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American Pain Society
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John D. Loeser, MD, Department Editor
Reviewed by Bradley S. Galer, MD
W. Janig & M. Stanton-Hicks (Eds.), International Association for the Study of Pain Press, Seattle, 1996, $55, 249 pages, ISBN 0-931092-13-2
As a clinician and researcher interested in this condition, I looked forward to reading this new text. On completion of the book, however, the part of me wearing the clinician hat was left rather unfilled and unsatisfied, while the part wearing the researcher hat overflowed with facts, concepts, and thoughts based on scientific study.
Unfortunately, it seems that many of the clinical chapters in the book were written before the era of Complex Regional Pain Syndrome, Type 1, which has made the diagnosis of this condition purely clinical. To minimize the confusion in the text and to bring the reader immediately into this new era, I suggest reading Chapter 5 first, which discusses the current classification and concepts of complex regional pain syndromes and sympathetically maintained pain. The discussions about the role of laboratory tests and sympathetic nerve blocks in the diagnosis of reflex sympathetic dystrophy are outdated. In addition, many of the clinical chapters are much less a reappraisal than a reaffirmation of old clinical dogma based on anecdote and supported by little or no scientific data, epidemiological study, or controlled clinical trials. For the clinician, a significant shortcoming in this book is the lack of a discussion and reappraisal of the treatment(s) of this refractory condition.
The latter half of the book contains several superb chapters, including reviews of both animal and human experimental studies and of psychological issues. The chapter entitled “The Challenge and Problem of Placebo” is excellent and all pain clinicians and clinical researchers should read it.
I strongly recommend this volume to those with an interest in complex regional pain syndromes, especially researchers. However, clinicians who are looking for a new insight from which new treatment recommendations might evolve will not find them in this book.
Bradley Galer is assistant professor of anesthesiology and neurology and a member of the Multidisciplinary Pain Center at the University of Washington in Seattle.
