The highly anticipated new edition of Pain: a textbook for health professionals (previous subtitle a textbook for therapists) has undergone a major rewrite in order to reflect the rapid developments in the field of pain management. It highlights an effective and evidence-based method, providing the theoretical basis to help with the assessment and management of persistent pain, while also discussing in depth a range of specific approaches.
Pain: a textbook for health professionals is written emphatically from a biopsychosocial perspective. In order to set the scene, the introductory section includes chapters on the patient's voice and social determinants of pain. This ensures that the deeply personal and social aspects of pain are not lost among the more technical and biological commentary. These aspects provide an overall context, and are revisited in chapters on participation of life roles, work rehabilitation and psychology.
The basic science section includes key chapters on the psychology, neuroanatomy and neurophysiology of pain. This provides a basis for subsequent chapters on specific approaches such as pharmacology, physical therapy and complementary medicine. Pain in specific patient groups, including children, the elderly and those with cancer, are dealt with in separate chapters, as are pain problems such as complex regional pain syndrome and chronic spinal pain. Although the emphasis of the book is on long term pain, acute pain is discussed as a possible precursor and determinant of chronicity.
- Patient-centred approach to care - advocates listening to the patient's voice
- Covers social determinants of pain
- Guides the reader from pain psychology to the practical application of psychological interventions
- Learning aids - chapter objectives, reflective exercises, case examples, and revision questions
- Emphasizes an evidence-based perspective
- Written by an international team of experts
- topics such as pain in children and the elderly, pain education for professionals, disability and medico-legal aspects
- expanded focus on complex regional pain syndrome, acupuncture and psychology
- improved layout for a better learning and studying experience
Front Cover 1
Pain: A textbook for health professionals 4
Copyright 5
Contents 6
Foreword 8
Contributors 10
Chapter 1: Introduction to pain 14
OVERVIEW 14
WHAT IS PAIN? 15
THE PERSON WHO LIVES WITH PAIN 15
THE INTERPROFESSIONAL PAIN TEAM 16
THE PHYSICIAN 16
THE NURSE 17
THE PSYCHOLOGIST 17
THE PHYSIOTHERAPIST (PHYSICAL THERAPIST) 17
THE OCCUPATIONAL THERAPIST 18
OTHER HEALTHCARE PROVIDERS 18
ACKNOWLEDGEMENTS 19
REFERENCES 19
Chapter 2: The patient's voice 22
OVERVIEW 22
THE EXPERIENCE OF LIVING WITH CHRONIC PAIN 22
THE SEARCH FOR RESTORATION 23
LOSS 24
Loss of employment 24
Loss of social and family roles 25
Loss of 'self' 26
STIGMA 27
THE VALUE OF THE PATIENT'S VOICE 28
SHARED VOICES: THE VALUE OF CONSUMER GROUPS 29
CONCLUSION 30
REFERENCES 31
Chapter 3: Social determinants of pain 34
OVERVIEW 34
THE SOCIAL COMMUNICATION MODEL OF PAIN 35
SOURCES OF PAIN: OPPORTUNITIES FOR PREVENTION 36
THE EXPERIENCE OF PAIN 37
HOW PAIN IS COMMUNICATED TO OTHERS 39
HOW OTHERS RECOGNIZE, INTERPRET AND RESPOND TO THE PERSON'S PAIN 40
Social policy and health service delivery 41
CONCLUSION 41
REFERENCES 42
Section 1: Overview: what is pain? 46
Chapter 4: The psychology of pain: models and targets for comprehensive assessment 48
OVERVIEW 48
PAIN AND CHRONIC PAIN DEFINED 48
MODELS PERTINENT TO UNDERSTANDING PAIN 49
Gate control theory 49
Biopsychosocial models 49
Summary 50
COGNITIVE CONSTRUCTS 50
Beliefs 50
Mood 51
Anxiety and fear 52
Spirituality 52
BEHAVIOURAL CONSTRUCTS 52
Avoidance behaviour 52
Activity limitation for secondary gain 53
Pain coping behaviours 53
Pain and suicide 53
ENVIRONMENTAL INFLUENCES 54
Family 54
Culture and ethnicity 54
Socioeconomics 54
Work 55
