Biobehavioral Approaches to Pain
von: Rhonda J. Moore
Springer-Verlag, 2008
ISBN: 9780387783239
Sprache: Englisch
589 Seiten, Download: 5829 KB
Format: PDF, auch als Online-Lesen
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| Biobehavioral Approaches to Pain | 2 | ||
| Preface | 6 | ||
| Forward | 8 | ||
| Acknowledgements | 10 | ||
| Contents | 12 | ||
| Contributors | 14 | ||
| Introduction | 21 | ||
| The Experience of Pain and Suffering from Acute and Chronic Pain | 30 | ||
| Introduction | 30 | ||
| Acute Pain | 30 | ||
| Chronic Pain | 32 | ||
| The Transition from Recent Onset Pain to Long-Term Distress and Disability | 34 | ||
| Preventing the Development of Chronic Pain Following Episodes of Acute Pain | 35 | ||
| Common and Distinct Elements of Suffering in Acute and Chronic Pain | 36 | ||
| Developing Approaches to Pain and Suffering | 38 | ||
| Summary | 39 | ||
| References | 40 | ||
| The Neuroanatomy of Pain and Pain Pathways | 46 | ||
| Introduction | 46 | ||
| Peripheral Pathways | 46 | ||
| Nociceptors | 47 | ||
| Peripheral Sensitization and Primary Hypersensitivity | 47 | ||
| Primary Afferents: Somatic and Visceral | 48 | ||
| Chemical Mediators | 49 | ||
| Central Pathways | 49 | ||
| Pathways in the Ventral (Anterior) Quadrant | 50 | ||
| The Spinothalamic Tract | 50 | ||
| Pathways in the Dorsal (Posterior) Quadrant | 52 | ||
| Spinocervical Pathway | 52 | ||
| The Dorsal Column | 53 | ||
| Postsynaptic Dorsal Column Pathway | 55 | ||
| Representation of Nociceptive Sensation in the Brain | 56 | ||
| Thalamic Representation of Pain | 57 | ||
| Cortical Pain Processing | 58 | ||
| Descending Modulatory Pathways | 59 | ||
| Gender Differences in Pain Processing | 60 | ||
| Conclusion | 60 | ||
| Future Directions | 61 | ||
| References | 61 | ||
| The Genetic Epidemiology of Pain | 73 | ||
| Genetic Influences on Pain at the Population Level: The Evidence | 73 | ||
| Cultural, Social and Gender Influences on Pain | 74 | ||
| Twin and Family Studies | 76 | ||
| Genetic Influences on Diseases Characterised by Pain | 76 | ||
| Genetic Influences on Experimental Pain | 77 | ||
| Genetic Influences on Affective, Cognitive and Behavioural Aspects of Pain | 80 | ||
| Genetic Association Studies in Pain | 81 | ||
| The Multifactorial Model | 85 | ||
| Conclusions | 85 | ||
| References | 86 | ||
| Pain and the Placebo Effect | 93 | ||
| Psychological Modulation of Pain | 93 | ||
| The Placebo Effect and Its Measurement | 94 | ||
| From the Sugar Pill to Context Effects: Conditioning and Expectation | 95 | ||
| The Neurobiology of the Placebo Effect | 97 | ||
| How the Brain Produces Placebo Analgesia - The Neuroimaging Studies | 99 | ||
| Placebo and Nocebo | 103 | ||
| Clinical Implications of Placebo Analgesia | 105 | ||
| The Role of Expectation on the Outcome of a Clinical Trial: The ‘‘Principle of Uncertainty’’ | 105 | ||
| The Placebo Therapeutic Potential | 106 | ||
| Patients Without Expectations | 107 | ||
| Conclusions | 107 | ||
| References | 108 | ||
| The Narrative Approach to Pain | 113 | ||
| Introduction: Narrative | 113 | ||
| History: Changes in the Clinical Focus | 113 | ||
| Devotion to the Images | 115 | ||
| Narrative Brings Empathy | 116 | ||
| Narrative in Oncology | 116 | ||
| Pain and Suffering in Oncology | 117 | ||
| Context Counts in Cancer | 118 | ||
| When to Emphasize Narrative/Empathy | 118 | ||
| Final Remarks | 119 | ||
| References | 121 | ||
| Understanding and Enhancing Patient and Partner Adjustment to Disease-Related Pain: A Biopsychosocial Perspective | 122 | ||
| A Biopsychosocial Model of Adjustment to Pain | 122 | ||
| Arthritis | 126 | ||
| Unique Demands of Patient Adjustment to Arthritis | 126 | ||
| Unique Demands of Partner Adjustment to Arthritis | 128 | ||
