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Wallac-Prelims.qxd 6/30/2004 2:10 PM Page vi
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PAIN MEDICINE
AND MANAGEMENT
Just the Facts
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Notice
Medicine is an ever-changing science. As new research and clinical experience
broaden our knowledge, changes in treatment and drug therapy are required. The
authors and the publisher of this work have checked with sources believed to be
reliable in their efforts to provide information that is complete and generally in
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the possibility of human error or changes in medical sciences, neither the authors
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publication of this work warrants that the information contained herein is in every
respect accurate or complete, and they disclaim all responsibility for any errors or
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and that changes have not been made in the recommended dose or in the con-
traindications for administration. This recommendation is of particular importance
in connection with new or infrequently used drugs.
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Mark S. Wallace, MD
Program Director
Center for Pain and Palliative Medicine
University of California, San Diego
La Jolla, California
Peter S. Staats, MD, MBA
Associate Professor, Division of Pain Medicine
Department of Anesthesiology and Critical Care Medicine
and Department of Oncology
Johns Hopkins University
Baltimore, Maryland
McGraw-Hill
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PAIN MEDICINE
AND MANAGEMENT
Just the Facts
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DOI: 10.1036/0071442197
To my loving wife, Anne, and my two sons, Zachary and Dominick
— MSW
To my wife, Nancy, my parents, and my children, Alyssa, Dylan, and Rachel
— PSS
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Contributors xi
Foreword xvii
Preface xix
Section I
TEST PREPARATION AND PLANNING 1
1 Test Preparation and Planning Stephen E. Abram, MD 1
Section II
BASIC PHYSIOLOGY 7
2 Nociceptive Pain Linda S. Sorkin, PhD 7
3 Neuropathic Pain Tony L. Yaksh, PhD 9
Section III
EVALUATION OF THE PAIN PATIENT 15
4 History and Physical Examination
Brian J. Krabak, MD, Scott J. Jarmain, MD 15
5 Electromyography/Nerve Conduction Studies
Nathan J. Rudin, MD, MA 20
6 Quantitative Sensory Testing Mark S. Wallace, MD 26
7 Radiologic Evaluation
Marcus W. Parker, MD, Kieran J. Murphy, MD 28
8 Psychological Evaluation Robert R. Edwards, PhD,
Michael T. Smith, PhD, Jennifer A. Haythornthwaite, PhD 30
Section IV
ANALGESIC PHARMACOLOGY 37
9 Topical Agents Bradley S. Galer, MD,
Arnold R. Gammaitoni, PharmD 37
CONTENTS
vii
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10 Acetaminophen and Nonsteroidal Anti-Inflammatory
Drugs Michael W. Loes, MD 46
11 Antidepressants Michael R. Clark, MD, MPH 52
12 Anticonvulsant Drugs Misha-Miroslav Backonja, MD 56
13 Sodium and Calcium Channel Antagonists
Mark S. Wallace, MD 59
14 Tramadol Michelle Stern, MD,
Kevin Sperber, MD, Marco Pappagallo, MD 63
15 Opioids Tony L. Yaksh, PhD 67
16 Miscellaneous Drugs Mark S. Wallace, MD 74
Section V
ACUTE PAIN MANAGEMENT 77
17 Intravenous and Subcutaneous Patient-Controlled
Analgesia Anne M. Savarese, MD 77
18 Epidural Analgesia Jeffrey M. Gilfor, MD,
Eugene R. Viscusi, MD 82
19 Intrathecal Therapy for Cancer Pain
Peter S. Staats, MD, Frederick W. Luthardt, MA 90
20 Interpleural Analgesia Michael D. McBeth, MD 99
21 Peripheral Nerve Blocks and Continuous Catheters
Eric Rey Amador, MD, Sean Mackey, MD, PhD 102
Section VI
REGIONAL PAIN 107
22 Abdominal Pain Alan Millman, MD,
Elliot S. Krames, MD 107
23 Upper Extremity Pain Matthew Meunier, MD 125
24 Lower Extremity Pain William Tontz, Jr., MD,
Robert Scott Meyer, MD 128
25 Headaches Joel R. Saper, MD, FACP, FAAN 131
26 Low Back Pain Michael J. Dorsi, MD,
Allan J. Belzberg, MD, FRCSC 141
27 Neck and Shoulder Pain Donlin Long, MD 147
28 Orofacial Pain Bradley A. Eli, DMD, MS 151
29 Pelvic Pain Ricardo Plancarte, MD,
Francisco Mayer, MD, Jorge Guajardo Rosas, MD,
Alfred Homsy, MD, Gloria Llamosa, MD 154
30 Thoracic Pain P. Prithvi Raj, MD 167
Section VII
CHRONIC PAIN MANAGEMENT 175
31 AIDS-Related Pain Syndromes
Benjamin W. Johnson, Jr., MD, MBA, DAPBM 175
