Clinical Pain Management: A Practical Guide Second Edition

Cover
Title Page
Copyright Page
Contents
List of Contributors
Foreword to First Edition
Foreword to Second Edition
Part 1 Basic Understanding of Pain Medicine
	Chapter 1 The challenge of pain: a multidimensional phenomenon
		Introduction
		References
	Chapter 2 Epidemiology and economics of chronic and recurrent pain
		Introduction
		Expert-Based Classification of Pain
		Epidemiology of Chronic Noncancer Pain and Recurrent Pain
		Musculoskeletal pain
		Rheumatological diagnoses
		Headache
		Neuropathic Pain
		Pelvic Pain
		Temporomandibular Disorders
		IASP Primary classification (also referred to as chronic widespread pain and Central Sensitivity Syndromes (CSS))
		Factors associated with chronic and recurrent pain
		Demographic factors
		Occupational factors
		Role of disability compensation
		Economic impact of chronic pain
		Back Pain
		Osteoarthritis
		Headache
		Pelvic Pain
		Mental Health
		Conclusions
		References
	Chapter 3 Basic mechanisms and pathophysiology
		Introduction
		Primary afferent neurons
		Nociceptor subtypes
		Nociceptors and noxious stimulus detection
		Organization of the “pain system”
		Sensitization and persistent pain
		Analgesic targets
		Clinical considerations
		References
	Chapter 4 Psychosocial perspectives on chronic pain
		Introduction
		Modeling the network of biological, psychological and social determinants of pain
		Psychosocial factors in best practice
		The person in pain
		Caregivers
		Pain management
		Conclusions
		References
	Chapter 5 Identification of risk and protective factors in the transition from acute to chronic post surgical pain
		Introduction
		Definition and Epidemiology of CPSP
		Understanding Risk and Attributing Causality to Outcomes
		Factors Associated with CPSP
		Multi-modal Preventive Approaches
		Summary and Conclusion
		References
	Chapter 6 Placebo/nocebo: a two-sided coin in the clinician’s hand
		Introduction
		Before we begin: a few facts on placebo/nocebo
		Proposed mechanisms of placebo/nocebo effects
		Neurobiology of placebo analgesia
		Neurobiology of nocebo hyperalgesia
		The coin in the clinician’s hand
		Conclusions
		References
	Chapter 7 Knowledge transfer to patients experiencing pain and poor sleep and sleep disorder
		Assessment of pain and sleep interactions
		The circular pain and sleep interactions
		Pain processing during sleep and its consequences
		Sleep Disorders in Patients With Pain
		Advice Helping Pain and Sleep Patients: Behavioral to Medical (see Figures 7.2 and 7.3).
		Final take home messages
		References
	Chapter 8 Clinical assessment in adult patients
		Introduction
		The history
		Patient expectations and goals
		Psychological history
		Personal social vocational history
		Functional impact
		Measurement of pain and screening instruments
		Physical examination
		Observation
		Musculoskeletal examination
		Inspection
		Range of motion
		Palpation
		Special tests
		Neurological examination
		Cranial nerves
		Motor examination
		Sensory examination
		Reflexes
		Cerebellar examination
		Conclusions
		References
Part 2 Assessment of Pain
	Chapter 9 Measurement and assessment of pain in pediatric patients
		Introduction
		Comprehensive pain assessment in children
		Obtaining a pain history
		Approaches to measuring pain in children
		Tools for assessing pain in children
		Behavioral tools
		Physiological indicators
		Pain assessment in infants
		Pain assessment in children with intellectual and developmental disabilities (IDD)
		Other approaches for assessing pain in children
		Choosing the right pain assessment measure
		Frequency of pain assessment and documentation
		Conclusions
		References
	Chapter 10 Laboratory investigations, imaging and neurological assessment in pain management
		General principles
		Common laboratory, imaging and neurological investigations for the patient living with chronic pain
		Imaging studies
		Neurophysiological and other neurological investigations
		Interventional diagnostic procedures
		Conclusions
		References
	Chapter 11 Psychological assessment of persons with chronic pain
		Introduction
		Components of a psychological assessment
		Clinical Interviews
		Substance use disorder assessment
		Use of innovative technology to assess pain
		Future directions
		References
Part 3 Management
	Chapter 12 Introduction to management
		Overview
		Start with the basics
		Conclusions
		References
	Chapter 13 Managing chronic pain in primary care
		Introduction
		Management of Chronic Pain in Primary Care
		Agreeing Shared Treatment Goals
		Relevant Guidelines for Assessing and Managing Chronic Pain
		Drug Interventions
		Non-Drug Interventions
		Psychological Approaches
		Self-Management
		Physiotherapy and Exercise
		Peripheral Nervous System Stimulation
		Complementary Therapies
		Pain-Management Programs (PMPs)
		Referral to specialist pain clinic
		Conclusions
		References
	Chapter 14 Medical nutrition therapy for chronic pain management
		Introduction
		Current literature exploring the role of diet and chronic pain
