Topical Issues in Pain 5 – Review

Topical Issues in Pain 5: Treatment; Communication; Return to Work; Cognitive Behavioural; Pathophysiology.

Louis Gifford Editor

[Go to the Topical Issues in Pain page to link to sellers]

Following on from the huge success of the previous four books within the Physiotherapy Pain Association’s Topical Issues in Pain Series, this is the eagerly awaited fifth book in the series. Like those earlier books, it brings interesting, exciting and readable work within the field of pain right to the forefront of physiotherapy.
Topical Issues in Pain Five is directed not just at those working within pain management programmes. It is relevant to all physiotherapists and other clinicians who work with patients who have acute or chronic pain, whether seen individually, or within a group. It does a good job of introducing the biopsychosocial approach for those new to it and gives those familiar with it further useful models which they can apply to their own practice.

This impressive book brings together work by many experienced clinicians, working in a variety of clinical and non-clinical settings. It provides a really useful balance between theory, practical case scenarios and transcripts of patient-therapist interactions, giving the reader easily accessible information, based upon up to date experience and research.

Topical Issues in Pain 5 is divided into five parts, each covering different topics. In Part 1, looking at treatment, Steve Robson and Louis Gifford discuss manual therapies, their clinical roles and links to pain theory and current evidence-based practice. Part 1 is both challenging and exciting, with content which will encourage us all to review our clinical practice, treatment rationales and, most importantly, our approach to our patients.

Part 2 discusses communication. Chapters by Steve Goldingay, Anne Daykin and Jennifer Klaber-Moffett and colleagues remind us that communication, despite being a skill we all have, is something we must continue to reflect upon and develop our skills further. The chapters provide some very useful ways to ensure that the most appropriate and useful information is gathered, shared and translated between clinician and patient. All the authors stress the importance of the biopsychosocial model and consider how best to allow the patients to tell their story and feel they are being heard. From here the emphasis is on a patient-centered treatment and management approach involving shared information and open discussion of the various options available. This is in direct contrast to the clinician-biased and much more prescriptive medical-model style of approach that is repeatedly being shown to be unsatisfactory for the types of patients that concern us. Penny Mortimer writes an especially valuable chapter for those involved in requesting investigations or discussing their role and results with patients. She includes a practical guide to the best ways to reassure patients about the purpose of, and need, for investigations – and how to reassure them when investigations are or are not indicated.

The third section in the book provides a much needed and comprehensive review of the huge topic of return to work. This is a very timely section; clinicians’ awareness of work issues is becoming ever more relevant to successful patient care. Gail Sowden guides us easily through vocational rehabilitation, epidemiology and costs of work and sickness absence. Obstacles to return to work are expertly examined by Paul Watson and Shilpa Patel, with later chapters looking specifically at the issues for patients with chronic pain. This section is full of useful information for the clinician and for patients. Jaqueline Adams’ chapter provides the clinician with immediately applicable skills. Nicola Hunter’s chapter on her programme for back pain management in an occupational setting, with its use of a case study format and measures, is particularly valuable for those working in this environment or wishing to get involved in it.

Part 4 deals with important cognitive-behavioural issues. It includes a helpful overview by Francis Keefe, Cindy Scipio and Lisacaitlin Perri of the psychological approaches currently used for managing pain, with each approach described and briefly critiqued by the authors. This chapter will be useful for everyone working with patients who have pain, as it allows us all to bring some more awareness, understanding and insight into our practice. Post-traumatic stress disorder and the components of Cognitive Behavioural Treatment management are usefully discussed in subsequent chapters. The chapter by Mark Jones and Ian Edwards challenges the physiotherapist to consider and review their own learning styles, and to question how best to give information and work within the cognitive behavioural approach. This stimulating and thought provoking chapter encourages us to establish an ongoing exchange with patients and to remember that no one patient is ever the same. Thus, while the Cognitive-behavioural approach is based on using the same principles for all, it works best when we remember that we must see each patient as an individual. The authors suggest that by utilising the specific reasoning frameworks reviewed, physiotherapists can promote genuine change in patients.

Finally, in part 5, three world experts review and discuss three important areas of pain pathophysiology: Lorimer Moseley fluently explains the role of the reorganisation of the sensory cortex that has been shown to occur in chronic pain states; George Koumantakis gives us an in-depth and highly critical review of muscle activity and pain; and Steve Thompson explains the complexity of spinal cord processing in relation to chronic pain.

Without a doubt, Topical Issues in Pain 5 is a must-have for all clinicians (and students) wanting to ensure they keep up to date with the best of current research and practice in the field of acute and chronic pain. It is a useful, practical resource that can add real value to the work of the clinician, practice or department. And like the other books in the series, it will appeal to those who enjoy being stimulated and challenged, who want to continue to consider and debate what constitutes best practice in the treatment and management for pain and to help our patients to join in that debate.

I highly recommended this book, and as with all previous books in this series it is a reflection of the high standard of the PPA study days and conference presentations which lie behind the series.

Suzanne Brook
Chartered Physiotherapist
May 2006

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