Bioarchaeology is keenly interested in exposing the lived experience of people in the past. How much of that actual experience can be accessed, however, depends on research methods, analytical approaches, and theoretical frameworks. In Purposeful Pain: The Bioarchaeology of Intentional Suffering, coeditors and contributing authors take on the admirable task of researching the experience and meaning of pain in the past, guided by the lens of social theory. They do so by moving between the living and the dead in an attempt to make experience come alive for the reader. Contributors to this book illustrate how pain, induced by oneself or by others, can be related to the pursuit of individual and societal goals, and chapters consider “past and present motivations for self-inflicted pain, its sociopolitical repercussions, and the physical manifestations of repetitive or long-term pain-inducing behaviors” (p. 2). All of the authors take on this challenge, diving deep into the worlds of structural violence, ethnographic reports, and skeletal data, and they are successful. Some of the chapters focus on specific case studies, but most present wide-ranging overviews across cultures and time periods alongside case discussions.

The book is divided into three sections. The first, “No Pain, No Gain: Ideals of Beauty and Success,” includes chapters refocusing our understandings of skeletal markers within cultural contexts of the experience of pain. These three chapters discuss tuberculosis and beauty standards in Victorian London; foot binding, neck lengthening, and corseting; and interpersonal violence, sporting activities, and cranial trauma. These chapters complicate a traditional simplistic narrative of pain and structural violence. They integrate gender theory, ethnographic evidence, and historical data in order to show how choices that result in pain are logical behaviors within specific cultural contexts. Purposeful pain becomes complicated and messy. These three chapters set a strong model for considering bioarchaeological datasets.

The second section, “Rituals of Pain and Practice,” contains chapters that examine evidence of genuflection by Byzantian monks in the fifth through eighth centuries AD; the practice of tattooing for medicinal purposes and its relevance for understanding Ötzi, the “Ice Man” from the Italian Alps, and dating to the Copper Age; ethnographic and bioarchaeological data on childbirth and pain; and a reconsideration of the experience of drug addiction that draws on sociocultural as well as biological data. These four chapters do an exceptional job of weaving together ethnographic, historical, and bioarchaeological data, and they are very vivid in describing the experiences of pain that were probably associated with this kind of evidence. They collectively highlight the complicated choices of painful experiences, and how a holistic approach to a bioarchaeological question can offer a great deal more insight than traditional skeletal analysis alone.

The third section, “The Politics of Pain: Power and Social Control,” focuses on the idea of pain as a tool. These authors shift between time periods and locations. The authors examine warfare and status across multiple time periods and cultures, including violence and torture at Sacred Ridge, a Pueblo I village site (AD 700–900) in southwestern Colorado; infant head binding in cross-cultural perspective and with detailed consideration of precolumbian Chile; and instances of structural violence—to show how pain is (or is not) inflicted in order to create or maintain social structures across cultures. This inflicting of pain on others for purposes of control, status, or identity flips the narrative from the previous chapters, most (but not all) of which focused on self-inflicted pain. In these case studies, we are asked to think about how pain can be productive in social control.

One of the key strengths of this volume is that each chapter is vividly written, and each with robust scholarship and compelling new ideas. It is rare to find an edited volume in which every chapter is as strong and as closely tied to overarching themes as in the case of Purposeful Pain. The volume successfully makes the case that as bioarchaeologists, not only can we investigate the experience of pain the past, we really must if we are to get a full understanding of lived experience. Purposeful pain, as the authors demonstrate, is often a crucial aspect of society. As Tiffiny Tung writes in the concluding chapter, “In key moments in family, social, or civic life, purposeful pain may be one of the most effective means by which to demonstrate your affinity to, and/or authority in, particular groups” (p. 254).

What makes this volume so engaging is that it lives up to the challenge of integrating social theory with skeletal data. The addition of historic and contemporary ethnographic data in many of the chapters allows the readers to see the unfamiliar as familiar. The model employed by these researchers may not be completely new, but an entire volume dedicated to this kind of integrative social bioarchaeology around a very narrow theme is new, and it is exciting. This book will hold broad appeal for those interested in how we understand the past. And because it holds together so well, the book issues a powerful challenge to all bioarchaeologists to carefully consider the experience of pain in interpretations about life and lives in the past.