Publications
APS Bulletin • Volume 15, Number 2, Spring 2005
Resource Reviews
John D. Loeser, MD, Department Editor
Handbook on the Pharmacological Management of Chronic Pain
Reviewed by John D. Loeser, MD
Gerald M. Aronoff, Charlotte, NC: WaveCrest Publications, 2004, 339 pages, $29.95 (soft cover), ISBN 0-9758944-0-4.
Dr. Aronoff, with the help of 11 other pain experts, has produced a very authoritative text on the treatment of chronic pain patients with medications. He has deliberately omitted any discussion of other treatment modalities, even though he, as much as anyone active in the field of pain management, knows full well that drugs alone may not be an adequate solution to the problems of chronic pain patients. My fear is that those who buy and use this book will not be as savvy as its primary author and think that medications are the only, or even the best, treatment for patients with chronic pain. Readers should recall that whether one is looking at opioids, anticonvulsants, or antidepressants, the magnitude of pain relief is about 30% for most chronic pain patients. This is certainly better than zero, but by no means enough!
All aspects of drug treatment for chronic pain are covered, from oral to topical agents. The initial chapter on strategies for the use of drugs is particularly instructive. Subsequent chapters cover nonopioid analgesics, opioids, adjuvants, botulinum toxin, topical analgesics, and headache management.
The book is laden with pearls based upon 35 years of clinical experience by one of the great doctors in American pain medicine. This makes it far more valuable than other texts that just list drugs and doses. It has numerous tables, appendices, and diagrams that add to the narrative in each chapter. Chapter references and a useful index are included. Although lots of the information comes directly from the drug manufacturers’ materials, there is a full discussion of the pros and cons of each medication. This is a good book for those who treat chronic pain patients; it is a ready-to-use source of information about pain medications.
Dr. Loeser is Professor of Neurological Surgery and Anesthesiology at the University of Washington in Seattle.
Reviewer content represents the opinion of the reviewer, not APS.
Please direct your suggestions for future Resource Reviews to John D. Loeser, MD, Department Editor, at jdloeser@u.washington.edu.