Skip to main content
SpringerLink
Log in

Principles of Pain Management

  • Chapter
Book cover Fundamentals of Geriatric Medicine

Abstract

Upon completion of the chapter, the student will be able to:

  1. 1.

    Understand the pathophysiology of pain.

  2. 2.

    Know the steps on how to obtain an adequate pain history.

  3. 3.

    Identify the different types of medications used for treating pain, and their indications and limitations.

  4. 4.

    Appreciate that pain is multifactorial and often requires multiple modalities of treatment for improvement.

Material in this chapter is based on the following chapter in Cassel CK, Leipzig RM, Cohen HJ, Larson EB, Meier DE, eds. Geriatric Medicine: An Evidence-Based Approach, 4th ed. New York: Springer, 2003: Ferrell BA. Acute and Chronic Pain, pp. 323–342. Selections edited by R. Morgan Bain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Suggested Readings

  • Acute Pain Management Guideline Panel. Acute Pain Management: Post-operative or Medical Procedures and Trauma. Clinical Practice Guideline. AHCPR Pub. No. 92-0032. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, February 1993. A thorough review of current practices in acute pain management.

    Google Scholar 

  • American Geriatric Society Panel on Chronic Pain in Older Persons. The management of chronic pain in older persons. J Am Geriatr Soc 1998;46:635–651. A comprehensive guide to the management of pain among older adults with special emphasis to non-pharmacologic measures as well as dosing recommendations of pain medications.

    Google Scholar 

  • Ferrell BA. Acute and chronic pain. In: Cassel CK, Leipzig RM, Cohen HJ, et al., eds. Geriatric Medicine, 4th ed. New York: Springer, 2003:323–342.

    Google Scholar 

References

  1. Ferrell BA. Overview of aging and pain. In: Ferrell BR, Ferrell BA, eds. Pain in the Elderly. Seattle: IASP Press, 1996:1–10.

    Google Scholar 

  2. Ferrell BA, Ferrell BR, Osterweil D. Pain in the nursing home. J Am Geriatr Soc 1990;38:409–414.

    PubMed  CAS  Google Scholar 

  3. American Geriatric Society Ethics Committee. The care of dying patients: a position statement. J Am Geriatr Soc 1995;43:577–578.

    Google Scholar 

  4. Gibson SJ, Helme RD. Age differences in pain perception and report: a review of physiological, psychological, laboratory and clinical studies. Pain Rev 1995;2:111–137.

    Google Scholar 

  5. Gibson SJ, Helme RD. Age related differences in pain perception and report. Pain Reviews 1995;2:111–137.

    Google Scholar 

  6. Max MB, et al. Principles of Analgesic use in Treatment of Acute Pain and Cancer Pain, 4th ed. Glenview, IL: American Pain Society, 1999.

    Google Scholar 

  7. Acute Pain Management Guideline Panel. Acute Pain Management: Post-Operative or Medical Procedures and Trauma. Clinical Practice Guideline. AHCPR Pub. No. 92-0032. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, February 1993.

    Google Scholar 

  8. American Geriatric Society Panel on Chronic Pain in Older Persons. The management of chronic pain in older persons. J Am Geriatr Soc 1998;46:635–651.

    Google Scholar 

  9. Myer RA, Campbell JN, Raja SN. Peripheral and neural mechanisms of nociception. In: Wall PD, Melzack R, eds. Textbook of Pain, 3rd ed. New York: Churchill Livingstone, 1994:13–44.

    Google Scholar 

  10. Bennett GF. Neuropathic pain. In: Wall PD, Melzack R, eds. Textbook of Pain, 3rd ed. New York: Churchill Livingstone, 1994:201–224.

    Google Scholar 

  11. Galer BS, Dworkin RH. A Clinical Guide to Neuropathic Pain. New York: McGraw-Hill, 2000:33–36.

    Google Scholar 

  12. Craig KD. Emotional aspects of pain. In: Wall PD, Melzack R, eds. Textbook of Pain, 3rd ed. New York: Churchill Livingstone, 1994:261–274.

