Fibromyalgia, Chronic Fatigue Syndrome, and Repetitive Strain Injury: Current Concept in Diagnosis, Management, Disability, and Health Economics.

This book is a compilation of papers presented at the Physical Medicine Research Foundation's eighth International Symposium held in June 1994 at the University of British Columbia, Vancouver, BC, Canada. The book's purpose is to provide education for primary care physicians, specialist physicians, other health care disciplines, patients, and the public and to provide a forum for investigators in the three topic areas. Disability and compensation issues were emphasized in the symposium.

Except for a historical article regarding the history of fibromyalgia, the first 11 articles report on the physiological aspects of fibromyalgia, chronic fatigue syndrome, and repetitive strain injury. There are three articles on the psychosocial aspects of these maladies. The remaining four articles discuss cost of treatment and disability issues.

The articles are well written and concise with a few exceptions. The articles pertaining to the psychological and physiological changes are very well done and easy to follow. Informative reviews of the neurologically of pain are provided in the articles "Aspects of the Pathogenesis of Chronic Muscular Pain" and "Evidence for Abnormal Nociception in Fibromyalgia and Repetitive Strain Injury." Other articles need to be more comprehensive. For example, there are numerous notations of successful efforts in Australia to control repetitive stress claims from reaching an epidemic level, but there is no mention of how this was accomplished, and no references are given.

A strength of this book is that the topics are varied and from many different disciplines. Dentistry, chiropractic, psychiatry, pain management, physical medicine and rehabilitation, occupational health, and the insurance Industry are represented. The reports are brief and are meant to raise questions more than provide answers. Unfortunately, this is a little unsettling for the clinician, who is attempting to gain more depth in these areas.

This book is applicable for physical therapists treating this patient population or a chronic pain population. This book allows a general exposure to issues about fibromyalgia, chronic fatigue syndrome, and repetitive strain injury.

Jeff Yarer, PT Kaiser Permanente Sacramento, Calif

Mr Yarer is Clinical Coordinator for an outpatient clinic. He treats and manages patients with musculoskeletal dysfunctions, utilizing manual therapy and exercise.