Abstract
Dawn A. Marcus. Totawa, NJ: Humana Press, 2005. $89.50, 352 pages. ISBN 1-58829-501-X.
This is a single-author text which is geared towards primary care physicians. The book provides an overview of multiple pain-related conditions. Some of the conditions that are discussed include: headache, neck and back pain, abdominal pain, pain from arthritic conditions, neuropathic pain and fibromylagia. Chapters dedicated to paediatric pain, pain in the geriatric population as well as pregnancy and pain are provided in a special group section. Each chapter starts with a patient case history followed by key chapter points. There is then a discussion of the epidemiology of each particular pain condition, patient evaluation and treatment guidelines. A chapter on the role of opiates in chronic pain is also included. This is a controversial yet necessary topic. This chapter is nicely laid out and includes an example of an opiate contract that can be modified and then utilized by the reader. With regard to the topic of chronic headache, the appendix section provides a headache diary, headache diet and a medication/dosing table of acute and preventive agents.
What I liked about this text was the purely clinical focus, the case presentations and the nice use of tables, graphs and algorithms. Pain is a complicated subject for all physicians, especially non-pain specialists. The primary care physician is exposed to many patients with pain and they are not provided with significant medical education on the topic of pain and the evaluation and treatment of the pain patient. Dr Marcus provides a very good overview of multiple pain-related disorders.
Several items I would have liked to have seen added to the text include a glossary of pain-related definitions and a more in-depth chapter on pain pathogenesis and the anatomy of pain (pain-modulating and generating structures within and outside the central nervous system).
All in all, this is a nice introductory text to multiple pain-related topics. It will provide the primary care physician with an overview of chronic pain conditions. It would also be a useful source of information to medical students, residents and even neurologists who want a good clinical review of the management of patients with chronic pain.