    Google Scholar 

  13. Ferrell BA. Pain evaluation and management in the nursing home. Ann Intern Med 1995;123(9):681–687.

    PubMed  CAS  Google Scholar 

  14. Herr KA, Mobily PR. Pain management in alternate care settings. In: Ferrell BR, Ferrell BA, eds. Pain in the Elderly. Seattle: IASP Press, 1996:101–109.

    Google Scholar 

  15. Nishikawa ST, Ferrell BA. Pain assessment in the elderly. Clin Geriatr Issues Long Term Care 1993;1:15–28.

    Google Scholar 

  16. Keefe FJ, Beaupre PM, Weiner DK, Siegler IC. Pain in older adults: A cognitive behavioral perspective. In: Ferrell BR, Ferrell BA, eds. Pain in the Elderly. Seattle: IASP Press, 1996:11–19.

    Google Scholar 

  17. World Health Organization. Cancer Pain Relief, 2nd ed. With a guide to opioid availability, cancer pain relief and palliative care: Report of the WHO Expert Committee (WHO Technical Report Series, No. 804). Geneva: WHO, 1996.

    Google Scholar 

  18. Bradley JD, Brandt KD, Katz BP, et al. Comparison of an anti-inflammatory dose of ibuprofen, an analgesic dose of ibuprofen and acetaminophen in treatment of patients with osteoarthritis of the knee. N Engl J Med 1991;325:87–91.

    Article  PubMed  CAS  Google Scholar 

  19. Roth SH. Merits and liabilities of NSAID therapy. Rheumatol Dis Clin North Am 1989;15:479–498.

    CAS  Google Scholar 

  20. Griffin MR, Piper JM, Daugherty JR, et al. Nonsteroidal anti-inflammatory drug use and increased for peptic ulcer disease in elderly persons. Ann Intern Med 1991;114:257–263.

    PubMed  CAS  Google Scholar 

  21. Gurwitz JH, Avorn J, Ross-Degnan D, Sipsitz LA. Nonsteroidal anti-inflammatory drug associated azotemia in the very old. JAMA 1990;264:471–475.

    Article  PubMed  CAS  Google Scholar 

  22. Graham DY, White RH, Foreland LW, et al. Duodenal and gastric ulcer prevention with misoprostol in arthritis patients taking NSAIDs: Misoprostol Study Group. Ann Intern Med 1993;119:257–262.

    PubMed  CAS  Google Scholar 

  23. Ehsanullah RS, Page MC, Tildesley G, Wood JR. Prevention of gastroduodenal damage induced by non-steroidal anti-inflammatory drugs: controlled trial of ranitidine. Br Med J 1988;297:1017–1021.

    Article  CAS  Google Scholar 

  24. Taha As, Hudson N, Hawkey CJ, et al. Famotidine for the prevention of gastric and duodenal ulcers caused by nonsteroidal anti-inflammatory drugs. N Engl J Med 1996;334:1435–1449.

    Article  PubMed  CAS  Google Scholar 

  25. Stucki J, Hohannesson M, Liang MH. Use of misoprostyl in the elderly: Is the expense justified? Drugs Aging 1996;8:84–88.

    PubMed  CAS  Google Scholar 

  26. Pope JE, Anderson JJ, Felson DT. A meta-analysis of the effects of nonsteroidal anti-inflammatory drugs on blood pressure. Arch Intern Med 1993;153:477–484.

    Article  PubMed  CAS  Google Scholar 

  27. Jaffe JH. Drug addiction and drug abuse. In: Gilman AG, Goodman LS, Rall TW, Murad F, eds. Goodman and Gillman’s The Pharmacological Basis of Therapeutics, 7th ed. New York: Macmillan, 1985:532–581.

