
Practical Management of Pain
- 6th Edition - February 10, 2022
- Imprint: Elsevier
- Authors: Honorio Benzon, James P. Rathmell, Christopher L. Wu, Dennis Turk, Charles E. Argoff, Robert W Hurley
- Editor: Andrea L Nicol
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 7 1 1 0 1 - 2
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 7 1 1 0 3 - 6
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 7 1 1 0 2 - 9
For more than 30 years, Practical Management of Pain has offered expert guidance to both clinicians and trainees, covering every aspect of acute and chronic pain medicine fo… Read more

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Request a sales quotePresents a wealth of information in a clearly written, easily accessible manner, enabling you to effectively assess and draw up an optimal treatment plan for patients with acute or chronic pain.
Takes a practical, multidisciplinary approach, making key concepts and techniques easier to apply to everyday practice.
Shares the knowledge and expertise of global contributors on all facets of pain management, from general principles to specific management techniques.
Discusses the latest, best management techniques, including joint injections, ultrasound-guided therapies, and new pharmacologic agents such as topical analgesics.
Covers recent global developments regarding opioid induced hyperalgesia, neuromodulation and pain management, and identification of specific targets for molecular based pain.
Includes current information on the use of cannabinoids in pain management and related regulatory, professional, and legal considerations.
Includes the latest guidelines on facet injections and safety of contrast agents.
Provides new, evidence-based critical analysis on treatment modality outcomes and the latest information on chronic pain as a result of surgical interventions.
Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
- Cover Image
- Title Page
- Copyright
- Dedication
- Contributors
- Preface
- Table of Contents
- Part 1 General Considerations
- 1 History Is a Distillation of Rumor
- Abstract
- Pain and Religion
- Pain and Pain Theories
- Pain as a Disease
- Pain in the 20th Century
- Pain and the Impact of Psychology
- Pain and Pain Organizations
- Pain and the Hospice Movement
- Pain and Palliative Care
- Opioid Crisis
- Key Points
- Suggested Readings
- References
- 2 Classification of Acute Pain and Chronic Pain Syndromes
- Abstract
- Definition of Pain
- Taxonomy and Classification
- International Classification of Diseases (ICD)
- IASP Chronic Pain Classifications
- Acute Pain
- Headache Classification
- New Pain Classification
- Psychiatric Aspects of Chronic Pain
- International Psychiatric Classifications
- Key Points
- Suggested Readings
- References
- 3 Organizing an Inpatient Acute Pain Service
- Abstract
- The Rationale
- General Principles
- Identifying Service Leadership
- Assessment of Need
- Definition of the Service
- Financing and the Business Plan
- Billing and Collection
- Marketing Plan
- Future Service Flexibility
- Conclusion
- Key Points
- Suggested Readings
- Appendix A
- Appendix B
- Appendix C
- Appendix D
- References
- 4 Interdisciplinary Pain Management
- Abstract
- Introduction
- History of Pain Rehabilitation
- Continuum of Care: Pain Rehabilitation
- Conclusion
- Key Points
- Suggested Readings
- References
- 5 The Healthcare Policy of Pain Management
- Abstract
- Rationale for Pain Management Being a Healthcare Policy Priority
- Corporatization of American Pain Medicine: Its Implications for Widening Pain Care Disparities
- Pain Management as a Global Public Health Priority and a Human Right
- The Continued Need to Achieve a More Equitable and Balanced, Worldwide Access to Analgesics and Effective Analgesia
- The Need for a More Rational Strategy and Equitable Approach to Prescribing Chronic Opioids in the United States
- The Need for a More Comprehensive Approach to Chronic Pain-Related Mental Health in the United States
- Conclusions
- Key Points
- Suggested Readings
- References
- 6 Quality Assessment, Improvement, and Patient Safety in Pain Management
- What Is “Quality” in Healthcare?
- Drivers of Attention to Quality in Healthcare
- What Is “Quality” in Pain Management?