KEY CONSIDERATIONS IN ASSESSMENT AND CASE CONCEPTUALIZATION 55
Assessment and case conceptualization 55
Treatment overview 55
CONCLUSION 56
REFERENCES 56
Chapter 5: Neuroanatomy of the nociceptive system 62
OVERVIEW 62
STRUCTURE AND FUNCTION OF PERIPHERAL NOCICEPTORS 62
Nociceptors 63
Skeletal muscle nociceptors 64
Joint nociceptors 65
Visceral nociceptors 65
NON-NEURONAL CELLS 65
ANATOMY OF REFERRED PAIN 65
DORSAL ROOT GANGLION CELLS 66
PRIMARY AFFERENTS 66
THE DORSAL HORN 66
Terminations of afferent fibres in the dorsal horn 68
Large-diameter myelinated fibres 68
Small-diameter myelinated fibres 68
Unmyelinated fibres 68
Visceral projections 68
Somatotopic organization of dorsal horn 68
Response properties of dorsal horn neurons 68
SPINAL CORD TRANSMISSION PATHWAYS 69
Ascending tracts 69
TRIGEMINAL SYSTEM 71
SYMPATHETIC NERVOUS SYSTEM 72
AREAS OF THE BRAIN INVOLVED IN THE PERCEPTION, INTEGRATION AND RESPONSE TO NOCICEPTION 74
Thalamus 74
Termination of spinothalamic afferents in the thalamus 74
The lateral nuclear group 74
The medial nuclear group 75
Brainstem 75
Periaqueductal grey matter 75
Reticular formation 76
Dorsolateral pontine tegmentum 76
Rostral ventral medulla 76
Limbic structures 77
Basal ganglia 78
Cerebral cortex 79
Cortical representation of pain 79
Corticospinal projections 79
Role of corticospinal projections 81
CONCLUSION 82
REFERENCES 83
Chapter 6: Neurophysiology of pain 90
OVERVIEW 90
NOCICEPTION OF SOMATIC AND VISCERAL ORIGIN 91
Cutaneous nociception 91
Deep somatic nociception 92
Visceral nociception 92
Referred pain 93
PERIPHERAL SENSITIZATION 93
CENTRAL SENSITIZATION 94
DESCENDING INHIBITION AND FACILITATION 96
PROCESSING AND CONTROL BY HIGHER CENTRES 97
CONCLUSION 98
REFERENCES 99
Section 2: Assessment and management of pain 102
Chapter 7: Assessing pain 104
OVERVIEW 104
SOME IMPORTANT ISSUES IN THE MEASUREMENT OF PAIN 104
Clinical utility 105
Reliability of pain measures 105
Validity of pain measures 106
Types of pain measures 106
Self-report 106
Observational measures 107
Physiological measures 108
ASSESSMENT OF PAIN 108
Measurement of the description of the pain 109
Numeric scales 109
Visual analogue scales 110
The pain drawing 111
McGill Pain Questionnaire 112
Measurement of responses to pain 112
Measurement of the impact of pain 119
Multidimensional assessment of pain 120
Advances in technology for pain assessment and measurement 121
Assessment and measurement of pain in patients from special populations 122
FACTORS THAT MAY INFLUENCE ASSESSMENT AND MEASUREMENT OUTCOMES 122
Social desirability 122
Compensation 122
Memory problems 122
Therapist attitudes 122
CONCLUSION 123
ACKNOWLEDGEMENTS 123
REFERENCES 123
Chapter 8: Psychological interventions: a conceptual perspective 128
Psychological treatment of pain 129
Behavioural/operant programmes 130
Back schools 130
Cognitive-behavioural programmes 130
Stress management programmes 131
Acceptance and commitment therapy 131
Risk-factor targeted interventions 132
Progressive goal attainment 132
Graded activity and exposure 133
Choosing among different psychological interventions 133
References 134
Chapter 9: Psychological interventions: application to management of pain 138
OVERVIEW 138
PATIENT EDUCATION 139
Description 139
Sources of more information 139
OPERANT CONDITIONING APPROACHES 140
Description 140
Sources of more information 140
COGNITIVE-BEHAVIOURAL THERAPY 140
Description 140
Theoretical rationale 141
Sources of more information 141
DISTRACTION 142
Description 142
Theoretical rationale 142
Sources of more information 142
CLASSICAL CONDITIONING APPROACHES 142
Description 142
Theoretical rationale 143
Sources of more information 143
SOCIAL SUPPORT METHODS 143
Description 143
Theoretical rationale 143
Sources of more information 143
RELAXATION METHODS 143
Description 143
Theoretical rationale 144
Sources of more information 144
