Radiologic Assessment of the Patient with Spine Pain
Imaging is a significant, but not independent, component of the multifaceted evaluation of the patient with spine or limb pain. Imaging must be interpreted in concert with the history, physical…
History and Physical Examination of the Pain Patient
Physical examination serves to further explore and confirm the findings from the clinical history. Objective data obtained from the examination are essential to accurately diagnose the etiology of the pain….
An Introduction to Pharmacogenetics in Pain Management: Knowledge of How Pharmacogenomics May Affect Clinical Care
CASE 11.1 A 58-year-old Asian male with no significant past medical history presents with acute herpes zoster in the left T4 dermatome. Presenting signs and symptoms include severe localized pain…
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…