| Intervention Studies | 129 | ||
| Cancer Pain | 132 | ||
| Unique Demands of Patient Adjustment to Cancer Pain | 132 | ||
| Unique Demands of Partner Adjustment to Cancer Pain | 135 | ||
| Intervention Studies | 137 | ||
| Future Directions for Clinical and Research Efforts in Disease Related Pain | 139 | ||
| Focus on Partner’s Experience | 139 | ||
| Individual Differences in Response to Couples Interventions | 140 | ||
| Disease-Specific Couples Interventions | 140 | ||
| Couple Based Interventions | 141 | ||
| Depression in Chronic Pain | 141 | ||
| Family Intervention | 142 | ||
| Pain Patients Without an Intimate Partner | 142 | ||
| More Behavioral Intervention | 143 | ||
| Positive Emotions | 143 | ||
| Physiological Mechanisms | 143 | ||
| Acceptability of Psychosocial Pain Treatment | 144 | ||
| Delivery Methods of Partner-Based Interventions | 144 | ||
| Longitudinal Studies | 145 | ||
| Increasing Diversity | 145 | ||
| Conclusions | 146 | ||
| References | 146 | ||
| Sex Differences in Pain | 152 | ||
| Introduction | 152 | ||
| Evidence for Sex Differences in Pain and Analgesia | 152 | ||
| Sex Differences in Prevalence of Pain Experience | 152 | ||
| Sex Differences in Health Care Utilization, Analgesic Use and Analgesic Effectiveness | 154 | ||
| Sex Difference in Pain Sensitivity to Experimental Stimuli | 155 | ||
| Sex Differences in Non-pharmacological Treatment | 156 | ||
| Explanations for Sex Differences in Pain | 158 | ||
| Emotions and Pain: The Role of Depression, Anxiety and Anger | 158 | ||
| Health Cognitions, Beliefs and Expectations | 160 | ||
| Coping Behaviors | 162 | ||
| Interpersonal Interactions | 163 | ||
| Biological Factors | 164 | ||
| Summary and Conclusions | 166 | ||
| References | 167 | ||
| Pain in Children | 176 | ||
| Neurobiology of Pain Pathways in Children | 177 | ||
| What Is a Child: Towards a Definition | 178 | ||
| Epidemiology | 178 | ||
| Neonates | 179 | ||
| Acute Pain in Children | 179 | ||
| Chronic Pain in Children | 179 | ||
| Headache | 180 | ||
| Chronic Tension-Type Headache | 180 | ||
| Chronic Post-Traumatic Headache | 181 | ||
| Complex Regional Pain Syndrome | 181 | ||
| Abdominal Pain | 182 | ||
| Diagnosing and Measuring Pain in Children | 184 | ||
| Taking a Pain History | 184 | ||
| Acute Pain | 185 | ||
| Chronic Pain | 185 | ||
| Acute Pain Assessment | 186 | ||
| Self Report | 186 | ||
| Physiologic | 186 | ||
| Behavioral Observation | 187 | ||
| Chronic Pain Assessment | 189 | ||
| Medications: Evidence-Based Best Practices | 192 | ||
| Acute Pain | 192 | ||
| Opioids | 192 | ||
| Non-steroidal Anti-inflammatory Drugs (NSAIDS) | 194 | ||
| Acute Pain: Regional Anesthesia | 194 | ||
| Chronic Pain | 195 | ||
| Chronic Pain and Development | 196 | ||
| Chronic Pain Management | 197 | ||
| The Process | 198 | ||
| Cancer Pain | 198 | ||
| Pharmacological | 198 | ||
| Opioids | 198 | ||
| Methadone | 199 | ||
| Fentanyl | 199 | ||
| Implanted Infusion Pumps | 200 | ||
| Headache | 200 | ||
| Migraine | 201 | ||
| Tension-Type Headache | 203 | ||
| Post-Traumatic Headache | 203 | ||
| Cervicogenic Headache | 203 | ||
| Neuropathic Pain | 204 | ||
| Peripheral and Trigeminal Neuropathy | 204 | ||
| Tricyclic Antidepressants | 205 | ||
| Anticonvulsants | 205 | ||
| Opioids | 206 | ||
| Complex Regional Pain Syndrome | 206 | ||
| Abdominal Pain | 207 | ||
| Conclusion | 207 | ||
| Future Perspectives | 208 | ||
| References | 210 | ||
| Pain in the Older Person | 222 | ||
| Introduction | 222 | ||
| Neurophysiology of Aging | 223 | ||
| Assessing and Measuring Pain in Older People | 224 | ||
| Assessing and Measuring Pain in Cognitively Intact Patients | 225 | ||
| Assessing and Measuring Pain in Cognitively Impaired Patients | 225 | ||