32 Arthritis Zuhre Tutuncu, MD, Arthur Kavanaugh, MD 179
viii CONTENTS
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[...]... Participation in pain medicine review courses provides both visual and auditory inputs Such courses are offered by the American Pain Society, the International Association for the Study of Pain, the American Society of Regional Anesthesia and Pain Medicine, and the American Academy of Pain Medicine Many of the specialty societies offer topics in acute, chronic, and cancer pain management at their annual... of pain mechanisms and treatment Prior times were difficult for the patient suffering from pain Now, with the increased awareness and better understanding of pain, the pain practitioner has a full armamentarium for the management of pain and suffering There are numerous textbooks focusing on various aspects of pain management including pharmacologic, psychologic, interventional, and rehabilitative... Internal Medicine, with subspecialty qualification in Endocrinology & Metabolism Diplomate, American Board of Anesthesiology, with added qualification in Pain Management Diplomate, American Board of Pain Medicine Honorary Fellow, Faculty of Pain Medicine, Australia and New Zealand College of Anaesthetists PREFACE The latter part of the 20th century produced great achievements in our understanding of pain. .. Fishman, MD, Chief, Division of Pain Medicine, Associate Professor of Anesthesiology, Department of Anesthesiology and Pain Medicine, University of California, Davis, California Kenneth A Follett, MD, PhD, Professor, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa Wesley Foreman, MD, Pain Medicine Fellow, Department of Anesthesiology and Pain Medicine, University of California,... Professor of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Theodore Grabow, MD, Assistant Professor, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Robert S Greenberg, MD, Assistant Professor of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Jennifer... School of Medicine; Director of Inpatient Services, Comprehensive Pain Treatment Center, Hospital for Joint Diseases, New York City, New York Peter S Staats, MD, MBA, Associate Professor, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine and Department of Oncology, Johns Hopkins University, Baltimore, Maryland Michael Stanton-Hicks, MB, BS, Division of Pain Medicine, ... Mexico R Samuel Mayer, MD, Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland Michael D McBeth, MD, Director, Pain Management Group, Kaiser Permanente, San Diego, California; Clinical Instructor (Voluntary), Department of Anesthesiology, Center for Pain and Palliative Medicine, School of Medicine, University of California, San Diego, La... College of Medicine, Burlington, Vermont Eugene R Viscusi, MD, Thomas Jefferson University Hospital, Department of Anesthesiology, Philadelphia, Pennsylvania Mark S Wallace, MD, Program Director, Center for Pain and Palliative Medicine, University of California, San Diego, La Jolla, California Bradley W Wargo, DO, Pain Management Fellow, Cancer Pain Management Section, University of Texas MD Anderson... required to complete an ACGME-approved pain fellowship The name of the certification process has recently been changed to Subspecialty Certification in Pain Medicine Beginning with the year 2000 examination, the ABA Pain Medicine Examination was made available to diplomates of the American Board of Psychiatry and Neurology and the American Board of Physical Medicine and Rehabilitation For a period of 5... body regions One might begin with a review of the topographical anatomy and imaging techniques, followed by a review of the more common regional block techniques used for pain management Keep in mind that the exam covers acute pain management as well as chronic and cancer pain, and anesthetic techniques begun in the operating room and continued into the postoperative period are part of the required knowledge . for Pain and Palliative
Medicine, University of California, San Diego, La Jolla, California
Bradley W. Wargo, DO, Pain Management Fellow, Cancer Pain
Management.
qualification in Pain Management
Diplomate, American Board of Pain Medicine
Honorary Fellow, Faculty of Pain Medicine, Australia and New Zealand
College of Anaesthetists
xviii
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