Index

Symptom Oriented Pain Management Sanjay Bakshi, Sanjeeva Gupta, Dwarkadas K Baheti, Raghbir Singh P Gehdoo

SECTION 1: BASICS
CHAPTER 1:Pain Management: A Historical Perspective
- INTRODUCTION
- HISTORICAL ASPECT
- ROLE OF MEDICATION
- CONCLUSION
CHAPTER 2:Acute Pain
- INTRODUCTION
- ACUTE PAIN
  - Cause and Mechanism of Acute Pain
  - Rationale for Treatment of Acute Pain
- CONCLUSION
CHAPTER 3:Acute Turn to Chronic: Causes, Prevention, and Management
- INTRODUCTION
- CHRONIC POSTSURGICAL PAIN
- RISK FACTORS FOR DEVELOPING CHRONIC POSTSURGICAL PAIN
- PATHOPHYSIOLOGY OF CHRONIC PAIN
- CONCLUSION
CHAPTER 4:Chronic Pain
- DEFINITION
- PREVALENCE
- ECONOMICS
- CLASSIFICATION
- CAUSES
- ETIOLOGY
- SOCIAL AND PSYCHOLOGICAL IMPACT
- CONCLUSION
CHAPTER 5:Interpretation of Blood Levels of Drugs Used in Chronic Pain Management
- INTRODUCTION
- TDM OF CHRONIC PAIN MEDICATIONS
- CONCLUSION
SECTION 2: CLINICAL EXAMINATION AND EVALUATION
CHAPTER 6:Clinical Examination and Evaluation of Cervical Spine
- INTRODUCTION
- CAUSES
  - Anatomical Considerations
- HISTORY
- EXAMINATION
- NEUROLOGICAL EXAMINATION
  - Examination of Myotomes
  - Sensory and Motor Examination
- Conclusion
CHAPTER 7:Clinical Examination and Evaluation of Lumbar Spine
- INTRODUCTION
- CAUSES
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION
- INVESTIGATIONS
- DIFFERENTIAL DIAGNOSIS
- TREATMENT PROTOCOL
- CONCLUSION
SECTION 3: UNDERSTANDING IMAGING MODALITIES FOR PAIN PATIENT
CHAPTER 8:Interpretation of X-ray Spine
- AIMS
- ROLE OF X-RAY IN PAIN MEDICINE
- RADIOLOGICAL ANATOMY OF SPINE
- HOW TO INTERPRET A SPINE X-RAY?
- CONCLUSION
CHAPTER 9:Interpretation of Computer Tomography Scans for Interventional Pain Treatment Procedures
- INTRODUCTION
- BASIC PROCEDURES
- ADVANCED PROCEDURES
- CONCLUSION
CHAPTER 10:Magnetic Resonance Imaging in Pain Management
- INTRODUCTION
- MRI IN BACK PAIN
  - The Degenerative Spinal Disease
    - Lumbar Spine
    - MR Imaging of Normal Disk and Disk Pathologies
  - Degenerative Pathologies other than Disk
    - The Facet Joints and Pathologies
- THE CERVICAL SPINE
- VERTEBRAL BODY COLLAPSE
- IMAGING IN INFLAMMATORY SPONDYLOARTHROPATHY
- THE SPINAL TUMORS
- THE BONE MARROW PATHOLOGIES
- SPINAL INFECTIONS
- MRI IN POSTOPERATIVE SPINAL PAIN
- MRI IN CHRONIC ABDOMINAL PAIN
- CONCLUSION
CHAPTER 11:Role of Electrodiagnosis in the Management of Neck and Back Pain
- INTRODUCTION
- HOW DOES ELECTRONEUROMYOGRAPHY HELP?
- WHY ELECTRONEUROMYOGRAPHY IN BACK AND NECK PAIN?
