A World of Hurt: A Guide to Classifying Pain

© 2015, Thomas Land Publishers Inc., 367 pages, 7" X 10", softcover, 1.5 lbs.

A better approach to treating musculoskeletal pain that's comprehensive, accessible, and gets results

Here is a clear, efficient path to better outcomes for patients with musculoskeletal pain. This book is based on over 16 years of research and clinical observation at the Shirley Ryan AbilityLab (formerly known as the Rehabilitation Institute of Chicago).

The key to curing musculoskeletal pain and decreasing recurrence rates is to identify and treat the dominant pain mechanism. Utilizing a combination of two proven pain classification systems, World of Hurt: A Guide to Classifying Pain presents patient education and specific exercise prescriptions based on the identification and classification of the source and mechanism of the pain. These interventions guide the active care necessary to effectively address musculoskeletal pain.

A World of Hurt has been widely tested and used in clinical settings, seminars, and university curricula. Clinicians, payors, and patients can all benefit from the insight provided by this resource. See user reviews below.

NEW:
World of Hurt: A Guide to Classifying Pain - PATIENT EDUCATION MATERIALS. Click here to learn more.

Table of Contents
Click here for the full Table of Contents.
Foreword Click here to read the Foreword.
Chapter 1 Musculoskeletal Pain: The Big Picture Click here to read Chapter 1.
Chapter 2 Overview of the Pain Mechanism Classification System and Mechanical Diagnosis and Therapy
Chapter 3 Subjective Evaluation
Chapter 4 Nociceptive Pain Mechanisms: Inflammation and Ischemia
Chapter 5 Peripheral Neurogenic Pain Mechanism
Chapter 6 Central Sensitization Pain Mechanism
Chapter 7 Affective Pain Mechanism
Chapter 8 Motor/Autonomic Pain Mechanism

Patient Handouts
Figure 4.1 Nociceptive: Inflammatory Pain Mechanism
Figure 4.4 Nociceptive: Ischemia (Overuse) Pain Mechanism
Figure 4.6 Baseline Activity Tolerance Tool
Figure 5.2 Nerve Pain
Figure 6.7 Persistent Musculoskeletal Pain
Figure 7.1 Tension Myositis Syndrome
Figure 7.2 Musculoskeletal Pain Mechanisms
Figure 7.4 Active Sleep Restoration Strategies
Figure 8.6 Graded Motor Imagery
Figure 8.8 Stress Loading
Figure 8.9 Desensitization

Melissa C. Kolski, PT, OCS, Dip MDT, is a senior education program manager and practicing clinician at Shirley Ryan AbilityLab, with a specialty interest in spine care and treatment of patients with musculoskeletal pain and dysfunction.

Annie O’Connor, PT, OCS, Cert. MDT, is a clinical manager at Shirley Ryan AbilityLab with a specialty interest in musculoskeletal pain and dysfunction.

Reviews of A World of Hurt: A Guide to Classifying Pain...

“This book is a fresh and welcome ‘next step’ for clinicians interested in using pain science evidence in a clinical setting. It is timely, relevant and useful for all health care professionals working with individuals in persistent pain.

‘A World of Hurt’ links current pain neurobiology with clinical reasoning and decision making, giving clinicians a template for categorizing and managing patients within the broad spectrum of pain expression and related functional limitations. Highly recommended.

This text links current conceptual neuroscience and neurobiology of pain mechanisms with clinical practice, providing a template for clinicians decision making and patient management. Case studies and patient related handouts make this a very useful clinical reference for anyone managing chronic pain.

Pain Science continues to deepen awareness of the many biological systems engaged in protecting individuals with persistent pain. This text offers an opportunity for clinicians to strengthen decisions and management of these patients using accepted pain science algorithms and evidence.

A good read and clinical reference, useful for patients and colleagues alike, as an educational tool for acute or chronic pain expression. This text provides a bridge between conceptual change and clinical practice within the pain science paradigm. Well done! “

Robert Johnson PT, DPT, OCS
NOI US Director of Education
Senior Lecturer
Clinical Director
Achieve Orthopedic Rehab Institute
Chicago, IL, USA


“If you have been struggling with pain and you are willing to put in the necessary effort, you can change your life. I thought I would never be able to sit, drive or carry my children again after a severe disk extrusion, but learning to recognize the six different alarm systems discussed in this book has kept me in touch with my body and allowed me to cure myself from deep within.“

Lauren Bass
Patient


“A book that incorporates both the highly effective pain mechanism classification system and the well-known McKenzie Method of Mechanical Diagnosis & Therapy is not only unique, but very much needed. The authors have taught this approach of pain classification to many clinicians, which has clearly resulted in not only improved outcomes but also reduced costs. They now share this exciting approach with all of us in their new book. I highly recommend that you keep this book close to you during your clinic time and refer to it with each patient to help determine which type of pain they have.”

