Buch, Englisch, 178 Seiten, Format (B × H): 140 mm x 216 mm, Gewicht: 252 g
Reihe: What Do I Do Now
Buch, Englisch, 178 Seiten, Format (B × H): 140 mm x 216 mm, Gewicht: 252 g
Reihe: What Do I Do Now
ISBN: 978-0-19-982760-2
Verlag: Oxford University Press
Patients with pain disorders pose many clinical challenges for the attending physician. Even experienced clinicians occasionally arrive at the point where diagnostic, work-up, treatment, or prognostic thinking becomes blocked.
Pain teaches the reader to recognize and appropriately treat a variety of pain disorders using a case study format. Divided into three section, chronic pain conditions, chronic pain and related disorders, and treatment overview, and derived from consultation requests from providers in medical practice, the cases are written in a format that encourages the reader to formulate a differential diagnosis and treatment plan for a variety of pain problems. Succinct in its presentation and
logical in its layout, Pain is the perfect resource for the busy practitioner on the go.
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Weitere Infos & Material
SECTION I CHRONIC PAIN CONDITIONS
1. Complex Regional Pain Syndrome
Commonly over diagnosed, CRPS has little especial association with the Autonomic Nervous System, does not involve Dystrophy, and has no known Reflex associated with it. Type 1 is the classical Reflex Sympathetic Dystrophy differing from Type 2- Causalgia, only in that Type 2 involves injury to a major nerve.
2. Peripheral Neuropathy
The debilitating pain of peripheral neuropathy can be difficult to treat and relies on pain management and treatment of the underlying pathology. This chapter reviews the causes, sign and symptoms, diagnostic criteria and treatment options available for these patients.
3. Post-Herpetic Neuralgia
Post-herpetic neuralgia is a devastating and painful consequence of shingles (herpes zoster) and is most common in the elderly and the immunocompromised. Medications are the mainstay of treatment, however caution should be used in the elderly secondary to side effects.
4. Post-Stroke Central Pain
Often thought only in association with thalamic pain syndrome following infarct to the thalamus, pain following stroke may occur with any setting of stroke affecting nociceptive fibers at any level. Neuropathic or central pain can occur in up to 8% of patients after a stroke. Medical treatment usually begins with a trial of Lamotrigine and a second-line drug may be added. For severe, refractory cases, repetitive transcranial magnetic stimulation (rTMS) may be offered.
5. Multiple Sclerosis Related Pain
Multiple sclerosis (MS) is usually associated with a loss of sensation; however, since the late 1800s, physicians have recognized that pain is often associated with multiple sclerosis and can at times be the heralding symptom. Pain can occur in 29-86% of MS patients an can include neuropathic pain, dysesthetic pain and trigeminal neuralgia, as well as somatic pain mostly originating from back pain and painful spasms. Medication, physical therapy, behavioral therapy, occupational therapy,
interventional procedures, baclofen pump placements, and surgical interventions have been employed.
6. Radiculopathy
Probably the most common cause of neuropathic pain, lumbar and cervical radiculopathy are frequently encountered clinical entities while thoracic is more rare. These syndromes may involve an anatomical abnormality and can be gratifying to both diagnose and treat, but a nonanatomical abnormality syndrome is equally as common and presents more of a diagnostic and therapeutic dilemma or even conundrum.
7. Brachial Plexus Avulsion Injury
Brachial plexus injuries are most commonly due to trauma, of which, motor cycle accidents are the most common. Men are most frequently affected. Other causes can include; penetrating or sports related injuries, falls, work related accidents, radiation therapy and iatrogenic causes (ie, first rib resection, shoulder surgery, interventional radiology). The most common mechanism of injury is a traction injury due to forceful separation of the neck from the shoulder. Persistent brachial plexus
pain is often treated in a fashion similar to neuropathic pain.
8. Superficial Radial Nerve Injury
This small sensory nerve can be a cause of excruciating pain when injured iatrogenically. Diagnosis can be confusing and treatment a challenge.
9. Post-Thoracotomy Pain Syndrome (Acute and Chronic Pain)
Persistent post-thoracotomy pain syndrome (PTPS) is one of the most prevalent sources of chronic post-operative pain. Up to 20-70% of patients may complain of symptoms consistent with post-thoracotomy pain. Targeting the points before, during, and after surgery that could decrease the risk of PTPS has been understudied and there is no clear evidence for any specific recommendations. That being said, recommendations and standard of care include a multimodal analgesic approach during surgery and
perioperatively with nonopioid and local anesthesia. Treatment of chronic PTPS can include medical therapy, i
