I really learned a lot from this book! Super informative and engaging!! I highly highly recommend for all my med students out there who will be treating people in any type of pain
I took a personal interest in this subject since I required the services of a pain clinic for a herniated cervical disc. The clinic literally saved my life. Interesting, technical read.
The author provides the many facets that make up the healthcare treatment of chronic pain. He presents many interesting clinical case studies, physiology, medication, and the environment for healthcare delivery. Furthermore, the Dr Lalkhen provides the dark side of medicine as it pertains to pain-specialized physicians. Hence, the opioid epidemic and the fruition of opioids jumping from cancer pain to chronic pain. I was pleasantly surprised with some of the topics the author wrote regarding neuroscience. Although brief, he mentions the correlation between grey matter and patients with back pain, the connectome, and various enzymes that may provide a clue as to why some people get chronic pain and others do not. Furthermore, the author extensively writes about the mind's experience of pain and the differences between being in pain and suffering. I have worked with chronic patients utilizing neuromodulation techniques. In conclusion, the author is spot on regarding the psychological aspects of pain and how catastrophizing about the pain only serves to amplify it. I was quite impressed with the chapter, "Give Me Something For the Pain". Here, Dr. Lalkhen describes the various medications used to treat pain and the mechanism as to which the drugs manipulate neurotransmitters and hormones to provide "pain relief" and side effects. Furthermore, Dr Lalkhen cites that 56% of patients who have had a technically successful knee replacement continue to experience pain. I believe he is spot on when he references weight loss and strengthening the quadriceps muscles as a cure for the pain. Muscles are underlooked in medicine and are one of our most powerful assets regarding longevity and quality of life. "Poor lifestyles cannot be medicated, and wellness cannot be prescribed". This book was published in 2021 but the author only briefly touches on spinal cord stimulation (SCS) for chronic pain and nothing about peripheral nerve stimulation (PNS) for chronic pain. That was most disappointing as I work in the field of Neuromodulation. Although PNS is brand new to the industry, there is plenty of literature out there regarding its efficacy in many kinds of neuropathies. The author was spot on regarding medicine's disconnect from properly understanding the complexity between the psychological and biological aspects of pain. This, in turn, will lead to poor treatment and understanding of chronic pain. Furthermore, Dr Lalkhen's take on how pain is propagated at the initial instance of injury is as follows: Transduction, Transmission, Perception, and then Modulation. During Perception and Modulation, we attach meaning to injury. Hence, the pain has been processed and modulated in the brain and the result is what we end up feeling and how we interpret this sensation.