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Practical Guide to Chronic Pain Syndromes

2009 Edition, November 23, 2009

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Active, Most Current

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ISBN: 978-1-4200-8046-9
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Product Details:

  • Revision: 2009 Edition, November 23, 2009
  • Published Date: November 23, 2009
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 436
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


Chronic pain syndromes (CPS) are complex problems that present a major challenge to health care providers. They are biological, psychological, and sociological in nature, may have an unclear etiology, and, frequently, poor responses to therapy. CPS, if treated in a typical mono- or bimodality manner may not give the patient the best treatment outcome, but as things are now, that may be the best that can be done for these difficult patients. Even the definition of a CPS (of any kind) may be considered unsettled, as some look at it as pain that persists more than three months, while others consider chronic pain to begin after six months. Pain that persists after physiological healing has occurred, typically in three months, posttreatment, for example, tells us nothing new—it becomes an entity in and of itself. The best way to treat it is to understand the complex interactions of the pathophysiology of pain as well as the issues of the psychological and sociological aspects of an individual patient's pain, and deal with it all as best as one can.

The purpose of this book is to give the practitioner the basics and more regarding a number of important, not uncommon, CPS that pain specialists, as well as other medical specialists see. Sometimes the most difficult issue is diagnosis— Clinically speaking, pain is what the patient says it is, and it is up to the clinician to determine what the patient means. Then the treatment phase begins and this may engender the use/need of chronic opioids, physical therapy, and psychological therapy—whatever it may take to help your patient's chronic pain problems.

Chronic pain can be considered to be like diabetes or hypertension—a disease that can be treated and controlled, but not necessarily cured.

Practical Guide to Chronic Pain Syndromes has been written for the noninterventional pain specialist as well as for other physicians who treat chronic pain of one, two, or multiple types. All of the pain syndrome chapters have information on a specific disorder, the pathophysiology, the treatment, any evidence-based medicine issues and, of course, up to date references.

I have elected to place the largest section, "Neuropathic Pain," first. This is followed by a section on probably the most common pain problems: the soft tissue pain syndromes including myofascial pain and fibromyalgia. One of the most frequently missed problems in my longer than a quarter century of patient care is the piriformis syndrome, which is also discussed in detail. Mechanical and neuropathic low back pain are also discussed in detail.

Many times, pain specialists are asked to deal with visceral pain syndromes such as interstitial cystitis and vulvovestibulitis, which are discussed by experts, along with prostatitis.

Cancer pain and palliative care are ever-growing issues and separate chapters dealing with both are included.

The section titled "Other Pain Syndromes" includes chapters on osteoarthritis, electrical injury, and neurogenic thoracic outlet syndrome.

Finally, no book would be complete, practical, and useful if it did not include a medications section. 

I want to thank the many erudite, patient focused, and excellent contributors to this textbook.

It was an honor and a pleasure to work with you! It was a long road to get to here, and I believe it has been well worth it for the pain specialists, neurologists, anesthesiologists, physiatrists, urologists, rheumatologists, oncologists, general practitioners, internists, psychologists, nurses, physical therapists, as well as the residents and fellows and others who may benefit from the knowledge contained in these books.

Most of all, our patients should receive the ultimate benefit of this work.