Many of you are familiar with John Senneff's first book '"Numb Toes and Aching Soles", which gave a victim's-eye-view of peripheral neuropathy. He has now written a second book, covering in greater detail the newer approaches to pain management, with particular emphasis on so-called 'alternative therapy' and nutrient supplementation.

According to the Neuropathy Association, there are 22 million people in the USA suffering from peripheral neuropathy; over 2 million of them have their lifestyle seriously compromised by the disease. Obviously, treatment should be directed at any cause discovered in individual sufferers. However, the search for a cause is often quickly outstripped by the longing to be pain-free. The need for effective pain relief measures is great, even if they sometimes yield disappointing results.

After a chapter discussing the physiology of neuropathic pain, Senneff analyses what is known today about pain medications. It's important to realize that classical analgesics (non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen) have less to offer peripheral neuropathy subjects than drugs originally intended for other conditions - the antidepressants, anticonvulsants, anti-arrythmics, and antispasmodics. The enormous range of medications that have been tried, often with success, and the numerous combinations and formulations tested, indicate the rather poor outcome that traditional medicine has to offer, in many cases.

Not surprisingly, victims of peripheral neuropathy have turned to non-pharmacological approaches to treatment. These include most of the various types of alternative, or complementary, medicine, as well as nutrient supplements, and the author has covered most of these in some detail. Subjects such as massage, magnets, meditation and music therapy are dealt with evenhandedly; evidence for and against effectiveness is quoted, without any evidence of the author's personal bias.

Newer, experimental, therapies, such as nerve growth factor, substance P, and insulin-like growth factor (IGF) are also discussed. The hope offered by gene and stem-cell therapy is summarized, along with that from more classical drugs designed to influence aspects of neurochemical transmission.

It would be good if there were no need for a book like this - if peripheral neuropathy was a clearly defined condition that responded quickly and effectively to a class of readily available drugs. As it is, the need is considerable, and this book meets the challenge admirably. Anyone with peripheral neuropathy causing unrequited pain should get it at once.