Pain Management

Published by: Apollo Managed Care Consultants

Published: Jan. 1, 2008 - 230 Pages

Table of Contents

Part I Pain Evaluation and Management

Pain management introduction

Washington State Pain Management Guidelines

Classification of Pain, Pain measurement/scoring

Barriers to adequate pain control

Pre-emptive, multimodal or balanced analgesia/pain management

Behavioral Therapy Aspects of Pain Management

Palliative or ‘End-of-life’ care/Cancer pain

Placebo use

JCAHO standards

Diabetic peripheral neuropathy

Surgical pain management - Conscious sedation (P & P); Post-op wound irrigation with local anesthetics; Opioid-related adverse events in surgical patients: increased LOS

Patient satisfaction

Pain Management Issues

Opioid contracts

Pain Rehabilitation Programs

Pain Clinics or Centers

Chronic/Persistent Pain Programs - coverage

Chronic/Persistent Pain Programs - Inpatient

Pain Rehabilitation, Outpatient

Outpatient Hospital Pain Rehabilitation Programs, Medicare NCD

Exit Criteria from chronic pain programs

Dental pain management - after hours care

Headaches

Pain Management in Long Term Care; Care plan, links

Pain Management in the Emergency Department

Case Management

Pain Management Notes

Pharmacologic/Non-pharmacologic Pain Management

Initial oral mild to moderate pain management

Prescribing Guideline - California model guideline

Medical Marijuana

Opioid therapy

Methadone

Cancer Pain Management

Topical NSAIDs for chronic musculoskeletal pain

Neuralgic/Neuropathic Pain

Pharmacologic Challenges for Sympathetically Maintained Pain

Continuous Epidural Analgesia for the treatment of Complex Regional Pain Syndrome (CRPS)/Reflex SympatheticDystrophy (RSD)

Coanalgesic drug therapy to manage specific pain syndromes (Table)

Cognitive behavioral therapy

Physical therapy for regional pain syndromes

Cryoanalgesia and Cold Laser Therapy

Pulsed Radiofrequency for Pain Management

Trigger Point Injections

Induced Lesions of Nerve Tracts, Medicare NCD

PCA by proxy - JCAHO sentinel alert

Pain management patient self-evaluation tools

Pharmacy tables - drugs, eqianalgesic calculations

Addiction

Diversion

Complementary and Alternative Medicine; Approaches to pain management

Acupuncture

Biofeedback

Bioelectromagnetic therapy

Guided imagery

Manual/massage therapies

Naturopathy

Relaxation therapy

Transcendental meditation

Resources - CAM

Legal issues related to pain management - California Medical Board policy statement and guideline

References/suggested reading by topic related to Pain Management

References/suggested reading by topic related to CAM

CAM web sites

Anesthesiology Pain Management Services

Anesthesia services - General Coverage Policy; Office-based anesthesia; Dental Anesthesia; Safe sedation of children; Pain Management; Intrathecal/subarachnoid injections; Epidural injections for pain; Continuous epidural analgesia; Cryoanalgesia and Cold Laser (low-energy or low-level) Therapy for wound healing, pain therapy, and other disorders;

Facet Joint Injections/Median Branch Nerve Blocks; Facet Denervation, Facet Denervation: Neurotomy, Facet Rhizotomy, or Articular Rhizolysis; Facet Denervation: Percutaneous Radiofrequency; Celiac plexus nerve blocks; Paravertebral Nerve Blocks; Percutaneous alcohol injections for the ablation of intractable pain; Anesthesiology Notes.

Resources - Pain Management

Pain Management Organization web links: CAM, Pain, and Palliative/End-of-Life Care

Consent and Agreement Forms for long-term controlled substance/opioid therapy

Informed Consents for Long-term Narcotic Use - example

Opioid Contract - UC Davis form

Pain Publications for Patients and Their Families

Palliative Care Leadership Centers

Model Policy for the Use of Controlled Substances for the Treatment of Pain. Federation of State Medical Boardsof the United States, Inc. 2004

Pain Management Provider Credentialing

Pain Management Notes

Part II Skeletal Muscular System Guidelines

Knee

Arthroscopy, knee

Total Knee Replacement

Hyaluronidase, intra-articular injections for osteoarthritis, knee

Knee, general references

Back and Neck Pain - Evaluation and Procedures

Low back pain (Acute, ‘slow to recover’)

Anti-depressant drug therapy for low back pain

Machines to test and treat low back pain

Algorithm for back pain evaluation

Chymopapain Chemonucleolysis

Endoscopic Anterior Spinal Surgery

Epidural injection of steroids for back pain

Facet Joint Injections/Nerve Blocks

Facet Denervation, Facet Neurotomy, Facet Rhizotomy, or Articular Rhizolysis

Hypertonic saline for the treatment of epidural adhesions, adhesive arachnoiditis, or failed back syndrome

Intradiscal electrothermal therapy (IDET)

Laminectomy

Magnets for the treatment of chronic low back pain

Meniscectomy

Microdiscectomy, Percutaneous Lumbar Discectomy

Percutaneous vertebroplasty

Spinal Instability - Pedicle screw fixation

Spinal stenosis

Trigger Point Injections

Cervical Pain, acute

Chiropractic Medicine

Spinal manipulation under anesthesia

Bone stimulators, electric and low-intensity ultrasound

Distraction osteosynthesis, Ilizarov method

Olecranon bursa aspiration

Total Hip Replacement (arthroplasty); Primary, excluding hip fracture;

Injection, tendon sheath, ligament, or trigger points or ganglion cyst

Arthrocentesis - Joints; Aspiration/Injection Ganglion Cyst

Kyphoplasty

Ultrasound therapy for calcific tendinitis of the shoulder

Fibromyalgia

Rheumatology links

Post-work Injury Evaluation and Work Hardening

‘Prehab’

Web Sites - Skeletal-Muscular System-related

References - General - for skeletal-muscular pain management

Abstract

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