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Pain Management, An Issue of Hand Clinics, E-Book

Pain Management, An Issue of Hand Clinics, E-Book

Catherine Curtin

(2016)

Abstract

This issue will cover everything from various therapies to alleviate symptoms or help patients learn to cope to regain normal function of their hand/or upper extremity and resume daily activities, to mechanism/anatomy and outcomes and measurement of pain.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Pain Management\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Pain Management\r v
Pain and Hand Function\r v
Self-Report Measures of Hand Pain Intensity: Current Evidence and Recommendations\r v
Pain Examination and Diagnosis\r v
Factors Associated with Greater Pain Intensity\r v
Pain Psychology and Pain Catastrophizing in the Perioperative Setting: A Review of Impacts, Interventions, and Unmet Needs\r vi
New Concepts in Complex Regional Pain Syndrome\r vi
Pharmacologic Management of Upper Extremity Chronic Nerve Pain\r vi
Hand Therapy Treatment\r vi
Surgical Treatment of Upper Extremity Pain\r vi
The Proper Use of Neurostimulation for Hand Pain\r vii
Future Directions for Pain Management: Lessons from the Institute of Medicine Pain Report and the National Pain Strategy\r vii
HAND CLINICS\r viii
FORTHCOMING ISSUES viii
May 2016 viii
August 2016 viii
November 2016 viii
RECENT ISSUES viii
November 2015 viii
August 2015 viii
May 2015 viii
Preface: Pain Management \r ix
REFERENCES x
Pain and Hand Function 1
Key points 1
INTRODUCTION 1
PAIN 2
ACUTE PAIN 2
Transduction 2
Transmission 2
Perception 2
Modulation 2
CHRONIC PAIN 2
NEUROPATHIC PAIN 3
Complex Regional Pain Syndrome 3
Phantom Limb Pain 3
HAND FUNCTION 3
MEASURING HAND FUNCTION AND PAIN 6
SUMMARY 8
REFERENCES 8
Self-Report Measures of Hand Pain Intensity 11
Key points 11
INTRODUCTION 11
ASSESSING HAND PAIN INTENSITY 12
Single-Dimensional Pain Intensity Scales 12
Visual analog scales 12
Numerical rating scales 14
Verbal rating scale 14
Multi-Item Pain Intensity Scales 15
The Australian/Canadian Osteoarthritis Hand Index 15
The Patient-Rated Wrist/Hand Evaluation 16
SUMMARY AND RECOMMENDATIONS 16
REFERENCES 17
Pain Examination and Diagnosis 21
Key points 21
INTRODUCTION 21
Musculoskeletal Pain 21
Neuropathic Pain 21
Allodynia 21
Dysesthesia 21
Complex Regional Pain Syndrome 21
HISTORY 22
Pain Quality 22
Pain Severity 22
Pain Duration 22
Pain Catastrophizing 22
PHYSICAL EXAMINATION 23
Inspection 23
Motor 23
Palpation 23
Cold Perception 24
Tinel Sign 24
Scratch Collapse Test 24
DIAGNOSTIC TESTING 24
Nerve Conduction Studies 24
Ultrasonography 24
MRI 24
Diagnostic Blocks 25
SUMMARY 25
REFERENCES 25
Factors Associated with Greater Pain Intensity 27
Key points 27
INTRODUCTION 27
VARIATION IN PAIN INTENSITY FOR A GIVEN NOCICEPTION 28
MINDSET AND CIRCUMSTANCES 28
THE LIMITS OF BIOMEDICAL TREATMENT 29
PEACE OF MIND IS THE BEST PAIN RELIEVER 30
SUMMARY 30
REFERENCES 30
Pain Psychology and Pain Catastrophizing in the Perioperative Setting 33
Key points 33