ACCEPTANCE AND COMMITMENT THERAPY 144
Description 144
Sources of more information 145
HYPNOSIS 145
Description 145
Theoretical rationale 145
Sources of more information 145
BIOFEEDBACK 145
Description 145
Theoretical rationale 146
Sources of more information 146
CONCLUSION 146
REFERENCES 146
Chapter 10: Neuropathic pain and complex regional pain syndrome 150
Overview 150
Neuropathic pain 150
Introduction 150
Mechanisms of neuropathic pain 151
Examination 152
Treatment and management of neuropathic pain 154
Overall approach 155
Desensitization 155
Sensory re-education 155
Cortical remapping 156
Aids and adaptations 156
Complex regional pain syndrome 156
Introduction 156
Clinical characteristics of CRPS 157
Pain and sensory changes 157
Motor and trophic changes 159
Vasomotor changes 159
Sudomotor changes and oedema 159
Mechanisms of CRPS 160
Inflammation 160
Pain and sensory changes 160
Autonomic involvement 160
Vasomotor and sudomotor changes 161
Motor changes 161
Psychological factors 161
Clinical examination 161
Subjective assessment 161
Objective assessment 162
The treatment of CRPS 162
Therapy intervention for CRPS 162
Education 162
Management of pain 164
Medication 164
Desensitization 164
Oedema management 164
Range of movement and exercise 164
Addressing cortical changes 165
Mirror therapy 165
Graded motor imagery 166
Observed tactile discrimination 166
Functional tasks and workshop activities 167
Conclusion 167
References 167
Chapter 11: Pain pharmacology and the pharmacological management of pain 172
Overview 172
Pain classification 172
Nociceptive pain 173
Inflammatory pain 173
Neuropathic pain 173
Peripheral sensitization 173
Central sensitization 175
Nociceptive neurotransmitters and their target receptors 175
Major goals for the pharmacological treatment of clinical pain 176
Pharmacological treatment of pain 176
WHO analgesic ladder 176
Analgesic agents 177
Non-opioid analgesics 177
Paracetamol 177
Paracetamol adverse effects 178
Oral non-steroidal anti-inflammatory drugs 178
Adverse effects of NSAIDs 179
Topical NSAIDs 179
Coxibs 179
Opioid analgesics 180
Weak opioid analgesics 181
Codeine 181
Meperidine 181
Tramadol 181
Strong opioid analgesics 182
Morphine 182
Oxycodone 182
Methadone 182
Hydromorphone 183
Buprenorphine 183
Fentanyl 183
Tapentadol 183
Ultra-short-acting opioid analgesics 183
Remifentanil 183
Opioid antagonists for improving constipation 184
Adjuvant medications 184
Antidepressants 184
Anticonvulsants 184
NMDA receptor antagonists 185
Cannabinoids 185
Local anaesthetics 185
Capsaicin patch 185
a2-adrenergic receptor agonists 185
Glucocorticoids 186
Invasive procedures 186
Neurolytic celiac plexus blockade 186
Implantable intrathecal drug delivery 186
Spinal cord stimulation 186
Conclusions 187
References 187
Chapter 12: Manual therapy and influence on pain perception 194
Introduction 194
The rationale of manual therapy 194
Manual therapy in a biopsychosocial context 195
Mechanisms of pain relief through manual therapy 196
The somatosensory system 197
The gate control theory 198
Hypoalgesia mediated by the central inhibition 199
Diffuse noxious inhibitory control 200
The pleasure and pain of manual therapy 200
Manual therapy as an aid to motor control 201
Effects of manual therapy on local tissue 202
Manual therapy case study 202
Initial interview 202
Symptomology 202
Relevant history 202
Behaviour of symptoms 202
Diurnal pattern 202
Special questions 202
Plan of the objective examination 202
Physical examination 203
Observation 203
Active movement 203
Passive physiological intervertebral movement 203
Passive accessory intervertebral movement 204
Muscular assessment 204
First treatment 204
Second treatment 204
Third treatment 204
Fourth treatment 204
Fifth treatment 205
Sixth treatment 205
Conclusion 205
References 206
Chapter 13: Exercise therapy 210
OVERVIEW 210
KEY DEFINITIONS AND PRINCIPLES 210