		Other Nutrition Considerations
		Conclusions
		References
	Chapter 15 Physical therapy and rehabilitation
		Pain and Physical Therapies
		Synthesizing Assessment Findings with Treatment Planning
		Summary
		References
Part 4 Pharmacotherapy
	Chapter 16 Antidepressant analgesics in the management of chronic pain
		Introduction
		Pharmacological mechanisms
		Safety profile
		Chronic pain conditions
		Children and adolescents
		Summary
		References
	Chapter 17 Anticonvulsants in the management of chronic pain
		Introduction
		Antiepileptics in chronic pain: mechanisms of action
		AEDs in neuropathic pain
		AEDs in migraine
		AEDs in fibromyalgia
		Other AEDs
		Safety and dosing
		Conclusions
		References
	Chapter 18 Opioids
		Introduction
		Pharmacology
		Patient selection and risk stratification
		Monitoring and management
		Opioid Tapering and Discontinuation
		Opioid use During Pregnancy
		Conclusions
		References
	Chapter 19 Topical analgesics
		Introduction
		Topical therapeutics that block sensory input
		Topical therapeutics that activate inhibitory systems
		Topical analgesics that target peripheral sources of pathology
		Topical combinations
		Topical therapeutics for mucosal tissue
		Current advancements in topical analgesics
		Acknowledgements
		References
	Chapter 20 Cannabis and cannabinoid for pain
		Introduction
		The complexity of cannabinoids as a medication
		Indications for cannabinoids in the management of pain
		Maximizing the safety and efficacy of cannabinoids
		Side effects and drug-drug interactions of cannabinoids
		Conclusions
		References
	Chapter 21 Combined pharmacotherapy for chronic pain management
		Introduction
		Current status of drug therapy for chronic pain
		Clinical rationale for analgesic combinations
		Optimizing the potential benefits of combination pharmacotherapy
		Combination pharmacotherapy for different chronic pain conditions – current status
		Clinical implementation of combination pharmacotherapy
		Conclusions
		Acknowledgments
		References
Part 5 Interventional
	Chapter 22 Diagnostic and therapeutic blocks
		Diagnostic block
		Therapeutic intervention/block
		Peripheral nerve intervention
		Spinal intervention
		Musculoskeletal intervention
		Conclusion
		References
	Chapter 23 Neuromodulation therapy
		Introduction
		Spinal Cord Stimulation
		DRG Stimulation
		Peripheral Nerve Stimulation
		Intrathecal Drug Delivery Systems
		Conclusion
		References
	Chapter 24 Neurosurgical management of pain
		Introduction
		Anatomic
		Spinal Disorders
		Neuromodulatory
		Neuroablation
		Peripheral nervous system
		Spinal Cord
		Conclusions
		Acknowledgment
		References
Part 6 Psychological
	Chapter 25 Pain self-management: theory and process for clinicians
		Introduction
		What is self-management?
		Background: Stanford self-management program model
		Content, process and strategies to enhance self-efficacy
		Effectiveness of pain self-management programs: main findings
		Getting started: conducting a needs assessment
		Focus groups
		Conclusions and resources
		References
	Chapter 26 Psychological interventions: a focus on cognitive-behavioral therapy
		Introduction
		How pain is processed in the brain: An overview and therapeutic rationale
		What “turns up the volume on pain” versus “what turns down the volume on pain”?
		Cognitive-Behavioral Therapy for chronic pain management
		Conclusions
		References
	Chapter 27 Pain catastrophizing and fear of movement: detection and intervention
		Pain catastrophizing
		Assessment of catastrophizing
		Treatments aimed at reducing catastrophizing
		Assessment of fear of movement
		Treatments aimed at reducing fear of movement
		Summary
		References
Part 7 Complementary Therapies
	28 Complementary and Integrative Approaches for Pain Relief
		Categories of Complementary and Integrative Health Approaches Based on Primary Therapeutic Input
		Primary Dietary Input
		Primary Psychological and Physical Input
		Psychological and Physical Input
		Combined/Multimodal Input
		Therapeutic Output—Systems Impacted and Challenges of Mechanistic Research
		General Challenges with Integrating Complementary Approaches into Pain Medicine
		Conclusions
		Acknowledgments
		References
Part 8 Specific Clinical States
	Chapter 29 Chronic low back pain
		Introduction
		Clinical evaluation
		Trivial findings and the “pseudo-diagnosis”
		Natural history
		Progression to chronic low back pain
		Treatment of chronic LBP with only common degenerative changes
		Pharmacotherapy
		Alternative therapies
		Percutaneous injections, nerve ablation and heating techniques
		Surgery
		Conclusions
		References
	Chapter 30 Fibromyalgia syndrome and myofascial pain syndromes
		Introduction
		Definitions
		Prevalence
		Course and prognosis
		Diagnosis of fibromyalgia syndrome
		Diagnosis of myofascial pain syndrome
		Basic mechanisms
		Treatment of fibromyalgia syndrome
		Conclusions
		References
	Chapter 31 Clinical pain management in the rheumatic diseases
		Introduction
		Basic mechanisms in rheumatic pain
		Anatomic considerations
		The active inflammatory setting
