SUMMARY An estimated 21% of American adults, including 50% of those 65 years or older, have arthritis. Of these, osteoarthritis (OA) and rheumatoid arthritis (RA) are among the most common. OA is a disease of total joint failure; it affects…
SUMMARY Management of postoperative pain is challenging because of the complex pathophysiological sequelae of surgical trauma. The broad humeral and neuronal responses to surgery are still being studied. The diversity of pain mechanisms, patient responses, and disease states necessitates a…
SUMMARY Muscle pain is distinct from cutaneous pain and one of the most common pain complaints. Muscle nociceptors are free nerve endings that are connected to the central nervous system through thin myelinated or unmyelinated afferent fibers. Most nociceptors have…
SUMMARY In a normal joint, only intense pressure on the joint and movements exceeding the working range elicit pain. However, under pathological conditions such as joint inflammation and osteoarthritis, hypersensitivity of the nociceptive system occurs frequently and leads to pain…
SUMMARY Numerous forms of complementary and alternative medicine (CAM) are used with the aim of controlling pain. Many doctors now tend to accept CAM, and all too frequently the subject is discussed uncritically. This chapter focuses on acupuncture, chiropractic treatment,…
SUMMARY A significant percentage of individuals with persistent pain continue to experience distressing symptoms despite our increased knowledge of neurophysiology and the availability of an expanded treatment armamentarium. This set of circumstances had resulted in growing awareness of the important…
SUMMARY Spinal cord stimulation (SCS), which emerged as a direct clinical application of the gate control theory, has been in use since the early 1970s. It should now be regarded as a mainstream specific treatment of certain forms of neuropathic…
SUMMARY The neurosurgeon is often consulted for the treatment of pain. With many patients in chronic pain, an opportunity exists to intervene and eliminate the pain in a definitive manner. Since the 1970s there have been significant changes in the…
SUMMARY This chapter summarizes research on new drugs being developed for the treatment of pain. It outlines the process of drug discovery and development and covers the hurdles that a new drug must surmount before it can be introduced into…
SUMMARY Even though the psychotropic and therapeutic effects of Cannabis sativa have been appreciated for millennia, elucidation of the pharmacology of its constituents is altogether more recent. The receptors through which cannabinoids (natural and synthetic compounds that interact with cannabinoid…