- Quality Assessment and Measurement
- Reducing Unnecessary Variation by Understanding Root Cause Analysis
- Implementation Science and Toolkits
- Creating a CQI Program for a Pain Practice
- Summary
- Strategies to Reduce and Improve Safety Events
- What to do When an Adverse Event Does Occur
- Conclusions
- Key Points
- Suggested Readings
- References
- 7 Education, Training, and Certification in Pain Medicine
- Abstract
- The Evolution of Pain Medicine as a Subspecialty
- Training and Credentialing in Interventional Pain Medicine
- Future Directions
- Key Points
- Suggested Readings
- References
- Part 2 Basic Considerations
- 8 Neurophysiology of Pain: Peripheral, Spinal, Ascending, and Descending Pathways
- Abstract
- Introduction
- Nociceptors
- Spinal Cord and Spinal Trigeminal Nucleus
- Ascending Pain Pathways
- Modulation of Pain
- Centers for Higher Processing of Nociception
- Conclusion
- Key Points
- Suggested Readings
- References
- 9 Neurochemistry of Nociception
- Abstract
- Origins of the Pain Phenotype
- Primary Afferent Signaling
- Dorsal Root Ganglion
- Adaptive Immunity
- Spinal Inhibitory Systems
- Nerve Injury Initiated Signaling and Pain
- Overview
- Key Points
- Suggested Readings
- 10 Neuroimaging Techniques
- Abstract
- Introduction
- Brain Imaging of Acute Experimental Pain
- Brain Imaging of Chronic Pain
- Conclusion and Future Directions
- Key Points
- Suggested Readings
- References
- 11 Individual Differences in Experience and Treatment of Pain: Race, Ethnicity, and Sex
- Abstract
- Keywords
- Clarification of Terminology
- Racial and Ethnic Differences in Pain
- Sex and Gender Differences in Pain
- Racial and Ethnic Differences in Pain Treatments Provided
- Sex Differences in Pain Treatment
- Racial and Ethnic Differences in Pain Treatment Outcomes
- Sex Differences in Pain Treatment Outcomes
- Contributing Factors to Racial, Ethnic, and Sex Disparities
- Conclusion
- Key Points
- Suggested Readings
- References
- 12 Communication and Clinician Relationships to Improve Care for Patients With Chronic Pain
- Abstract
- KEYWORDS
- Introduction
- Listening and Narrative Medicine
- Clinician-Patient Relationships: Empathy and Therapeutic Alliance
- Expectations Influence Pain
- Patient-Centered, Shared Decision Making
- Motivational Interviewing
- Enhancing Clinician-Patient Relationships With a Collaborative Pain Care Model
- Summary: Putting It Into Practice
- Key Points
- Suggested Readings
- References
- 13 Pharmacogenetics in Pain Management
- Abstract
- Keywords
- The Impact of Pharmacogenomic Research on Clinical Medicine
- The Impact of Pharmacogenomics on Pain Medicine
- Tricyclic Anti-depressants
- Nonsteroidal Anti-inflammatory Drugs (NSAIDS)
- Opioid Analgesics
- Future Outlook and Conclusions
- Key Points
- Suggested Readings
- References
- 14 Psychosocial and Psychiatric Aspects of Chronic Pain
- Abstract
- Keywords
- Introduction
- Historical Models
- Conclusion
- Key Points
- Suggested Readings
- References
- 15 Comprehensive Approach to Evaluating Patients With Chronic Pain
- Abstract
- Keywords
- Introduction
- Pain Definition
- Pathophysiology of Chronic Pain
- Assessing Chronic Pain
- What Is the History of the Pain?
- Assessment of Physical and Medical Factors
- Physical Examination
- Red Flag Symptoms Associated With Back Pain
- Neurologic Injury
- Spinal Stenosis
- Musculoskeletal Sources of Pain
- Risk Factors for Poorer Outcome Or Delayed Recovery
- Specific Evaluation for Procedures
- Diagnostic Studies
- Summary
- Assessment of Psychosocial Factors
- Elements of the Psychological Evaluation
- Brief Psychosocial Screening
- Assessment of Pain
- Assessment of Emotional Distress
- Assessment of Substance Use and Abuse
- Assessment of Beliefs, Coping, and Psychosocial Adaptation To Pain
- Assessing Functional Impact
- Assessment of Physical Capacity
- Assessment of Social Supports
- Conclusion
- Key Points
- Suggested Readings
- References
- 16 Mechanism-Based Treatment and Precision Medicine
- Abstract
- Key words
- Introduction
- Current and Developing Mechanism-Based Treatments
- Progress in Neuroimmune Modulation of Pain and Emerging Targets
- Targeting Neuroimmune Mechanisms by Emerging Regenerative Pain Medicine
- Targeting Neuroimmune Mechanism by Neuromodulation
- Precision Pain Medicine
- Conclusion and Perspective
- Key Points
- Suggested Readings
- References
- 17 Placebo and Nocebo Effects in Clinical Trials and Clinical Practice
- Abstract
- Key words
- The Magnitude of Placebo Analgesia
- Placebo-Induced Activation of Endogenous Painkillers