- PROTOCOL
- EQUIPMENT
- ELECTRONEUROMYOGRAPHY TESTS
- CONCLUSION
- REVIEW OF RECENT LITERATURE
CHAPTER 12:Bone Mineral Density: Interpretation, Treatment, and Prevention
- INTRODUCTION
- PATHOPHYSIOLOGY
- RISK FACTORS
  - Fixed Risks
  - Modifiable Risks
- DIAGNOSIS
- INDICATIONS
- CONTRAINDICATIONS
- TREATMENT
- PREVENTION
- CONCLUSION
SECTION 4: CERVICAL/NECK PAIN
CHAPTER 13:Headache: Causes and Treatment Modalities
- INTRODUCTION
- CAUSES
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS
- DIFFERENTIAL DIAGNOSIS
  - Primary Headaches
    - Migraine
  - Treatment
- EMERGENCY TREATMENT
- HEADACHE CLINIC
- CONCLUSION
CHAPTER 14:Trigeminal Neuralgia: Causes and Treatment
- INTRODUCTION
- CLASSIFICATION OF TRIGEMINAL NEURALGIA
- DIAGNOSIS
- ANATOMICAL PERSPECTIVE
- MANAGEMENT OPTIONS
- PERCUTANEOUS INTERVENTIONS
  - Indications for Radiofrequency/Balloon Microcompression/Glycerol Injection for Trigeminal Neuralgia
- SALIENT FEATURES RELATED TO EACH INTERVENTION AS RELEVANT IN PRACTICE
- PATIENT REPORTED OUTCOMES FROM AN AUDIT FROM AUTHOR'S UNIT
- BILATERAL TRIGEMINAL NEURALGIA
- ALTERNATIVE NEUROABLATIVE OPTIONS
- CONCLUSION
CHAPTER 15:Cervical Radiculopathy Pain and Its Management
- INTRODUCTION
- CAUSES
  - Factors that Contribute to Cervical Radiculo Pathy
- SYMPTOMS AND SIGNS
- CLINICAL EXAMINATION
  - Inspection
  - Palpation
- DIAGNOSTIC CRITERIA
- FOLLOW-UP ADVICE
- CONCLUSION
CHAPTER 16:Cervical Facet Joint Pain and Its Management
- INTRODUCTION
- CAUSES
- SYMPTOMS AND SIGNS
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS
- DIFFERENTIAL DIAGNOSIS
- PROBLEM DEFINITION
- CONCLUSION
CHAPTER 17:Cervical Diskogenic Pain and Its Management
- INTRODUCTION
- CAUSES
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS
- DIFFERENTIAL DIAGNOSIS
- DIAGNOSIS AND TREATMENT ALGORITHM
- CERVICAL DISKOGRAPHY
- TREATMENT
- CONCLUSION
SECTION 5: LOW BACK PAIN
CHAPTER 18:Focal Back Pain and Its Management
- INTRODUCTION
- CAUSES
- MECHANICAL CAUSES OF FOCAL LOW BACK PAIN
- NONMECHANICAL CAUSES OF FOCAL LOW BACK PAIN
- DESCRIPTION OF SOME COMMON CAUSES OF NONMECHANICAL FOCAL LOW BACK PAIN ENCOUNTERED IN THE PAIN CLINIC
- CONCLUSION
CHAPTER 19:Lumbar Facet Joint Pain Syndrome
- INTRODUCTION
- PREVALENCE AND EPIDEMIOLOGY
- ANATOMY
- CAUSES
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- TREATMENT
- CONCLUSION
CHAPTER 20:Lumbar Spinal Stenosis
- INTRODUCTION
- CAUSES
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION AND FINDINGS
- DIAGNOSTIC CRITERIA AND IMAGING
- TREATMENT OPTIONS
- CONCLUSION
CHAPTER 21:Lumbar Diskogenic Back Pain
- INTRODUCTION
- CAUSES
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS SUGGESTED
- DIFFERENTIAL DIAGNOSIS
- TREATMENT PROTOCOL
- CONCLUSION
CHAPTER 22:Sacroiliac Joint Pain Syndrome and Its Management
- INTRODUCTION
- CAUSES OF SACROILIAC JOINT PAIN SYNDROME
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS
- DIFFERENTIAL DIAGNOSIS
- TREATMENT PROTOCOL
- FOLLOW-UP ADVICE
- CONCLUSION
CHAPTER 23:Coccygodynia and Its Pain Management
- INTRODUCTION
- CLINICAL ANATOMY
- ETIOLOGY
- SIGNS AND SYMPTOMS