		The chronic rheumatic process
		Clinical practice
		Treatment
		1. Lifestyle and self-help measures
		2. Pharmacotherapy
		Herbal medicine and food supplements
		3. Invasive procedures
		4. Physical therapy
		5. Psycho-social interventions
		Obstacles to optimal pain management
		Conclusions
	Chapter 32 Headache
		Introduction
		Evaluation and diagnostic testing
		Migraine
		Description of the migraine attack
		Pathophysiology
		Treatment
		Preventive treatment
		Chronic daily headache
		Medication overuse headache
		Treatment
		Tension-type headache
		Management
		Cluster headache and other trigeminal autonomic cephalgias
		Management
		Trigeminal neuralgia
		Conclusions
		References
	Chapter 33 Orofacial pain
		Introduction
		Orofacial nociceptive processes
		Primary afferent mechanisms
		Brainstem mechanisms
		Thalamocortical mechanisms
		Modulatory influences
		Clinical aspects
		Temporomandibular disorders
		Tooth pain
		Idiopathic Orofacial Pain
		Persistent Idiopathic Facial Pain and Persistent Idiopathic Dentoalveolar Pain
		Constant Unilateral Facial Pain with Additional Attacks
		Orofacial Pains Resembling Presentations of Primary Headaches
		References
	Chapter 34 Visceral pain
		Introduction
		Basic mechanisms of visceral pain
		Molecular mechanisms of visceral sensation
		Structural elements of visceral sensation
		Central processing of visceral sensation
		Sensitization and visceral pain
		Pain without peripheral input
		Evidence-based treatment strategies
		Interventions targeting peripheral pathways
		Interventions targeting luminal contents
		Interventions targeting visceral contractions
		Interventions targeting central processing
		Alternative and complementary therapies
		Management of common visceral pain syndromes
		Inflammatory bowel disease
		Chronic pelvic pain
		Conclusions
		References
	Chapter 35 Pelvic and urogenital pain
		Introduction
		Etiology
		Evaluation
		Irritable Bowel Syndrome
		Interstitial Cystitis or Bladder Pain Syndrome
		Endometriosis
		Vulvodynia
		Myofascial pain
		Treatment
		Disease-specific treatment
		Endometriosis
		Irritable bowel syndrome
		Interstitial cystitis/Bladder Pain Syndrome
		Vulvodynia/Vestibulodynia
		Myofascial Pelvic Pain
		Pain-specific treatment
		Conclusions
		References
	Chapter 36 Neuropathic pain
		Introduction
		Basic mechanisms
		Clinical picture
		Clinical examination
		Other diagnostic procedures
		Grading of the certainty of the diagnosis of neuropathic pain
		Management of neuropathic pain
		Pharmacotherapy of neuropathic pain
		Treatment of trigeminal neuralgia
		Conclusions
		References
	Chapter 37 Complex regional pain syndrome
		History
		Introduction
		Diagnosis and Influencing Factors
		Adjuncts to Diagnosis
		Pathophysiology
		Management of CRPS
		Immunomodulation and the Future
		Functional Restoration
		CRPS in children
		References
	Chapter 38 Cancer pain management
		Introduction
		Basic mechanisms
		Assessment
		Management
		Opioid mechanism of action
		Clinical use of opioids
		Adverse effects of opioids
		Opioid rotation
		Prescribing opioids during an opioid epidemic
		Non-Medical Opioid Use and Substance Use Disorder
		Adjuvant therapies
		Continuity of care and multidisciplinary management
		References
	Chapter 39 Pain and addiction
		Pain and addiction
		Neurobiology of addiction
		Tolerance [6]
		Physical dependence/withdrawal
		Approach to clinical care in the physically dependent/substance use disordered pain patient
		Pain and chemical dependency: not an either/or proposition
		Legitimate versus appropriate factors in considering a trial of opioid therapy [39]
		Universal precautions in pain medicine [37]
		The 10 steps of universal precautions in pain medicine:
		The following clinical pearls may be useful to remember when treating chronic pain.
		Conclusions
		References
Part 9 Special Populations
	Chapter 40 Pain in older adults: a brief clinical guide
		Epidemiology
		The Undertreatment of Pain Among Older Adults
		Age-related Change in Pain Sensitivity and Nociceptive Processing
		A Clinical Approach to Pain Assessment in Adults with Dementia
		Psychosocial Interventions
		Other Non-Pharmacological Approaches to Pain Management
		Pharmacological Therapies
		References
	Chapter 41 Pain in children
		Introduction
		Etiology and significance of recurrent and chronic pain in children
		Conceptual models of chronic pain
		Clinical practice: evaluation and treatment
		References
	Chapter 42 Pain in individuals with intellectual disabilities
		Introduction & Overview
		Defining ID and Conceptual Issues
		Scope of the Problem of Pain in Individuals with ID
		Pain Assessment Tools
		Pain Management
		Summary
		Acknowledgements
		References
	Chapter 43 Pain and psychiatric illness
		Mood Disorders
		Anxiety Disorders
		Trauma and Stressor Related Disorders
		Conclusions
		References
	Chapter 44 Basic principles in acute and perioperative pain management in patients with opioid tolerance
		Background
		Neurophysiology of Pain
		Practical Management
		Summary
		References
Index
Supplemental Images
EULA