley’s vast range of compelling stories leads one easily to the conclusion that destiny is being revealed here from whose strivings real hope to many, many can now be offered.

In a word, Pain Pandemic is a vitally important book. The essence of its lesson is that adherence to sound principle is a practical and rewarding option that turns conformity pale. And from that, Pain Pandemic may now well be destined.

Jane Presta
a pain patient (after she read the original manuscript)
June 30, 1994

Dear Dr. Goodley:

I hope you don't mind my writing to you again. A friend of mine has agreed to type this up so I feel free to ramble on.

I have repeated Dr. Jean Marie Charcot's quote to many people. It amazes me that in 100 years, physicians haven't improved in that regard.

You mention Peter Edgelow in your book. He is a wonderful man as well as an exceptional Physical Therapist. I am alive today because he recognized in one visit what my doctor and my pulmonary specialist didn't in over 10 weeks and many visits, and that wasn't why I was seeing him.

Years ago, while spraining an ankle, or jamming a finger playing softball, I looked for an orthopedic doctor. I could only find orthopedic surgeons. I didn't need a surgeon, just a doctor in the orthopedic field. I was too embarrassed to ask how to find one and finally just went to the orthopedic surgeon. I was glad when sports medicine physicians started popping up. It was interesting reading about the advent of orthopedic surgeons and the need for orthopedic medicine in your book. You are so right.

I spent 2½ years being sent from one doctor to another because of a problem I was having with right shoulder, arm, hand and neck pain. I was unable to work during this time because of the excruciating pain. At least the doctors didn't suggest the problem was all in my head. They just couldn't figure it out. Each would try different drugs, physical therapy, etc., until they realized it wasn't anything they could diagnose, and then they would refer me on to another physician. One doctor very positively told me I had a pinched nerve in my neck; he could remove it, and in six weeks I would be fine. "Great," I said, "go ahead and operate." Six weeks passed after surgery with no improvement. The doctor then said it takes six to eight weeks, so I waited. Ten weeks later, he said there must have been an additional shoulder problem and sent me on to a shoulder specialist.

Several doctors later, I ended up at the University of California at San Francisco where the orthopedic surgeon sent me to physical therapy. The physical therapist who specialized in neck and shoulder problems couldn't figure me out so in turn had me see one of her colleagues. It was that therapist who changed my life. She had attended seminars/classes given by Peter . and was familiar with Thoracic Outlet Syndrome. She said she would treat me as though that is what I had, and she wrote a letter to my doctor documenting this. For the first time in 2½ years I had some relief. Would you believe, though, she got in trouble for doing this? My doctor called her superior and was angry that she "diagnosed" and had no right to do this since she wasn't a doctor. Needless to say, I quickly changed doctors to ones who are familiar with TOS. The first chapter of your book easily could have been written about the first nine doctors I saw!

I developed severe complications following surgery to help my TOS. I won't go into the details here, but it was Peter to the rescue! When I read what you said about the prescription from the (orthopedic) surgical resident, "Teach this woman to use her right arm!" I could fully understand him. My pulmonary specialist would have loved to write a prescription something like, "Teach this woman to breathe!" I saw him every two weeks and each time I was weaker and having a harder time breathing. He just kept telling me that people with only one lung do better than I was doing. He never seemed to take my complaint of having a hard time breathing seriously. Finally, after the first time I saw Peter, he took a little more notice and it was still an afterthought that caused him to request a lung scan. He even said, "I know it won't show anything, but I'd sure feel like a fool if it did." The findings were that my "right lung was obliterated with blood clots." A few days later he apologized to me and said he'd been treating me "like a "hysterical female who wasn't recovering fast enough from surgery." Near the end of your book where you quote from an except from the AMA - Minneapolis, I laughed out loud. Once again, what you have to say speaks directly to me!