- Neuroimaging of Placebo Analgesia
- The Reward Dopaminergic System
- No Prefrontal Functions, No Placebo Effects
- Nocebo Hyperalgesia
- Nocebo-Induced Activation of Cholecystokinin
- Neuroimaging of Negative Expectations and Nocebo Hyperalgesia
- Communication Strategies
- Conclusions
- Key Points
- Suggested Readings
- References
- Part 3 Clinical Evaluation and Assessment
- 18 History and Physical Examination of the Patient With Pain
- Abstract
- Keywords
- General Physical Examination
- Neurologic Examination
- Musculoskeletal Examination
- Spinal Examination
- Myofascial Examination
- Examination of the Extremities
- Special Tests
- Tests for a Nonorganic Etiology of Pain
- Suggested Readings
- References
- 19 Electromyography and Evoked Potentials
- Abstract
- Keywords
- Electromyography
- Key Points
- Suggested Readings
- References
- 20 Radiologic Assessment of Patient With Spine Pain
- The Goal of Imaging
- Specificity: Asymptomatic Imaging Findings
- Sensitivity: Physiologic Imaging
- Validity
- Imaging Risk/Benefit
- Imaging Recommendations
- Radiographs
- Advanced Imaging Modalities
- Imaging of Axial Pain Generators
- Imaging Correlates of Discogenic Pain
- Cervical Discogenic Pain: Imaging Correlates
- Imaging of Axial Pain Generators
- Imaging of Radicular Pain, Radiculopathy, and Myelopathy
- Unusual Manifestations of Disc Disease
- Radicular Pain
- Cervical Disc Herniations
- Thoracic Disc Herniations
- Degenerative Spondylolisthesis
- Spinal Stenosis: Lumbar Neurogenic Intermittent Claudication
- Thoracic Spinal Stenosis
- Cervical Stenosis: Cervical Spondylotic Myelopathy (CSM)
- Systemic Disease Causal of Spine/Limb Pain
- Conclusion
- Acknowledgments
- Key Points
- Suggested Readings
- References
- 21 Biomarkers of Pain: Quantitative Sensory Testing, Conditioned Pain Modulation, Punch Skin Biopsy
- Abstract
- Keywords
- Introduction
- Quantitative Sensory Testing
- Conditioned Pain Modulation
- Pharmacodynamic
- Skin Punch Biopsy
- Summary
- Key Points
- Suggested Readings
- References
- 22 Psychological and Behavioral Assessment
- Abstract
- Keywords
- Psychological and Behavioral Assessment
- Clinical Objectives
- Overview of the Psychological and Behavioral Assessment Process
- Domains of Functioning
- Overview of Assessment Strategies
- Specific Psychological and Behavioral Assessment Strategies
- Pain Intensity
- Pain Interference
- Personality
- Emotional Functioning
- Pain Beliefs and Coping
- Quality of Care
- Conclusion
- Key Points
- Suggested Readings
- References
- 23 Disability Assessment
- Introduction
- United States Disability and Personal injuries Compensation Systems
- Models and Classification of Disablement
- Measuring Disability for Compensation Purposes
- American Medical Association Guides
- Medicolegal Constructs and Constraints
- Implications for Disability Assessment of Chronic Pain
- Resources Available to the Physician Disability Examiner
- Key Points
- Suggested Readings
- References
- Part 4 Clinical Conditions: Evaluation and Treatment
- 24 Chronic Post-surgical Pain Syndromes: Prediction and Preventive Analgesia
- Abstract
- Keywords
- Introduction
- Definition of CPSP
- Risk Factors and Prediction of CPSP
- Prevention of CPSP
- Analgesics
- Regional Anesthesia
- Future Directions
- Summary
- Key Points
- Suggested Readings
- References
- 25 Evaluation and Pharmacologic Treatment of Postoperative Pain
- Abstract
- Keywords
- Evaluation of Pain Using Pain Scales
- Visual Analog Scale
- Numerical Rating Scale
- Verbal Rating Scale
- Pharmacologic Treatment of Pain
- Summary
- Key Points
- Acknowledgments
- Suggested Readings
- References
- 26 Regional and Multimodal Treatments of Perioperative Pain
- Abstract
- Keywords
- Introduction
- Pathophysiology of Acute Postoperative Pain
- Preoperative Assessment and Informed Consent
- Multimodal Analgesia
- Enhanced Recovery After Surgery (ERAS) Protocols
- Drug Toxicity
- Regional Anesthesia Techniques
- Neuraxial Analgesia
- Peripheral Nerve Blockade
- Lower Extremity Peripheral Nerve Blocks
- Upper Extremity Peripheral Nerve Blocks
- Fascial Plane/Truncal Nerve Blocks
- Modes of Local Anesthetic Delivery
- Special Patient Populations
- Conclusion
- Key Points
- Acknowledgments
- Suggested Readings
- References
- 27 Evaluation and Treatment of Postoperative Pain in Patients With Opioid Use Disorder
- Background
- Management of Opioid Use Disorder
- Acute Pain Treatment Goals
- Challenges of Postoperative Pain Management in Patients With Opioid Use Disorder
