1. Section Editor(s): Bak, Jennifer A. MSN RN CCRN

Article Content

In Pain Comorbidities: Understanding and Treating the Complex Patient, editors Giamberardino and Jensen compile the work of experts in the field of pain, addressing pain as part of the whole person and the factors that contribute to the complexity of pain diagnosis and treatment. Together, the chapter authors provide a comprehensive volume of pain with causes, clinical presentations, and interactions of medical conditions that run the gamut of body systems and psychological factors that potentially enhance or inhibit a patient's experience of pain. It is designed to give insights to optimal patient care.


The book is divided into three parts: general aspects and models of pain, concurrent conditions effecting pain, and pain management. Each stand alone chapter can be used on its own or integrated into a complete pain assessment, evaluation, and management guide.


In Part 1, the authors address general aspects of pain management including epidemiology, experimental models, hormonal contributors, and psychosocial and environmental factors that contribute to pain. In this section, we are introduced to the concepts of acute and chronic pain and comorbidity as well as methods of pain assessment. Also addressed are the genetic and immunological factors that contribute to comorbid pain conditions. Tables and graphics illustrate the concepts and processes described.


Concurrent pain and nonpain conditions are discussed at length in Part 2, including the presentation and effects of pain associated with specific disease processes including hypertension, diabetes, cardiovascular disease, joint diseases, and affective disorders. In each chapter, the relationship between pain and the disease process is addressed by discussing assessment of pain, how pain is enhanced or diminished, and factors that contribute to increased or decreased pain. Evidence from clinical studies is included along with directions for future work.


The third and final section addresses pharmacological, psychological, and physiological methods of pain management. Contained within the chapters are sections on physical medicine and rehabilitation; pain medications; and management of mood, depression, and anxiety. In addition, the section provides information on managing the symptoms that often accompany pain such as fatigue and insomnia. The authors provide a practical and comprehensive guide to care for patients with acute and chronic pain; they very specifically emphasize the importance of addressing the psychological factors that accompany pain and comorbid conditions.


The book concludes with a synopsis by the editors that highlights the key points in each section of the book. The synopsis points to the complexity of the patient with pain comorbidities and the importance of addressing the whole patient in their treatment using a multidisciplinary approach.


The book as a whole is a valuable resource for the neuroscience nurse as it provides numerous references, graphics, and charts to support the information provided. In a healthcare climate where patients rarely present with one disease, a tool for managing pain among comorbidities will provide the neuroscience nurse with a guide for caring for the whole patient across the continuum of care.