PREFACE

Inspection of the “pain” section of any bookstore will reveal a wide and diverse range of texts that
address everything from the basic science that underpins our understanding of pain, all the way through
to the clinical treatment of specific conditions. We are spoiled with choices. These books largely use
scientific evidence to validate the propositions that they make, and provide an invaluable resource for
anyone interested in pain and its treatment, although deciding which book best fits the individual’s
requirement can be problematical.
The fourth edition of Pain Secrets differs from most of these books. It contains a refreshing mixture
of scientifically robust information combined with a more anecdotal nature. It has become fashionable to
discredit opinion unless it is based on the results of rigorously performed studies, and yet by ignoring the
combined wealth of knowledge possessed by experienced practitioners based on years of involvement in
their field, we risk having a less complete knowledge of our field of interest than would otherwise be the
case. Pain Secrets is liberally seeded with little “pearls of wisdom,” which many will find interesting,
thought provoking, and hopefully useful. Some of these you may know already, but almost certainly
others will be new. They have the potential for transforming the practitioner from being knowledgeable
and widely read to being even more effective in his or her practice than before. These useful pieces of
knowledge have a value that is timeless, and they are not a representation of a current fashion in our
thinking about pain. As such, they can provide the reader with an insight that normally is acquired only
by long years of practical experience.
Perhaps one of the other distinguishing features of Pain Secrets is that it can be used when a
specific answer to a specific question is needed. Each chapter concentrates on one facet of pain
management. Contained in each chapter are a series of individual questions for which an answer is
provided. Alternatively, the book can be read chapter by chapter to give a more comprehensive insight
into the subject being considered. Given the style used and the content of each chapter, this book should
be of interest, indeed value, to anyone involved in pain management, whether they are fully qualified or
still in training. It should also be of use to those in whom pain management is an incidental requirement
rather than a primary focus of interest.
I am so fortunate to have two of my colleagues at Albany Medical College, Dr. Julie Pilitsis, a
neurosurgeon and neuroscientist, and Dr. Andrew Dubin, a physical medicine and rehabilitation specialist
and electrodiagnostician, join me as editors of this edition. Both Dr. Pilitsis and Dr. Dubin are
internationally recognized for their innovative contributions to pain management. We are also fortunate
that so many new chapters have been added to this edition, each written by internationally recognized
contributors. Pain management as a medical specialty has grown significantly and is in an active state of
maturation. We now have the ability to evaluate and treat our patients with more medical, nonmedical,
invasive, complimentary, regenerative approaches than ever before. These are indeed exciting times in
pain management, with an explosion of new information that itself might appear daunting to the
providers who are not pain specialists. This is why we have included the preface to the 3rd edition of
Pain Management Secrets. The fourth edition holds true to the third edition in how it is organized and
how it is intended to be used by all, regardless of their level of training. Thank you to all who have
contributed to this edition, and I am confident that this edition will be of immense value to all interested
in pain management.

Charles E. Argoff, MD
Andrew Dubin, MD, MS
Julie G. Pilitsis, MD, PhD

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