- PHYSICAL EXAMINATION
- DIAGNOSTIC AND IMAGING WORK-UP
  - Imaging
- TREATMENT STRATEGY
  - Nonsurgical Management
- CONCLUSION
CHAPTER 24:Piriformis and Iliopsoas Pain Syndromes and Its Pain Management
- PIRIFORMIS SYNDROME
- PSOAS OR ILIOPSOAS SYNDROME
- CONCLUSION
SECTION 6: UROGENITAL AND PELVIC PAIN
CHAPTER 25:Nonmalignant Urogenital Pain Management
- INTRODUCTION
- NEUROANATOMY OF PELVIS AND PERINEUM
- CHRONIC PROSTATITIS (CHRONIC PROSTATE PAIN)
  - Symptoms
- PROSTADYNIA
  - Treatment
- ORCHIALGIA/TESTICULAR PAIN
- BLADDER PAIN SYNDROME (INTERSTITIAL CYSTITIS)
  - Treatment
- VULVAR PAIN SYNDROME (VULVODYNIA)
- URETHRAL PAIN SYNDROME
- ANORECTAL PAIN SYNDROMES
  - Levator Ani Syndrome
  - Proctalgia Fugax
- PUDENDAL NEURALGIA
- COCCYGODYNIA
  - Treatment
- GENERALIZED TREATMENT OF UROGENITAL PAIN
  - Medications
  - Interventional Procedures
- CONCLUSION
CHAPTER 26:Chronic Nonmalignant Pelvic Pain
- INTRODUCTION
- DEFINITIONS
- EPIDEMIOLOGY
- ETIOLOGY
- ASSESSMENT
- MANAGEMENT/TREATMENT OPTIONS
  - Multidisciplinary Team Approach
  - Specific Treatment
- CONCLUSION
SECTION 7: CANCER PAIN
CHAPTER 27:Head and Neck Cancer Pain Management
- INTRODUCTION
- PREVALENCE OF PAIN IN HEAD AND NECK CANCER
- ETIOLOGY OF HEAD AND NECK CANCER-RELATED PAIN
- ASSESSMENT OF HEAD AND NECK CANCER-RELATED PAIN
- MANAGEMENT OF HEAD AND NECK CANCER-RELATED PAIN
- CONCLUSION
CHAPTER 28:Breast Cancer: Pain and Its Management
- INTRODUCTION
- SYMPTOMATOLOGY
  - Pain Due to Tumor
- TREATMENT-RELATED PAIN
- CONCLUSION
CHAPTER 29:Carcinoma Lung: Pain and Its Management
- INTRODUCTION
- CAUSES
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS
- DIFFERENTIAL DIAGNOSIS
- TREATMENT
- FOLLOW-UP ADVICE
- CONCLUSION
CHAPTER 30:Upper Abdominal Malignancy: Pain and Its Management
- INTRODUCTION
- CAUSES OF CHRONIC UPPER ABDOMINAL PAIN
- SYMPTOMS AND SIGNS
- DIAGNOSTIC CRITERIA
  - General Examination
  - Examination of Abdomen
- INVESTIGATIONS
  - Blood Tests
  - Other Tests
- TREATMENT PROTOCOL
- COMPLICATIONS
- CONCLUSION
CHAPTER 31:Malignant Pelvic Pain and Its Management
- INTRODUCTION
- PATHOPHYSIOLOGY OF PELVIC PAIN
- ANATOMICAL CONSIDERATION
- TESTICULAR TUMORS
- COCCYDYNIA
  - Pain Description of Pelvic Pain Patients
- MANAGEMENT OF PELVIC PAIN
  - Neural Blockade for Relief of Pelvic Pain
  - Sympathetic Nerve Block
- CONCLUSION
- ACKNOWLEDGMENT
CHAPTER 32:Metastatic Bone Pain Management
- INTRODUCTION
- MECHANISMS OF BONE METASTASIS
- CLINICAL FEATURES
- DIAGNOSIS
  - Laboratory Tests
  - Radiographic Examination
- TREATMENT OPTIONS
- CONCLUSION
SECTION 8: NEUROPATHIC PAIN
CHAPTER 33:Neuropathic Pain: Approach, Pathophysiology, and Management
- INTRODUCTION
- DEFINITION
- ETIOLOGY
- PATHOPHYSIOLOGY
  - Peripheral Mechanisms
- CLINICAL APPROACH
  - History
- EXAMINATION
- INVESTIGATIONS
- MANAGEMENT
- PHARMACOTHERAPY
  - Principles of Therapy
  - Trigeminal Neuralgia
- INTERVENTIONAL PAIN MANAGEMENT
- CONCLUSION
SECTION 9: ISCHEMIC PAIN
CHAPTER 34:Peripheral Vascular Disease: Causes and Pain Management
- INTRODUCTION
- ETIOPATHOPHYSIOLOGY
  - Etiology
  - Pathophysiology
