Introduction According to the American Society of Anesthesiologists (ASA) practice guidelines, acute pain in the perioperative setting is defined as the presence of pain in a surgical patient after a procedure. The United States Institute of Medicine reported that despite…
Pain after a surgical procedure is inevitable. However, as stated by Haruki Murakami, “Suffering is optional.” Management of postoperative pain has come a full circle. The Joint Commission recognized the underassessment and undertreatment of pain in 2000 and introduced the…
Introduction Chronic post-surgical pain (CPSP) is a growing area of study in pain medicine. An increasing number of patients undergoing surgery each year, multiplied by a variable reported incidence (5%–85%), produces an increased number of patients with new chronic pain.…
Introduction The transition from acute to chronic pain and disability because of multiple factors has been well documented in the literature. According to a morbidity and mortality weekly report from the Centers for Disease Control and Prevention (CDC), one in…
Psychological and Behavioral Assessment Chronic pain presents two broad challenges to proper assessment: 1) pain is personal and subjective, and 2) chronic pain impacts a wide range of patient functioning. These challenges necessitate a systematic approach to the standardized assessment…
Introduction Identification of potential biomarkers for chronic pain is essential for correct diagnosis, prediction, and evaluation of treatment response. A biomarker is defined as a “characteristic objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or…
Imaging is a significant but not independent component of the multifaceted evaluation of a patient with spine or limb pain. Imaging must be interpreted in concert with the history, physical exam, electrodiagnostic evaluation, and responses to image guided anesthetic or…
In almost all instances, tests and/or studies can help elucidate the cause of a problem. However, of equal, and possibly greater, importance is the potential for a test to introduce data that clouds the picture and adds complicating factors that…
This chapter provides an overview of appropriate history taking and a structured approach to the physical examination of a pain patient, along with the anatomic and physiologic basis of the physical findings. Physical examination serves to further explore and confirm…
The Magnitude of Placebo Analgesia Pain is by far the most studied placebo condition, and a large number of studies on the placebo effect have been performed in experimentally induced pain in healthy subjects or patients experiencing a painful condition.…