Why 40%-80% of Chronic Pain Patients Are Misdiagnosed & How to Correct That

This book is authored by a former faculty member of Johns Hopkins University School of Medicine and the past president of the American Academy of Pain Management, and the Reflex Sympathetic Dystrophy Association of America. He previously has authored three books, 33 medical textbook chapters, and 59 articles. The book addresses conceptual methods of problem solving as they are applied to medicine. This book is designed to be the freakanomics for medicine. Many research reports document that 40%-80% (or more, for certain disorders) of chronic pain patients are misdiagnosed. The leading cause of this failure is inadequate history taking and the use of the wrong medical tests. Part of this problem is the failure to recognise the specificity and sensitivity, as well as the false negative and false positive rates, of medical tests in use today. As an example, there are many articles in the literature which document that the MRI, an anatomical test, missed the detection of a damaged vertebral disc up to 78% of the time. The book explores the use of physiological tests, such as facet blocks, root blocks, peripheral nerve blocks, and provocative discograms to supplement anatomical testing. Compiled into a step-wise fashion, this book addresses the issues and provides methods to correct these problems. The techniques of history taking and the application of the correct medical tests have been proven effective, based on dramatic improvement in patients documented by outcome studies, which are validated by third parties, (not just self-reported). This book offers information based on evidence based medicine, not opinion. It provides information on how to think, not what to think.