    Google Scholar 

  28. Melzack R. The tragedy of needless pain. Sci Am 1990;262:27–33.

    Article  PubMed  CAS  Google Scholar 

  29. Portenoy RK. Opiate therapy for chronic noncancer pain: Can we get past the bias? Am Pain Soc Bull 1991;1:4–7.

    Google Scholar 

  30. Max MB. Antidepressants and analgesics. In: Fields HL, Leibeskind JC, eds. Progress in Pain Research and Management, vol 1. Seattle: IASP Press, 1994:229–246.

    Google Scholar 

  31. Swerdlow M. The use of local anesthetics for relief of chronic pain. Pain Clin 1988;2:3–6.

    Google Scholar 

  32. Backonja M, Beydoun A, Edwards KR, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998;280(21):1831–1836.

    Article  PubMed  CAS  Google Scholar 

  33. Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998;280(21):1837–1842.

    Article  PubMed  CAS  Google Scholar 

  34. Prager JP. Invasive modalities for the diagnosis and treatment of pain in the elderly. Clin Geriatr Med 1996;12(3):549–561.

    PubMed  CAS  Google Scholar 

  35. Ferrell BR, Rhiner M, Ferrell BA. Development and implementation of a pain education program. Cancer 1993;72(11 suppl):3426–3432.

    Article  PubMed  CAS  Google Scholar 

  36. Rhiner M, Ferrell BR, Ferrell BA, Grant MM. A structured nondrug intervention program for cancer pain. Cancer Pract 1993;1:137–143.

    PubMed  CAS  Google Scholar 

  37. Eisenberg, Kessler RC, Foster C, et al. Unconventional medicine in the United States: prevalence, costs and patterns of use. N Engl J Med 1993;328:246–252.

    Article  PubMed  CAS  Google Scholar 

  38. Ferrell BA. Pain. In: Osterweil D, Brummel-Smith K, Beck JB, eds. Comprehensive Geriatric Assessment. New York: McGraw-Hill, 2000:390.

    Google Scholar 

  39. Jocox A, Car DB, Payne R, et al. Management of Cancer Pain. Clinical Practice Guideline No. 9. AHCPR Publ 94-0592. Rockville, MD: Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Public Health Service; 1994.

    Google Scholar 

  40. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain 1975;1:277–299.

    Article  PubMed  CAS  Google Scholar 

  41. Herr KA, Mobily PR, Kohour FJ, et al. Evaluation of the faces pain scale for use with the elderly. Clin J Pain 1998;14:1–10.

    Article  Google Scholar 

  42. Ferrell BA, Ferrell BR, Rivera L. Pain in cognitively impaired nursing home patients. J Pain Symptom Manage 1995;10:391–598.

    Google Scholar 

  43. Fishman B, Pasternak S, Wallenstein SL, Houde RW, Holland JC, Foley KA. The Memorial Pain Assessment Card: a valid instrument for the evaluation of cancer pain. Cancer 1987;60(5):1151–1158.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Palliative Care Unit, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA

    R. Morgan Bain MD (Assistant Professor and Medical Director)

Authors
  1. R. Morgan Bain MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, 10029, USA

    Rainier P. Soriano MD (Assistant Professor and Director of Medical Student Education), Helen M. Fernandez MD (Assistant Professor and Fellowship Director) & Rosanne M. Leipzig MD, PhD (Professor and Vice Chair of Education) (Assistant Professor and Director of Medical Student Education),  (Assistant Professor and Fellowship Director) &  (Professor and Vice Chair of Education)

  2. ABIM Foundation and American Board of Internal Medicine, Philadelphia, PA, 19106, USA

    Christine K. Cassel MD, MACP (President and CEO) (President and CEO)

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Bain, R.M. (2007). Principles of Pain Management. In: Soriano, R.P., Fernandez, H.M., Cassel, C.K., Leipzig, R.M. (eds) Fundamentals of Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-32326-8_32

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-32326-8_32

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-32324-4

  • Online ISBN: 978-0-387-32326-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation