This book is aimed at all who have chronic pain, but is actually only relevant to the more motivated and intelligent patient or perhaps a pain clinic nurse, medical student or other allied health professional.
The four Australian authors are erudite and include a clinical psychologist, an anaesthetist, a physiotherapist and a nurse who write about their successful ADAPT programme of active day patient care, which is mainly psychotherapeutic.
A detailed questionnaire is given on page 2 which tells one whether the book is suitable – by which time the book will have been bought!
The mechanisms of chronic pain are described in too much detail, likewise details of the drugs. Little mention is made of increased pain in depression and the antidepressants that specifically help pain have not been accentuated ie. the tricyclics and SNRIs. Duloxetine has been found to help peripheral neuropathy and fibromyalgia, which was not mentioned.
Acupuncture has been dismissed as a short term treatment with small needles when there is evidence for some benefit in chronic pain especially with longer needles and electro-acupuncture. Stretching and exercises merited 37 pages but there were only 6 pages for relaxation techniques
On showing the book to a graduate scientist with various pains he replied that patients want a quick fix and wouldn`t want to wade through a book like this.
All in all I’m afraid I feel this is over-detailed for patients but may be of interest to a health professional.
Dr Rosemary Alexander is a GP in West Hendon.