- Evaluation of Patients With Opioid Use Disorder who Present for Surgery
- Patients With OUD in Remission who Present for Surgery
- Postoperative Pain Management Techniques for Patients With Opioid Use Disorder
- Conclusions
- Key Points
- Suggested Readings
- References
- 28 Evaluation and Treatment of Acute Pain in Children
- Developmental Neurobiology of Pain
- Assessment of Pediatric Acute Pain
- Nonmedical Management of Pediatric Acute Pain
- Pain Treatment Modalities
- Conclusion
- Key Points
- Suggested Readings
- References
- 29 Low Back Pain Disorders
- Introduction
- Lumbar Radicular Syndrome
- Lumbar Herniated Disc
- Lumbar Spinal Stenosis
- Internal Disc Disruption
- Diagnostic Studies for Low Back Pain
- Symptomatic Treatments for Low Back Pain
- Diagnostic Challenges in Patients WithLow Back Pain
- Approach to Managing Patients WithLow Back Pain
- Limitations of the Current Approach
- Treatment Challenges, Prevention, and Future Directions
- Key Points
- Suggested Readings
- References
- 30 Buttock and Sciatica Pain
- Abstract
- Keywords
- Sacroiliac Joint Complex (SIJC) Pain
- Coccydynia
- Piriformis Syndrome
- Non-Piriformis Muscle Pain
- Ischial Bursitis
- Summary Comments
- Key Points
- Suggested Readings
- References
- 31 Facet Pain: Pathogenesis, Diagnosis, and Treatment
- Abstract
- Keywords
- Introduction (Importance of the Problem)
- Anatomy and Function
- Pathophysiology
- Prevalence
- Diagnosis
- Treatment
- Complications
- Guidelines or Recommendations of Best Practice
- Conclusions
- Key Points
- Suggested Readings
- References
- 32 Neurosurgical Approaches to Pain Management
- Neuroablation
- Neuromodulation
- Summary
- Key Points
- Acknowledgment
- Suggested Readings
- References
- 33 Evaluation and Treatment of Cancer-Related Pain
- Abstract
- Keywords
- Introduction
- World Health Organization Analgesic Ladder
- Acetaminophen
- Nonsteroidal Anti-inflammatory Medications
- Antiepileptic Drugs
- Anti-depressants
- Opioids
- Use of Psychoactive Drugs in Oncology
- The Opioid Epidemic and Cancer Pain
- Intravenous Infusions for Cancer Pain
- Intrathecal Therapies for Cancer Pain
- Vertebral Augmentation (Vertebroplasty, Kyphoplasty)
- Neurolytic Autonomic Plexus Blocks
- Summary
- Key Points
- Suggested Readings
- References
- 34 Evaluation and Treatment of Neuropathic Pain Syndromes
- Abstract
- Keywords
- Introduction
- Complex Regional Pain Syndrome
- Postherpetic Neuralgia
- Diabetic Neuropathy
- HIV-Related Pain Syndromes
- Chemotherapy Induced Peripheral Neuropathy
- Summary
- Key Points
- Suggested Readings
- References
- 35 Evaluation and Treatment of Complex Regional Pain Syndrome
- Abstract
- Keywords
- Introduction
- Pathophysiology
- Epidemiology
- Clinical Features
- Treatment
- Anti-Inflammatory Treatment
- Summary
- Key Points
- Suggested Readings
- References
- 36 Evaluation and Treatment of Pain in Selected Neurologic Disorders
- Abstract
- Pain in Selected Neurologic Disorders
- Conclusion
- Key Points
- Suggested Readings
- References
- 37 Chronic Widespread Pain
- Abstract
- Keywords
- Fibromyalgia
- Summary
- Key Points
- Acknowledgments
- Suggested Readings
- References
- 38 Headache Management
- Abstract
- Keywords
- Introduction
- Instruments and Scales in Headache
- Scales that Assess Quality of Life
- Scales that Assess Headache Impact and Disability
- Migraine
- Chronic Daily Headache
- Tension-Type Headache
- Cluster Headache and Other Trigeminal Autonomic Cephalgia
- Chronic Paroxysmal Hemicrania
- Summary
- Key Points
- Suggested Readings
- References
- 39 Cervicogenic Headache, Post-meningeal Puncture Headache, and Spontaneous Intracranial Hypotension
- Abstract
- Keywords
- CERVICOGENIC HEADACHE
- Definition
- Epidemiology
- Pathophysiology
- Summary of Cervical Nerve Anatomy5
- Diagnostic Criteria
- Differential Diagnosis
- Investigations
- Treatment
- Summary
- POST-MENINGEAL PUNCTURE HEADACHE
- Post-Meningeal Puncture Headache
- SPONTANEOUS INTRACRANIAL HYPOTENSION
- Clinical Symptoms of SIH
- Diagnosis of SIH
- Treatment of SIH
- SIH Summary
- Key Points
- Suggested Readings
- References
- 40 Orofacial Pain
- Abstract
- Keywords
- Introduction
- Temporomandibular Disorders
- Neurovascular Pains: Orofacial Manifestations of Primary Headache Disorders
- Orofacial Pain and Worrisome Differential Diagnosis
- Conclusion
- Key Points
- Suggested Readings
- References
- 41 Visceral Pain
- Abstract
- Keywords
- Introduction
- Physiologic Basis of Visceral Sensation and Pain
- Regional Block and Neural Ablation
- Central Treatment Targets for Visceral Pain