Another thing you said means a lot to me, and may I take it out of context: If I had only one thing I could take from you it would be this: "You have no right to make me feel uncomfortable...or confused." In your book, that was the feeling patients are given by the doctors. Yet, because of your book I will never again let a doctor make me feel that way. Because of your book I have the courage to make physicians take my symptoms seriously, to make them look further, deeper, elsewhere, to find the problems. I won't let them stop at what they've been taught. I will make them look beyond!

In my first letter to you I wrote Capital Hill needs you. The reason for this comes from something near the end of your book...referring to managed health and what will happen to the people whose real and salvageable problems are not within certain limits... "Health must not be endangerable by policy."

I feel your book would be the perfect gift for the young person going off to medical school. Also, it would be a good book for all patients to read. We, the general public, need to know what good medicine can be. In this day, we are more aware of the fact that doctors are human. We do question them more, but we have only scratched the surface. Your book will enable us to know what to accept and what to expect from doctors.

I would hope all of the physicians and other care givers will read your book with a truly open mind. They would benefit so greatly, and their patients would benefit so greatly.

Let's be realistic, should half the people reading your book actually realize what the fundamental flaw is and decide to do what they can to alleviate it, we would have a medical revolution. How wonderful for all of us.

I sincerely hope your book is published soon. I will keep abreast of its progress through Peter. When you see a run on sales in Northern California you'll know it's me.

Sincerely, Jane Presta

Vert Mooney, M.D.
Emeritus Professor, University of California at San Diego
Department of Orthopedics
Medical Director, San Diego Spine Center

Relief From Pain is a marvelous and powerfully challenging book by a brilliant and very caring physician. It is exciting reading and uniquely directed both to support and defend the public in pain and for clinicians -predominantly those who care for soft tissue injuries. However, there is something in here for almost anyone who lives with pain or is involved with those who are. I certainly wish my orthopedic surgical colleagues to read it.

Dr. Goodley is a great storyteller. With a wonderful memory for details, he writes as a novelist and well proves the case with real people. Along the way, he tosses off many asides about the inner workings of medicine that are involved with this dilemma he so well describes. Dr. Goodley writes for high purpose as he strives for the fundamental changes that will bring with them a far more realistic reason for hope.

I have been an orthopaedic surgeon for 35 years, and despite it responsibilities I have sadly seen my specialty become more and more surgically oriented. There were 502 presentations at the 1998 Annual Meeting of the American Association of Orthopaedic Surgeons. None of them discussed a non-surgical orthopaedic subject. If there is one book that will shake the tragically skewed situation, this is it.

Viola M. Frymann D.O., F.A.A.O.
Director of the Osteopathic Center for Children
La Jolla, California
Professor of Osteopathic Principles and Practice of the
College of Osteopathic Medicine of the Pacific.

“…Read, mark, learn and inwardly digest the profound wisdom to be found within these pages.”

Philip E. Greenman, D.O., F.A.A.O.
Emeritus Professor Department of Osteopathic Manipulative Medicine
Emeritus Professor Department of Physical Medicine and Rehabilitation
Michigan State University College of Osteopathic Medicine

The author is a physician, - a family physician, a physiatrist, and an orthopedic physician – who has shared in this easily readable book his experiences as a physician in a variety of settings. He gives the reader a number of episodes where manipulation has gained for the patient relief of debilitating and discouraging pain. As a physician, he espouses an old medical truth, - examine the patient, - listen to the patient. He challenges his colleagues in the allopathic profession (M.D.) to take a new approach to patients with musculoskeletal pain. He has dared to be different and pursue knowledge from the chiropractic and osteopathic professions, and from those in his own profession, that led to his devotion to the role of manipulation in patient care. His message is loud and clear, the health professions must do a better job in helping patients in pain. He challenges the reader to look at the ART of medicine and not pursue answers only in the SCIENCE of medicine, which may not be as scientific as we would like.

In this extraordinary and daring book, Dr. Goodley offers hope to many in pain by rationally challenging medicine to reexamine its lost fundamental. Release From Pain is written both in the name of - and directly to – the multitudes who continue in pain because of inadequate treatment. This book empowers them and gives real answers. For man, this is their justification for hope.

