Pain and Brain Changes
Change, alternatively referred to as reorganization or plasticity, is a fundamental property of the brain that enables it to adapt and thus enhance survival of the organism. It has been…
A Review of Pain-Processing Pharmacology
In the early 1900s, Sir Charles Sherrington designated high-intensity stimuli that signaled a potential injury to the body as being nociceptive in character. The application of such stimuli to the…
Pain Pathways: Peripheral, Spinal, Ascending, and Descending Pathways
Introduction The neural circuits that are responsible for pain and the reactions to pain can be termed the pain system or, perhaps more appropriately, the pain systems . The pain…
Quality Assessment and Improvement and Patient Safety in the Pain Clinic
This chapter covers both quality assessment and improvement systems and patient safety issues. These are in some cases distinct and in others inextricably interrelated. They are each debated on national…
Education, Training, and Certification in Pain Medicine
The Evolution of Pain Medicine as a Subspecialty As knowledge expands and the need for detailed skills arises, specialization ensues. This is a natural progression, and it has become impossible…
The Health-Care Policy of Pain Management
Introduction Chronic pain is a major cause of suffering, disability, lost productivity, and diminished quality of life across the entire life course. Cross-sectional studies have revealed that upward of 55%…
Measurement-Based Stepped Care Approach to Interdisciplinary Chronic Pain Management
Introduction Chronic pain is an urgent public health concern that significantly impairs the physical, psychological, and social functioning of those experiencing it and their significant others. The Institute of Medicine…
Organizing an Inpatient Acute Pain Service
The Rationale An estimated 48 million inpatient surgical procedures are performed annually in the United States (National Center for Health Statistics, National Hospital Discharge Survey: 2009, cdcinfo@cdc.gov ). Although it…
Taxonomy and Classification of Chronic Pain Syndromes
Defining Pain The first task of the authors of any taxonomy is to know what they are talking about. Sometimes knowledge is taken for granted. A taxonomy of pain needs…
The History of Pain Medicine
History is a distillation of rumor. THOMAS CARLYLE (1795-1881) Management of pain, like management of disease, is as old as the human race. In the view of Christians, the fall…