- Mechanism-Oriented Pharmacotherapy of Visceral Pain
- Serotonin and Gastrointestinal Pain Management
- Smooth Muscle Relaxants andVisceral Pain
- Botulinum Toxin and Visceral Pain
- κ-Opioids and Visceral Pain
- Agents Targeting the α2δ Calcium Channel Subunit
- Luminal Contents and Visceral Pain
- Psychological Interventionsand Visceral Pain
- Conclusion
- Key Points
- Suggested Readings
- References
- 42 Pelvic Pain
- Abstract
- Keywords
- Introduction
- Causes of Pelvic Pain and Initial Evaluation
- Pelvic Pain That Should Not Be Missed: Dangerous Acute Causes and Cancer
- Organ-Based Causes of Pelvic Pain With Treatment
- Male Urologic Problems (Including Sexual Pain)
- Special Considerations
- Chronification of Pain (Central and Peripheral Sensitization of Pain)
- Summary
- Key Points
- Acknowledgments
- Suggested Readings
- Patient Resources
- References
- 43 Pediatric Chronic Pain Management
- Abstract
- Keywords
- Assessment of Chronic Pain in Children
- Chronic Pain Syndromes
- Pain in Terminal Illness
- Conclusion
- Key Points
- Suggested Readings
- References
- 44 Geriatric Pain Management
- Abstract
- Keywords
- Introduction
- Barriers to Successful Pain Management in the Older Patient
- Assessing Pain in the Older Adult
- Management of Pain in Older Adults
- Opioids
- Adjuvant Agents
- Practice Recommendations
- Conclusion
- Key Points
- Suggested Readings
- References
- Part 5 Pharmacologic, Psychologic, and Physical Medicine Treatments and Associated Issues
- 45 Managing Pain During Pregnancy and Lactation
- Abstract
- Use of Medications During Pregnancy
- Use of Medications in the Breastfeeding Mother
- Medications Commonly Used in Pain Management
- Evaluation and Treatment of Pain During Pregnancy
- Conclusion
- Key Points
- Suggested Readings
- References
- 46 Rheumatologic Conditions
- Abstract
- Introduction
- The Experience of Rheumatologic Pain
- Why Are Rheumatologic Conditions Painful?
- Assessment of Painful Rheumatologic Conditions
- Pain Prognosis and Treatment Outcomes
- Management
- Conclusions
- Key Points
- Suggested Readings
- Permissions and Courtesies
- References
- 47 Pain Management in Patients With Comorbidities
- Abstract
- Introduction
- Renal Disease
- Non-opioid Medications
- Opioid Medications
- Liver Disease
- Diabetes
- Conclusion
- Pain Management in Older Adults
- Evaluation: Assessment and Physical Examination
- Conclusion
- Summary and Conclusions
- Key Points
- Suggested Readings
- References
- 48 Major Opioids and Chronic Opioid Therapy
- General Considerations of Opioid Administration
- Selected Opioids
- Rational Opioid Prescribing
- Key Points
- Suggested Readings
- References
- 49 Minor Analgesics: Non-Opioid and Opioid Formulations
- Abstract
- Specific Drugs
- Conclusion
- Key Points
- Suggested Readings
- References
- 50 The U.S. Opioid Crisis and the Legal and Legislative Implications
- Abstract
- Introduction
- Historical Perspective
- Recent History
- Current State
- Legal Landscape
- Conclusions
- Key Points
- Suggested Readings
- References
- 51 Evaluation for Opioid Management: Opioid Misuse Assessment Tools and Drug Testing in Pain Management
- Abstract
- Background and Overview of Pain Issues
- Terminology
- Prevalence of Prescription Opioid Misuse and Addiction
- Prescription Opioid Misuse Risk Factors
- Negative Affect and Opioid Misuse
- Opioid Therapy and Mood Disorder
- Risk Assessment Tools
- Strategies for Managing High Risk Patients
- Future Considerations
- Summary and Conclusions
- Key Points
- Suggested Readings
- References
- 52 Pain and Addictive Disorders: Challenge and Opportunity
- Abstract
- Introduction
- Nomenclature
- Substance Use Disorder Screeners
- Conclusion
- Key Points
- Uncited References
- Suggested Readings
- References
- 53 Anti-depressants
- Introduction
- SNRIs
- SSRI
- Noradrenaline Reuptake Inhibitors
- Conclusion
- Key Point
- Suggested Readings
- References
- 54 Adjunct Medications for Pain Management
- Abstract
- Membrane Stabilizers
- Calcium Channel Modulators
- Sodium Channel Blockers
- GABAergic Medications
- Local Anesthetics
- Miscellaneous
- Conclusion
- Key Points
- Acknowledgments
- Suggested Readings
- References
- 55 Skeletal Muscle Relaxants
- Abstract
- Mechanism of Action
- Indications for Use
- Specific Drugs By Class
- Conclusion
- Key Points
- Suggested Readings
- References
- 56 Cannabinoids for Pain Management
- Abstract
- Introduction
- Definitions/Terminology
- Endocannabinoid System
- Cannabinoid
- Mechanisms of Analgesia of Cannabinoids
- Routes of Administration
