Edited by Stephen E. Abram and J. David Haddox. Philadelphia, Lippincott Williams & Wilkins, 1999. Pages: 480. Price: $45.00.

This is a multiauthored manual (32 contributors plus editors), containing six sections plus appendices. Chapters, 40 in total, ranging in length from 2 to 12 pages, divide each section.

It is a practical, portable guide for the treatment of chronic pain. As well-explained in the preface to the first edition, the manual per se  is not a definitive reference because it contains limited information about the pathophysiology of the common and rare painful disorders presented, and it does not detail the technical aspects of treatment. However, the book does provide the experience and likelihood that a particular modality of assessment or treatment will be beneficial. The book focuses on the priority of a multimodal approach for pain treatment because the practitioner who applies a single modality to the entire range of pain conditions costs his or her patients and society financially and in personal suffering.

Part I, the introduction, includes the subjects Pain Clinic Organization and Staffing, Pain Pathways and Mechanisms, and Pain: The Patient’s Perspective in three chapters. Part II discusses Patient Assessment, including collection of data, physical and psychologic assessment, and, finally, diagnostic and prognostic nerve blocks. Part III focuses on different treatment methods, including pain rehabilitation programs, intrathecal drug administration, local anesthetics, opioids, and alternative treatment, such as electrical stimulation of the nervous system. Adjuvant drugs are well-presented in a two-page table. The management of the most common pain disorders, such as back pain, myofascial pain, complex regional pain syndromes, sympathetically maintained pain, acute herpes zoster, neuropathies, facial pain, headache, chronic pelvic pain, central pain syndromes, chronic pain in children, and substance abuse, are described in part IV. Part V discusses information about cancer pain, palliative care, radiation therapy, neurolytic blocks, and the psychologic assessment. Part VI discusses sympathetic blocks, epidural steroids injections, peripheral nerve blocks, and head and neck blocks. It contains a reasonable amount of figures to help the reader. Finally, the appendices are short but useful and interesting.

In general, the book The Pain Clinic Manual, Second Edition  describes in a short and nice way what was proposed for each chapter, showing the best individual viewpoints of each coauthor. In addition, because it provides limited information about the pathophysiology of the common and rare painful disorders presented, I advise the book for two distinct groups. The first one, those already trained in pain syndromes and treatment, will consider this book to be an excellent manual for reference; the second one, those not familiar with pain modalities and not working in clinical practice with pain, will consider the manual to be a reference text for further information for pain specialists.