Additional Information
Book Details
Abstract
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
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Pain: A textbook for health professionals | iii | ||
| Copyright | iv | ||
| Contents | v | ||
| Foreword | vii | ||
| Contributors | ix | ||
| Chapter 1: Introduction to pain | 1 | ||
| OVERVIEW | 1 | ||
| WHAT IS PAIN? | 2 | ||
| THE PERSON WHO LIVES WITH PAIN | 2 | ||
| THE INTERPROFESSIONAL PAIN TEAM | 3 | ||
| THE PHYSICIAN | 3 | ||
| THE NURSE | 4 | ||
| THE PSYCHOLOGIST | 4 | ||
| THE PHYSIOTHERAPIST (PHYSICAL THERAPIST) | 4 | ||
| THE OCCUPATIONAL THERAPIST | 5 | ||
| OTHER HEALTHCARE PROVIDERS | 5 | ||
| ACKNOWLEDGEMENTS | 6 | ||
| REFERENCES | 6 | ||
| Chapter 2: The patient's voice | 9 | ||
| OVERVIEW | 9 | ||
| THE EXPERIENCE OF LIVING WITH CHRONIC PAIN | 9 | ||
| THE SEARCH FOR RESTORATION | 10 | ||
| LOSS | 11 | ||
| Loss of employment | 11 | ||
| Loss of social and family roles | 12 | ||
| Loss of 'self' | 13 | ||
| STIGMA | 14 | ||
| THE VALUE OF THE PATIENT'S VOICE | 15 | ||
| SHARED VOICES: THE VALUE OF CONSUMER GROUPS | 16 | ||
| CONCLUSION | 17 | ||
| REFERENCES | 18 | ||
| Chapter 3: Social determinants of pain | 21 | ||
| OVERVIEW | 21 | ||
| THE SOCIAL COMMUNICATION MODEL OF PAIN | 22 | ||
| SOURCES OF PAIN: OPPORTUNITIES FOR PREVENTION | 23 | ||
| THE EXPERIENCE OF PAIN | 24 | ||
| HOW PAIN IS COMMUNICATED TO OTHERS | 26 | ||
| HOW OTHERS RECOGNIZE, INTERPRET AND RESPOND TO THE PERSON'S PAIN | 27 | ||
| Social policy and health service delivery | 28 | ||
| CONCLUSION | 28 | ||
| REFERENCES | 29 | ||
| Section 1: Overview: what is pain? | 33 | ||
| Chapter 4: The psychology of pain: models and targets for comprehensive assessment | 35 | ||
| OVERVIEW | 35 | ||
| PAIN AND CHRONIC PAIN DEFINED | 35 | ||
| MODELS PERTINENT TO UNDERSTANDING PAIN | 36 | ||
| Gate control theory | 36 | ||
| Biopsychosocial models | 36 | ||
| Summary | 37 | ||
| COGNITIVE CONSTRUCTS | 37 | ||
| Beliefs | 37 | ||
| Mood | 38 | ||
| Anxiety and fear | 39 | ||
| Spirituality | 39 | ||
| BEHAVIOURAL CONSTRUCTS | 39 | ||
| Avoidance behaviour | 39 | ||
| Activity limitation for secondary gain | 40 | ||
| Pain coping behaviours | 40 | ||
| Pain and suicide | 40 | ||
| ENVIRONMENTAL INFLUENCES | 41 | ||
| Family | 41 | ||
| Culture and ethnicity | 41 | ||
| Socioeconomics | 41 | ||
| Work | 42 | ||
| KEY CONSIDERATIONS IN ASSESSMENT AND CASE CONCEPTUALIZATION | 42 | ||
| Assessment and case conceptualization | 42 | ||
| Treatment overview | 42 | ||
| CONCLUSION | 43 | ||
| REFERENCES | 43 | ||
| Chapter 5: Neuroanatomy of the nociceptive system | 49 | ||
| OVERVIEW | 49 | ||
| STRUCTURE AND FUNCTION OF PERIPHERAL NOCICEPTORS | 49 | ||
| Nociceptors | 50 | ||
| Skeletal muscle nociceptors | 51 | ||
| Joint nociceptors | 52 | ||
| Visceral nociceptors | 52 | ||
| NON-NEURONAL CELLS | 52 | ||
| ANATOMY OF REFERRED PAIN | 52 | ||
| DORSAL ROOT GANGLION CELLS | 53 | ||
| PRIMARY AFFERENTS | 53 | ||
| THE DORSAL HORN | 53 | ||
| Terminations of afferent fibres in the dorsal horn | 55 | ||
| Large-diameter myelinated fibres | 55 | ||
| Small-diameter myelinated fibres | 55 | ||
| Unmyelinated fibres | 55 | ||
| Visceral projections | 55 | ||
| Somatotopic organization of dorsal horn | 55 | ||
| Response properties of dorsal horn neurons | 55 | ||
