Topical Issues in Pain 4: Placebo and nocebo. Pain management. Muscles and pain.

Edited by Louis Gifford

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It was a pleasure to be asked to review this book. It is a book by enthusiasts for enthusiasts.

Each chapter is written by a different clinician which makes one of the book’s strengths the differing perspectives they all bring. There is however a consistent narrative and the articles are very readable and complement each other well.

The authors explore the way that the patient’s experience of pain alters from onset. It offers some refreshing insights into why the nature of a patient’s pain changes and where the opportunities occur and barriers arise when engaging as clinician or therapist. This book considers the broader issues underlying the patient’s response to pain and why this may be ‘adaptive’ or ‘maladaptive’ even in evolutionary terms. It demonstrates the value of understanding this.

One cannot but help be impressed that of all potential therapies, the placebo effect is one of the most researched and evidence based. Traditional teaching continues to either overlook or dismiss it, always hoping for something that out-performs it. One of the themes cogently argued throughout is that this is a mistake – both to miss it’s positive effects and risking negative (nocebo) ones. This serves as a useful reminder to us all and this book goes a long way to provide a fairer and more pragmatic analysis of this valuable therapeutic observation.

All the articles are well referenced, however this book is not an academic’s tome, as it clearly arises from much experience gained treating patients.

Dr Mark Reeves