Publications
APS Bulletin • Volume 14, Number 1, 2004
Resource Reviews
John D. Loeser, MD, Department Editor
Explain Pain
Reviewed by John D. Loeser, MD
David S. Butler and G. Lorimer Moseley, Adelaide, Australia, Noigroup Publications, 2003, 126 pages (soft cover), ISBN 0-9750910-0-X. $70 AUD (Australian). Order online at www.noigroup.com, or phone +61 (0)8 8211 6388
This is an unusual antipodean book. Its conceptual foundation, content, and artwork are unusually good. Also unusual are a spiral-bound, nonstandard shape and text size targeted to both patients and healthcare providers.
The authors present four goals: to communicate basic science information to clinicians and their patients, to educate people with pain so that they can gain understanding and have less fear, to assist people in pain to make good management choices, and to outline modern management models. They have succeeded on all four fronts.
The original artwork (the book features 90 illustrations) is superb, as are the illustrations of anatomy and physiology. The page layout, the use of color, and the morsels of information are presented in a way that recalls the delights of a smorgasbord in Sweden. Rather than lengthy chapters, the book is constructed of brief paragraphs, each with a single point. Bold-face is used to indicate paragraphs of particular importance. Cartoons of nerve cells and the brain are both fun and factual, laden with essential information.
The management sections focus on physical modalities and cognitive/behavioral conceptualizations of chronic pain. They are on target, but the omission of any mention of pharmacological or procedural interventions does not give patients a fair picture of all options available for some pain syndromes. An illustration of an onion skin model of pain on page 97, said to be based on Waddell, has some familiarity to me. The way this onion skin is drawn, however, violates the principles of this type of diagram, which originally was constructed to emphasize that nociception, pain, and suffering were personal, private, internal events that could only be inferred on the basis of pain behaviors emitted by a patient. To put pain at the root of the onion and nociception on the innermost section is not helpful as an explanatory model.
Overall, this is a great book. It is packed with the right messages for patients and healthcare providers and presented in a visually pleasing format. I highly recommend it for one’s patient library and as an introductory summary for those who are entering the field of pain management.
Dr. Loeser is professor of neurological surgery and anesthesiology at the University of Washington in Seattle.
Reviewer content represents the opinion of the reviewer, not APS.
Please direct your suggestions for future Resource Reviews to John D. Loeser, MD, Department Editor, at jdloeser@u.washington.edu.