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Doody's Review ServiceReviewer: Tariq M. Malik, MD (University of Chicago Pritzker School of Medicine)
Description: This update of an abridged book of basic information for pain physicians and pain fellows comes with a new set of editors and many new topics. The previous edition was published in 2000.
Purpose: In addition to serving as a text for pain fellows and residents, the book is a quick reference source for pain physicians in their daily practice. It is somewhat successful in achieving these goals.
Audience: It is targeted at pain physicians, pain fellows, and residents interested in pain, as well as anyone who wants a brief review of a pain topic. This multiauthored collaboration is written by people who have written or edited work in this area in the past.
Features: The book follows the familiar format used in the third edition as well as by other pain textbooks. The 72 chapters are grouped into nine sections. The first three sections deal with the history of pain, the organization and management of pain services, and policy issues such as quality control and pain certification, followed by pain physiology and clinical evaluation of pain patients with history, examination, and radiological and electrical testing. The fourth section covers management of different acute and chronic pain conditions, such as headache, phantom pain, back pain, and pain in the elderly, children, and pregnant women. Chapters cover incidence, clinical features, pathophysiology, and management. Conditions are discussed in broad terms. Most of the chapters include brief descriptions under each heading and provide no algorithms or specific treatment guidelines. Section four deals with pharmacology of pain medication as well noninjection treatment modalities, such as acupuncture, physical therapy, and psychological interventions. Again the discussion is brief and informative, providing just enough information so that the modalities can be recommended to patients, but there is no evidence-based critical analysis. Sections six and seven cover different pain procedures commonly done in acute or chronic pain settings. The well done chapter on facet radiofrequency goes into technical detail, but most of the procedures are described in cursory detail and have few images to support the text. The procedure discussion follows a familiar format of indications, anatomy, and complications. Section eight deals with pain control in special situations like in the ICU, at home, and at the end of life. This section includes an important chapter on radiation safety, a topic that is often ignored. It includes useful information on the optimal use of the fluoro machine, optimizing radiation safety, and the pharmacology of radiocontrast agents. The five chapters in the last section evaluate the outcome and efficiency of different interventions in acute and chronic pain conditions. This is the best part of the book. Very helpful information appears at the end of the book in the form of CPT codes, evaluation and management coding templates, and useful Internet resources for journals and professional societies. The book is comprehensive in its approach and tries to cover as much as possible without being overwhelming, although the quality of chapters is inconsistent. It has something on every topic and there are plenty of images and tables. It is more of an outline of pain management than a book on practical pain management. Management is discussed primarily in general terms; techniques are not described in detail and not at all for a few procedures. There are no guidelines for the starting dosage for any drugs. It lacks a section on ultrasound-guided injection therapies and does not cover chronic joint pain or joint injections as such.
Assessment: This update is much better than the previous edition. It has shed many dreary details and the editors have added many new relevant topics. The book is very presentable and easier to read. It is neither a manual of injection techniques nor a comprehensive textbook of pain medicine, but is somewhere in between. It would help pain fellows or physicians to begin to understand a disease or an injection therapy and would start them on a path to learn more.