Chronic Pain: Biomedical
And Spiritual Approaches
By Harold G. Koenig, MD
The Haworth Pastoral Press, NY, 2003
Reviewed by David P. Sniezek, MD
This is an authoritative text by a research scientist, nurse, academic physician, psychiatrist, and chronic pain sufferer all wrapped up in one author, on the subject of chronic pain. I have read many attempts to explain how the practice of medicine has entered the New Age; however, this text is particularly successful in several ways.
The author's credentials are impressive. Dr Koenig is a tenured Associate Professor of Psychiatry and Medicine as well as the Director and founder of the Center for the Study of Religion/Spirituality and Health at Duke University. He has published over 150 scientific peer-reviewed articles, 35 book chapters, and 16 books.
Secondly, he has a unique ability not to talk down the subject matter to the reader. The book is written for a broad audience of professionals, but especially for people and their families living with chronic pain. Those of us in active practice recognize that patients are much more knowledgeable than in the past about their health problems and want to take a more hands-on approach with their own health. Patients often enter the office for the first time already having thoroughly researched their medical condition online and have a good working knowledge of various treatment options. Dr Koenig clearly understands the perspective of the patient because he has also been a patient himself.
Initially, Dr Koenig defines and discusses the causes of pain. He personalizes this by giving examples of conversations with patients who have back pain, headache pain, rheumatologic pain, generalized pain, etc. He then delves into the assessment of pain. This is particularly helpful to the chronic pain sufferer to understand how physicians categorize pain. There are individual chapters of medications for pain, psychosocial and behavioral treatments, alternative and complementary treatments, as well as surgical and other procedures for the treatment of pain. These chapters are very useful for health care professionals to help navigate an individual patient's treatment through the vast array of established therapies available. When is surgery appropriate? Why not try alternative medicines first? These are questions often asked by our patients and are addressed clearly and concisely by Dr Koenig. He also goes further to discuss specific disease conditions, such as osteoarthritis, fibromyalgia, headache, and cancer-related pain.
What makes Dr Koenig's text even more enlightening is his discussion on the spiritual approaches to pain. In this chapter, he talks about faith, community involvement, Scripture, and prayer in health and disease. He even provides an appendix of "Healing Scriptures for Those in Chronic Pain." Dr Koenig embraces an attitude of calm prayerfulness, by physician and patient alike, to facilitate natural healing.
Then, for 13 pages, the last chapter, "Ten Practical Steps for Slaying the Giant," is perhaps the most concise and practical published treatise on how to treat and manage chronic pain. This is a must-read for every health professional who treats individuals and families with sufferers of chronic pain, and for every chronic pain sufferer. For the price of 1 unit of physical therapy, one-third of the price of 1 acupuncture treatment , or 1 pain pill, the soft cover price of $24.95 is remarkable. Because this book can provide immeasurable benefit to your chronic pain patients and is simply good reading, you can, in good conscience, recommend this text to your patients. I now keep a copy in my waiting room and office/patient library.
Dr David P. Sniezek is in solo private practice specializing in Medical Acupuncture, Pain Management, and Physical Medicine and Rehabilitation in Washington, DC, and McLean, Virginia.
David P. Sniezek, DC, MD, LAc
2021 K St, NW #710
Washington, DC 20006
Phone: 202-296-3555 • E-mail: Sniezek@aol.com
Medicine And Acupuncture
Claire Monod Cassidy, editor
Medical Guides To Complementary
& Alternative Medicine
Marc S. Micozzi, Series editor
Philadelphia, PA: Churchill Livingstone, 2002. ISBN 0-443-06589-6
Reviewed by Joanne Shay, MD
Edited by a medical anthropologist with extensive experience in understanding the character and relationships inherent in given medical systems, Contemporary Chinese Medicine and Acupuncture is a primer for subscribers to Western medicine to establish a conceptual foundation for definition and appreciation of the potential healing offered by Chinese medicine. This book is composed of 4 sections, containing 21 chapters, a glossary, and the 1997 NIH Consensus Statement on Acupuncture. There are 34 contributors from a variety of medical backgrounds and training, including physician acupuncturists, licensed acupuncturists, and clinical scientists. The stated goal of this book is "to help health care practitioners understand enough about this Asian medicine that is sweeping the West to be able to judge its utility for their own patients and learn how to develop collegial relationships with professional practitioners of Chinese medicine."
The first 2 sections, titled respectively, "The Theories and Modalities of Chinese Medicine" and "Delivering Care," not only meet but also exceed the stated goal. The first 3 chapters share some redundancies but overall, give a basic introduction to concepts of energy within the body, organ representations, meridian pathways, and cyclic considerations for time, elements, and physiologic degeneration. The 3rd chapter, which focuses on diagnosis, should be required reading for all novice medical professionals, with its admonition for the practitioner to "be capable of correlating context, perceptual data, and sensibility to diagnose what has been happening in each particular patient."
The 2nd section builds upon the theories introduced in the 1st section by providing therapeutic examples that highlight diagnostic patterns and relationships. The 3rd section looks at specific disease processes and the current research involving Oriental medicine modalities. In addition to defining the clinical entity from both the Western and Chinese perspective, relevant research data are presented and the methodology strengths and limitations are scrutinized for topics including addiction medicine, COPD, and post-stroke paralysis. The presentation in this section is sophisticated and responsible. For example, in chapter 16, there is a discussion reviewing serious gastrointestinal symptoms such as bleeding, weight loss, jaundice, and vomiting that must be referred to an appropriate biomedical consultant. The scope of topics in section 3 broadens the appeal for this book from interested novice to seasoned practitioner.
Overall, Contemporary Chinese Medicine and Acupuncture is well-written, well-illustrated, and well-referenced, with supplemental sources including Internet sites. It is an excellent resource for physicians in training at all levels, as well as any physician encountering patients interested in Chinese medicine.
Dr Joanne Shay is a Pediatric Anesthesiologist and practices at Sinai Hospital in Baltimore, Maryland. Dr Shay's special interest is pediatric pain, especially in the developmentally disabled population.
Joanne Shay, MD
11 Jenny Lane
Pikesville, MD 21208
Phone: (H) 410-580-2875; (W) 410-601-5209 • E-mail: email@example.com