Mechanisms and Management of Pain for the Physical Therapist

Mechanisms and Management of Pain for the Physical Therapist
Ed Kathleen A. Sluka, PT, PhD, IASP Press, Seattle, 2009, ISBN 978-0-931092-77-0, Soft cover, 394 pages, US$90.00. Foreword by Rebecca L. Craik PT, PhD, FAPTA, Editor-in-Chief of Physical Therapy

Kathleen Sluka has contributed much to the profession of Physical Therapy in the United States and to the better understanding of pain mechanisms and management through clinical practice, academic teaching, research, extensive contributions to and reviews of medical literature and significant participation in the work of the IASP, The American Pain Society and the American Physical Therapy Association.

The aim of the Editor has been to draw an additional twelve authors together to cover a broad spectrum of key pain issues relating to understanding and explaining pain mechanisms and how they relate to pain as a multifaceted experience. How this influences treatment through assessment, clinical reasoning and consideration of the evidence base for therapeutic intervention is considered in detail.

The book is divided into four distinct sections. The first covers four chapters of pain understanding namely definitions, concepts and models of pain, the peripheral and central mechanisms involved in pain processing and individual differences in pain variability.

Section Two covers Physical Therapy Pain Management embracing assessment, principles of practice, exercise, Transcutaneous Electrical Nerve Stimulation, other electro physical and thermal agents and manual therapy. Contributing to such chapters are Deirdre Walsh and Stephan Milosavljevic.

Interdisciplinary Pain Management constitutes the short, three-chapter third section. Eva Kosek covers Medical Management and the legendary Dennis Turk co-authoring Psychological Approaches.

The final section covers specific pain entities and their treatment; Myofascial Pain & Fibromyalgia, TMJ Disorders & Headache, Spinal Pain, Neuropathic Pain & CRPS, OA & RA, rounded off with ten Case Studies bringing the book to a sensible and practical conclusion.

All chapters have a logical flow, are well ordered and comprehensively referenced. All key terms are well indexed. Diagrams in both black & white and colour are used to enhance the text not detract from it and on the whole were a welcome addition. Some tables, whilst containing useful information, felt cluttered and harsh on the eye on occasion. The text is clear and not overly academic but given the author`s background and publishing base American English understandably predominates and this may grate with some UK readers. Likewise the point of reference for guidelines and accepted practice is firmly rooted in the US Health Care system. Case Study One may also cause raised eyebrows amongst UK readers still absorbing the recent NICE Guidance on the Management of LBP. However the firm educational messages transcend this. A minor complaint would be that the inclusion of bulleted key points at the end of chapters may have reinforced the take home messages and my review copy had two page 290`s and lacked a page 288…

The book is large enough to contain ample detail for most users and is small enough to be a practical departmental and personal reference point for pain management. I believe it is a worthy addition to the resources of any Physiotherapy Department and anticipate it will become the standard text for all undergraduates which continues to be of substantial use post qualification.

Review by Mr Martin Hey MSc, Grad Dip Phys, MCSP. Martin is Clinical Manager for Pain Services, Training and Development at the Mid Yorkshire Hospitals NHS Trust, UK. He is also chairperson of the Physiotherapy Pain Association in the UK.