Core Topics in Pain

Abstract

This book aims to provide an introduction to the field of pain medicine. The layout is clear, with many short chapters covering a wide range of topics. The book is divided into six sections, some of which are further subdivided. The first section provides a very readable and concise overview of the basic science of pain mechanisms, including changes in response to inflammation and nerve injury. This is written in such a way that readers unfamiliar with this area will easily understand the mechanisms being discussed, while also providing a comprehensive update on pain mechanisms. The second section looks at methods of pain assessment and is divided into two subsections looking at measurement of pain and diagnostic techniques. This section gives a good introduction to the principles of pain assessment. The third section entitled ‘Pain in the Clinical Setting’ is also subdivided: dealing with pain in different clinical settings, for example, in intensive care, chronic pain and post-operatively; and dealing with different pain syndromes, such as musculoskeletal pain, visceral pain and low back pain, and pain in specific groups, such as the elderly. This section is clearly laid out and allows quick and easy access to relevant information on a particular topic. The fourth short section is entitled ‘The Role of Evidence in Pain Management’. While this could perhaps have been incorporated into other sections of the book it does give a very valuable and thought-provoking review of evidence for current practice. The fifth section is a large section subdivided into different treatment modalities for pain, focusing predominantly on chronic pain. Within this section there is a subsection about physical treatment options. While not comprehensive, each chapter offers useful information about particular physical treatments, as diverse as physiotherapy, acupuncture, regional nerve blocks and neurosurgery. The subsection on pharmacological treatment has chapters on commonly, and some less commonly, used analgesics that are informative and helpful. The fourth subsection gives an introduction to more specialised areas of pain management including managing patients with psychiatric disorders or addiction, paediatric pain and cancer pain. The title of the final section as ‘Summaries’ is rather misleading, as the two chapters in this section do not summarize the preceding chapters. Instead, they deal with some of the ethical issues presented in pain management and look at the use of guidelines. Multiple authors have contributed their expertise in particular areas—it would be of interest to see the affiliations of each author. The style of each chapter is quite variable, probably a reflection of the many contributors, although this does not necessarily detract from the book as a whole. Illustrations are clear and concise, with well-presented tables. The key points at the end of each chapter and the suggested further reading lists are helpful. Some chapters are very well referenced, providing good further reading lists and useful web addresses, while others are more limited. The comprehensive index is well laid out and aids in finding relevant information quickly. There is also a useful glossary of terms for those who are relatively new to the field. Overall, this book is not only an excellent introduction to the field of pain management, but will also provides a good reference tool for anyone involved in the treatment of patients in pain. Additionally, it will be a valuable aid to anyone preparing for the FRCA and other postgraduate qualifications in the field of pain, with a highly readable style and comprehensive coverage of most areas of pain management.