Division of Rehabilitation Medicine, Department of Clinical, Sciences, Karolinska Institutet, Danderyd University Hospital, E-182 88 Stockholm, Sweden. E-mail: email@example.com
Pain Care Essentials and Innovations, Sanjog Pangarkar, Quynh G. Pham, Blessen C. Eapen (editors). pp. 294, 2021. Price €84.99 . ISBN: 978-0-323-72216-2. Elsevier Inc., Amsterdam, The Netherlands. Elsevier.com/books-and-journals
This book comprises 18 chapters written by a total of 41 authors, all listed in the Preface. The book has an impressive aim regarding its content; the chapter subjects range from basic pain mechanisms to headache, palliative care, pain and addiction, and geriatric pain. The intended reader is a general practitioner or other healthcare professional with an interest in pain medicine. All chapters have a reference list.
Two chapters should be mentioned in particular as essential and innovative, as implied by the book title. Chapter 9, addresses pain and addiction. Although this chapter’s suggestions for treatment and management are mainly for the American reader, the information is comprehensive and important, reflecting the immense and iatrogenically induced overuse of opioids worldwide. Chapter 10, focusing on the treatment of geriatric pain, provides important information for the clinician involved in everyday pain practice. In addition to a well-written text about geriatric pain treatment, this chapter also includes 2 tables summarizing the physiological changes that occur with ageing, together with dosing considerations and indications for treatment.
Another chapter focuses on the use of cannabis in pain treatment, which is intriguing and difficult. The chapter includes comprehensive information about cannabis receptors, available forms of administration (for the American reader), and a review of the literature regarding the possible fatal effects of both cannabis and opioids. Figures show the large increase in deaths due to opioid overdose. What the chapter lacks, however, is any scientific information about endogenous cannabinoids, or scientific evidence regarding the treatment of clinical pain.
The shortcoming of this book is, by its nature, its wide scope, making the content of some of the chapters superficial (e.g. the chapters about visceral and neuro-pathic pain). Many clinically important pain-related diagnoses are missing or mentioned only in a sentence (e.g. fibromyalgia, low-back pain, and, more specifically, diagnoses such as endometrioses). Furthermore, the editors include very little reading about pain mech-anisms in the first chapter, despite the fact that one of the co-authors is Tony Yaksh, a renowned scientist in the field of pain research. In modern pain medicine the mechanistic discussion is of utmost importance for the understanding of the development of longstanding pain. The chapter on rehabilitation in pain medicine is almost 100% focussed on passive strategies, such as traction, Rolfing® and “Swedish massage”; meth-ods with little importance and supporting scientific evidence in modern pain rehabilitation. Cognitive behavioural therapy and multimodal rehabilitation; treat-ment strategies with supporting scientific evidence, are scarcely mentioned. In my opinion this area should have a chapter of its own.
In summary, this book provides informative reading about opioids and pain, use of cannabis in the USA and treating geriatric pain. However, it cannot be used as a comprehensive and up-to-date instructive book for clinicians in everyday practice.