Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-16T16:55:49.401Z Has data issue: false hasContentIssue false

Chapter 8 - Musculoskeletal and Neurogenic Pain

from Section 2 - Common Neurologic Presentations: A Symptom-Based Approach

Published online by Cambridge University Press:  10 January 2024

Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
Get access

Summary

Pain is one of the most common presenting complaints in the emergency department (ED), both acute pain and exacerbation of chronic pain syndromes. Acute pain is accompanied by anxiety and sympathetic hyperactivity, whereas chronic pain is often associated with affective symptoms of depression. Nociceptive (musculoskeletal, inflammatory, or somatic) pain involves activation of the peripheral receptors secondary to tissue damage from trauma or heat. Neuropathic pain involves direct activation of either sensory nerves or ganglia by nerve injury or disease. Differentiation between nociceptive and neuropathic pain in the ED can be difficult, but should be considered for successful management of the pain.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahn, UM, Ahn, NU, Buchowski, JM, et al. Cauda equine syndrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes. Spine 2000;25(12):15151522.CrossRefGoogle Scholar
American Society of Anesthesiologists Task Force on Neuroaxial Opioids, Horlocker, TT, Burton, AW, et al. Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration. Anesthesiology 2009;110:218230.Google Scholar
Arnold, PM, Harsh, V, Oliphant, SM. Spinal cord compression secondary to intrathecal catheter-induced granuloma: a report of four cases. Evid Based Spine Care J 2011;2(1):5762.Google Scholar
Baker, K. Chronic pain syndromes in the emergency department: identifying guidelines for management. Emerg Care Australia 2005;17:5764.Google ScholarPubMed
Bauman, BH, McManus, JG. Pediatric pain management in the emergency department. Emerg Med Clin North Am 2005;23:393414.Google Scholar
Dillard, J, Knapp, S. Complementary and alternative pain therapy in the emergency department. Emerg Med Clin North Am 2005;23:529549.Google Scholar
Ducharme, J. The future of pain management in emergency medicine. Emerg Med Clin North Am 2005;23:467475.CrossRefGoogle ScholarPubMed
Fosnocht, DE, Swanson, ER, Barton, E. Changing attitudes about pain and pain control in emergency medicine. Emerg Med Clin North Am 2005;23:297306.Google Scholar
Gilmer-Hill, H, Boggan, JE, Smith, KA, et al. Intrathecal morphine delivered via subcutaneous pump for intrathecal cancer pain: a review of the literature. Surg Neurol 1999;51:1215.Google Scholar
Hansen, G. Management of chronic pain in the acute care setting. Emerg Med Clin North Am 2005;23:307338.Google Scholar
Hassenbusch, S, Burchiel, K, Coffey, RJ, et al. Management of intrathecal catheter-tip inflammatory masses: a consensus statement. Pain Med 2002;3(4):313323.Google Scholar
Lawrence, L. Legal issues in pain management: striking the balance. Emerg Med Clin North Am 2005;23:573584.Google Scholar
Motov, SM, Khan, , Problems and barriers of pain management in the emergency department: are we going to get better? J Pain Res 2009;2:511.Google Scholar
Motov, SM, Marshall, JP. Acute pain management curriculum for emergency medicine residency programs. Acad Emerg Med 2011;18:S87S91.CrossRefGoogle ScholarPubMed
Perrone, J, Mycyk, MB, A challenging crossroads for emergency medicine: the epidemics of pain and pain medication deaths. Acad Emerg Med 2014;21:334336.Google Scholar
Prager, J, Deer, T, Levy, R, et al. Best practices for intrathecal drug delivery for pain. Neuromodulation 2014;17:354372.Google Scholar
Richards, C. Establishing an emergency department pain management system. Emerg Med Clin North Am 2005;23:519527.Google Scholar
Ross, JC, Cook, AM, Steward, GL, et al. Acute intrathecal baclofen withdrawal: a brief report of treatment options. Neurocrit Care 2011;14(1):103108.CrossRefGoogle ScholarPubMed
Santana, L, Quintero, M. Management baclofen withdrawal syndrome. Rev Columb Anesthesiol 2012;40(2):158161.Google Scholar
Smith, HS, Deer, TR, Staats, PS, et al. Intrathecal drug delivery. Pain Phys 2008;11:S89S104.CrossRefGoogle ScholarPubMed
Thomas, S. Management of pain in the emergency department. ISRN Emerg Med 2013;23:119.CrossRefGoogle Scholar
Todd, K. Treating chronic pain patients in the emergency department. ACEP News, 2008.CrossRefGoogle Scholar
Tomycz, ND, Ortiz, V, McFadden, KM, et al. Management of symptomatic intrathecal catheter-associated masses. Clin Neurol Neurosurg 2012;114(2):190195.Google Scholar
Venkat, A, Fromm, C, Isaacs, E, Ibarra, J. An ethical framework for the management of pain in the emergency department. Acad Emerg Med 2013;20:716723.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×