Introduction The advancement of pain medicine is driven by the continual search for new and innovative solutions to a wide range of chronic pain conditions that affect more than 50 million Americans. An important approach is to better understand the…
Introduction In the United States, chronic pain is one of the most common reasons adults seek medical care. It has been linked to anxiety, depression, poor mobility, dependence on opioids, and poor perceived health and quality of life. Based on…
Introduction When a patient presents to a healthcare provider with a symptom of pain, the initial focus is on the patient’s medical history and the underlying pathology—a search to identify the “broken body part” that once identified is treated to…
Case13.1 A 58-year-old Asian-American male with no other significant past medical history presents to the clinic with acute herpes zoster in the left T4 dermatome. The patient endorsed severe localized pain and tactile allodynia associated with a vesicular eruption. After…
Introduction In March 1927, Dr. Francis Peabody, Harvard Medical School educator and Boston surgeon, published a seminal article in the Journal of the American Medical Association with the oft-quoted maxim, “One of the essential qualities of the clinician is interest…
Though the experience of pain is nearly universal, the experience and burden of pain vary across race, ethnicity, sex, and gender. This chapter will discuss the disparities in the experience and burden of pain and variability in responses to treatment across…
Introduction Pain, defined as the conscious subjective experience associated with real or potential tissue damage, is a product of coordinated activity across large portions of the brain. In contrast, the concept of nociception refers to the objective neural processes triggered…
Origins of the Pain Phenotype For heuristic purposes, we can distinguish the three mechanistically distinct sources of a pain state: (1) high intensity stimulation, (2) local tissue injury and products released secondary to injury and inflammation, and (3) injury to…
Introduction The neural circuits that are responsible for pain and the reactions to pain can be termed the pain system, or perhaps more appropriately, the pain systems . The pain systems include (1) peripheral neurons with a set of peripheral…
The Evolution of Pain Medicine as a Subspecialty As medical knowledge expands, there is a natural progression toward specialization. No physician can become an expert in every field, yet there is discomfort with this inevitable narrowing of focus. The urge…