| Psychosocial Issues Associated with Pain in the Older Person | 226 | ||
| Depression | 226 | ||
| Symptoms Associated with Depression | 227 | ||
| Fatigue | 227 | ||
| Treating Older People with Pain Based Upon Pathophysiology | 228 | ||
| Evidence Based Interventions | 229 | ||
| Medications | 230 | ||
| Complementary and Alternative Medicine (CAM) | 230 | ||
| Pain Management in Long-Term Care Facilities | 231 | ||
| Barriers | 232 | ||
| Medications for Pain | 232 | ||
| Pain at the End of Life | 233 | ||
| Hospice Versus Palliative Care | 235 | ||
| Providing the Best Care at the End of Life | 236 | ||
| Conclusions | 236 | ||
| Future Directions | 237 | ||
| References | 238 | ||
| Healthcare Economic Evaluation of Chronic Pain: Measuring the Economic, Social and Personal Impact of Chronic Pain and its Management | 246 | ||
| Introduction | 246 | ||
| The Definition and Prevalence of Chronic Pain | 246 | ||
| The Implications of Chronic Pain | 247 | ||
| The Potential Role of Economic Evaluation in Chronic Pain | 247 | ||
| An Overview of Healthcare Economic Evaluation | 248 | ||
| The Dimensions of a Healthcare Economic Evaluation | 249 | ||
| The Types of Analysis in a Healthcare Economic Evaluation | 250 | ||
| The Categories of Costs in a Healthcare Economic Evaluations | 253 | ||
| Delineating Healthcare Costs | 253 | ||
| The Point of View or Perspective of a Healthcare Economic Evaluation | 255 | ||
| A Framework for Assessing Healthcare Economic Analyses | 256 | ||
| Chronic Low Back Pain | 256 | ||
| The Definition and Prevalence of Chronic Low Back Pain | 256 | ||
| The Treatment of Chronic Low Back Pain | 257 | ||
| The Burden of Chronic Low Back Pain | 258 | ||
| Economic Evaluation of the Treatment of Chronic Lower Back Pain | 260 | ||
| Fibromyalgia | 262 | ||
| The Definition and Prevalence of Fibromyalgia | 262 | ||
| The Treatment of Fibromyalgia | 263 | ||
| The Burden of Fibromyalgia | 265 | ||
| Economic Analyses of the Treatment of Fibromyalgia | 268 | ||
| Implications for the Clinical Application of Healthcare Economic Evaluations of Chronic Pain Management | 270 | ||
| Can Cost-Effectiveness Analysis Be Performed Simultaneously With an Efficacy Study of Chronic Pain Treatment? | 270 | ||
| When Designing an Economic Evaluation to Be Conducted Alongside a Clinical Trial, Upon Which Endpoint Should the Overall Study Sample Size Be Based? | 271 | ||
| Costs per Country Be Pooled or Remain Separate in Multinational Studies of Chronic Pain? | 272 | ||
| Conclusions | 273 | ||
| References | 275 | ||
| Chemotherapy Induced Peripheral Neuropathies (CIPNs): A Biobehavioral Approach | 286 | ||
| Introduction | 286 | ||
| Epidemiology | 287 | ||
| Symptoms Associated with CIPNs | 288 | ||
| Barriers | 289 | ||
| A Biobehavioral Approach to Understanding CIPNs | 291 | ||
| Healthy Peripheral Nerves | 292 | ||
| The Danger Model | 292 | ||
| Cancer as a Context | 293 | ||
| Peripheral Nerve Injury and Peripheral Sensitization | 293 | ||
| Peripheral Nerve Injury and Glial Activation of the Spinal Cord | 294 | ||
| Immune to Brain Communication | 295 | ||
| Sickness Responses and Sickness Behaviors | 296 | ||
| Conclusions | 297 | ||
| References | 299 | ||
| Pain and Use of Health Services Among Persons Living with HIV | 312 | ||
| Introduction | 313 | ||
| Prevalence of Pain in the General Population of Adults | 313 | ||
| Prevalence of Pain Among the General Population of Children | 315 | ||
| Prevalence of Pain in Adults and Children Living with HIV | 316 | ||
| Pain and Health Status | 317 | ||
| Types of Pain | 317 | ||
| Undertreatment of Pain | 318 | ||
| Pain and Functional Impairment | 319 | ||
| Psychological Distress and Pain | 320 | ||
