Treatment of Chronic Pain: The AAPM Textbook on Pain Management

This book represents an important effort by the American Academy of Pain Medicine to prepare a single text that provides a comprehensive overview of the field of pain medicine. The focus of the textbook is on the treatment of chronic non-cancer pain, so there is little discussion of acute pain or palliative care. The book aims to provide the reader with a detailed discussion of interventional therapy, medication management, rehabilitation, and psychological therapy for the treatment of pain. Another aim is to provide an illuminating discussion of the suffering the patient with chronic pain may experience, a topic often missing in other textbooks. The textbook represents a significant effort by a number of individuals. The project was led by seven editors and over 150 contributors. The effort involved in assembling the 1059 page text is impressive, but the large number of editors and contributors creates challenges with regard to organization and readability. Nonetheless, I found several chapters to stand out for their particularly clear, informative writing and high-quality figures. The book is divided into five major sections. The first section offers 19 chapters that discuss medical approaches to the treatment of pain. Opioids are an important discussion topic, as seven of the 19 chapters discuss the use of opioids to treat pain. The next three sections discuss interventional therapy for the treatment of chronic pain and include detailed discussions of specific procedures and techniques. Although the textbook does not appear to be intended to guide the clinician on the technical aspects of how to do a particular intervention, several of the chapters provide an excellent overview of the conduct of a specific procedure. The last section provides a discussion of a variety of alternative pain therapy modalities, including psychological therapy, rehabilitation, and complementary and alternative therapy. Of particular interest are the discussions regarding the impact that chronic pain can have on the patient and family. Several important topics, such as aberrant drug-related behavior, addiction, and sleep disorders, are discussed throughout the text by different authors. This provides the reader the opportunity to read and understand different aspects of these conditions that the pain physician often needs to address. Other chapters introduce the reader to complementary and alternative approaches to pain therapy. Although one can argue the usefulness of some of these techniques, it is important for the practicing physician to be aware of the core concepts related to them. On balance, I believe this textbook will be an important resource to the health care provider interested in having a single resource that covers the vast spectrum of chronic non-cancer pain and its clinical management. Michael A. Ashburn, MD, MPH, is Professor of Anesthesiology and Critical Care and Director, Pain Medicine, Penn Pain Medicine Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.