EXAMPLE1: EXERCISE FOR PERSISTENT NON-SPECIFIC LOW BACK PAIN 212
The problem 212
Clinical guidelines 212
Exercise for persistent non-specific LBP: the evidence 212
Effect of exercise on work disability 213
Factors improving outcomes with exercise 213
Safety of exercise in persistent non-specific low back pain 214
Summary 214
EXAMPLE2: EXERCISE FOR KNEE PAIN IN OLDER ADULTS 214
The problem 214
Clinical guidelines 215
Exercise for knee pain: the evidence 215
Type of exercise 215
Delivery of exercise 215
Exercise dose 217
Short- and long-term effects of exercise for knee pain 217
Safety of exercise for knee pain in older adults 217
Summary 217
EXAMPLE3: EXERCISE FOR HAND PAIN IN OLDER ADULTS 218
The problem 218
Clinical guidelines 218
Exercise for hand OA: the evidence 219
Summary 219
EXERCISE ADHERENCE 220
Assessment of exercise adherence 220
Factors that influence exercise adherence 222
Strategies to enhance adherence to exercise 223
Summary and key points 223
IMPLICATIONS FOR CLINICAL PRACTICE 223
IMPLICATIONS FOR RESEARCH 224
ACKNOWLEDGEMENTS 224
REFERENCES 224
Chapter 14: Transcutaneous electrical nerve stimulation and acupuncture 228
OVERVIEW 228
Part 1: Transcutaneous electrical nerve stimulation 228
DEFINITION 229
Standard TENS device 229
TENS-like devices 230
PRINCIPLES UNDERPINNING TENS 230
CLINICAL TECHNIQUE 231
Conventional TENS (low intensity, high frequency) 232
Acupuncture-like TENS 232
Other TENS techniques 232
CONTRAINDICATIONS, PRECAUTIONS AND ADVERSE EVENTS 232
Principles of electrode placement 233
Principles of choosing electrical characteristics for TENS 235
Clinical practice and dosage 235
MECHANISM OF ACTION 235
Peripheral mechanisms 236
Spinal mechanisms 236
Supraspinal mechanisms 236
CLINICAL RESEARCH 236
TENS and acute pain 238
TENS and postoperative pain 238
TENS and labour pain 238
TENS and other acute pain conditions 238
TENS and chronic pain 238
TENS and low back pain 238
TENS for arthritic pain 238
Chronic neck pain, chronic headache and cancer pain 238
Part 2: Acupuncture 239
CONTEXT 239
DEFINITION 239
Traditional Chinese acupuncture 239
Western medical acupuncture 239
TYPES OF ACUPUNCTURE STIMULATION 240
Manual stimulation 240
Electroacupuncture 240
Auricular acupuncture 240
Moxibustion 240
Acupressure 240
Laser acupuncture 241
POINT SELECTION 241
CLINICAL PRACTICE AND DOSAGE 241
CONTRAINDICATIONS AND PRECAUTIONS 241
MECHANISM OF ACTION 242
Peripheral mechanisms 242
Spinal mechanisms 243
Supraspinal mechanisms 243
CLINICAL EFFECTIVENESS 244
Acupuncture for painful conditions 244
CONCLUSION 244
REFERENCES 245
Chapter 15: Complementary therapy approaches to pain 250
OVERVIEW 250
POPULARITY OF COMPLEMENTARY AND ALTERNATIVE MEDICINE 251
REASONS FOR USING CTs 251
WORKING WITH THE WHOLE PERSON IN PAIN 251
PSYCHONEUROIMMUNOLOGY, IMAGERY AND PAIN 252
PLACEBO, NOCEBO AND PAIN 252
TOUCH: A TOOL FOR ACKNOWLEDGING AND RELIEVING DISTRESS AND PAIN 253
SPECIFIC PATIENT-FOCUSED THERAPIES 253
Aromatherapy and the clinical use of essential oils 258
Hypnotherapy 259
Massage 259
Reflexology 260
Relaxation 260
THE PAIN OF LOSS: CARING FOR CARERS 261
Legal, professional and managerial issues 262
RECOMMENDATION FOR BEST PRACTICE IN DELIVERING COMPLEMENTARY THERAPIES 262
CONCLUSION 262
REFERENCES 263
RESOURCES/CONTACTS 265
Chapter 16: Workplace rehabilitation 266
High cost of pain and work disability 266
Allied health professional role 267
Knowledge and skills required for workplace rehabilitation 268
The worker's perspective 268
Evidence-based principles for return to work for all stakeholders 269
The workplace rehabilitation process 269
1. Referral 270
2. Rehabilitation needs assessment 270
3. Planning 273
Developing the RTW goal 273
A new paradigm: an emphasis on communication 274
Other models 274
Return-to-work programme hierarchy 275
Workplace assessment and modified work/suitable duties programmes 275
