Follow Us On
Contact Us
info@ampainsoc.org847.375.4715
American Pain Society
4700 W Lake Ave
Glenview, IL 60025
John D. Loeser, MD, Department Editor
Reviewed by John D. Loeser, MD
E.M. Catalano & H.H. Hardin, New Harbinger Publications, Oakland, CA, 1996, 251 pages, $17.95, ISBN 1-57224-050-4
This book claims to address the chronic pain patient. It provides an overview of the cognitive-behavioral approach to chronic pain, as well as chapters devoted to sleep, diet, medications, certain regional or organ-specific syndromes such as back and neck pain, fibromyalgia, myofascial pain, headache, temporomandibular disorders, arthritis, irritable bowel syndrome, and neuropathic pain. The authors believe that the book can also be used by healthcare providers who deal with chronic pain patients. The book is printed in a large format with adequate-sized type and clear line drawings to illustrate anatomy and exercises. Each chapter has 6 to 10 references to texts or articles relevant to that chapter's content. There is no index.
I am not comfortable recommending this book for patients for two reasons. First, it ignores Fordyce's final conundrum: Information is a low-power way to change behavior. Patients rarely can redirect their lives by reading a set of instructions. Second, the level of sentence construction and the concepts are above the comprehension level of many chronic pain patients. Nor do I see the book as adequate for pain therapists, with the possible exception of those who are new to the issues of chronic pain and its treatment strategies. Because the text is usually aimed at the patient, it often does not provide contextual and explanatory background.
I am concerned about the chapters on neuropathic pain. They allege the utility of unproved therapies (acupuncture, psychological strategies) for tic douloureux and downplay the proven efficacy of anticonvulsants and surgery, deny the effects of steroids for acute herpes zoster, and really do not provide information in a useful format. Some other chapters (e.g., the chapter on temporomandibular disorders) give much more useful information, presented in a careful fashion.
So this volume is either too much or too little, depending upon the reader. It may have utility for the unusually intelligent and self-motivated pain patient. However, I do not see it as a backbone of a treatment program, as it sets no treatment priorities and does not integrate the facets of a cognitive-behavioral and physical treatment program. It covers drug usage, but not strategies for removing patients from inappropriate medications. It does not deal with the issue of treating depression in the chronic pain patient.
John Loeser is professor of neurological surgery and anesthesiology and director of the Multidisciplinary Pain Center at the University of Washington, Seattle.