| SPINAL CORD TRANSMISSION PATHWAYS | 56 | ||
| Ascending tracts | 56 | ||
| TRIGEMINAL SYSTEM | 58 | ||
| SYMPATHETIC NERVOUS SYSTEM | 59 | ||
| AREAS OF THE BRAIN INVOLVED IN THE PERCEPTION, INTEGRATION AND RESPONSE TO NOCICEPTION | 61 | ||
| Thalamus | 61 | ||
| Termination of spinothalamic afferents in the thalamus | 61 | ||
| The lateral nuclear group | 61 | ||
| The medial nuclear group | 62 | ||
| Brainstem | 62 | ||
| Periaqueductal grey matter | 62 | ||
| Reticular formation | 63 | ||
| Dorsolateral pontine tegmentum | 63 | ||
| Rostral ventral medulla | 63 | ||
| Limbic structures | 64 | ||
| Basal ganglia | 65 | ||
| Cerebral cortex | 66 | ||
| Cortical representation of pain | 66 | ||
| Corticospinal projections | 66 | ||
| Role of corticospinal projections | 68 | ||
| CONCLUSION | 69 | ||
| REFERENCES | 70 | ||
| Chapter 6: Neurophysiology of pain | 77 | ||
| OVERVIEW | 77 | ||
| NOCICEPTION OF SOMATIC AND VISCERAL ORIGIN | 78 | ||
| Cutaneous nociception | 78 | ||
| Deep somatic nociception | 79 | ||
| Visceral nociception | 79 | ||
| Referred pain | 80 | ||
| PERIPHERAL SENSITIZATION | 80 | ||
| CENTRAL SENSITIZATION | 81 | ||
| DESCENDING INHIBITION AND FACILITATION | 83 | ||
| PROCESSING AND CONTROL BY HIGHER CENTRES | 84 | ||
| CONCLUSION | 85 | ||
| REFERENCES | 86 | ||
| Section 2: Assessment and management of pain | 89 | ||
| Chapter 7: Assessing pain | 91 | ||
| OVERVIEW | 91 | ||
| SOME IMPORTANT ISSUES IN THE MEASUREMENT OF PAIN | 91 | ||
| Clinical utility | 92 | ||
| Reliability of pain measures | 92 | ||
| Validity of pain measures | 93 | ||
| Types of pain measures | 93 | ||
| Self-report | 93 | ||
| Observational measures | 94 | ||
| Physiological measures | 95 | ||
| ASSESSMENT OF PAIN | 95 | ||
| Measurement of the description of the pain | 96 | ||
| Numeric scales | 96 | ||
| Visual analogue scales | 97 | ||
| The pain drawing | 98 | ||
| McGill Pain Questionnaire | 99 | ||
| Measurement of responses to pain | 99 | ||
| Measurement of the impact of pain | 106 | ||
| Multidimensional assessment of pain | 107 | ||
| Advances in technology for pain assessment and measurement | 108 | ||
| Assessment and measurement of pain in patients from special populations | 109 | ||
| FACTORS THAT MAY INFLUENCE ASSESSMENT AND MEASUREMENT OUTCOMES | 109 | ||
| Social desirability | 109 | ||
| Compensation | 109 | ||
| Memory problems | 109 | ||
| Therapist attitudes | 109 | ||
| CONCLUSION | 110 | ||
| ACKNOWLEDGEMENTS | 110 | ||
| REFERENCES | 110 | ||
| Chapter 8: Psychological interventions: a conceptual perspective | 115 | ||
| Psychological treatment of pain | 116 | ||
| Behavioural/operant programmes | 117 | ||
| Back schools | 117 | ||
| Cognitive-behavioural programmes | 117 | ||
| Stress management programmes | 118 | ||
| Acceptance and commitment therapy | 118 | ||
| Risk-factor targeted interventions | 119 | ||
| Progressive goal attainment | 119 | ||
| Graded activity and exposure | 120 | ||
| Choosing among different psychological interventions | 120 | ||
| References | 121 | ||
| Chapter 9: Psychological interventions: application to management of pain | 125 | ||
| OVERVIEW | 125 | ||
| PATIENT EDUCATION | 126 | ||
| Description | 126 | ||
| Sources of more information | 126 | ||
| OPERANT CONDITIONING APPROACHES | 127 | ||