| Pain and Access to Health Services | 323 | ||
| Access to Health Services | 323 | ||
| HIV and the Healthcare System | 324 | ||
| Funding for HIV-Related Services | 325 | ||
| Barriers to Accessing Health Care Among Persons Living with HIV | 326 | ||
| Pain and the Healthcare System | 328 | ||
| Chronic Pain and the Use of Conventional Health Services | 328 | ||
| Chronic Pain and the Use of Complementary and Alternative Therapies | 331 | ||
| Psychological Distress, Pain, and Use of Health Services | 333 | ||
| Chronic Pain and the Use of Conventional Health Services and Complementary and Alternative Therapies Among Persons Living with HIV | 334 | ||
| Conclusion | 337 | ||
| Future Directions | 338 | ||
| References | 339 | ||
| Pain Measurement | 347 | ||
| Introduction | 347 | ||
| Measuring Pain | 348 | ||
| Assessment Instruments | 349 | ||
| Assessing Pain in Non-Verbal Populations | 351 | ||
| Measuring Pain in Children | 352 | ||
| Other Instruments | 353 | ||
| Quality Measures | 353 | ||
| Improving Pain Management | 355 | ||
| Quality Improvement | 355 | ||
| Interventions Targeting Health Care Professionals | 356 | ||
| Assessment, Educational, and Psychosocial Interventions Targeting Patients | 357 | ||
| Conclusion | 358 | ||
| References | 359 | ||
| Phantom Pain | 362 | ||
| Introduction | 362 | ||
| Describing Phantom Limb Pain and Phantom Sensations | 364 | ||
| Epidemiology | 365 | ||
| Risk Factors | 366 | ||
| Etiology | 367 | ||
| Phantom Pain as a Psychiatric Problem | 367 | ||
| Neuromata | 368 | ||
| Neurons of the Spinal Cord | 368 | ||
| Reorganization (Remapping) | 368 | ||
| Treatments | 371 | ||
| Surgical treatments | 373 | ||
| Pharmacological treatments | 374 | ||
| Salmon Calcitonin | 374 | ||
| Oral Dextromethorphan | 375 | ||
| Gabapentin | 375 | ||
| Amitryptiline | 376 | ||
| Ketamine | 376 | ||
| Psychological treatments | 377 | ||
| Supportive treatments | 378 | ||
| Prosthetic Management | 378 | ||
| Transcutaneous Electrical Nerve Stimulation (TENS) | 378 | ||
| Farabloc | 379 | ||
| Mirror Treatments | 379 | ||
| Self Management | 380 | ||
| Conclusion | 380 | ||
| References | 381 | ||
| Pain: Substance Abuse Issues in the Treatment of Pain | 387 | ||
| A Brief History of Drug Regulation in the United States | 388 | ||
| Risk versus Benefit | 389 | ||
| A Continuum of Pain and Opioid Addiction | 390 | ||
| Definitions | 390 | ||
| Pseudoaddiction | 391 | ||
| Pseudotolerance | 391 | ||
| Multiple Types of Tolerance | 392 | ||
| Iatrogenic Addiction | 392 | ||
| Universal Precautions in Pain Medicine | 394 | ||
| Group I - Primary Care Management Patients | 394 | ||
| Group II - Primary Care Patients with Specialist Support | 395 | ||
| Group III - Specialty Pain Management | 395 | ||
| Urine Drug Testing in Pain or Addiction Medicine | 396 | ||
| Specimen Choice | 397 | ||
| Whom to Test | 397 | ||
| Testing Strategies | 397 | ||
| Opioid Agreements | 400 | ||
| Reality and Responsibility: The Treatment of Pain and Suffering in Our Society | 401 | ||
| References | 402 | ||
| The Use of Complementary and Alternative Medicine for Pain | 405 | ||
| Manipulative and Body-Based CAM Therapies for Pain | 407 | ||
| Massage | 407 | ||
| Mind-Body Medicine CAM Therapies for Pain | 408 | ||
| Hypnosis and Imagery | 408 | ||
| Yoga | 410 | ||
| Meditation | 412 | ||
| Tai-Chi and Qi Gong | 412 | ||
| Energy Medicine | 414 | ||
| Reiki | 414 | ||
| Acupuncture | 415 | ||
| Methodological Issues | 419 | ||
| Control Groups | 419 | ||
| Mechanisms of Action & Placebo | 420 | ||
| Masking & Dose-Ranging | 423 | ||
| Effects of Age | 424 | ||
| Standardized Treatments | 425 | ||
| Limitations and Directions | 425 | ||
| References | 426 | ||
| Imaging Modalities for Pain | 433 | ||
