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This book challenges some long-held beliefs, models of treatment, and clinical reasoning about pain. It presents the current evidence on whatwe know about the sympathetic nervous system and the implications it has for patients with complex regional pain syndromes. Part 1 tackles controversial issues surrounding the role of the sympathetic nervous system in pain states and explores clinical challenges and questions that surround the topic. Can visceral disease precipitate musculoskeletal disorder? What do we know about mind body pathways? Where does the immune system fit in? What is complex regional pain syndrome? What is sympathetic maintained pain? How is it managed and treated? What are sympathetic blocks? Do they work? What happens to tissues when they are immobilised or under-used? What role does the sympathetic nervous system play in oedema, ischaemia and supersensitivity development? How can it cause pain? Part 2 is devoted to pain management. A single and highly authoritative chapter provides the information and clinical tools for us to deal more effectively with the distress and anger shown by some patients with back pain. There are excellent guidelines for clinicians seeking to further their ‘Yellow Flag’ assessment and management skills Part 3 addresses clinical effectiveness. It introduces, explains and discusses the concept and provides a rich resource for further research and investigation of the topic. There is also a critical look at ‘evidence’ and research into the effectiveness of acupuncture and TENS to help our understanding of the systematic review process and the pitfalls that so often occur in clinical research. The Topical Issues in Pain series derives from the work, study days and seminars of the Physiotherapy Pain Association and is written by clinicians for clinicians. Each volume reviews the literature and presents best practice in a lively and understandable text. All clinicians will benefit from the straightforward advice.