Suitable duties programmes: the cornerstone of return-to-work programmes 276
Improving the work environment 277
Education 277
Other services 277
Functional capacity evaluation 277
On-the-job training 278
Vocational assessment 279
Implementation, review and evaluation 279
REFERENCES 279
Section 3: Special issues 282
Chapter 17: Pain education for professionals 284
OVERVIEW 284
BUILDING A KNOWLEDGE BASE AND IDENTIFYING KEY SKILLS 284
Learning experiences and strategies 285
Making the most of lectures 285
Group work 287
E-learning 287
UNDERGRADUATE EDUCATION 288
Learners on undergraduate programmes 288
Academics and clinicians promoting pain education 288
INTERPROFESSIONAL LEARNING AND WORKING 289
POSTGRADUATE EDUCATION 291
Personal benefits of higher level study 291
Development of transferable skills for enhanced employability 291
Career progression and the development of a strong academic and vocational profile 292
Potential rewards and career options 292
Characteristics of postgraduate education 292
Opportunities for advanced study 292
IN-SERVICE EDUCATION 293
PROFESSIONAL ORGANIZATIONS 293
Benefits of membership of a professional organization 293
Networking opportunities 294
Conferences, education and access to online resources 294
Discounted publications 295
Special interest groups 295
Political and educational interests 295
Protection 295
Benefits of conference attendance 295
Summary 295
USING THE INTERNET FOR PAIN EDUCATION AND FURTHER RESOURCES 295
CONCLUSION 296
REFERENCES 297
INTERNET RESOURCES –INTERPROFESSIONAL EDUCATION 299
PROFESSIONAL ORGANIZATIONSTHAT HAVE AN INTEREST IN PAINEDUCATION 299
Pain-specific organizations 299
Generic organizations 299
Chapter 18: Pain in childhood 300
OVERVIEW 300
WHAT IS THE PROBLEM? 300
WHAT ARE THE CHALLENGES? 302
Developmental considerations 303
Attitudes of health professionals and others 303
Families 304
School system 304
Assessment and measurement of children's pain 304
WHAT CAN HEALTH PROFESSIONALS DO? 305
Pain in infants and young children 305
Pain in children and adolescents 306
RESOURCES FOR HEALTH PROFESSIONALS 307
REFERENCES 308
Chapter 19: Pain in the elderly 312
OVERVIEW 312
THE EPIDEMIOLOGY OF PAIN ACROSS THE LIFESPAN 313
AGE DIFFERENCES IN PAIN AS A PRESENTING SYMPTOM OF CLINICAL DISEASE 313
SUMMARY OF EPIDEMIOLOGIC STUDIES ON AGE DIFFERENCES IN PAIN 314
EPIDEMIOLOGY OF PAIN IN SPECIAL OLDER POPULATIONS 314
EXPLAINING AGE DIFFERENCES IN PAIN PREVALENCE AND REPORT 315
AGE DIFFERENCES IN PSYCHOSOCIAL ASPECTS OF PAIN 315
AGE-RELATED CHANGES IN NEUROPHYSIOLOGY 316
AGE DIFFERENCES IN PAIN PROCESSING UNDER PATHOPHYSIOLOGIC CONDITIONS 317
PAIN PROCESSING IN PERSONS WITH DEMENTIA 318
Assessment of pain in older people 318
MANAGING PAIN IN OLDER PERSONS 319
CONCLUSIONS 320
ACKNOWLEDGEMENTS 320
REFERENCES 320
Chapter 20: Cancer pain 326
OVERVIEW 326
FREQUENCY OF PAIN IN CANCER 327
Types of cancer pain 327
IMPACT OF AND RESPONSES TO CANCER PAIN 328
ASSESSMENT AND MEASUREMENT OF CANCER PAIN 329
Assessment considerations 329
Impact of pain on the occupations of daily life 331
Family context 331
PRINCIPLES OF PAIN MANAGEMENT 331
Pharmacological means of pain control 331
Opioids 332
Adjuvants 332
Therapists' understanding of pharmacological approaches to cancer pain management 332
Non-pharmacological medical methods 332
Education 333
Non-pharmacological physical methods 333
Psychosocial approaches 334
Lifestyle adjustment 335
Barriers to adequate pain management 335
DIFFERENT CONTEXTS FOR CANCER PAIN MANAGEMENT 336
CANCER PAIN IN CHILDREN 336
PALLIATIVE-CARE PAIN MANAGEMENT 336
ISSUES FACING PRACTITIONERS WHEN WORKING WITH PATIENTS WITH CANCER 337
CONCLUSION 338
REFERENCES 338
Chapter 21: Managing chronic spinal pain 342
OVERVIEW 342
THE ASSESSMENT OF CHRONIC SPINAL PAIN 342
Principles of examining persistent spinal pain 343
The relevance of a diagnosis 344
