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Cure Arthritis Naturally

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Table 1-1 Traditional versus biopsychosocial models of pain . . 6 Table 1-2 Role of psychiatrists in pain management

(biopsychosocial approach) 8

Table 2-1 Sensory neural fiber types of first-order neurons. . . 14

Table 2-2 Mediators of pain processing and transmission. . . . 20 Table 2-3 Monoamine neurotransmission involved in descending pain inhibition 22

Table 2-4 Causes of chronic pain 23

Table 2-5 Features distinguishing acute and chronic pain. . . . 26

Table 2-6 Categories of chronic pain 28

Table 2-7 Common problems encountered by patients with chronic pain 29

Table 2-8 Simple versus complex chronic pain 30

Table 3-1 Obtaining a pain history 38

Table 3-2 Psychiatric disorders accompanying acute and chronic pain 39

Table 3-3 Problematic cognitive patterns in pain 43

Table 3-4 Factors that suggest poor surgical outcome for pain disorders 48

Table 3-5 Psychometric scales used in assessing chronic pain 49

Table 3-6 Pain assessment instruments for acute and chronic pain 50

Table 3-7 Short form of the McGill Pain Questionnaire 55

Table 3-8 Uses of the Minnesota Multiphasic Personality

Inventory for patients with chronic pain 58

Table 4-1 DSM-IV-TR diagnostic criteria for pain disorder . . . . 65 Table 4-2 Limitations of the DSM-IV-TR nosology of pain disorder 66

Table 4-3 Psychiatric disorders in which pain can be a prominent complaint 68

Table 4-4 Factors that raise suspicion of malingering 69

Table 4-5 Physiologic substrates common to pain and depression 71

Table 4-6 Distinguishing features of pseudoaddiction and addiction 77

Table 5-1 Opiate dosing and use 84

Table 5-2 Medication suggestions for pain in the adult patient 86

Table 5-3 Opioid therapy guidelines for chronic nonmalignant pain 87

Table 5-4 Dosing guidelines 91

Table 5-5 Analgesic effects of antidepressants 100

Table 5-6 Antidepressants used in chronic pain 101

Table 5-7 Tricyclic antidepressant side effects 102

Table 5-8 Uses of anticonvulsants in various pain conditions 104

Table 5-9 Anticonvulsant mechanisms of action relevant to pain 105

Table 5-10 Side effects of anticonvulsants 107

Table 5-11 Number-needed-to-treat (NNT) values obtained from two meta-analyses assessing antidepressant and anticonvulsant efficacy in neuropathy 109

Table 5-12 Triptans available for abortive migraine treatment 112

Table 5-13 Side effects of corticosteroid use in pain 117

Table 5-14 Dosing of muscle relaxants 118

Table 5-15 Herbal agents used for pain 121

Table 6-1 Components of pain and associated psychotherapeutic interventions 132

Table 6-2 Psychotherapy interventions employed to facilitate access of emotions 136

Table 6-3 Reasons why emotions are poorly identified and regulated 137

Table 6-4 Early psychodynamic conceptualizations of pain 137

Table 6-5 Steps of behavior therapy 141

Table 6-6 Script for deep breathing exercises 154

Table 6-7 Techniques of hypnosis 156

Table 7-1 Treatment interventions for management of acute and chronic pain conditions 162

Table 7-2 Complications and contraindications of subarachnoid and epidural analgesia 167

Table 7-3 Risks of continuous epidural or subarachnoid anesthetic infusions 167

Table 7-4 Modalities of regional nerve blockade 169

Table 7-5 Types of and uses for autonomic nerve blocks. . . 170 Table 7-6 Neurosurgical interventions for use in pain management 171

Table 7-7 Role of psychiatrists in the care of patients undergoing interventional pain management . . . . 173 Table 7-8 Psychiatrists' guide for assessing patient decision-making capacity 175

Table 8-1 Evaluation of the headache patient 180

Table 8-2 Treatment of headache 182

Table 8-3 Factors influencing likelihood of response to psychotherapeutic measures in patients with tension headache 183

Table 8-4 Common auras associated with migraine headache 184

Table 8-5 Common causes of back pain 187

Table 8-6 Treatment options for back pain 189

Table 8-7 Diagnostic criteria for fibromyalgia 190

Table 8-8 Features associated with fibromyalgia 191

Table 8-9 Summary of treatment approaches for fibromyalgia based on strength of evidence in the available literature 193

Table 8-10 Pharmacologic treatment strategies for comorbidities of fibromyalgia 194

Table 8-11 Treatment options for patients with osteoarthritis 195

Table 8-12 Treatment options for patients with rheumatoid arthritis 196

Table 8-13 Types of neuropathic pain 199

Table 8-14 Treatment strategies for patients with neuropathic pain 200

Table 8-15 Treatment of patients with complex regional pain syndrome 202

Table 8-16 Common pain-related disorders associated with HIV/AIDS 205

Table 8-17 Management of cancer pain and pain associated with HIV and AIDS, based on pain ratings 206

Table 9-1 Behavior parameters warranting consideration to assess discomfort 218

Table 9-2 Barriers to pain management in minority patients 221

Table 9-3 Pain management in patients with substance abuse/dependence 223

Table 9-4 Medicare requirements for hospice care 227

Table 9-5 Approaches to dealing with spiritual issues 229

Table 10-1 Items to be factored into a patient contract for use with controlled substances 239

Table 10-2 Advantages of urine drug testing in clinical pain management practice 241

Table 10-3 Purposes of the National All Schedules Prescription Electronic Reporting Act database system 242

Table 10-4 Limitations considered by Social Security

Administration adjudicators 245

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Arthritis Joint Pain

Arthritis Joint Pain

Arthritis is a general term which is commonly associated with a number of painful conditions affecting the joints and bones. The term arthritis literally translates to joint inflammation.

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