Pain Medicine at a Glance

Beth B. Hogans is Associate Professor in the Department of Neurology at Johns Hopkins Medical School, and Associate Director for Education in the Geriatric Research Education and Clinical Center at the Veterans Affairs Maryland Health Care System in Maryland, USA. She is board certified in Neurology, Clinical Neurophysiology and Pain (ABPM), and is Chair of the Pain Education Special Interest Group for the International Association for the Study of Pain (IASP).

PAIN MEDICINE At-A-Glance Table of Contents

Dr. Beth Brianna Hogans, M.D., Ph.D

I Pain Basics

1 What is pain, how do we assess it?

2 Nociceptive processing, how does pain occur?

3 What are the major types of pain?

4 How prevalent is pain, what are the common forms?

5 How do we resolve dilemmas in pain?

6 What are the big challenges in pain?

7 Cognitive factors that influence pain

II Pain Clinical skills 8 Managing pain safely: diagnosis and treatment

9 Gathering the history with a pain narrative

10 Assessing pain in those with communication barriers

11 Examination skills I: Observation and affect

12 Examination skills II: Inspection and manual skills

13 Knowledge, skills, and compassionate practices

14 Counseling and shared decision-making: applying psychological approaches in primary care for pain

15 Communicating with teams of patients with pain

16 Planning therapy: coordinated, comprehensive care

III Pain Pharmacology 17 Basic considerations for pharmacological therapy - balancing mechanisms of drugs and disease

18 Non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (over-the-counter analgesia)

19 Neuromodulating agents: pain-active anti-depressants and anti-convulsants

20 Opioids - the basics and perioperative pain control

21 Opioids - the details: equianalgesia and safe use

22 Opioids - advanced practice - alternative delivery: IV, PCA, epidural

23 Focal treatments for pain in primary practice: topical, iontophoretic, basic injections, TENS

24 Interventional treatments and surgery for pain

IV Non-pharm. treatments 25 Activating treatment: Physical/occupational therapy, hydrotherapy, exercise: walking, yoga, chi gong

26 Cognitive therapies: CBT, ACT, reframing

27 Manual therapies: massage: trigger points, acupressure, chiropractic, stretching, inversion

28 Therapies that utilize descending pain pathways: video, music, distraction, acupuncture, meditation

V Major pain forms 29 Acute and Chronic pain: the basics

30 Surgical and procedural pain

31 Musculoskeletal pain

32 Orofacial pain

33 Neck Pain, cervical and thoracic spine pain

34 Arm Pain

35 Low back pain

36 Back pain emergencies

37 Radiating leg, buttock, and groin pain

38 Knee pain

39 Foot and ankle pain

40 Headache emergencies

41 Headache - basic diagnosis and management

42 Headache - chronic pain and the acute flare

43 Visceral pain

44 Pelvic pain

45 Exceptional causes of severe, chronic pain: CRPS, fibromyalgia, erythromelalgia

VI Special patient groups and clinical contexts 46 Management of pain with substance abuse

47 Pain at the end of life, opioid rotation

48 Opioids for chronic pain: preventing iatrogenic OUD

49 Tapering opioids in patients with pain

50 Pain in infants, children, and adolescents

51 Pain in older patients

52 Pharmacotherapy in aging, renal & liver dysfunction

53 Pain in pregnancy and the peripeurium

Appendices

I Sample exam sheet

II Sample pain diary

III Daily stretching guide

IV Patient packet - Your power over pain

V Glossary