Symptom Oriented Pain Management DK Baheti, Sanjay Bakshi, Sanjeeva Gupta, RP Gehdoo
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1SYMPTOM ORIENTED PAIN MANAGEMENT
Under the Aegis of Pain Management and Research Foundation—India2
SYMPTOM ORIENTED PAIN MANAGEMENT
Editors DK Baheti MD Professor and Head, Department of Anesthesiology and Pain Bombay Hospital Institute of Medical Sciences, Mumbai Pain Physician to Lilavati, Raheja, Shushrusha Hospital Mumbai, Maharashtra, India Sanjay Bakshi MD Interventional Pain Management Lenox Hill Hospital, New York, USA Beth Israel Hospital, New York, USA Spine and Pain Medicine 899 Park Avenue, NY 10021, USA Sanjeeva Gupta MD Dip NB FRCA FIPP Consultant in Pain Management and Anesthesia Bradford Teaching Hospitals NHS Foundation Trust Department of Anesthesia, Pain Management and Critical Care Field House, Bradford Royal Infirmary, Duckworth Lane Bradford, BD9 6RJ, UK RP Gehdoo MD DA Professor of Anesthesia Tata Memorial Hospital Parel, Mumbai, Maharashtra, India Foreword Subhash Jain
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Symptom Oriented Pain Management
First Edition: 2012
9789350257975
Printed at
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5CONTRIBUTORS
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9FOREWORD
Pain is as old as mankind's existence. The aftermath of tissue injury is the human body's warning system to protect against further damage and allow it to respond to the cause of injury. When pain occurs without trauma or persists beyond the expected healing period, it becomes a major concern for individuals as well as the treating physician. The suffering induced by chronic pain can impose serious disruptions in one's personal and professional lives, leading to overwhelming costs to society.
Over the past several decades, significant progress has been made towards understanding the basic and clinical sciences underlying the various pain syndromes. In spite of this progress, pain remains inadequately and inappropriately treated throughout the world. There is unacceptable variation in clinical management of pain due to inadequate training; distorted physician beliefs; and inadequate application of pharmacological, behavioral, interventional, and alternative methods of pain management.
Of particular concern has been the emergence of pain treatment centers across the world that focus almost exclusively on interventional methods of pain management. The focus on this modality, while offering some benefit to some patients, leave many missed opportunities to help our patients. We must rethink the direction of our field and recognize chronic and acute pain syndromes as distinct entities. Chronic pain conditions are complex and require the total dedication of physicians capable of managing these conditions with a full appreciation of their underlying pathophysiology. One cannot manage these patients by occasionally coming out of the operating room to treat the patient. Chronic pain patients require dedicated clinicians who can skillfully apply multiple modalities that are carefully tailored for use in their syndrome.
Drs Baheti, Bakshi, Gupta and Gehdoo are leaders and pioneers in the field of pain management, having done so much to establish it as a distinct field in the Indian subcontinent. During the last 20 years, I have personally witnessed their enthusiasm, humility and dedication in improving the care of pain patients and the broader development of the discipline. This book is their next important contribution to improve patient care, and to broaden access to high quality pain care services. I am confident that their dedication will bear important fruit for the clinicians who invest in reading it and the countless patients they serve.
Subhash Jain md fipp
Diplomate of American Board of Anesthesiology
Former Chief of Pain Service at Memorial Sloan Kettering Cancer Center, NY
Senior Attending Physician at Beth Israel Hospital, NY
Medical Director, Institute for Pain and Palliative Care, NY
10PREFACE
We are very delighted to present our second book titled Symptom Oriented Pain Management.
We are basking in the glory of our first book titled “Interventional Pain Management A Practical Approach”. We express our heartfelt gratitude to the readers for their tremendous response and many valuable comments and suggestions.
We have picked up one of the most important suggestion about the urgent need of a comprehensive and practical book about various types of pain and how to tackle them. Chronic pain as a symptom (now also a disease) has a variety of facets which at times makes it difficult to manage.
Pain physicians often face dilemma of how to reach correct diagnosis of a particular symptom such as backache, headache, neck pain, neuropathic pain, ischemic pain and cancer pain.
It is mandatory for pain physician to learn techniques to accurately diagnose the etiology and mechanisms of pain which facilitates appropriate management with pharmacotherapy and where necessary the correct interventional procedure.
There are many books by eminent authors which provide excellent theoretical and other aspects of pain. There was a need for a comprehensive book to help pain physicians reach a diagnosis to facilitate management with maximum pain relief.
We have through this book sincerely attempted to help pain physicians to treat patients in simplistic manner and tips to reach a correct diagnosis and aspire to achieve “Total Pain Relief” for their patients.
We express our heartfelt gratitude to all contributors in this book for their invaluable support to make this herculean task easy.
DK Baheti
Sanjay Bakshi
Sanjeeva Gupta
RP Gehdoo