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37 of 38 people found the following review helpful:
5.0 out of 5 stars
Holistic approach firmly grounded in modern medicine, July 17, 2003
Chronic pain has become perhaps the most trying and least understood health problem in this country. Millions of people suffer from chronic pain, and most of them have little hope that their pain will end. Many doctors are ignorant about the pain experience of their patients, and some are even dubious that the pain exists!Part of the problem is that pain is an entirely subjective experience. It has no existence in the world outside of the pain sufferer (and the observable consequences of that pain). There are no instruments that can objectively measure pain. The plain fact, known only too well to chronic pain sufferers, is that nobody feels your pain but you, period. Dr. Dillard, however, among a growing number of progressive and caring physicians, realizes that the pain is real and has trained himself to appreciate and understand pain. On page 59 he even has a list of 68 adjectives for describing pain ranging from "aching" to "gnawing" to "wrenching." Another part of the problem, as Dr. Dillard points out, is that many physicians have not had adequate training in pain management and tend to respond to their patients' needs from a narrow and relative uninformed perspective. A third part of the problem is that pain management is not a medical specialty. Most physicians simply are not experts in treating chronic pain. I am not a chronic pain sufferer, but I know about this tragedy because someone I love has suffered for several years from near-constant pain of unclear origin. She has seen a number of doctors but has found little relief. To some extent she has become discouraged and cynical about ever finding help. I hope she will read this book and be inspired to renew her efforts to manage and reduce her pain. Clearly this book does not offer a magic pill or any sort of miraculous solution. What it offers is an up-to-date and relatively thorough examination of ways to reduce and cope with chronic pain using methods combining alternative and conventional medicine. Dr. Dillard's training and experience as both a chiropractor and a medical physician, and his open-minded and far ranging approach to the healing arts make this well-organized, well presented and eminently readable book the best I have read on the subject. Dillard begins with an attempt to understand pain using a whole body/whole mind approach. He encourages pain suffers to become part of a "pain management team" that includes the patient along with doctors, physical therapists and other professionals. His is a pro-active agenda in which he advocates "Taking Control of Your Treatment" (title of Part II). Part III presents an evaluation of therapies from exercise, yoga, and meditation to acupuncture, pharmaceuticals, implants, and surgery. Part IV outlines the various complaints from headache through back pain and fibromyalgia to myofascial and complex regional pain syndrome. Part V focuses on "Special Considerations," pain management for children, pregnant women, the elderly and terminally ill. Dillard apparently has no prejudices against any given form of treatment, evaluating each according to its merits and appropriateness. He sees a place for methadone as well as meditation. Indeed, he usually recommends a combination of approaches. Even though there is no magic bullet yet, and even though such a miracle may be many years in the future, Dr. Dillard's book offers hope that chronic pain can be reduced and managed (and in some cases eliminated entirely). People who are completely disabled by their pain can gain enough control to return to a more active lifestyle. Others who live only a reduced existence because of their pain may again find the joy in living. What Dr. Dillard's experience shows is that those who take an active part in managing their pain receive a synergistic effect by their active involvement. He emphasizes that immobility and lack of exercise (caused by the pain) tend to increase the pain experience, while exercise and an active engagement with life tend to reduce it. Consequently his approach for those whose pain is so bad they cannot exercise at all is to recommend even very strong pain medications so that exercise is possible, and then as activity increases to gradually lower the dosage. This is an excellent first course in understanding and managing chronic pain and the sort of book that pain sufferers will want to read.
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by Paula Kamen
by Norman J. Marcus
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