Michael C. Geraci, Jr., MD PT
Board Certified, Physical Medicine &
Rehabilitation and Sports Medicine
Medical Director & Owner,
Michael C. Geraci, Jr., MD, P.C
Clinical Associate Professor, SUNY at Buffalo School
of Medicine and Biomedical Sciences
Michigan State University,
College of Osteopathic Medicine

“A World of Hurt brilliantly selects the best elements from two medical classification systems to create one useful and comprehensive guide to classifying pain. A groundbreaking effort that will undoubtedly lead to better outcomes for patients with pain and an improved utilization of the health care system. A World of Hurt outlines an integrative approach to pain classification and contains practical guidance on how to approach many problems and ailments not easily accessible to conventional diagnosis or treatment. A guide like this is long overdue.”

Thomas J. Lotus, DC, FACO, Cert. MDT
Spine & Sports Center of Chicago

“These highly regarded clinicians have combined two different but overlapping research-backed classification systems into a common sense, effective way to manage musculoskeletal pain. This book serves as an essential guidebook for old and new clinicians seeking active pain management strategies for their patients, especially for chronic pain.”

Jane Borgehammar, PT, Dip MDT
Synergy PT LLC

“Rarely does a book come along that takes an incredibly difficult topic and put it in a format that is easy to read, understandable, and has numerous practical tools (that allow you) to use the information for your patients right away. “A World of Hurt by Melissa Kolski and Annie O’Connor is one of those rare books that takes on the difficult topic of musculoskeletal pain and serves it up in bite size, easily digestible pieces.

The book presents an overview of pain treatments and the excessive variability of care pathways. The authors provide the background for why a clear, usable, reproducible classification system is critical to providing evidence-based care and decreasing health care costs for a group of patients who are quite expensive in our health care system, those with chronic pain. The six main pain mechanisms are described from a clinical and physiological basis. The clinical pearls and thought process in Chapter 3 is one of the highlights for me as it helps make some sense of the plethora of symptoms described by patients with chronic pain and gives me a focus on how those complaints fit into the classification structure.

The authors describe in detail how patients present in clinic, what their intake forms look like, what the pain drawings looks like, and how to go about providing them with a focused approach to their specific problems. The value to clinicians to be able to classify patients with chronic pain issues into a few categories that allows more focused treatment approaches is immense.

“A World of Hurt is a very different type of book that looks a very complex problem, chronic pain. I think that clinicians and researchers who read this book will have much to think about with respect to how they approach their patients with chronic pain. I think the clinical wisdom, integrated with the clinical science, that is shared by Melissa Kolski and Annie O’Connor will have a dramatically positive effect on our patients.“

Joel Press, MD
Medical Director/Spine and Sports Rehabilitation Centers
Rehabilitation Institute of Chicago
Reva and David Logan Distinguished Chair of Musculoskeletal Rehabilitation
Professor, Physical Medicine and Rehabilitation
Feinberg/Northwestern School of Medicine

“A World of Hurt is a landmark book weaving the best evidence of the cognitive-behavioral, pain science, and rehabilitation worlds together. It makes a compelling case for a modern, patient-centered vision in the musculoskeletal pain field.”

Craig Liebenson, D.C.
Member, International Association for the Study of Pain
Member, American Pain Society
Recognized Provider: Back Pain Recognition Program
by the National Committee on Quality Assurance (NCQA)
L.A. Sports and Spine

“A World of Hurt book has completely transformed and shifted my PT practice in working with patients with neurological diagnosis/injuries who suffer from pain. It has taught me how to accurately and efficiently identify a patient's dominating pain mechanism, which in turn has allowed me to use the most effective treatment approach and provide the needed individualized education to each patient. I have been applying these principles to many patients with a variety of neurological diagnosis/injuries, physical impairments, ages, and cognitive abilities. The principles have held true and have been proven effective for each patient. Learning and understanding these principles has provided me with the important treatment tools I needed as a clinician to better serve my patients who are suffering from pain. It has assisted me in helping to restore the patient’s function and ultimately help them get their life back. I believe that this information is the missing foundational piece in health care practice today in patients who silently suffer from pain. ”

Melissa Watson
Physical Therapist, RIC Willowbrook Day Rehab.
Rehabilitation Institute of Chicago