Essentials of Pain Medicine

Professor of AnesthesiologySenior Associate Chair for Academic AffairsFeinberg School of MedicineNorthwestern UniversityChief, Division of Pain MedicineNorthwestern Memorial HospitalChicago, IL

I.BASIC CONSIDERATIONS

1.Anatomy and Physiology of Somatosensory and Pain Processing
2.The Neurochemistry of Somatosensory and Pain Processing
3.Taxonomy: Definition of Pain Terms and Chronic Pain Syndromes

II.CLINICAL EVALUATION AND DIAGNOSTIC EXAMINATIONS

4.Physical Examination of the Patient with Pain
5.Pain Assessment
6.Psychologic Evaluation and Testing
7.Neurophysiologic Testing for Pain
8.Anatomy, Imaging and Common Pain Generating Degenerative Pathologies of the Spine
9.Determination of Disability

III.PHARMACOLOGY AND PHARMACOLOGIC MODALITIES

10.Opioid Receptors
11.Major Opioids in Pain Management
12.Minor and Short-Acting Opioids
13.Opioid Therapy: Adverse Effects Including Addiction
14.Psychopharmacology for Pain Medicine
15.Membrane Stabilizers
16.Nonsteroidal Antiinflammatory Drugs and COX-2 Selective Inhibitors
17.Muscle Relaxants
18.Drugs for the Interventional Physician: Botulinum Toxin, Steroids, Radiopaque Dye

IV.THERAPEUTIC INTERVENTIONS

19.Diagnostic Nerve Blocks
20.Neurosurgical Procedures for Treatment of Intractable Pain
21.Physical Medicine and Rehabilitation Approaches to Pain Management
22.Acupuncture
23.Pyschological Interventions For Chronic Pain
24.Substance Use Disorders and Detoxification

V.PERIOPERATIVE PAIN MANAGEMENT

25.Pain Management in the Emergency Department
26.Preemptive Analgesia: Physiology and Clinical Studies
27.Patient-Controlled Analgesia
28.Intrathecal Opioid Injections for Postoperative Pain
29.Epidural Opioids for Postoperative Pain
30.Intraarticular and Intraperitoneal Opioids for Postoperative Pain
31.Pediatric Postoperative Pain
32.Pain Management During Pregnancy and Lactation
33.Pain Management in the Critically Ill Patient

VI.CHRONIC PAIN SYNDROMES

34.Classification of Headache Disorders
35.Migraine Headache and Cluster Headache
36.Tension Type Headache, Chronic Tension Headache and Other Chronic Headache Types
37.Postdural Puncture Headache and Spontaneous Intracranial Hypotension
38.Cervicogenic Headache and Orofacial Pain
39.An Overview of Low Back Pain Disorders
40.Interlaminar Epidural Steroid Injections for Lumbosacral Radiculopathy
41.Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections
42.Facet Joint Pain: Facet Joint Injections and Facet Rhizotomy
43.Pain Originating from the Buttock: Sacroiliac Joint Dysfunction and Piriformis Syndrome
44.Myofascial Pain Syndrome
45.Fibromyalgia
46.Complex Regional Pain Syndrome (CRPS): Terminology and Pathophysiology
47.Complex Regional Pain Syndrome (CRPS): Diagnosis, and Treatment
48.Herpes Zoster and Postherpetic Neuralgia
49.Phantom Pain
50.Central Pain States
51.Visceral Pain and Pelvic Pain
52.Sickle Cell Anemia
53.Diabetic and Other Peripheral Neuropathies
54.Entrapment Neuropathies
55.Chronic Pain Management in Children
56.Geriatric Pain

VII.INTERVENTIONAL TECHNIQUES FOR PAIN MANAGEMENT

57.Spinal Cord Stimulation
58.Implanted Drug Delivery Systems for Control of Chronic Pain
59.Discography
60.Intradiscal Techniques: Intradiscal Electrothermal Coagulation (IDET) and Nucleoplasty
61.Osteoporosis and Percutaneous Vertebroplasty
62.Issues in Fluoroscopy: Advantages of Fluoroscopy, Radiation Safety

VIII.CANCER PAIN

63.Pharmacologic Management of Cancer Pain
64.Management of Pain at End of Life
65.Visceral Neurolytic Sympathetic Blocks
66.Intrathecal and Epidural Neurolysis: Agents Used for Neurolytic Block

IX.LOCAL ANESTHETICS AND NERVE BLOCKADE

67.Local Anesthetics - Clinical Aspects
68.Spinal Anesthesia
69.Epidural Anesthesia
70.Combined Spinal-Epidural Technique
71.Caudal Anesthesia
72.Head and Neck Blocks
73.Brachial Plexus Block: Techniques Above the Clavicle
74.Brachial Plexus Block: Techniques Below the Clavicle
75.Truncal Blocks: Intercostal, Paravertebral, Interpleural, Suprascapular, Ilioinguinal, and Iliohypogastric Nerve Blocks
76.Lumbar Plexus, Femoral, Lateral Femoral Cutaneous, Obturator, Saphenous, and Fascia Iliaca Blocks
77.Sciatic Nerve Block
78.Ankle Block
79.Issues in Peripheral Nerve Blocks: Use of Nerve Stimulators, Multiple Versus Single Injection Techniques, and Use of Adjuvants
80.Peripheral Sympathetic Blocks
81.Complications After Peripheral Nerve Blockade
82.Complications After Neuraxial Blockade
83.Anticoagulants and Neuraxial Injections