Diagnostic tests 344
REHABILITATION OF PERSISTENT SPINAL PAIN 344
Patient goals 345
Exercise 345
Expectations 345
Pacing and other strategies to facilitate increases in activity 345
Flare-up management 346
PSYCHOLOGICAL APPROACHES 346
MEDICAL APPROACHES TO MANAGING SPINAL PAIN 347
Pharmacological management 347
Interventional medicine 347
Injections 347
Surgery 348
Spinal cord stimulation 348
CONCLUSION 348
REFERENCES 348
Chapter 22: Rehabilitation and the World Health Organization's International Classification of Functioning, Disability an... 352
OVERVIEW 352
GENERIC MODELS OF HEALTH AND DISABILITY USED IN PAIN: A BRIEF HISTORICAL OVERVIEW 353
INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH 353
Development 353
Overview 354
Structure 355
Qualifier scale 355
TOOLS TO OPERATIONALIZE THE ICF 355
ICF checklist 355
ICF core sets 356
Development 356
ICF core sets and pain practice 356
Acute and subacute musculoskeletal conditions 360
Chronic musculoskeletal conditions 360
APPLYING THE ICF IN CLINICAL PRACTICE: A CASE STUDY 361
Clinical scenario: Mrs Smith 361
Assessment 361
Assignment 362
Intervention 362
Evaluation 362
Summary 362
MEASURING OUTCOMES FROM THE ICF PERSPECTIVE 362
Indirect applications of the ICF in outcome measurement 367
Direct applications of the ICF in outcome measurement 367
LIMITATIONS 368
CONCLUSION 369
ACKNOWLEDGEMENTS 369
REFERENCES 369
Chapter 23: Participating in life roles 374
OVERVIEW 374
MANAGING LIFE WITH PERSISTENT PAIN 374
GOAL SETTING 376
ACTIVE INVOLVEMENT OF THE CLIENT IN DECISION MAKING 376
ACTIVITY ENGAGEMENT 377
SELF-MANAGEMENT 378
SOCIAL SUPPORT 380
CONCLUSION 380
REFERENCES 380
Chapter 24: Persistent pain and the law: clinical and legal aspects of chronic pain 382
LEGAL LIABILITY AND PAIN MANAGEMENT 382
Valid consent to treatment and medical duty of adequate disclosure 383
Negligent advice 383
Malpractice claims and pain management 384
Iatrogenic narcotic addiction 384
Failure to provide adequate pain relief 385
Drug-specific liability issues 385
PERSONAL INJURY CLAIMS AND PERSISTENT PAIN 386
The effect of compensation on pain treatment outcome 387
Malingering 387
The rating of pain-related impairment 388
ENDNOTES 389
REFERENCES 390
Chapter 25: Chronic pain and psychiatric problems 396
OVERVIEW 396
THE ASSOCIATION BETWEEN PAIN AND PSYCHIATRIC DISORDERS 396
PSYCHIATRIC DISORDERS COINCIDENTAL WITH PAIN 397
PRE-EXISTING FACTORS PREDISPOSING TO BOTH CHRONIC PAIN AND PSYCHIATRIC DISORDERS 397
CHRONIC PAIN CAUSING PSYCHIATRIC DISORDERS 398
SPECIFIC PSYCHIATRIC SYNDROMES AND PAIN 399
Adjustment disorder 399
Depression 399
Anxiety disorders 400
Post-traumatic stress disorders 401
CHRONIC PAIN, SUBSTANCE ABUSE AND DEPENDENCE 402
Long-standing prior history of illicit drug abuse 402
Prior history of inappropriate use of prescription drugs 402
SOMATOFORM DISORDERS 403
Pain disorder 403
Conversion disorder 403
Somatization disorder 403
Factitious disorders 404
'DIFFICULT PATIENTS' OR PATIENTS WITH DIFFICULT PROBLEMS? 404
CONCLUSION 404
REFERENCES 405
Chapter 26: Acute pain 408
OVERVIEW 408
PRINCIPLES OF ACUTE PAIN MANAGEMENT 409
Systemic Pharmocological Modalities 409
Systemic opioids 409
Oral opioids 410
Intramuscular opioids 410
Subcutaneous opioids 410
Intravenous opioids 411
Intermittent IV boluses 411
Continuous IV infusion 411
Patient-controlled analgesia 411
Summary 412
Systemic non-opioid analgesics 412
Paracetamol/acetaminophen 412
Non-steroidal anti-inflammatory drugs 412
Other systemic agents 413
Entonox 413
Clonidine 413
Ketamine 413
Tricyclic antidepressants and anticonvulsants 413
REGIONAL TECHNIQUES 414
Neuraxial analgesia 414
Intrathecal analgesia 414
Epidural analgesia 414
Local anaesthetics 414
Opioids 414
Benefits of neuraxial techniques 415
Complications of neuraxial techniques 415
Peripheral neural blockade 416
Wound infiltration 416
Femoral nerve blocks 416
