Many patients suffer from problems in their muscles or nerves in combination with pain. This book is about the complex interplay between the causes of these problems and the puzzle they pose. Pain is the subjective experience of a psychophysical phenomenon arising from a defined area in the body. It is a cry for help and challenges the physician to ask the right questions and to carry out the right examinations. If they succeed in doing so, the patient's signs and symptoms will be translated into the present knowledge of pain concepts to initiate appropriate therapy. With this goal in mind, this book summarizes the latest scientific information on pain states and their mechanisms. It provides a deeper understanding of the different pain conditions and allows physicians to form strategies for better pain therapy. The second edition includes more graphs, tables, and illustrations. It is updated with the current and dynamically expanding knowledge on the therapy of several disease states and explains in more detail the processing of pain in the central nervous system. When puzzling symptoms of sensory, motor, and autonomic deficits are evident, an examination has to be performed systematically in order to reach the correct diagnosis. This calls for suitable anatomical knowledge. Depending on where a lesion exists within a peripheral nerve, the root or the plexus, typical patterns of paralysis can be detected. Numerous illustrations in the book help physicians to more easily understand and solve problems of peripheral nerve and root injuries and their sequelae in their daily work.

In many cases of neuromuscular disorders the physician is faced with a complete lack of therapeutic approaches. This helplessness places the doctor in a position of conflict between his desire to help and his awareness that there is no treatment. In this situation it is tempting to indiscriminately use any procedure that avoids an admission of medical helplessness while satisfying the patient's demand for treatment. Electrical interventions are often used to avoid this situation. Due to the random use of therapeutic approaches it is not known what really happens. Presumptions and biased empirical observations have led to the exten sive use of different forms of electrical stimulation regimes in neuromuscular diseases. Due to this unsatisfactory situation it is necessary to know more about appropriate methods that are being used in particular disorders. The search for a better understanding of nerve-muscle interaction has shown that certain activity patterns can influence muscle. These experi mental results provide a rational basis for a possible therapeutic use of electrical stimulation of nerve and muscle. Previously most research has been conducted in normal tissue, and little is known regarding the re sponses of diseased muscle. In an interdisciplinary approach to this, it is our intention to present the current knowledge about basic principles of electrical stimulation in normal muscle. Before electrical stimulation can be accepted as a therapeutic tool, we felt it necessary to summarize the effects of activity in normal and diseased muscle and nerve."