In contrast to the use of a systemic analgesic, the use of a topical analgesic may result in pain relief without the requirement for notable systemic absorption. In certain situations, and with specific agents (i.e. nitroglycerine, fentanyl, clonidine), transdermal application…
Key Points There are three broad classes of muscle relaxants: antispasmodic, antispasticity, and combination agents. Muscle relaxants may treat muscle spasticity in two manners. First, they can modify the stretch reflex arc, either by reducing the excitatory signals or by…
Treatment of chronic pain involves understanding the delicate interplay of nociceptive, neuropathic, and nociplastic mechanisms involved in any given pain syndrome’s pathophysiology. Research into the underlying pathways for chronic pain has provided the mechanistic basis to utilize numerous non-opioid medications…
Key Points Anti-depressants can be effective for treating neuropathic pain independently of their actions on comorbid depression. The analgesic effects tend to occur more rapidly and at lower doses than those used for treating depression. The primary mechanism of action…
Pain in Selected Neurologic Disorders Although chronic pain may be the defining feature of certain neurologic disorders, physicians often focus on treatments aimed at addressing the primary neurologic condition. As most comorbidities may come from pain associated with the condition,…
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…
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…