A Superb Contribution on Neuropathic Pain

Abstract

Neuropathic Pain: Causes, Management, and Understanding by Drs. Cory Toth and Dwight E. Moulin is a comprehensive book on the study and treatment of neuropathic pain. In their preface, the editors write that “the book provides a head-to-toe overview of neuropathic pain,” and I fully agree with their statement. The field of pain medicine has had a complex and rocky course throughout history. Of interest is the parallel the editors draw in the book preface between epilepsy and chronic pain. Epilepsy was first described 2000 years ago and was thought to be caused by demons attacking the person. It was only after scientific discoveries that epilepsy became known to be a treatable neurologic condition. Similarly, some pain symptoms were believed to be brought about by evil and magic, but recent findings have greatly advanced the knowledge in the field, and in particular, the understanding of another neurologic condition, that is, neuropathic pain. The book is organized into seven sections. Each section is divided into multiple chapters (29 in total). Section 1 deals with the clinical presentation of neuropathic pain (history and physical examination, diagnostic testing, and epidemiologic considerations) and Section 2 with the general condition of neuropathic pain (animal models, peripheral and central sensitization, pathophysiology of neuropathic pain). I was quite engaged by the first two sections of the book, which I read very quickly. I thought they were outstanding. Sections 3, 4, and 5 relate to specific conditions of neuropathic pain. In particular, Section 3 deals with peripheral neuropathic pain (diabetic and other peripheral neuropathies, postherpetic neuralgia, painful conditions affecting nerve roots and plexus), Section 4 with central pain (spinal cord injury pain, central pain in multiple sclerosis, poststroke pain), and Section 5 with “other causes” (complex regional pain syndrome, neuropathic pain in cancer, and fibromyalgia). Section 6 relates to the management of neuropathic pain and Section 7 to the prognosis of neuropathic pain. I also found several of the chapters in Sections 3 through 7 to be outstanding. The book lists a total of 54 contributing authors. Of these, 16 appear to be academically linked to the fields of neurology, neurosurgery, and neurosciences, 15 to pain medicine, 13 to anatomy, physiology, and pharmacology, four to anesthesiology, three to medicine, one to psychiatry, and one to palliative medicine. One of the authors is even the President of the Canadian Pain Coalition. The book has a true multidisciplinary diverse perspective and offers channels of communication to all. Obviously, with multiple chapters and multiple authors, some reiteration can occur when discussing overlapping topics, but this does not interfere with the book's readability and does not diminish the importance of this great educational work. The book achieves its goal. It helps the reader become familiar with the key biological mechanisms at the basis of neuropathic pain. It delivers not only up-to-date knowledge on research progress but also on the fundamentals of current care. I think that Neuropathic Pain: Causes, Management, and Understanding has the perfect mixture of readability and scholarship. It is a superb contribution to pain management and it is likely to become a must-have textbook on the shelves of anyone interested in the field. Thus, I want to express my congratulations to the editors and the authors for their magnificent work. Marco Pappagallo, MD, is Clinical Professor, Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, New York, and Director, Pain Management & Medical Mentoring, New Medical Home for Chronic Pain, New York, New York, USA