The management of various chronic pain conditions poses a significant challenge for providers of all specialties, particularly in the era of the opioid epidemic. Education on pain management, however, is often lacking in medical schools. This omission may prove disastrous in the current social climate. Recent literature concludes that trainees are not comfortable in managing chronic pain patients and demonstrates that even first-year medical students have formed negative attitudes toward patients with chronic pain in early clinical rotations.1 The task of reading a comprehensive textbook on pain management to supplement understanding of such a crucial topic may be daunting to a trainee or medical student with limited time. Pocket review books are invaluable to this group, and many highly rated pocket review books exist for a variety of subspecialties including anesthesiology and surgery.
Chronic Pain Management, by Thanthullu Vasu, Shyam Balasubramanian, Mahesh Kodivalasa, and Pradeep Mukund Ingle, is an excellent choice for medical students or trainees on a pain management rotation, practitioners in primary care or internal medicine looking to further their knowledge of chronic pain management, or postmatch residents looking for prereading before starting a pain management fellowship. The book is 318 pages long and is split into 55 succinct chapters, none of which exceeds 10 pages in length. This makes for a particularly time-efficient read; a short 20-minute reading session may allow readers to cover a few chapters. The ability of the authors to condense pertinent material, even that which pertains to complex topics such as the physiology of pain in Chapter 3, is very impressive. The first half of the book is devoted to characterization of pain including that of the International Association for the Study of Pain, outlining pain assessment tools, and discussion of the presentation, pathophysiology, diagnosis, and management of various painful conditions. The second half details all of the pieces of a multimodal analgesic plan, including injection therapy, pharmacologic options, and noninterventional techniques such as physical therapy and complementary medicine. Unique to this book is a brief chapter on management of chronic pain in the current COVID-19 pandemic.
This book will make an excellent companion for a medical student or resident on a chronic pain management rotation or as a primer before pain management fellowship. The authors recommend this book as a study resource for competitive examinations such as the American Board of Anesthesiology subspecialty examination in pain. I believe that this book is not a sufficient stand-alone resource in studying for such an examination, or as a sole resource in preparing for clinical practice. The chapter on radiofrequency ablation is limited to just over two pages and certainly is not comprehensive. It only pertains to lumbar medial branch radiofrequency ablation and does not cover water-cooled radiofrequency or cryoablation. A discussion of the evidence for lumbar radiofrequency ablation, a comparison between various types of ablation methods, the applicability of radiofrequency ablation to other painful conditions beyond lumbar facet arthropathy, and a more complete explanation of the physics involved in radiofrequency would be very helpful to a nascent pain management physician. Expansion of certain topics such as pain management in pregnant patients and in children (which is combined in Chapter 42, Pain Management in Special Populations) would be useful in board examination preparation as well as clinical practice.
Overall, I am delighted to endorse this review book to anyone hoping to gain a better understanding of chronic pain management. It is well written, easy to follow, and promises to be an efficient read. My hope and belief is that those who read this book will gain a better overall view of pain management and what providers in this specialty have to offer, as well as some solid background on the management of chronic pain in the outpatient and inpatient settings. Hopefully, this book will allow practitioners to fill in knowledge gaps in education and feel more confident in managing patients with chronic pain.