| Section 3: Special issues | 269 | ||
| Chapter 17: Pain education for professionals | 271 | ||
| OVERVIEW | 271 | ||
| BUILDING A KNOWLEDGE BASE AND IDENTIFYING KEY SKILLS | 271 | ||
| Learning experiences and strategies | 272 | ||
| Making the most of lectures | 272 | ||
| Group work | 274 | ||
| E-learning | 274 | ||
| UNDERGRADUATE EDUCATION | 275 | ||
| Learners on undergraduate programmes | 275 | ||
| Academics and clinicians promoting pain education | 275 | ||
| INTERPROFESSIONAL LEARNING AND WORKING | 276 | ||
| POSTGRADUATE EDUCATION | 278 | ||
| Personal benefits of higher level study | 278 | ||
| Development of transferable skills for enhanced employability | 278 | ||
| Career progression and the development of a strong academic and vocational profile | 279 | ||
| Potential rewards and career options | 279 | ||
| Characteristics of postgraduate education | 279 | ||
| Opportunities for advanced study | 279 | ||
| IN-SERVICE EDUCATION | 280 | ||
| PROFESSIONAL ORGANIZATIONS | 280 | ||
| Benefits of membership of a professional organization | 280 | ||
| Networking opportunities | 281 | ||
| Conferences, education and access to online resources | 281 | ||
| Discounted publications | 282 | ||
| Special interest groups | 282 | ||
| Political and educational interests | 282 | ||
| Protection | 282 | ||
| Benefits of conference attendance | 282 | ||
| Summary | 282 | ||
| USING THE INTERNET FOR PAIN EDUCATION AND FURTHER RESOURCES | 282 | ||
| CONCLUSION | 283 | ||
| REFERENCES | 284 | ||
| INTERNET RESOURCES –INTERPROFESSIONAL EDUCATION | 286 | ||
| PROFESSIONAL ORGANIZATIONSTHAT HAVE AN INTEREST IN PAINEDUCATION | 286 | ||
| Pain-specific organizations | 286 | ||
| Generic organizations | 286 | ||
| Chapter 18: Pain in childhood | 287 | ||
| OVERVIEW | 287 | ||
| WHAT IS THE PROBLEM? | 287 | ||
| WHAT ARE THE CHALLENGES? | 289 | ||
| Developmental considerations | 290 | ||
| Attitudes of health professionals and others | 290 | ||
| Families | 291 | ||
| School system | 291 | ||
| Assessment and measurement of children's pain | 291 | ||
| WHAT CAN HEALTH PROFESSIONALS DO? | 292 | ||
| Pain in infants and young children | 292 | ||
| Pain in children and adolescents | 293 | ||
| RESOURCES FOR HEALTH PROFESSIONALS | 294 | ||
| REFERENCES | 295 | ||
| Chapter 19: Pain in the elderly | 299 | ||
| OVERVIEW | 299 | ||
| THE EPIDEMIOLOGY OF PAIN ACROSS THE LIFESPAN | 300 | ||
| AGE DIFFERENCES IN PAIN AS A PRESENTING SYMPTOM OF CLINICAL DISEASE | 300 | ||
| SUMMARY OF EPIDEMIOLOGIC STUDIES ON AGE DIFFERENCES IN PAIN | 301 | ||
| EPIDEMIOLOGY OF PAIN IN SPECIAL OLDER POPULATIONS | 301 | ||
| EXPLAINING AGE DIFFERENCES IN PAIN PREVALENCE AND REPORT | 302 | ||
| AGE DIFFERENCES IN PSYCHOSOCIAL ASPECTS OF PAIN | 302 | ||
| AGE-RELATED CHANGES IN NEUROPHYSIOLOGY | 303 | ||
| AGE DIFFERENCES IN PAIN PROCESSING UNDER PATHOPHYSIOLOGIC CONDITIONS | 304 | ||
| PAIN PROCESSING IN PERSONS WITH DEMENTIA | 305 | ||
| Assessment of pain in older people | 305 | ||
| MANAGING PAIN IN OLDER PERSONS | 306 | ||
| CONCLUSIONS | 307 | ||
| ACKNOWLEDGEMENTS | 307 | ||
| REFERENCES | 307 | ||
| Chapter 20: Cancer pain | 313 | ||
| OVERVIEW | 313 | ||
| FREQUENCY OF PAIN IN CANCER | 314 | ||
| Types of cancer pain | 314 | ||
| IMPACT OF AND RESPONSES TO CANCER PAIN | 315 | ||