Dr. Goodley demystifies and explains manipulation and other essentials to effective relief, and from real cases he dramatically proves the rightness of what he contends. This book is comprehensive. As Dr. Goodley says, he leaves no place to hide.

Especially in our managed care crisis, what Release From Pain advocates needs to be known by all who are involved with the care of patients in pain. Vintage Goodley!

Frank Schoenholtz, D.C.
Regent Emeritus
Los Angeles Chiropractic College
Whittier, California

“…Release From Pain is remarkable… If there is any book that will break the bonds of ignorance, fear and prejudice that have kept manipulation from being seen in the light, this is it…”

Louis Sportelli, D.C.

"On balance Dr. Goodley this will be a great book for those whose minds are open and whose thirst for information overshadows their blindness."

Joseph C. Keating, Jr., Ph.D.
Homewood Professor
Canadian Memorial Chiropractic College
17 August 2000

$100 billion per year. That’s the estimated cost to American patients and their insurers which results from medicine’s “Fundamental Flaw.” The toll in misery and ruined lives cannot be calculated. A century ago, when medicine rejected manual therapies and their less well educated practitioners (bonesetters, chiropractors and osteopaths), it also abandoned a wealth of skill and knowledge related to 60% of the body’s mass: the musculo-skeletal system. Generations of MDs have graduated with misplaced confidence in the proliferating technology of scientific medicine, and in ignorance of the basic insights to be gleaned from palpatory skills and a biomechanical understanding of human function and illness.

In Pain Pandemic, Paul Goodley draws upon his 40+ years of experience as a physician and physiatrist to describe the real world consequences of this studied incognizance: how neck pain patients became a “pain in the neck,” how the absence of radiologically visible pathology promoted smug unconcern for patients in pain and a tendency to cast off the unresponsive to psychiatry, why the treatment of garden variety back pain (“meat and potatoes” for the chiropractor) became a source of frustration to the medical man and a financial drain on society. All for the lack of elementary skills. And now, suggests this voice from the trenches, the bean-counting mentality of managed care threatens to carve the fundamental flaw into stone by encouraging a categorical (as opposed to an analytic) mind-set in medicine.

Dr. Goodley tells this tale not with the statistics of clinical epidemiology, but from the perspective of an orthopedic physician called upon to care for the human debris of orthopedic surgery and its hegemony. Rich case vignettes illustrate the price patients pay for allopathy’s disinterest in the life-altering (albeit not usually life-threatening) dysfunction of soft-tissues: fascia, ligaments, skin and their interactions. The remedy, he suggests, lies in a return to a patient-focus: attention to detail in history-taking, practice in detecting the subtle signs of musculoskeletal dysfunction, and greater use of basic manual interventions in general medical practice and education. The politically demarcated boundaries among those healers who encounter musculoskeletal disorders (just about all of them, but especially medicine, chiropractic and osteopathy) must be relaxed, in the interest of patient welfare.

Goodley admits his ambivalence in selecting the audience for this book. And yet he succeeds in addressing multiple constituencies: patient and professional alike. This is a work that deserves the attention of anyone concerned with the present and future of health care in America.

Peter I. Edgelow, DPT
Assistant Clinical Professor in the Graduate Program in Physical Therapy
University of California in San Francisco
Clinical Specialist at Physiotherapy Associates
Hayward, California

"Paul is a visionary who has struggled to find ways to treat people in pain with approaches that are more likely to help when traditional methods more likely fail. "

Alon Marcus, DOM, LAc, DAAPM
Author: Musculoskeletal Disorders: Healing Methods from Chinese Medicine,
Orthopaedic Medicine and Osteopathy

Release From Pain is a passionate and compelling plea for a far better approach to pain than is now commonly employed. Dr. Goodley proves what he preaches by totally committing to his patients and through that intimacy he irrefutably clarifies the value of the orthopaedic medicine he espouses. This extraordinary book is desperately needed and now more than ever.