INTRODUCTION 33
PAIN-RELATED PSYCHOLOGICAL FACTORS AND MUSCULOSKELETAL SURGERY OUTCOMES 34
HAND SURGERY 35
PRACTICAL IMPLICATIONS AND TREATMENTS 36
PRESURGICAL PSYCHOBEHAVIORAL INTERVENTIONS 36
SUMMARY AND FUTURE DIRECTIONS 37
REFERENCES 38
New Concepts in Complex Regional Pain Syndrome 41
Key points 41
INTRODUCTION 41
ANIMAL MODELS OF COMPLEX REGIONAL PAIN SYNDROME 42
SYMPATHETIC NERVOUS SYSTEM 42
NEUROGENIC INFLAMMATION 43
AUTOIMMUNITY 44
CENTRAL NERVOUS SYSTEM CHANGES 44
ACUTE VERSUS CHRONIC COMPLEX REGIONAL PAIN SYNDROME 45
SUMMARY 45
REFERENCES 46
Pharmacologic Management of Upper Extremity Chronic Nerve Pain 51
Key points 51
GENERAL TENETS 52
TRICYCLIC ANTIDEPRESSANTS 55
DULOXETINE AND VENLAFAXINE 56
GABAPENTINOIDS 57
COMBINATIONS 57
OPIOIDS 58
LAMOTRIGINE 58
TOPIRAMATE 58
TOPICAL MEDICATIONS 59
Lidocaine 59
Capsaicin 59
CONCLUSION 59
REFERENCES 59
Hand Therapy Treatment 63
Key points 63
INTRODUCTION 63
IMPORTANCE OF PAIN 63
PAIN MECHANISMS 64
Peripheral Nociceptive 64
Peripheral Neurogenic 64
Central Pain or Central Sensitization 65
TREATMENT OF PAIN MECHANISMS 66
Treatment of Peripheral Nociceptive and Inflammatory Mechanism 67
Treatment of Peripheral Neurogenic Symptoms 67
Treatment of Central Sensitization Mechanism 67
SUMMARY 68
REFERENCES 69
Surgical Treatment of Upper Extremity Pain 71
Key points 71
INTRODUCTION 71
PATIENT PRESENTATION 72
Typical Presentation One: The Cutaneous Neuroma 72
Typical Presentation Two: Nerve Compression 72
Typical Presentation Three: Joint Pain 72
Typical Presentation Four: Complex Regional Pain Syndrome 73
DIAGNOSTIC TESTING: NERVE BLOCKS 73
NERVE COMPRESSION 73
NEUROMA PAIN: NERVE RECONSTRUCTION 74
NEUROMA PAIN: NEUROMA RESECTION AND MUSCLE IMPLANTATION 74
JOINT PAIN OF NEURAL ORIGIN 76
COMPLEX REGIONAL PAIN SYNDROME 76
SUMMARY 79
REFERENCES 79
The Proper Use of Neurostimulation for Hand Pain 81
Key points 81
INTRODUCTION 81
Cause of Neuropathic Pain of the Upper Extremity 82
Conservative Treatment Options 82
NEUROMODULATION OF THE UPPER EXTREMITY 82
SPINAL CORD STIMULATION: DORSAL COLUMNS 82
Background 82
Mechanism of Action 82
Indications and Patient Selection 82
Technical Aspects for Both Trial and Implant Stages 83
Outcomes 83
DORSAL ROOT GANGLION SPINAL STIMULATION 84
PERIPHERAL NERVE STIMULATION 85
Spinal Cord Stimulation Equipment in the Periphery 86
Ultrasound-Guided Percutaneous Lead Placement Technique 86
Open Peripheral Nerve Paddle Lead Placement Stimulation 86
Innovative Peripheral Nerve Stimulation–Specific Systems 86
SUMMARY 87
REFERENCES 87
Future Directions for Pain Management 91
Key points 91
INTRODUCTION 91
Relieving Pain in America: a Blueprint for Transforming Prevention, Care, Education, and Research 92
THE NATIONAL PAIN STRATEGY 94
Population Research 94
Prevention and Care 95
Disparities 95
Service Delivery and Reimbursement 95
Professional Education and Training 95
Public Education and Communication 95
National Pain Strategy Vision 95
FUTURE NEEDS: LEARNING HEALTH SYSTEMS AND PRECISION PAIN MEDICINE 96
REFERENCES 97
Index 99