- Adverse Effects of Cannabinoids With Acute and Chronic Use
- Contraindications to the Use of Cannabinoids
- Limitations of the Current Research on Cannabinoids
- Legal and Regulatory Considerations
- Summary of Current Guidelines and Practical Recommendations for the Use of Medical Cannabis
- Perioperative Use of Cannabis
- Conclusions
- Key Points
- Suggested Readings
- References
- 57 Topical Analgesics
- Abstract
- Background
- Use of Topical Analgesics for Specific Clinical Conditions (see Box 57.1)
- Conclusion
- Key Points
- Suggested Readings
- Uncited References
- References
- 58 Psychological Approaches in Pain Management
- Abstract
- Plight of Individuals With Chronic Pain
- Psychological Formations of Chronic Pain
- Psychogenic View
- Behavioral Formulations
- Gate Control Theory
- Cognitive-Behavioral Perspectives
- Biopsychosocial Model
- Referral for Psychological Intervention
- Psychological Interventions
- Insight-Oriented Therapies
- Behavioral Approaches
- Acceptance and Commitment Therapy (ACT)
- Other Psychological Techniques
- Conclusions
- Key Points
- Suggested Readings
- References
- 59 Evidence-Based Rehabilitation Approaches to Acute and Chronic Pain Management
- Abstract
- Rehabilitation Approach
- Approach to Treatment
- Pain Management Considerations
- Specific Rehabilitation Interventions
- Summary
- Key Points
- Suggested Readings
- References
- 60 Physical Rehabilitation for Patients With Chronic Pain
- Abstract
- Patient Evaluation
- Therapy for Chronic Pain
- In the past week, were you able to walk a mile?
- Conclusion
- Key Points
- Suggested Readings
- References
- 61 The Integrative Approach to Pain Management
- Abstract
- Integrative Medicine: Overview
- Multidimensional Perception of Pain
- Integrative Medicine Modalities and Pain
- Manual Medicine and the Biopsychosocial Model
- Summary
- Key Points
- Suggested Readings
- Appendix A
- References
- 62 Patient Education and Self-Management
- Abstract
- Pain Self-Management: Definition and Components
- Pain Self-Management in the Context of Primary Care
- Key Points
- Suggested Readings
- References
- Part 6 Neural Block and Interventional Techniques
- 63 Neurolytic Agents, Neuraxial Neurolysis, and Neurolysis of Sympathetic Axis for Cancer Pain
- Abstract
- Neurolytic Agents (Table 63.1)
- Neurolytic Blocks
- Conclusion
- Key Points
- Suggested Readings
- References
- 64 Head and Neck Blocks
- Atlanto-Axial Joint Blockade
- Third Occipital Nerve Blockade
- The Third Occipital Nerve and Headache Pain
- Facial Pain Nerve Blockades
- Sphenopalatine Ganglion Blockade
- Trigeminal Nerve Blockade
- Glossopharyngeal Nerve Block
- Summary and Conclusions
- Key Points
- Suggested Readings
- References
- 65 Interlaminar and Transforaminal Therapeutic Epidural Injections
- Abstract
- History
- Pathophysiology
- Epidural Injection Techniques
- Pharmacology
- Evidence-Based Medicine for Corticosteroid Epidural Injections
- Contrast Media Use in Epidural Steroid Injections
- Complications of Epidural Steroid Injections
- Summary
- Key Points
- Suggested Readings
- References
- 66 Radiofrequency Treatment
- Abstract
- Radiofrequency Generator System
- Theoretical Aspects of Radiofrequency Treatment
- Indications for Radiofrequency Treatment
- Conclusions
- Key Points
- Suggested Readings
- References
- 67 Pain Interventions for the Knee, Hip, and Shoulder
- Abstract
- Introduction
- Pharmacology of Agents Utilized for Joint Injections
- Joint Injection Techniques
- Hip
- Knee
- Radiofrequency Ablation
- Conclusion
- Key Points
- Suggested Readings
- References
- 68 Myofascial Injections and Fascial Plane Blocks for Perioperative and Chronic Pain Management
- Abstract
- Overview and Pathophysiology of Myofascial Pain Syndromes
- Clinical Presentation and Diagnosis of Myofascial Pain Syndromes
- Treatment of Trigger Points
- Piriformis Injections
- Iliopsoas Injection
- Truncal Blocks
- Quadratus Lumborum Block
- Scalene Muscle Injections for Neurogenic Thoracic Outlet Syndrome
- Summary
- Key Points
- Suggested Readings
- References
- 69 Minimally Invasive Procedures for Vertebral Compression Fractures
- Conservative Medical Therapy
- Technical Aspects
- Controversies and Special Topics
- Outcomes
- Mortality Benefit
- Complications
- Post-procedure and Follow Up Care
- Summary and Conclusions
- Key Points
- Suggested Readings
- References
- 70 Biopsychosocial Pre-screening for Spinal Cord and Peripheral Nerve Stimulation Devices
- Abstract
- Overview
- The Biopsychosocial Approach to Assessment
- The Biopsychosocial Pre-screening Process