| ASSESSMENT AND MEASUREMENT OF CANCER PAIN | 316 | ||
| Assessment considerations | 316 | ||
| Impact of pain on the occupations of daily life | 318 | ||
| Family context | 318 | ||
| PRINCIPLES OF PAIN MANAGEMENT | 318 | ||
| Pharmacological means of pain control | 318 | ||
| Opioids | 319 | ||
| Adjuvants | 319 | ||
| Therapists' understanding of pharmacological approaches to cancer pain management | 319 | ||
| Non-pharmacological medical methods | 319 | ||
| Education | 320 | ||
| Non-pharmacological physical methods | 320 | ||
| Psychosocial approaches | 321 | ||
| Lifestyle adjustment | 322 | ||
| Barriers to adequate pain management | 322 | ||
| DIFFERENT CONTEXTS FOR CANCER PAIN MANAGEMENT | 323 | ||
| CANCER PAIN IN CHILDREN | 323 | ||
| PALLIATIVE-CARE PAIN MANAGEMENT | 323 | ||
| ISSUES FACING PRACTITIONERS WHEN WORKING WITH PATIENTS WITH CANCER | 324 | ||
| CONCLUSION | 325 | ||
| REFERENCES | 325 | ||
| Chapter 21: Managing chronic spinal pain | 329 | ||
| OVERVIEW | 329 | ||
| THE ASSESSMENT OF CHRONIC SPINAL PAIN | 329 | ||
| Principles of examining persistent spinal pain | 330 | ||
| The relevance of a diagnosis | 331 | ||
| Diagnostic tests | 331 | ||
| REHABILITATION OF PERSISTENT SPINAL PAIN | 331 | ||
| Patient goals | 332 | ||
| Exercise | 332 | ||
| Expectations | 332 | ||
| Pacing and other strategies to facilitate increases in activity | 332 | ||
| Flare-up management | 333 | ||
| PSYCHOLOGICAL APPROACHES | 333 | ||
| MEDICAL APPROACHES TO MANAGING SPINAL PAIN | 334 | ||
| Pharmacological management | 334 | ||
| Interventional medicine | 334 | ||
| Injections | 334 | ||
| Surgery | 335 | ||
| Spinal cord stimulation | 335 | ||
| CONCLUSION | 335 | ||
| REFERENCES | 335 | ||
| Chapter 22: Rehabilitation and the World Health Organization's International Classification of Functioning, Disability an... | 339 | ||
| OVERVIEW | 339 | ||
| GENERIC MODELS OF HEALTH AND DISABILITY USED IN PAIN: A BRIEF HISTORICAL OVERVIEW | 340 | ||
| INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH | 340 | ||
| Development | 340 | ||
| Overview | 341 | ||
| Structure | 342 | ||
| Qualifier scale | 342 | ||
| TOOLS TO OPERATIONALIZE THE ICF | 342 | ||
| ICF checklist | 342 | ||
| ICF core sets | 343 | ||
| Development | 343 | ||
| ICF core sets and pain practice | 343 | ||
| Acute and subacute musculoskeletal conditions | 347 | ||
| Chronic musculoskeletal conditions | 347 | ||
| APPLYING THE ICF IN CLINICAL PRACTICE: A CASE STUDY | 348 | ||
| Clinical scenario: Mrs Smith | 348 | ||
| Assessment | 348 | ||
| Assignment | 349 | ||
| Intervention | 349 | ||
| Evaluation | 349 | ||
| Summary | 349 | ||
| MEASURING OUTCOMES FROM THE ICF PERSPECTIVE | 349 | ||
| Indirect applications of the ICF in outcome measurement | 354 | ||
| Direct applications of the ICF in outcome measurement | 354 | ||
| LIMITATIONS | 355 | ||
| CONCLUSION | 356 | ||
| ACKNOWLEDGEMENTS | 356 | ||
| REFERENCES | 356 | ||
| Chapter 23: Participating in life roles | 361 | ||
| OVERVIEW | 361 | ||
| MANAGING LIFE WITH PERSISTENT PAIN | 361 | ||
| GOAL SETTING | 363 | ||
| ACTIVE INVOLVEMENT OF THE CLIENT IN DECISION MAKING | 363 | ||
| ACTIVITY ENGAGEMENT | 364 | ||
| SELF-MANAGEMENT | 365 | ||
| SOCIAL SUPPORT | 367 | ||
| CONCLUSION | 367 | ||
| REFERENCES | 367 | ||
