Tabitha A. Washington - Pain

More Advance Praise for
Pain

It was a pleasure to read the advance copy of Pain in the What do I do now series. Drs. Washington, Brown, and Fanciullo do an admirable job of condensing the field of pain medicine into important clinical vignettes which bring the reader effortlessly through complex, interesting cases using best practices in pain medicine. The highly readable volume is rationally divided into three sections: chronic pain conditions, chronic pain related disorders, and treatment overview. In my opinion, the chapters on the difficult pain patient and medical marijuana are among the best I have seen anywhere. This book will serve the busy primary care practitioner and the pain specialist alike with helpful clinical pearls throughout.

Allen W. Burton, MD, Houston Pain Associates, Houston, TX

This eighth volume of the new series entitled What Do I Do Now? by Drs. Tabitha A. Washington, Khalilah M. Brown, and Gilbert J. Fanciullo covers a wide variety of challenging clinical pain syndromes as well as the latest therapies. The authors elegantly present each case with a comprehensive yet clinically relevant review of the literature in order to provide the reader with a rapid and clear understanding of chronic pain conditions as well as the most appropriate therapeutic options. The expertise of the authors is put in the practicing clinicians hands though an attractive format of tables, figures, references and bullet points. This also makes it attractive for exam preparation.

Thomas T. Simopoulos, MD, MA, Director of the Interventional Pain Service,
Arnold Pain Management Center, Beth Israel Deaconess Medical Center,
Boston, MA

Chronic pain is complex and difficult to treat, and often leaves clinicians perplexed about what to do when usual analgesics fail. What do I do now? Pain directs readers through a variety of scenarios, clinical cases that represent common chronic pain diagnoses (section 1), linked disorders (section 2), and different treatment types (section 3). The format is easy to follow, and key points at the end of each chapter focus the lessons learned through each case. Washington, Brown and Fanciullo are recognized authorities and have produced a book that will appeal to a wide range of practitioners, regardless of specialty.

Jane C. Ballantyne, MD, FRCA, Professor of Anesthesiology and Pain
Medicine, Center for Pain Relief, University of Washington, Seattle, WA

What Do I Do Now?

SERIES CO-EDITORS-IN-CHIEF

Lawrence C. Newman, MD
Director of the Headache Institute
Department of Neurology
St. Lukes-Roosevelt Hospital Center
New York, NY

Morris Levin, MD
Co-director of the Dartmouth Headache Center
Director of the Dartmouth Neurology Residency Training Program.
Section of Neurology
Dartmouth Hitchcock Medical Center
Lebanon, NH

PREVIOUS VOLUMES IN THE SERIES

Headache and Facial Pain
Peripheral Nerve and Muscle Disease
Pediatric Neurology
Stroke
Epilepsy
Neurocritical Care
Neuro-Ophthalmology
Neuroimmunology

Pain

Tabitha A. Washington, MD, MS

Associate Pain Fellowship Program Director, Section of Pain Medicine
Department of Anesthesiology
Dartmouth Hitchcock Medical Center
Dartmouth Medical School
Lebanon, NH

Khalilah Brown, MD, MPH
Department of Anesthesiology
Dartmouth Hitchcock Medical Center
Lebanon, NH

Gilbert Fanciullo, MD, MS
Director, Section of Pain Medicine
Department of Anesthesiology
Dartmouth Hitchcock Medical Center
Dartmouth Medical School
Lebanon, NH

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Copyright 2012 by Oxford University Press, Inc.

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First issued as an Oxford University Press paperback, 2012

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Library of Congress Cataloging-in-Publication Data

Washington, Tabitha A.
Pain/Tabitha A. Washington, Khalilah Brown, Gilbert Fanciullo.
p.; cm.(What do I do now?)
Includes bibliographical references and index.
ISBN 978-0-19-982760-2 (pbk. : alk. paper)
1. PainDiagnosisCase studies. 2. PainTreatmentCase studies. I. Brown, Khalilah. II. Fanciullo,
Gilbert. III. Title. IV. Series: What do I do now?
[DNLM: 1. PaindiagnosisCase Reports. 2. PaintherapyCase Reports. 3. Diagnosis, Differential
Case Reports. WL 704]
RB127.W37 2012
616.0472 dc23
2011026018

The science of medicine is a rapidly changing field. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy occur. The author and publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is accurate and complete, and in accordance with the standards accepted at the time of publication. However, in light of the possibility of human error or changes in the practice of medicine, neither the author, nor the publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete. Readers are encouraged to confirm the information contained herein with other reliable sources, and are strongly advised to check the product information sheet provided by the pharmaceutical company for each drug they plan to administer.

9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper

To my Michael, thank you for all your love and support. To our children, Gwendolyn and Ethan, who are my inspiration in everything I do and every choice I make. To my parents, James and Alice, who have always supported me in every endeavor and made me who I am today. To my family, who have always been there for me, and have never doubted my dreams. In loving memory of my father, James Ethan Washington.

TW

To Delores and Jesse, who inspire and encourage my every step and whom without fail and with more love than any one person deserves. To Sallie, my conscience; Krystal, my spirit; and Patrick, my heartI stand on your shoulders. Thank you.

KB

To Peggy. Thank you, Darling, for your sacrifices, support, and love.

GF

Preface

Chronic Pain is a debilating disorder which is often difficult to treat. Diagnosis can be complex, patients can be time consuming for practioners and treatment may seem futile. It is the practioner whom often first encounters these patients and when treatment is unsuccessful will often ask, What do I do now? Literature review and textbooks can be helpful, however time consuming and expansive for the practioner to utilize in their busy practices which are limited by time and financial constraints. A quick resource could help facilitate treatment of chronic pain patients.