THE MASSACHUSETTS GENERAL HOSPITAL HANDBOOK OF PAIN MANAGEMENT. 4TH EDITION

Contributing Authors iii
Preface xv
• SECTION I: GENERAL CONSIDERATIONS 1
Neurophysiologic Basis of Pain 3
Pain Mechanisms and Their Importance in Clinical Practice and Research 12
Ethics of Pain Management 21
• SECTION II: DIAGNOSIS OF PAIN 27
The History and Clinical Examination 29
Assessment of Pain 38
Psychological Assessment of Pain and Headache 60
Diagnostic Imaging and Pain Management 79
CONTENTS8 Neurophysiologic Testing in Pain Management 91
9 Disability Assessment 102
• SECTION III: THERAPEUTIC OPTIONS: PHARMACOLOGIC APPROACHES 113
10 Neuropathic Pain Medications 115
11 Opioids 139
12 Nonsteroidal Anti-inflammatory Medications 151
13 Psychopharmacology for the Pain Specialist 160
• SECTION IV: THERAPEUTIC OPTIONS: INTERVENTIONAL APPROACHES 177
14 Epidural Steroid Injection 179
15 Radiofrequency Procedures for Chronic Pain 192
16 Sympathetic Blocks 206
17 Lumbar Diskography and Intradiscal Treatments 222
Peripheral Nerve Blocks 241
Implanted Spinal Drug Delivery Systems 250
Infusion Therapies 257
Neurosurgical Interventions for Pain 266
Complications Associated With Interventional Pain Treatment 274
Fluoroscopy and Radiation Safety 283
Outcome Data and Interventional Pain Medicine 293
• SECTION V: THERAPEUTIC OPTIONS: NONPHARMACOLOGIC/NONINTERVENTIONAL APPROACHES 299
Behavioral Treatments for Chronic Pain 301
Physical Therapy 314
Myofascial Pain Syndrome and Fibromyalgia: Evaluation and Treatment 320
Acupuncture 334
• SECTION VI: ACUTE PAIN 349
30 Adult Postoperative Pain 351
31 Postoperative Pain in Children 371
32 Care of Burn Patients 390
33 Pain Management for Sickle Cell Disease 394
34 Pain Management in the Trauma Patient 405
• SECTION VII: CHRONIC PAIN 411
35 Neuropathic Pain Syndromes 413
36 Low Back Pain: Evaluation and Management 424
37 Complex Regional Pain Syndrome 437
38 Headache 449
39 Orofacial Pain 470
• SECTION VIII: CANCER PAIN AND PALLIATIVE CARE 491
40 Pain in Adults With Cancer 493
Palliative Medicine 512
• SECTION IX: SPECIAL CONSIDERATIONS IN PAIN MEDICINE 525
Opioids in Chronic Nonterminal Pain 527
Identifying and Mitigating the Risks of Long-Term Opioid Treatment 539
Geriatric Pain Management 546
Management of Noncancer and Chronic Pain in Children With Life-Threatening Illness 557
Emergencies in Pain Medicine 568
Appendix I: Dermatomes and Nerve Distribution 579
Appendix II: Prescription Guidelines 580
Appendix III: Drug Enforcement Administration
(DEA) Drug Schedules 594
Appendix IV: Medications Commonly Used in Pain
Practice 586
Appendix V: Definitions and Abbreviations 609

Offering expert guidance from seasoned clinicians at Massachusetts General Hospital, this bestselling handbook provides accurate, clinically essential information in a portable, quick-reference format. Broad-based, multidisciplinary coverage draws from the disciplines of anesthesiology, neurology, behavioral medicine, nursing, psychiatry, and physical therapy to provide practical, evidence-based information for sound therapeutic choices. Now in full color for the first time, The Massachusetts General Hospital Handbook of Pain Management, Fourth Edition, contains numerous new chapters, new illustrations, and other features that keep you up to date with today’s latest approaches to pain management.

• Contains an extensive new section on interventional approaches to pain management, as well as new chapters on radiotherapy and radiopharmaceuticals for cancer pain and ethical considerations in pain medicine.
• Features new chapters on discography, epidural steroid injections; intrathecal drug delivery; peripheral nerve blocks; and sympathetic blockade.
• Includes handy appendices that provide useful medication information, basic science coverage relevant to clinical strategies, and numerous tables and chapter-opening outlines for quick reference.

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