The book begins with a theory that is meant to explain pain as a human process and that is supplemented by an up-to-date, detailed analysis of the anatomy, physiology, and pharmacology of the pain system. The use of diagnostic blockade in spinal disease is also well covered. The development of long-acting narcotic compounds has redirected attention to the pharmacologic management of pain. The chapter on this topic is brief but thorough and is followed by a general assessment of how the whole patient must be cared for if interventions are to be useful. The second part of the book relates to the evaluation of patients who have pain. The chapters on the pharmacology of local anesthetics and neurolytic agents should be required reading for anyone using these interventions. The remaining chapters in this part of the book are superb descriptions of procedures. Some of these chapters outline straightforward interventions, well established in practice, with much documentation; others describe techniques for which outcomes have not been clearly established. There are also added chapters on implantable devices for the stimulation of the nervous system. The extensive documentation in the field of neurostimulation provides an excellent example of how outcomes research should precede and follow the introduction of any new technique.