- CLASSIFICATION
  - Fontaine Stages
  - Rutherford Categories
    - Asymptomatic/Claudication/Critical Limb Ischemia/Acute Limb Ischemia
- HISTORY
  - Symptoms
    - Other Symptoms and Signs
- CLINICAL EXAMINATION
- LABORATORY STUDIES
- IMAGING STUDIES
- OTHER TESTS
- TREATMENT
  - Immediate Management
  - In Hospital Management
- ACUTE LIMB ISCHEMIA
- CHRONIC SEVERE LIMB ISCHEMIA (CRITICAL LIMB ISCHEMIA)
  - Revascularization Referral
  - Procedures (Endovascular or Surgical Revascularization)
- CONTINUED INTERVENTIONAL MANAGEMENT
- CONCLUSION
SECTION 10: MYOFASCIAL PAIN
CHAPTER 35:Management of Myofascial Pain
- INTRODUCTION
- RELEVANT ANATOMY
- CLINICAL FEATURES
- DIAGNOSING MYOFASCIAL PAIN
- DIFFERENTIAL DIAGNOSIS
- MANAGEMENT
  - Available Therapeutic Options6 (Evidence and Recommendations)
    - Pharmacologic Treatment of Myofascial Pain
    - Nonpharmacologic Treatment Options
- CONCLUSION
- ADDENDUM
CHAPTER 36:Fibromyalgia: Causes and Pain Management
- INTRODUCTION
- HISTORY
- EPIDEMIOLOGY
- PATHOLOGY
- CLINICAL FEATURES
- SYMPTOMS
- SIGNS
- LIMITATIONS
- MANAGEMENT
- INVESTIGATIONS
- TREATMENT
- CONCLUSION
SECTION 11: SCAR PAIN
CHAPTER 37:Post-herniorrhaphy Pain and Its Management
- INTRODUCTION
- ANATOMY OF INGUINAL CANAL
- NEUROANATOMY OF ILIOINGUI-NAL NERVE
- NEUROANATOMY OF ILIOHYPO-GASTRIC NERVE (FIG. 2)
- GENITOFEMORAL NERVE
- TREATMENT MODALITIES FOR CHRONIC POSTSURGICAL INGUINAL PAIN
  - Preventive Approach
  - Therapeutic Approach
- CONCLUSION
CHAPTER 38:Post-coronary Artery Bypass Grafting Scar Pain and Its Management
- INTRODUCTION
- PREVALENCE OF POST-THORACOTOMY PAIN
- CAUSES 5–7
- CLINICAL EXAMINATION
- INVESTIGATIONS
  - DIFFERENTIAL DIAGNOSIS
- TREATMENT PROTOCOL
- CONCLUSION
SECTION 12: CHALLENGING PAIN
CHAPTER 39:Complex Regional Pain Syndrome: Where We Stand?
- INTRODUCTION
- CAUSES
- GENETICS IN COMPLEX REGIONAL PAIN SYNDROME
  - Role of Glia
- SYMPTOMS AND SIGNS
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS SUGGESTED
- TREATMENT PROTOCOL
- HYPERBARIC OXYGEN THERAPY
CHAPTER 40:Phantom Limb Pain: Causes and Pain Management
- INTRODUCTION
- SIGNS and SYMPTOMS
- CAUSES
- CLINICAL EXAMINATION
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS
  - Differential Diagnosis
- TREATMENT PROTOCOL
- CONCLUSION
CHAPTER 41:Postherpetic Neuralgia: Causes and Pain Management
- INTRODUCTION
- SIGNS AND SYMPTOMS
- CLINICAL EXAMINATION
- TREATMENT OPTIONS
- CONCLUSION
CHAPTER 42:Post-laminectomy Pain and Its Management
- INTRODUCTION
- ETIOLOGY
- PATHOPHYSIOLOGY
- CLINICAL EVALUATION
- HISTORY
- EXAMINATION
- DIFFERENTIAL DIAGNOSIS
- INVESTIGATIONS
- MANAGEMENT
- CONCLUSION
CHAPTER 43:Restless Leg Syndrome: Causes and Pain Management
- INTRODUCTION
- CAUSES
- DIAGNOSTIC CRITERIA FOR RESTLESS LEG SYNDROME
- PREVENTIVE TIPS FOR RESTLESS LEG SYNDROME
  - Symptoms and Signs
- CLINICAL EXAMINATION
  - Physical Examination
  - Neurological Examination
- INVESTIGATIONS
  - Blood Investigation
  - Sleep Studies
- DIFFERENTIAL DIAGNOSIS
- TREATMENT PROTOCOL
- CONCLUSION
CHAPTER 44:Calciphylaxis and Its Pain Management
- INTRODUCTION
- BACKGROUND