Brachial plexus blocks 416
Intercostal nerve blocks, interpleural blocks and paravertebral blocks 416
NON-PHARMACOLOGICAL MODALITIES 416
Physical modalities 417
Progression from acute to chronic pain 417
THE ACUTE PAIN SERVICE 417
REFERENCES 419
Chapter 27: Conclusions: the future 422
REFERENCES 424
Appendix: Glossary of pain physiology terms 426
References 426
Index 428
Contributors
Gordon J.G. Asmundson
Fellow of Royal Society of Canada, CACBT Certified in Cognitive Behaviour Therapy
President's Chair in Adult Mental Health Research
Professor of Psychology
Editor-in-Chief (NA) Cognitive Behaviour Therapy, Department of Psychology, University of Regina, Saskatchewan, Canada
Karl S. Bagraith, Occupational Therapist - Senior, Occupational Therapy Department, Royal Brisbane and Women's Hospital and, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Sally Bennett, Senior Lecturer in Occupational Therapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Annette Bishop, NIHR Research Fellow, Arthritis Research UK Primary Care Research Centre, Keele University, Keele, UK
Emma Briggs, King’s Teaching Fellow/Lecturer, Department of Postgraduate Research, Florence Nightingale School of Nursing & Midwifery, King's College London, London, UK
R. Nicholas Carleton, Assistant Professor, Department of Psychology, University of Regina, Saskatchewan, Canada
Ann Carter, Education Co-Lead, Integrative Therapies Unit, Christie NHS Trust, Manchester, UK
Jill MacLaren Chorney, Assistant Professor, Departments of Anesthesiology, Pain Management and Perioperative Medicine and Psychology, Dalhousie University, Complex Pain Team, IWK Health Centre, Halifax, Canada
Nicola U. Cook, British Accredited Hand Therapist, Sydney Hand Therapy and Rehabilitation, Australia
Kenneth D. Craig, Professor Emeritus of Psychiatry, Department of Psychology, University of British Columbia, Vancouver, Canada
Diarmuid Denneny, Pain Management Physiotherapist, University College London Hospitals, NHS Foundation Trust, London, UK
Krysia Dziedzic, NIHR Research Professor of Musculoskeletal Health in Primary Care, Arthritis Research UK Primary Care Research Centre, Keele University, Keele, UK
Samantha R. Fashler, Associate Faculty Member, Department of Psychology, York University, Toronto, Canada
Nadine E. Foster, NIHR Research Professor of Musculoskeletal Health in Primary Care, Arthritis Research UK Primary Care Research Centre, Keele University, Keele, UK
Mary P. Galea, Professor Fellow, Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Australia
Libby Gibson, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Stephen J. Gibson
Deputy Director, National Ageing Research Institute, Royal Melbourne Hospital
Professor, Department of Medicine, University of Melbourne
Director of Research, Caulfield Pain Management and Research Centre, Caulfield, Australia
Lydia Gomez-Perez, Sessional Lecturer of Psychology, Department of Psychology, University of Regina, Saskatchewan, Canada
Hubert van Griensven
Research Fellow in Musculoskeletal Physiotherapy, University of Brighton, Eastbourne, East Sussex, UK
Consultant Physiotherapist, Southend University Hospital NHS Foundation Trust, Essex, UK
Sarah E. Henderson, School of Clinical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
Melanie A. Holden, Research Fellow in Applied Osteoarthritis, NIHR Research Professor of Musculoskeletal Health in Primary Care, Arthritis Research UK Primary Care Research Centre, Keele University, Keele, UK
Anna Huguet, Research Associate, IWK Health Centre, Halifax, Canada
Mark I. Johnson
Professor of Pain and Analgesia
Faculty of Health and Social Sciences, Leeds Metropolitan University and Leeds Pallium Research Group, Leeds, UK
Peter A. Mackereth, Clinical Lead Supportive Care & Tobacco Control, Christie NHS Trust and Honorary Lecturer, Manchester Metropolitan University, Manchester, UK