| Introduction | 433 | ||
| Background/Historical Overview | 433 | ||
| Imaging Methodology | 435 | ||
| Magnetoencephalography (MEG) | 435 | ||
| The Principles of MEG | 435 | ||
| Temporal and Spatial Resolution | 437 | ||
| Positron Emission Tomography (PET) | 437 | ||
| The Principles of PET | 437 | ||
| Radiotracers and Receptor Binding | 438 | ||
| Experimental Design and Statistical Analysis | 438 | ||
| Functional Magnetic Resonance Imaging (fMRI) | 439 | ||
| The BOLD Response | 439 | ||
| Data Acquisition | 439 | ||
| Experimental Design | 440 | ||
| Statistical Analysis | 440 | ||
| Functional Connectivity | 441 | ||
| Pharmacological fMRI | 441 | ||
| Imaging Pain | 442 | ||
| The Pain Matrix | 442 | ||
| Sensory-Discriminative Aspect of Pain | 443 | ||
| Affective-Motivational Aspect of Pain | 445 | ||
| Pain Modulation | 447 | ||
| Impact of Attention and Distraction | 448 | ||
| Impact of Expectation and Emotion | 451 | ||
| Pain Imaging in Patients | 456 | ||
| Future Perspectives | 458 | ||
| References | 460 | ||
| Pain, Transportation Issues and Whiplash | 471 | ||
| The Whiplash Injury | 472 | ||
| Symptoms | 473 | ||
| Physical Characteristics of the Whiplash Condition | 474 | ||
| Motor and Sensori-Motor Dysfunction | 474 | ||
| Evidence for Augmented Central Pain Processes in WAD | 475 | ||
| Psychological Features of the Whiplash Condition | 478 | ||
| Posttraumatic Stress Symptoms - An Important Factor in Whiplash? | 480 | ||
| Relationships Between Physical and Psychological Factors | 482 | ||
| The Prediction of Outcome Following Whiplash Injury | 485 | ||
| Implications for Assessment and Management of Whiplash | 486 | ||
| Summary | 488 | ||
| References | 489 | ||
| Gene Therapy for Chronic Pain | 496 | ||
| Introduction | 496 | ||
| Methods of Gene Therapy | 497 | ||
| Liposomes and Naked Plasmid DNA | 497 | ||
| Viral Vectors | 498 | ||
| Adenoviral Vectors | 498 | ||
| Adeno-Associated Virus and Lentivirus Vectors | 499 | ||
| Herpes Simplex Virus (HSV)-1 | 499 | ||
| Preclinical Studies of Gene Therapy | 500 | ||
| Basal Nociceptive and Mechanical Sensitivity | 500 | ||
| Inflammatory Nociception and Hypersensitivity | 506 | ||
| Neuropathic Pain Models of Allodynia and Hyperalgesia | 507 | ||
| Cancer Pain Models | 507 | ||
| Specificity of Effects of Preclinical Studies | 507 | ||
| Human Clinical Trials | 508 | ||
| Conclusions | 510 | ||
| References | 511 | ||
| Palliative Care and Pain Management in the United States | 515 | ||
| Introduction | 515 | ||
| The Cultural Evolution of the Modern Palliative Care Movement: A Brief History | 515 | ||
| The Clinical Worlds of ‘‘Palliative Care’’ and ‘‘Pain Management’’ | 516 | ||
| Pain Management and Hospice | 516 | ||
| Total Pain | 517 | ||
| Saunders’ Total Pain, Engels’ Biopsychosocial Model, and Bonica’s Multidisciplinary Pain Centers | 519 | ||
| Hospice Care Comes to the United States | 520 | ||
| The Growth of Palliative Care Services in the United States | 522 | ||
| Palliative Care Post - SUPPORT | 524 | ||
| Palliative Care and Pain Management | 524 | ||
| Evidence Based Pain Management and Palliative Care | 525 | ||
| System Change and Advocacy | 527 | ||
| Palliative Care and Pain Management - Still Worlds Apart | 529 | ||
| An Eye to the Future | 530 | ||
| References | 531 | ||
| Pain in Society: Ethical Issues and Public Policy Concerns | 536 | ||
| Introduction | 536 | ||
| Ethical Dimensions of Pain and Its Relief | 537 | ||
| Barriers to Effective Pain Relief | 538 | ||
| Regulation of Opioid Analgesics | 541 | ||
| Litigating the Right to Pain Relief | 544 | ||
| Public Policy Responses to the Phenomenon of Undertreated Pain | 545 | ||
| Conclusion | 546 | ||
| References | 547 | ||
| Index | 550 |