The Explain Pain Handbook Proctometer by G. L. Moseley and D. S. Butler, Published by Noigroup Publications and distributed by OPTP, 2015, 48 pages, soft cover, $24.95.

David Butler and Lorimar Mosley have teamed up again to produce a valuable tool in pain science.

This text is meant to be used as a handbook for patients in conjunction with Explain Pain and Painful Yarns, which are books written by the same authors. The information in the book is not specific to any particular pain but directed at all types of chronic pain with the concept of sensitive nervous systems. The information provided by the authors aims to empower patients to take charge of the factors that influence their pain by decreasing the factors that increase pain (like stress, scary diagnosis, and unsupportive family) and increasing the factors that decrease pain (like having fun, feeling safe, and understanding sensations).

Chapter 1 begins to challenge some incorrect thoughts about pain; for example, the amount of injury equals the amount of pain. Chapter 2 introduces factors that influence pain "danger in me (DIM)" factors that increase pain and "safety in me (SIM)" factors that decrease pain. Patients are encouraged to write each on a small sticky note and add them to the center page. Becoming aware of DIMs is purported to help to decrease their influence and decrease pain response. Chapter 3 encourages patients to understand that the body can change and the authors provide a short case example. Chapter 4 outlines a step-by-step process for establishing a graded exposure treatment and challenges patients to write down their goals and progress.

This is a very short book and can be easily covered in several treatment sessions. I have some concern about the reading level and suspect some of the words are too complex for some patients (I tested one sentence and it came out to 15th-grade reading level). Used in the context of physical therapy treatment, these concepts can be individualized and tailored to the patient's cognitive, emotional, and physical needs. It has a patient-friendly price (unlike Explain Pain) and quirky pictures sure to entertain. The authors are working on an app to accompany the book (not available at the time of writing).

This is a good resource along with other patient resources now available for this patient population. I would recommend this book for all physical therapists treating chronic pain.

Beth Shelly, PT, DPT, WCS, BCB, PMD

Moline, IL