Tsipora Mankovsky-Arnold, Department of Psychology, McGill University, Montreal, Canada
Chris McCarthy, Lead Orthopaedic Physiotherapy Practitioner, Imperial College Healthcare, St Mary's Hospital, Paddington, London, UK
Patrick J. McGrath
Vice-President of Research, IWK Health Centre
Canada Research Chair, Dalhousie University
Professor of Psychology, Paediatrics and Psychiatry, Dalhousie University, Halifax, Canada
Danuta Mendelson, Professor of Law (Research), School of Law, Deakin University, Burwood, Australia
George Mendelson
Adjunct Clinical Associate Professor, School of Psychology and Psychiatry
Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria
Australia and Honorary Research Fellow, Caulfield Pain Management and Research, Caulfield Hospital, Caulfield, Australia
Harold Merskey, Professor Emeritus of Psychiatry, University of Western Ontario, Ontario, Canada
Geoffrey Mitchell, Professor of General Practice and Palliative Care, University of Queensland, Brisbane, Australia
Arjun Muralidharan, The University of Queensland, Centre for Integrated Preclinical Drug Development & School of Pharmacy, St Lucia Campus, Brisbane, Australia
Mandy Nielsen, Research Officer, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Carole A. Paley, Airedale NHS Foundation Trust, West Yorkshire, and Leeds Metropolitan University and Leeds Pallium Research Group, Leeds, UK
Esther M. Pogatzki-Zahn, Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, Münster, Germany
Ashley A. Richter, Research Associate, Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
Stephan A. Schug, Professor and Chair of Anaesthesiology, University of Western Australia, Perth, Australia
Maree T. Smith, The University of Queensland, Centre for Integrated Preclinical Drug Development & School of Pharmacy, St Lucia Campus, Brisbane, Australia
Jenny Strong, Professor of Occupational Therapy, Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
Jacqui Stringer, Clinical Lead for Supportive Care, Christie NHS Trust & Honorary Lecturer, University of Manchester, Manchester, UK
Michael J.L. Sullivan, Departments of Psychology, Medicine and Neurology, Canada Research Chair in Behavioural Health, McGill University, Montreal, Canada
Anita M. Unruh
Associate Dean (Research & Academic), Academic Integrity...
| Erscheint lt. Verlag | 6.12.2013 |
|---|---|
| Sprache | englisch |
| Themenwelt | Medizin / Pharmazie ► Gesundheitsfachberufe |
| Medizin / Pharmazie ► Medizinische Fachgebiete ► Schmerztherapie | |
| Medizin / Pharmazie ► Physiotherapie / Ergotherapie ► Behandlungstechniken | |
| Medizin / Pharmazie ► Physiotherapie / Ergotherapie ► Ergotherapie | |
| Medizin / Pharmazie ► Physiotherapie / Ergotherapie ► Rehabilitation | |
| ISBN-10 | 0-7020-5924-2 / 0702059242 |
| ISBN-13 | 978-0-7020-5924-7 / 9780702059247 |
| Haben Sie eine Frage zum Produkt? |
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Kopierschutz: Adobe-DRM
Adobe-DRM ist ein Kopierschutz, der das eBook vor Mißbrauch schützen soll. Dabei wird das eBook bereits beim Download auf Ihre persönliche Adobe-ID autorisiert. Lesen können Sie das eBook dann nur auf den Geräten, welche ebenfalls auf Ihre Adobe-ID registriert sind.
Details zum Adobe-DRM
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Systemvoraussetzungen:
PC/Mac: Mit einem PC oder Mac können Sie dieses eBook lesen. Sie benötigen eine
eReader: Dieses eBook kann mit (fast) allen eBook-Readern gelesen werden. Mit dem amazon-Kindle ist es aber nicht kompatibel.
Smartphone/Tablet: Egal ob Apple oder Android, dieses eBook können Sie lesen. Sie benötigen eine
Geräteliste und zusätzliche Hinweise
Buying eBooks from abroad
For tax law reasons we can sell eBooks just within Germany and Switzerland. Regrettably we cannot fulfill eBook-orders from other countries.
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