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Dynamic Chiropractic
June 17, 1994, Volume 12, Issue 13

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Book and Journal Reviews

By Stephen M. Savoie, DC, DABCO

Title:       Pain:  Mechanisms and Management
Author:      Rene Cailliet, MD
Publisher:   F.A. Davis Company (215) 568-2270
Category:    Doctor education
Publication: Softcover book, 299 pages, $19.95
Over the past 30 years Dr. Cailliet has brought the health disciplines a number of books, many now in their third and fourth editions, dealing with pain on a regional basis. From Head and Face Pain to Foot and Ankle Pain, he has consistently given us these common sense guides to the diagnosis and treatment of these painful conditions.

Although Dr. Cailliet has been writing about the importance of pain for 30 years, it is only recently that pain has been accepted as a disease entity in itself, not just a symptom. Now in his latest work, Dr. Cailliet discusses pain as the underlying problem.

The book covers pain from many aspects: the neuroanatomy of pain mechanisms; the concept of pain modulation and the role of the cerebral cortex; and the mediation of pain through the sympathetic nervous system, with a discussion of reflex sympathetic dystrophy, its clinical findings, and treatment options.

Chapter three covers psychologic testing of patients with chronic pain. There is a discussion of the standard tests and an explanation of their proper use. Chapter five discusses psychologic intervention in pain through the use of biofeedback and hypnosis.

In the chapter on physical intervention a number of modalities are covered including heat, cold, nerve block, TENS, acupuncture, and intracerebral and spinal cord stimulation. There is no direct mention of manipulation as a physical intervention in the treatment of pain and this is the one disappointing part of this otherwise excellent text.

Throughout the chapters there are the concise and detailed descriptions of the structural and functional anatomy we have come to expect from Dr. Cailliet. Some of these diagrams will be familiar to those who have read his other works. There is a chapter devoted to "Mechanisms of Pain in Specific Anatomic Sites" which integrates this new work on pain mechanisms and management with his earlier writing on pain of specific regions. This serves as an update of what we have learned from this author in the past.

There is also a discussion of chronic pain including theories of the mechanism of chronic pain, its diagnosis, and treatment. He talks about pain centers and some of the different models they adopt. This is important when referring patients, because not all models are appropriate for all types of chronic pain.

This text provides the same high level of information found in Dr. Calliet's other books. For those who want to keep current on changes in the concept of pain and its management this will be a welcome addition to their library.

Savoie Rating: 10

Dean of MPI Faculty

Title: Journal of the Neuromusculoskeletal System Author: Scott Haldeman, DC, MD, PhD, editor-in-chief Rand S. Swenson, DC, MD, PhD, editor Publisher: Data Trace Chiropractic Publishers, Inc., as an official journal of the American Chiropractic Assn. Category: Doctor/student education Publication: Quarterly, approximately 185 pages

See # J-316-C on the Preferred Reading and Viewing List on pages XX.

According to the publication's own self-description, this journal is "a new quarterly, peer-reviewed, primary source journal dedicated to the advancement of knowledge of disorders of the neuromusculoskeletal system and the non-operative management of these problems. The scope of the journal is multidisciplinary. The JNMS publishes in all areas reflecting the manifestations of neuromusculoskeletal function and dysfunction."

Subscription rates are $58 per year for DCs, however, "all general full members of the ACA will automatically receive the JNMS as a benefit of membership."

The JNMS has 16 section editors overseeing departments that range from biochemistry and nutrition, through orthopedics to sports injuries and exercise physiology. There are also 30 associate editors from a variety of disciplines.

The contents of JNMS consistently has four major sections:

Invited Review: This section generally contains a well-written, well-researched, and meticulously referenced article that is of significant importance in today's world. "Cervical acceleration/deceleration trauma: A reappraisal of physical and biomechanical events" by Arthur C. Croft, DC, is but one example of the extremely high standards set by the JNMS.

Original Article: This section contains one or more articles from a variety of sources and topics. They are short, concise, and very informative in nature and as they are original articles, they lean slightly to the controversial side while provoking your thought processes. These are enjoyable to read and provide the reader with a comprehensive list of references for further study.

Case Reports: Articles like "Reflex sympathetic dystrophy" by Mark Langweiler and Teresa Febbo provide another doctor's point of view to the case management of common office complaints. Each and every one of these allows the reader to broaden his or her personal database of treatment protocols and methods. Each journal contains a number of case reports covering a wide area of topics.

Grand Rounds: This is perhaps the highlight of the JNMS. A case history such as "Persistent back pain following a work related injury" is given and then is discussed by a number of doctors with the focus on evaluation, management, and prognostic indicators. The participants come from a multidisciplinary background which allows the reader to see the patient from the other person's point of view. It truly serves to expand the mind when you read through a discussion written by a physical therapist or an MD. This really puts you on the hot seat as you can become part of the discussion process and put yourself into the other person's shoes. There is no question that this section of the JNMS is destined to become one of the most popular forums of its kind within the various disciplines who participate in this endeavor.

Congratulations to Drs. Haldeman and Swenson for a job well done. Chiropractic now has two great journals -- JMPT and JNMS.

When you consider the small cost of this journal against its contents it is a must for everyone treating neuromusculoskeletal disorders. This journal should be on MPI's Preferred Reading and Viewing List immediately.

Innes Rating: 10

Dynamic Chiropractic
June 17, 1994, Volume 12, Issue 13

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