| Chapter 24: Persistent pain and the law: clinical and legal aspects of chronic pain | 369 | ||
| LEGAL LIABILITY AND PAIN MANAGEMENT | 369 | ||
| Valid consent to treatment and medical duty of adequate disclosure | 370 | ||
| Negligent advice | 370 | ||
| Malpractice claims and pain management | 371 | ||
| Iatrogenic narcotic addiction | 371 | ||
| Failure to provide adequate pain relief | 372 | ||
| Drug-specific liability issues | 372 | ||
| PERSONAL INJURY CLAIMS AND PERSISTENT PAIN | 373 | ||
| The effect of compensation on pain treatment outcome | 374 | ||
| Malingering | 374 | ||
| The rating of pain-related impairment | 375 | ||
| ENDNOTES | 376 | ||
| REFERENCES | 377 | ||
| Chapter 25: Chronic pain and psychiatric problems | 383 | ||
| OVERVIEW | 383 | ||
| THE ASSOCIATION BETWEEN PAIN AND PSYCHIATRIC DISORDERS | 383 | ||
| PSYCHIATRIC DISORDERS COINCIDENTAL WITH PAIN | 384 | ||
| PRE-EXISTING FACTORS PREDISPOSING TO BOTH CHRONIC PAIN AND PSYCHIATRIC DISORDERS | 384 | ||
| CHRONIC PAIN CAUSING PSYCHIATRIC DISORDERS | 385 | ||
| SPECIFIC PSYCHIATRIC SYNDROMES AND PAIN | 386 | ||
| Adjustment disorder | 386 | ||
| Depression | 386 | ||
| Anxiety disorders | 387 | ||
| Post-traumatic stress disorders | 388 | ||
| CHRONIC PAIN, SUBSTANCE ABUSE AND DEPENDENCE | 389 | ||
| Long-standing prior history of illicit drug abuse | 389 | ||
| Prior history of inappropriate use of prescription drugs | 389 | ||
| SOMATOFORM DISORDERS | 390 | ||
| Pain disorder | 390 | ||
| Conversion disorder | 390 | ||
| Somatization disorder | 390 | ||
| Factitious disorders | 391 | ||
| 'DIFFICULT PATIENTS' OR PATIENTS WITH DIFFICULT PROBLEMS? | 391 | ||
| CONCLUSION | 391 | ||
| REFERENCES | 392 | ||
| Chapter 26: Acute pain | 395 | ||
| OVERVIEW | 395 | ||
| PRINCIPLES OF ACUTE PAIN MANAGEMENT | 396 | ||
| Systemic Pharmocological Modalities | 396 | ||
| Systemic opioids | 396 | ||
| Oral opioids | 397 | ||
| Intramuscular opioids | 397 | ||
| Subcutaneous opioids | 397 | ||
| Intravenous opioids | 398 | ||
| Intermittent IV boluses | 398 | ||
| Continuous IV infusion | 398 | ||
| Patient-controlled analgesia | 398 | ||
| Summary | 399 | ||
| Systemic non-opioid analgesics | 399 | ||
| Paracetamol/acetaminophen | 399 | ||
| Non-steroidal anti-inflammatory drugs | 399 | ||
| Other systemic agents | 400 | ||
| Entonox | 400 | ||
| Clonidine | 400 | ||
| Ketamine | 400 | ||
| Tricyclic antidepressants and anticonvulsants | 400 | ||
| REGIONAL TECHNIQUES | 401 | ||
| Neuraxial analgesia | 401 | ||
| Intrathecal analgesia | 401 | ||
| Epidural analgesia | 401 | ||
| Local anaesthetics | 401 | ||
| Opioids | 401 | ||
| Benefits of neuraxial techniques | 402 | ||
| Complications of neuraxial techniques | 402 | ||
| Peripheral neural blockade | 403 | ||
| Wound infiltration | 403 | ||
| Femoral nerve blocks | 403 | ||
| Brachial plexus blocks | 403 | ||
| Intercostal nerve blocks, interpleural blocks and paravertebral blocks | 403 | ||
| NON-PHARMACOLOGICAL MODALITIES | 403 | ||
| Physical modalities | 404 | ||
| Progression from acute to chronic pain | 404 | ||
| THE ACUTE PAIN SERVICE | 404 | ||
| REFERENCES | 406 | ||
| Chapter 27: Conclusions: the future | 409 | ||
| REFERENCES | 411 | ||
| Appendix: Glossary of pain physiology terms | 413 | ||
| References | 413 | ||
| Index | 415 |