Clinical Management of Bone and Joint Pain

About the Editors
Contributors
Introduction (Gary McCleane)
PART I
Chapter 1. Basic Pain Mechanisms (Jana Sawynok)
Introduction
Joint Innervation and Activation
Models of Inflammation
Pain in Arthritis
Conclusion
Chapter 2. The Physiology and Basic Science of Bone and Joints (Helen Cohen and David Blake)
Skeletal Developmental Biology
Molecular Genetics
Mature Joint Tissues
Mature Bone
Gross Structure
Microscopic Structure
Mature Cartilage
Synovium
Synovial Fluid
Tendons
Ligaments
Bursae
Circulation
Joint Stability
Synovium and Inflammation
Summary
PART II
Chapter 3. NSAIDs for Painful Bone and Joint Conditions (Jennifer A. Elliott and Howard S. Smith)
Introduction
Mechanisms of Action of NSAIDs
Gastrointestinal Effects of NSAIDs
Renal Effects of NSAIDs
Platelet Effects of NSAIDs
Central Nervous System Effects of NSAIDs
Other NSAID Effects
Classification of NSAIDs
Potential Adverse Drug Interactions with NSAIDs
Conclusion
Chapter 4. Capsaicin (Gary McCleane)
Clinical Use of Capsaicin
Side Effects of Topical Capsaicin Application
Unanswered Questions Regarding Use of Capsaicin
Suggested Clinical Use of Capsaicin
Strategies to Reduce Discomfort of Application of Capsaicin
Chapter 5. Topical Nitrates (Gary McCleane)
Mode of Action of Topical Nitrates When Used As Analgesics
Human Experimental Pain
Studies Suggesting an Analgesic Effect When Nitrates Are Used Topically
Effect of Topical Glyceryl Trinitrate on Inflammation
Effect of Topical Nitrate on Analgesic Effect of Opioids
Issues with the Use of Transdermal Nitrates
Glyceryl Trinitrate Formulations
Side Effects on Topical Glyceryl Trinitrate
Suggested Clinical Use
Chapter 6. Topical Analgesic Options (Charles Argoff)
Topical versus Transdermal
Choice of Agents
Other Uses of Topical Analgesics
Chapter 7A. Intra-Articular Injections (William Lavelle, Elizabeth Demers, and Lori Lavelle)
History of Intra-Articular Steroid Injections
Mechanism of Action of Intra-Articular Steroid Injections
Selected Injection Techniques
Chapter 7B. Nerve Blocks (Elizabeth Demers, William Lavelle, and Lori Lavelle)
Introduction
Upper Extremity Blocks
Lower Extremity Nerve Blocks
Techniques for Localization of a Nerve
Chapter 8. Opioids (Gary McCleane)
Pain and Its Responsiveness to Opioids
Effect of Peripheral Application of Opioids For Acute Pain
Codeine
Dihydrocodeine
Tramadol
Meperidine
Propoxyphene
Pentazocine
Morphine
Diamorphine /
Hydromorphone
Methadone
Fentanyl
Buprenorphine
Oxycodone
Side Effects of Opioid Analgesics
Conclusions
Chapter 9. Acetaminophen (Nisar Soomro)
Structure
Mechanism of Action
Absorption
Metabolism
Toxicity
Antidote
Indications
Formulations
Dose
Arthritic Pain
Interactions
Conclusions
Chapter 10. Glucosamine (William Lavelle, Elizabeth Demers, and Lori Lavelle)
History
Mechanism of Action
Clinical Trials
Safety and Adverse Reactions
Discussion
Chapter 11. Clinical Pharmacology of Glucocorticoids (Muhammad A. Munir and Jun-Ming Zhang)
Introduction
Corticosteroids
Pharmacodynamics
Pharmacokinetics
Clinical Pharmacology
Clinical Summary
Chapter 12. Hyaluronic Acid (William Lavelle, Elizabeth Demers, and Lori Lavelle)
History
Mechanism of Action
Clinical Trials
Safety and Adverse Reactions
Discussion
Chapter 13. Disease-Modifying Antirheumatic Drugs (Lori Lavelle, William Lavelle, and Elizabeth Demers)
Introduction
Antimalarials
Glucocorticoids
Methotrexate
Leflunomide
Sulfasalazine
Azathiprine
Cyclosporine
D-Penicillamine
Cyclophosphamide
Mycophenolate Mofetil
Gold
Biologic Agents
Chapter 14. Physical Therapy (Denis Martin)
Introduction
Function
Addressing Impairment: A Biomedical Application of Physical Therapy
Addressing Activity and Participation: A Biopsychosocial Application of Physical Therapy
Conclusion
Chapter 15. Acupuncture (Gira Patel)
Introduction
How Acupuncture Works
History and Philosophy
Treatment Principles
Conditions Treated
Chapter 16. Botulinum Toxin (Charles Argoff)
Introduction
The Current USFDA-Approved Uses of the Botulinum Toxins
The Use of the Botulinum Toxins for the Treatment of Chronic Headache
The Use of Botulinum Toxin in the Management of Musculoskeletal Pain
The Use of Botulinum Toxin in the Management of Neuropathic Pain and Other Painful Conditions
Chapter 17. Radiopharmaceuticals (Rahul Parikh and Howard S. Smith)
Introduction
Pathophysiology of Painful Osseous Metastases
Current Treatment Options
Radiopharmaceutical Agents—Overview
Radiopharmaceutical Agents
Investigational Radiopharmaceuticals
Patient Selection Criteria and Treatment Guidelines
Administration of Radiopharmaceuticals and Follow-Up
Future Work
Conclusion
Chapter 18. Muscle Relaxants (Gary McCleane)
Baclofen
Benzodiazepines
Carisoprodol
Cyclobenzaprine
Dantrolene
Metaxalone
Methocarbamol
Orphenadrine
Tizanadine
Miscellaneous
Suggested Clinical Use of Muscle Relaxant Drugs
Chapter 19. Other Options (Howard S. Smith and Mark Guerdan)
NSAIDs
Biosynthetic Options
The Future
Summary
PART III
Chapter 20. Joint Pain (Gary McCleane)
Monoarticular Pain
Polyarticular Options
Chapter 21. Fracture Pain (Gary McCleane)
Is Fracture Pain Adequately Treated?
Pharmacological Options
Treatment of Specific Fractures
Chapter 22. Pathophysiology and Analgesic Approaches to Painful Bone Metastasis (Howard S. Smith and Jennifer A. Elliott)
Introduction
Pathophysiology of Bone Resorption
Osteoclast Osteolysis
Modulation of Osteoclastic Activity Modulates Nociception
Chapter 23. Pain Arising from Tendons and Tendon Sheaths (Gary McCleane)
Topical Options
Injections
Oral Options
Others
Suggested Treatment for Tendon-Related Pain
Chapter 24. When Is Pain Felt Over a Bone or Joint, Not Bone or Joint Pain? (Gary McCleane)
Radiated Pain/Neuropathic Pain
Referred Pain
Complex Regional Pain Syndrome
Aid to Diagnosis
Index
Reference Notes Included