Mechanisms and Management of Pain for the Physical Therapist.
Article Type: Book review
Subject: Books (Book reviews)
Author: Rice, David
Pub Date: 07/01/2010
Publication: Name: New Zealand Journal of Physiotherapy Publisher: New Zealand Society of Physiotherapists Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 New Zealand Society of Physiotherapists ISSN: 0303-7193
Issue: Date: July, 2010 Source Volume: 38 Source Issue: 2
Topic: NamedWork: Mechanisms and Management of Pain for the Physical Therapist (Nonfiction work)
Persons: Reviewee: Sluka, Kathleen
Accession Number: 263992605
Full Text: Mechanisms and Management of Pain for the Physical Therapist. Kathleen Sluka (Editor). 2009. IASP Press, Seattle ISBN 978-0-931092-77-0, soft cover. 394 pages. 90.00 US$

The editor of this book, Professor Kathleen Sluka, is a physiotherapist and internationally recognized pain researcher who sits as a councilor for the International Association for the Study of Pain (IASP). She has made an outstanding contribution to her profession, having published over 100 peer-reviewed journal articles focusing on the neural mechanisms of musculoskeletal pain and its treatment by physiotherapy interventions such as TENS and manual therapy. As outlined by Sluka, the purpose of this book is to provide students and clinicians with an up-to-date and comprehensive education in pain management, as recent advances in pain research continue to outstrip the minimal coverage this topic receives in undergraduate physiotherapy courses.

The book is divided into 4 sections that are further subdivided into chapters, with contributions from 13 different authors. Section 1 starts by presenting the basic definitions and models of pain before outlining the neurophysiological mechanisms involved in pain processing and modulation. This includes some detail on the neurotransmitters involved and importantly, emphasises the neuroplastic changes that occur within the nervous system following tissue damage. Finally, differences in pain processing are explored with respect to genetics, gender, age, ethnicity and psychological traits. Section 2 is specifically concerned with physiotherapy pain management and includes chapters on pain assessment, exercise induced analgesia, TENS and manual therapy. For each of the modalities included, a review of the known neurophysiological mechanisms is presented and some key clinical considerations are discussed. Section 3 deals with interdisciplinary pain management with a focus on chronic pain and includes chapters on the medical treatment of pain (including basic pharmacology) and psychological approaches to pain management. Section 4 is divided into a series of chapters dealing with the pain arising from specific pathologies/syndromes. These include myofascial pain and fibromyalgia, temporomandibular disorders and headache, spinal pain, neuropathic pain and pain associated with arthritis. Finally, a series of 10 case studies bring the book to a close. Each case study begins by outlining the key subjective and objective assessment findings. From these, patients are dichotomized as displaying primarily a peripheral component to their pain, primarily a central component, or both, and a treatment plan is provided accordingly.

This book provides a well balanced, contemporary overview of a complex topic. It is set out in a logical manner and is well indexed, making it easy to read and navigate. This is further enhanced by the use of diagrams and tables to supplement the text.

The book has a broad scope, covering a range of relevant topics and emphasizing a biopsychosocial understanding of pain--that pain does not simply depend on nociceptive signals but is strongly influenced by psychological and sociocultural factors. In general, the earlier sections on pain mechanisms and physiotherapy management provide sufficient detail without obscuring the key, take home messages. However, as with many edited texts, the quality varies somewhat from chapter to chapter. In addition, the pathology specific chapters in section 4 seemed brief and read a little like a Cochrane review providing a general overview of each topic while missing some of the subtleties that may be useful for clinicians. Nevertheless, the core principles in the text are sound and Sluka's evidence based bias is a real strength of this book, enabling the reader to make informed clinical decisions to enhance pain management.

Overall, this is an excellent text for physiotherapy students and a valuable resource for clinicians wanting to improve their understanding of pain mechanisms and its effective management.

David Rice

Senior Research Officer

Health and Rehabilitation Research Institute

AUT University
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