Fundamentals of Pain Medicine, 1st ed

Abstract

Pain is a unifying presenting symptom across many medical specialties. Nearly all physicians are routinely asked to provide quality care to patients whose primary request is assistance with pain control. However, most physicians feel ill-equipped to manage pain, especially in the chronic setting, which inevitably leads to increased patient suffering. In many cases, physicians without specialty training in pain are tasked with treating complex pain patients when pain physicians are not readily available. Fundamentals of Pain Medicine aims to level the playing field, so to speak, for physicians across varying fields who aspire to better treat their patients’ pain complaints. This text offers invaluable information regarding diagnosis, understanding, and treatment of both basic and complex pain states. Fundamentals of Pain Medicine is offered as a paperback text, as well as an eBook. The 359 pages of this book are easily viewed via the eBook platform, which also allows for zooming for improved visualization of the numerous figures used throughout to illustrate complex concepts. The 36 chapters are well organized in easy to manage sections that allow for quick reference to pertinent topics. The text covers 9 distinct topics: diagnosis of pain states, management of pain states, acute pain, chronic musculoskeletal pain, radicular pain, neuropathic pain, chronic visceral pain, headaches, and painful disease states in special populations (pediatrics, geriatrics, and the critically ill). The book is organized logically and with progressively more detail to allow for further investigation by the reader, as dictated by their interest. The sections can easily be referenced for rapid assistance in patient management, or the whole text can be taken in as a guide in the overarching themes of successful pain medicine. A strength of this text is its structure and ability to break pain states down by etiology, leading to improved clinical utility and more appropriate treatment plans. As is well known by pain physicians, the cause of the pain states often dictates the utility of various modalities and likelihood of success in treatment. In short, not all patients’ pain complaints can be treated using the same pharmacological and interventional techniques, and this text clarifies this concept and appropriate approaches. The chapters are broken down into etiologies of pain and their evidence-based treatment courses, which allows for improved patient response, particularly for physicians who may be less familiar with some of the rarer pain etiologies. For example, chapter 23 describes complex regional pain syndrome pathophysiology, epidemiology, diagnosis, and management. This chapter may prove quite valuable in directing the multimodal treatment of complicated, refractory pain patients seen by physicians who do not routinely treat complex regional pain syndrome patients. The author provides thorough details regarding levels of evidence, as well as a cogent summary of recommendations at the end of each chapter, allowing for improved understanding and more effective delivery of patient care. Fundamentals of Pain Medicine reads easily and functions as an excellent reference for those needing a quick refresher course on the nuts and bolts of pain medicine. In fact, many physicians in various fields could offer significantly improved pain management for their patients, namely those in primary care settings without immediate access to pain physicians, simply by consulting relevant chapters. This book may be especially useful for primary care physicians tasked with providing long-term care for patients with complicated, chronic pain conditions. For the trained pain physician, Fundamentals of Pain Medicine offers a concise, well-written summary and reference in a pinch but may fall short when it comes to in-depth analysis of physiological mechanisms of pain and more innovative, up-and-coming interventions. However, following the summary of each chapter, a comprehensive list of suggested readings offers an opportunity for a more detailed perusal into various topics as may pertain more so to specific patient populations, allowing for a more thorough understanding. For physicians of specialties outside the realm of pain management looking to improve efficacy of pain interventions in their patient populations, Fundamentals of Pain Medicine provides a concise overview of the physiological mechanisms, etiologies, and appropriate management of a multitude of pain states that is easy to read and comprehend. The text is extremely practical in its delivery of recommendations, including both pharmacological and more complementary and integrative techniques. This book serves as an excellent initial stepping stone in providing quality pain treatment for patients with common pain states and should be considered a staple desk reference for all physicians interested in improving their patients’ pain control. Caitlin D. Tourje, MDAmanda M. Kleiman, MDDepartment of AnesthesiologyUniversity of VirginiaCharlottesville, Virginia[email protected]