Pain
John Joseph Bonica (February 16, 1917 – August 15, 1994) was a Sicilian American anesthesiologist and professional wrestler known as the founding father of the discipline of pain medicine.
Journal
Definition
Pain is a multidimensional experience with an affective component: the unpleasantness.
Epidemiology
Pain is the most common reason patients seek medical care. Pain has sensory and emotional components.
Classification
Major types of pain:
a) somatic: well localized. Described as sharp, stabbing, aching or cramping. Results from tissue injury or inflammation, or from nerve or plexus compression. Responds to treating the underlying pathology or by interrupting the nociceptive pathway.
b) visceral: poorly localized. Poor response to primary pain medications.
Poorly localized. Described as crushing, tearing, tingling or numbness. Also causes burning dysesthesia numbness often with lancinating pain, and hyperpathia. Unaffected by ablative procedures.
“Sympathetically maintained” pain and the likes, e.g. causalgia
Often classified as acute or chronic.
Acute pain is frequently associated with anxiety and hyperactivity of the sympathetic nervous system (eg, tachycardia, increased respiratory rate and BP, diaphoresis, dilated pupils).
see Neuropathic pain
see Back pain
see Leg pain
Scales
see Pain Scales.
Pain intensity
see Pain intensity.
Pain diagnosis
Treatment
see Pain treatment.
In traumatic brain injury
Many patients with a traumatic brain injury (TBI) are unable to self-report their pain in the intensive care unit (ICU) because of altered levels of consciousness (LOC), mechanical ventilation, and/or aphasia 1).
In nonverbal populations, use of behaviors suggestive of pain (a.k.a pain behaviors) such as grimacing, increased muscle tension, protective movements, and noncompliance with the ventilator is recommended for pain assessment 2) 3).
Books
Integrating Pain Treatment into Your Spine Practice
This book fills the gap in knowledge and patient care by showing spine surgeons how to integrate pain management techniques into their practice. The first of its kind, Integrating Pain Treatment into Your Spine Practice is in tune with current efforts by major neurosurgical and neuromodulation societies and leading manufacturers of neuromodulation equipment to educate spine surgeons on the management of their patients’ post-surgical pain.
Designed as an all-in-one volume, this book explains how to identify candidates for pain treatment and when to refer them to specialists. It also presents “how-to” clinical information on approaches to managing pain, from the medical to the interventional and provides practical business guidance on coding and reinforcement.