- Summary and Conclusions
- Key Points
- Suggested Readings
- References
- 71 Spinal Cord Stimulation, Peripheral Nerve Stimulation, Restorative Neurostimulation, Deep Brain Stimulation, and Motor Cortex Stimulation
- Abstract
- Introduction
- SCS Mechanisms of Action
- Spinal Cord Stimulator Trial Technique
- Complications
- Clinical Outcomes
- Peripheral Nerve Stimulation (PNS)
- Motor Cortex and Deep Brain Stimulation
- Summary
- Key Points
- Suggested Readings
- References
- 72 Intrathecal Drug Delivery
- Patient Selection, Trialing, and Implantation
- Implantation
- II Intrathecal Medications
- Opioids (Box 72.3)
- Calcium Channel Antagonists (Box 72.4)
- g-Aminobutyric Acid Agonists (Box 72.5)
- Local Anesthetics
- Adrenergic Agonists (Box 72.6)
- Conclusion
- Key Points
- Suggested Readings
- References
- 73 Radiation Safety and Radiographic Contrast Agents
- Overview of Radiation Safety
- Basic Radiation Physics
- Minimizing Patient Radiation Exposure
- Minimizing Practitioner Exposure
- Optimizing Image Quality
- Radiation From Interventional Pain Procedures
- Overview of Radiographic Contrast Medium
- Pharmacology of RCM
- Adverse Reactions to RCM
- Nonidiosyncratic Reactions
- Hypersensitivity Reactions
- Recognition and Treatment of Reactions to RCM
- Prevention of Reactions to RCM
- Use of Gadolinium as an Alternative to Iodinated RCM
- Nephrogenic Systemic Fibrosis
- Brain Deposition/Retention
- Encephalopathy After Unintentional Intrathecal Gadolinium Injection
- Differences Between Interventional Pain Procedures and Diagnostic MRIs and CT
- Concluding Statements
- Key Points
- Acknowledgments
- Suggested Readings
- References
- 74 Infection and Anticoagulation Considerations in Pain Procedures
- Abstract
- Introduction
- Infection Rates
- Preoperative Risk Reduction
- Intra-procedural Risk Reduction
- Postoperative Risk Reduction
- Infection Management
- Conclusion
- Introduction
- Stratification of Risks
- Aspirin and Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
- P2Y12 Inhibitors
- Vitamin K Antagonists
- Heparin and LMWH
- Fibrinolytic Agents
- Fondaparinux and the Direct Oral Anticoagulants (DOACs)
- Laboratory Tests, Reversal, and Management of Direct Oral Anticoagulants Before Emergency Surgery
- Anti-depressants
- Herbal Medications
- New Anticoagulants Targeting CF XI
- COVID-19 Induced Coagulopathy
- Summary and Concluding Statements
- Key Points
- Suggested Readings
- References
- Part 7 Pain Management in Special Situations and Special Topics
- 75 Pain Management in Primary Care
- Background and Introduction
- Is Pain a Diagnosis or a Symptom?
- Definitions and Types of Pain
- Pain Assessment
- Diagnostic Assessment
- Model of Pain in Primary Care: Low Back Pain
- Timing and Description of Low Back Pain
- History/Physical Exam and Provocative Maneuvers
- Differential Diagnosis and Indications for Consultation
- Shared Decision Making
- Management of Chronic Low Back Pain
- Pharmacologic Therapy for Low Back Pain
- General Precautions for Non-opioid Pharmacologic Therapy
- Summary of Treatment Recommendations for Low Back Pain
- Musculoskeletal Pain in Adults
- Multimodal Therapy and Nonpharmacologic Options for Managing Pain
- Pharmacologic Approach to Pain and Opioid Use
- CDC Guideline for Prescribing Opioids for Chronic Pain
- Decision to Refer Patients for Pain Management
- Primary Care Goals for Pain Management
- Key Points
- Suggested Readings
- References
- 76 Pain Management in the Emergency Department
- Abstract
- Prevalence and Assessment of Pain in the ED
- The Problem of Balancing Undertreatment of Pain and the Risk of Addiction
- Pain Treatment
- Specific Treatment Modalities
- Patient-Controlled Analgesia
- Conclusion
- Key Points
- Suggested Readings
- References
- 77 Management of Pain in Sickle Cell Disease
- Abstract
- Epidemiology of Vaso-occlusive Pain
- Other Pain Etiologies in Sickle Cell Disease
- Sickle Cell Disease Pain Management
- Sickle Cell Disease Pain Management in the Inpatient Setting
- Management of Perioperative Pain in Sickle Cell Disease
- Management of Chronic Pain in Sickle Cell Disease: Largely Uncharted Territory
- Summary
- Key Points
- Suggested Readings
- References
- 78 Burn Pain
- Abstract
- Introduction
- Epidemiology
- Pathophysiology
- Phases of Burn Recovery
- Types of Pain in Burn Patients
- Pain Management Options
- Summary
- Key Points
- Suggested Readings
- References
- 79 Pain Evaluation and Management in Patients With Limited Ability to Communicate Because of Dementia
- Abstract
