The Explain Pain Handbook: Protectometer by G.L. Moseley and D.S. Butler

This is the newest publication from the Neuro Orthopaedic Institute, or Noigroup, and the prolific Lorimer Moseley–David Butler partnership. It is a patient-targeted handbook, fittingly described by one online patient-reviewer as ‘‘quirky—[an] accessible workbook,’’ and an updated and interactive alternative to the previous publication by the same authors, Explain Pain. If you are reading this review, you have likely already heard of the book because it has been well promoted by the successful marketing force that is the Noigroup. As the title describes, the book is meant to be a workbook that allows individuals to better understand their chronic pain and to take action to manage it and move forward successfully. In this manner, the book presents the latest evidence: that the pain experience is individual, is constructed in the brain, and can be changed. As well, the book’s content is supported by consistent evidence that individualized self-management and pain science education are basic to the rehabilitation management of chronic pain. The workbook also follows the principles of adult learning. It presents a series of short, concise, plainlanguage messages, well supported by cartoonlike diagrams, and is interactive. An interactive component of the book is described in its subtitle, Protectometer. It is a diagram on substantial, glossy, foldout paper that is as durable as the cover of a paperback. Readers are instructed to use this diagram as they apply the book’s teaching about understanding pain science to better manage their chronic pain. First, readers work to increase their awareness of the factors that can possibly affect their pain. They are asked to identify and label these factors as ‘‘DIMs—Danger in Me’’ or ‘‘SIMs—Safety in Me.’’ They are instructed that the more DIMS they have, the greater the risk of hitting the pain threshold, and the more SIMS they have, the lower the risk of hitting the pain threshold. An example given of a DIM is a diagnosis such as osteoarthritis of the spine; an example of a SIM is spending time with friends. The diagram guides readers through seven categories of factors to consider in detail, including ‘‘things you do,’’ ‘‘things you think and believe,’’ ‘‘things happening in your body,’’ and ‘‘people in your life.’’ This activity is introduced midway through the book and then used continually, with the teaching goal of integrating pain science into the readers’ understanding of their pain and how they can best manage it, especially with movement and exercise. Thus, the interactive task involves learning how and why to eventually decrease the DIMs and increase the SIMs to successfully self-manage one’s pain. Readers or clients with chronic pain can use the book on their own, but there is potential for clinicians to partner with a client to establish an individualized treatment and education plan. This book follows the quirky nature of the other publications authored by this partnership, which means it will invite an emotional reaction—its language and diagrams will be loved by some and disliked by others depending on their taste and learning style. It successfully avoids medical jargon, thereby making it accessible to the adult reader who is highly proficient in the English language. It is much clearer, more concise, and more applied than the Explain Pain book.