- EPIDEMIOLOGY
- PATHOPHYSIOLOGY
- DIAGNOSIS
- CLINICAL FEATURES
  - History
  - Physical Findings
- CAUSES/ASSOCIATION (TABLE 1)
- TREATMENT
- PAIN MANAGEMENT
- CONCLUSION
CHAPTER 45:Regenerative Medicine for Spine and Orthopedic Conditions
- INTRODUCTION
- HISTORICAL BACKGROUND
- BIOLOGIC AGENT SOURCES
- BIOCELLULAR CHEMISTRY
- CLINICAL CONSIDERATIONS
- INDICATIONS AND APPLICATIONS
- PROCEDURAL PROTOCOLS
- CONTRAINDICATIONS
- LEGISLATIVE AND ETHICAL UPDATE
- CONCLUSION
SECTION 13: PHYSIOTHERAPY
CHAPTER 46:Role of Physiotherapy in Treatment of Patients with Spinal Pain During the Acute/Inflammatory Phase
- INTRODUCTION
- CAUSES OF SPINAL PAIN
- SYMPTOMS
- CLINICAL EXAMINATION
- TREATMENT
  - Neutral Spine
  - First Aide Positions
- CONCLUSION
CHAPTER 47:Role of Physiotherapy in Treatment of Spinal Pain During Subacute/Reparative Phase
- INTRODUCTION
- GOALS OF PHYSICAL THERAPY TREATMENT
- SIGNS AND SYMPTOMS
  - Signs
  - Symptoms
- CLINICAL EXAMINATION
- INVESTIGATIONS SUGGESTED
- PHYSICAL THERAPY TREATMENT
- CONCLUSION
CHAPTER 48:Physiotherapy in Management of Chronic Pain
- INTRODUCTION
- CAUSES
- EVALUATION/ASSESSMENT
- GOALS OF TREATMENT
- INTERVENTIONS FOR PAIN MANAGEMENT
- ELECTROTHERAPEUTIC MODALITIES
- MANUAL THERAPY TECHNIQUES
- CONCLUSION
SECTION 14: PSYCHIATRY
CHAPTER 49:Role of Psychiatric Medications in Chronic Pain Management
- INTRODUCTION
- CHRONIC PAIN
- WHY PSYCHIATRIC MEDICATIONS IN CHRONIC PAIN?
- PSYCHIATRIC MEDICATIONS IN CHRONIC PAIN
  - Antidepressants
- PSYCHOTHERAPY
- CONCLUSION
CHAPTER 50:Pain Psychology and Its Treatment Options
- INTRODUCTION
- CAUSES
- SIGNS AND SYMPTOMS
- PAIN AND DEPRESSION
- PAIN AND ANXIETY
- DIAGNOSTIC CRITERIA
- INVESTIGATIONS
- DIFFERENTIAL DIAGNOSIS
- TREATMENT
  - Important Tips for Medical Practitioners
- CONCLUSION
SECTION 15: ALLIED THERAPY
CHAPTER 51:Role of Radiation in Cancer Pain
- INTRODUCTION
- TYPES OF RADIATION
- MECHANISM OF PAIN RELIEF BY RADIATION
- METASTATIC BONE PAIN MANAGEMENT
  - Isotope Therapy for Metastatic Bone Pain
    - Mechanism of Action
  - Targeted Isotope Therapy
- ROLE OF EXTERNAL RADIATION THERAPY IN CHRONIC PAIN MANAGEMENT
- CONCLUSION
CHAPTER 52:Role of Chemotherapy in Cancer Pain Management
- INTRODUCTION
- TYPES OF CANCER PAIN
- CAUSES OF CANCER PAIN
- TREATMENT MODALITIES FOR CANCER PAIN
- HOW TO INTEGRATE CANCER- DIRECTED SYSTEMIC THERAPIES IN MANAGEMENT OF CANCER PAIN?
- WHEN TO STOP CANCER-DIRECTED SYSTEMIC THERAPIES
- CONCLUSION
CHAPTER 53:Oncosurgery and Cancer Associated Pain
- INTRODUCTION
- DEFINITION AND UNDERSTANDING CONCEPTS IN SURGICAL PALLIATION FOR CANCER
- INDICATIONS FOR SURGICAL PALLIATION
- PATIENT SELECTION FOR PALLIATIVE SURGERY
- THE EVIDENCE AND THE OUTCOMES
- CONCLUSION
- ACKNOWLEDGMENTS
CHAPTER 54:Management of Ophthalmic Pain
- INTRODUCTION
- CHEMICAL INJURIES
  - Acute Glaucoma
- UVEITIS
- END-STAGE TREATMENT
- FLUOROSCOPIC TECHNIQUE
- CT-GUIDED TECHNIQUE
  - Inflammatory Causes: These Include
  - Specific Orbital Tumors: Common Types Include
- CONCLUSION

INDEX

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Index

Chapter Notes