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1. Pain mechanisms and pathways -- Anatomy of the nervous system -- Sympathetic and parasympathetic systems -- Different types of pain -- Peripheral mechanisms -- Spinal and medullary dorsal horns mechanisms -- Segmental and brain stem mechanisms -- Thalamocortical mechanisms -- Experimental models -- Peripheral mechanisms of pain transmission and modulation -- Synaptic transmission of pain in the dorsal horn -- Central sensitization -- Neurotransmitters involved in pain modulation -- Development of pain behavior in the fetus and newborn -- Physiologic and behavioral pain assessment measures in infants -- Long-term consequences of neonatal pain -- 2. Research and study design -- Critical analysis of literature and evidence-based medicine -- Principles of valid clinical research -- Effects of analysis on the clinical applicability of study results -- Components of clinical trials -- Special features of study of pain -- Outcome measures in clinical studies -- Common animal models in the study of pain -- Ethics of animal experimentation -- Ethics of pain management and research -- Professionalism and quality assurance -- Placebo, Nocebo and Pain -- Use of data from epidemiologic studies of pain -- Measurement of burden in a population, including epidemiologic measures of occurrence -- Observational studies: uses and limitations -- Cohort studies: use to determine natural history and predictors of outcome -- Case control studies: uses, indications, limitations and design -- Use of risk factors to guide treatment -- 3. Assessment of Pain -- Pain as a subjective, multidimensional experience -- Introspection and measurement of subjective experience -- Measurement of pain (all scales for neonates, infants, children, adults and elderly) -- Indirect pain measurement -- Dependence/tolerance/addiction/Abuse/misuse -- 4. Clinical Nerve Function Studies and Imaging -- Electrical nerve stimulation EMG/NCV -- Evoked potentials -- Quantitative sensory testing -- Skin punch biopsy -- MRI, fMRI, and MR spectroscopy -- PET scans -- EEG -- MEG -- X ray -- CT -- 5. Psychosocial and Cultural Aspects of Pain -- Pain as a biopsychological experience -- Individual differences in affective, cognitive, and behavioral responses to pain -- Coping styles -- Expectations, coping, cultural and environmental factors -- Cultural, environmental, and racial variations in experience and expression of pain -- Role of family in promoting illness and well behaviour -- Common emotional problems and psychiatric disorders associated with pain -- Sex and Gender Issues in Pain -- 6. Pharmacologic treatment of pain -- Opioids -- Antipyretic Analgesics -- Antidepressants -- Anticonvulsants -- Neuroleptic drugs -- Antihistamines -- Analeptic drugs -- Corticosteroids -- Muscle relaxants and antispasticity drugs -- NMDA antagonists -- Local anesthetics and membrane-stabilizing drugs -- Alpha 2 agonists -- Naloxone and Naltrexone -- Agonist/antagonist agents -- Ziconotide -- Marijuana -- Lidocaine infusion -- Herbal and vitamin supplements -- Fatty acids -- Capsaicin -- 7. Other methods for treatment of pain -- Cognitive and behavioral strategies -- Integration of approaches -- Stages of behavioral change and their effects -- Cognitive behavioral and self-management interventions -- Psychiatric and psychologic morbidities of chronic pain -- Psychiatric and psychological factors that impact treatment adherence and the therapeutic alliance with treatment providers -- Pharmacotherapy for treatment of comorbid conditions -- Psychotherapy for depressive disorders -- Differential diagnosis of anxiety disorders and their management -- Anger in chronic pain patients and relation to perceived pain -- Somatic complaints in chronic pain -- Role of family -- Role of patient beliefs and expectations in pain and disability -- Sleep disorders in chronic pain -- Work history and education in evaluation of chronic pain -- Peripheral stimulation techniques -- 8. Interventional Pain Management Including Nerve Blocks -- Anticoagulation -- Superficial and deep cervical plexus -- Stellate ganglion block -- Sympathetic blocks -- Brachial plexus -- Ulnar nerve -- Median nerve -- Radial nerve -- Femoral nerve -- Sciatic nerve -- Saphenous nerve -- Posterior tibial nerve -- Common peroneal nerve -- Superficial peroneal -- Deep peroneal -- Sural -- Lateral femoral cutaneous nerve -- Obturator nerve -- Ilioinguinal nerve -- Iliohypogastric nerve -- Genitofemoral nerve -- 9. Headache and Facial Pain -- Migraine headache -- Cluster headache -- Tension headache -- Other types of headache -- Botox injections -- Systematic case history -- Indications for further investigation of headache -- Physical, psychological, and social factors contributing to headache -- Occipital nerves -- Trigeminal nerve with all terminal branches -- Spheno-palatine ganglion -- Other ganglia -- Cranial nerves -- 10. Back -- Cervical Radicular Pain -- Neck Pain -- Thoracic radicular pain -- Thoracic back pain -- Lumbar Radicular Pain -- Low Back Pain -- Disc disease and discogenic pain -- PDPH -- Arachnoidtis -- Thoracic outlet syndrome -- 11. Musculoskeletal Pain -- Diagnostic labels for muscle pain -- Anatomy -- Multifactorial pathophysiology -- Common clinical characteristics -- Fibromyalgia -- Different muscle conditions -- Tendinosis and Tenditnitis -- TPIs -- TENS unit -- 12. Joints -- TMJ -- AA joint -- Sacroiliac joint -- Shoulder joint -- Elbow joint pain -- Wrist joint pain -- Hip joint pain -- Knee joint pain -- Ankle joint pain -- 13. Chest pain -- Anatomy -- Xiphodynia -- Costochondral junction, Costosternal junction and Intercosal nerve injections -- 14. Abdominal Pain -- Anatomy -- Causes and differential diagnosis -- Peripheral and central mechanisms of visceral pain modulation -- TAP block -- Celiac plexus block -- 15. Chronic Urogenital Pain -- Anatomy and epidemiology -- Clinical differentiation of gastrointestinal, urologic, gynecologic, and musculoskeletal pain -- Psychological principles in clinical assessment, explanation, and treatment -- Common causes, diagnostic evaluation, and treatment in men -- Common causes, diagnostic evaluation, and treatment in women -- Superior hypogastric plexus block -- Ganglion impar block -- 16. Surgical Pain Management -- Importance of general health status in preoperative evaluation -- Surgical lesioning of brain, brain stem, spinal cord, peripheral nerves -- Radiofrequency treatment -- Neurolysis -- Spinal cord and peripheral nerve stimulation -- Intrathecal drug delivery -- DRG stimulator -- Cordotomy -- Kyphoplast and vertebroplasty -- 17. Nerve conditions -- Complex Regional Pain Syndromes -- Phantom limb pain -- Peripheral neuropathy -- Other nerve conditions as mononeuropathy, mononeurpathy multiplex and others -- 18. Central pain -- Central pain -- 19. Cancer Pain -- Palliative care -- Hospice care -- Comprehensive evaluation of patients with cancer pain -- Principles of treatment -- Analgesic ladder approach -- Anesthetic approaches -- Surgical and interventional radiologic approaches -- Neurostimulatory approach -- Physical therapy -- Psychological approaches -- Needs of special populations -- Benefit to burden ratio -- Anorexia and cachexia associated with cancer -- 20. Pain in Pregnancy and Labor -- Factors influencing the perception of pain in pregnancy compared with the non-pregnant state -- Causes of pain and principles of pain management in pregnancy -- Mechanisms, characteristic, benefits, consequences and management of labor pain -- 21. Acute Pain -- Epidemiology of inadequate control -- Physiologic and psychologic effects -- Pharmacologic properties of major classes of drugs used for acute pain management -- Comprehensive plan for optimal perioperative pain management -- Non-pharmacologic treatment -- Clinical outcomes to be evaluated -- Tools for assessment and measurement -- Role of patient and family education -- Treatment of nonsurgical pain -- 22. Physical Medicine and Rehabilitation -- Temperature modalities -- Manipulation, mobilization, massage, traction -- Casting and splinting -- Exercise therapy -- 23. |