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Dr Carol A. Warfield published the first edition of this book in 1992 as Principles and Practice of Pain Management with 39 chapters. At around the same time, the Accreditation Council for Graduate Medical Education (ACGME) began the process of formally accrediting pain medicine fellowship training programs. The majority of ACGME-accredited pain programs were based in anesthesia departments, but within a few years, physicians from other specialties were welcomed into inter-disciplinary pain fellowship programs. The International Association for the Study of Pain (IASP) was soon joined by many other professional pain societies with the mission of bringing clinicians and researchers to think and work together to understand pain and help find better treatments for patients in pain.
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From the “decade of the brain” to the “decade of pain control and research,” our improved understanding of pain mechanisms led to more and generally better treatments for our patients. The second edition of this book, published in 2004, was a larger and more comprehensive text reflecting those advances and was entitled Principles and Practice of Pain Medicine. Not only had it expanded to 87 chapters, including emphasis on headache disorders, cancer pain, and palliative medicine, but it had also enhanced the multidisciplinary collaborative spirit among editors and authors. Since the publication of the second edition of Principles and Practice of Pain Medicine, the field of pain medicine has matured even further as a multidisciplinary specialty with a broad scientific and clinical knowledge base. This third edition seeks to capture the essentials of this knowledge and understanding in a comprehensive review of pain medicine. Since the topic of analgesia is the domain of no single discipline, the content of this book is authored by leaders who represent the many disciplines that constitute this evolving field. One could easily write entire volumes about the topics of each of the chapters in this text, but the task of the authors and editors here was to assimilate this large body of information on pain medicine and condense it into a useful textbook of manageable size. Each chapter represents a careful distillation of current science, key concepts, and clinical treatments of the subject at hand into an accessible format. For those readers seeking to expand their horizons further, the authors have prepared extensive lists of references at the end of each chapter to provide the reader with further details.
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This third edition discusses the fundamental dimensions of pain, the various disorders in which pain poses a major problem, and the methods employed in its management, with special emphasis on the use of injections and nerve blocks as an aid to diagnosis, prognosis, and therapy. It covers the biology of pain and the principles of physical and psychological evaluation of chronic pain. It goes on to discuss pain categorized by anatomic location, as well as by syndrome, such as acute and peri-operative pain, neuropathic pain, pain in the terminally ill, and pediatric and geriatric pain. The authors have been careful to incorporate vivid illustrations depicting the physical symptoms and anatomy of each site, as well as key findings from MRI, CT, X-rays, and other imaging and diagnostic technology. The next group of chapters discusses pain therapies and includes detailed attention to pharmacologic treatments, interventional therapies, and complementary and physical treatments of pain. Lastly, because pain medicine has now grown beyond its clinical bounds, we have introduced chapters covering the new areas of pain and law, ethics, and business administration.
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The breadth and rapidity of change in this specialty has prompted the publication of this edition, reflecting the expansion of pain medicine with former chapters updated and new chapters added. We have also attempted to be comprehensive in our consideration of pain medicine from a multidisciplinary perspective, with the idea that, regardless of the reader's background and training—whether anesthesiology, medicine, neurology, physical medicine and rehabilitation, neurosurgery, psychology, or other specialties—a picture of pain medicine as a multifaceted and continually evolving field emerges.
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We extend our thanks to all of the chapter authors for their tireless work on this project and extend a special thanks to Dr Scott M. Fishman for writing the foreword to the third edition of this textbook and to Drs Thomas T. Simopoulos, and John Keel for their help in developing content and multiple contributions. We welcome comments, suggestions, and constructive criticism from all our readers.
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R. Joshua Wootton, MDiv, PhD
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