- Pain Assessment Using Self-Report
- Pain Assessment Using Observational Assessment Tools
- Other Dimensions of the Pain Experience
- A Clinical Approach to Assessment of the Older Adult With Limited Ability to Communicate Because of Dementia
- A Clinical Approach to Assessment of the Older Adult With Limited Ability to Communicate Because of Dementia
- Nonpharmacologic Pain Management
- Pharmacologic Pain Management
- Conclusions
- Key Points
- Suggested Readings
- References
- 80 Disparities in Pain Care: Descriptive Epidemiology-Potential for Primary Prevention
- Abstract
- Background to this Chapter
- Part I: Introduction
- Part I: Epidemiology of Disparities in Pain Care
- Part II: Factors Contributing to the Occurrence of Disparities in Pain Care
- Patient Characteristics That Contribute to Disparities in Their Care
- PART III: Potential for the Primary Prevention of Disparities in Pain Care
- Conclusions
- Key Points
- Suggested Readings
- References
- 81 Pain Management in the Critically Ill Patient
- Abstract
- Introduction
- Prevalence of Pain in the Intensive Care Unit (ICU)
- Barriers to Pain Assessment in the ICU
- Barriers to Pain Treatment in the ICU
- Benefits of Assessing and Treating Pain in the ICU
- Methods of Pain Control in the ICU
- Neuraxial Analgesia and Regional Anesthesia in the ICU
- Sedation in the ICU
- Conclusion
- Key Points
- Suggested Readings
- References
- 82 Pain Management at the End of Life and Home Care for the Terminally Ill Patient
- Abstract
- Introduction
- Prevalence and Causes of Pain at the End of Life
- Assessing Pain and Suffering at the End of Life
- Caregivers on the Front Line at the End of Life
- Planning for Home Pain Management
- Communication: The Cornerstone of Good Pain Management in the Home
- Conclusion
- Key Points
- Suggested readings
- References
- Part 8 Research, Ethics, Healthcare Policy, and Future Directions in Pain Management
- 83 Clinical Trial Design Methodology and Data Analytic Strategies for Pain Outcome Studies
- Abstract
- Evidence-Based Medicine
- The Spectrum of Outcomes Research
- Experimental Versus Observational Study Designs
- Healthcare Economic Evaluation
- Standards for Reporting Study Design and Findings
- Standardization of Pain-Related Outcome Measures
- Assessing and Addressing Bias and Confounding in Clinical Research
- Statistical Concepts and Methods for Pain Outcome Studies
- Commonly Used Inferential Statistical Methods in Pain Research
- Important Statistical Considerations and Common Pitfalls
- Concluding Statements
- Key Points
- Suggested Readings
- References
- 84 Outcome Domains and Measures in Acute and Chronic Pain Clinical Trials
- Abstract
- Selecting Outcome Measures for Use in Clinical Trials
- Outcome Domains and Measures in Adult Acute Pain Trials
- Outcome Domains for Adult Chronic Pain Clinical Trials
- Pain
- Physical Functioning
- Emotional Functioning
- Domains and Measures in Acute and Chronic Pediatric Pain Clinical Trials
- Patient Satisfaction
- Summary and Conclusions
- Key Points
- Suggested Readings
- References
- 85 Ethical Issues in Pain Research
- Brief Historical Overview
- Ethical Issues Specific to Pain Research
- Ethics of Placebos
- The Ethics of Laboratory Induced Pain in Humans
- Clinical Trials in Minors
- Ethical Issues in Genomic Approaches to Understanding Pain
- Conclusion
- Key Points
- Suggested Readings
- References
- 86 Treatment Development: Directions and Areas in Need of Investigation
- Abstract
- Introduction
- Perioperative Pain Management
- Preoperative Considerations
- Intraoperative Considerations
- Pharmacologic Chronic Pain Management
- Newer Pharmacologic Options
- Non-pharmacologic Chronic Pain Management
- Non-interventional Chronic Pain Management
- The Value of Identifying Types of Pain and Underlying Processes
- The Value of Identifying the Chronic Overlapping Pain Conditions
- The Value of Understanding Central Sensitization
- Digital Pain Management Resources
- Expanding the Value of Symptom Tracking: Personalized Medicine Using N-of-1 Trials
- Conclusions
- Key Points
- Suggested Readings
- References
- Index
- Edition: 6
- Published: February 10, 2022
- Imprint: Elsevier
- Language: English
- Hardback ISBN: 9780323711012
- eBook ISBN: 9780323711036
- eBook ISBN: 9780323711029
AN
Andrea L Nicol
HB
Honorio Benzon
Professor Emeritus of Anesthesiology
Associate Chair for Academic Affairs and Promotions
Northwestern University Feinberg School of Medicine
Chicago, Illinois
JR
James P. Rathmell
CW
Christopher L. Wu
DT
Dennis Turk
CA
Charles E. Argoff
RH