Pain

One of the most critical issues in health care today -- chronic pain -- affects 34 million people. Causing untold suffering, pain also carries an enormous price tag for medical expense and lost income and productivity. This succinct and expertly written volume offers the most current thinking on pain assessment and management. As effective pain management begins with thorough assessment, so does this book, by presenting biomedical, conceptual, and biopsychosocial models. Although patients present a daunting array of idiosyncratic symptoms, clinicians are reassured that numerous viable strategies exist for tailoring treatment to the individual: pharmacologic, anesthetic, neuro-stimulatory, physiatric, surgical, psychological, and complementary. The importance of approaching pain as a multivariate syndrome is cogently emphasized in a review and analysis of psychogenic pain, an enigmatic form for which the biopsychosocial model is especially efficacious. In a uniquely formatted and practical chapter, readers accompany experts on "pain rounds," visiting patients with four common syndromes: lower back pain, neuropathic pain, migraine, and fibromyalgia. From initial consultation to case conference, diverse specialists offer professional opinions on evaluation, treatment, and difficulties that are likely to be encountered. The chapter is an elegant and useful demonstration of the multimodal approach. As this volume attests, researchers have successfully unraveled the complex physiology of pain. Now, with this book, clinicians have management models that rightly move beyond a view of pain as simply a mind-body, sensory-neural phenomenon.