An Intensive Review of Pain Management

Released May 2010

Expiration Date May 30, 2012*

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An Intensive Review of Pain Management on DVD ROM provides a comprehensive review of pain and pain management. This superb educational activity allows the user to earn valuable CME/CE credit while enhancing the user's ability to recognize, evaluate, and treat the patient with chronic pain. This course is intended to present the pain management specialist and other healthcare providers who treat patients in pain with an overview of the diagnosis and the comprehensive treatment of a wide range of painful disorders. This program contains 52 lectures from 11 renowned pain experts offering Category 1 CME credits for physicians and CE credits for nurses. CME/CE certificates are provided through an Internet link allowing the user to complete a posttest as well as an evaluation and print certificates directly from a computer. Individual transcripts of completed lectures are kept to allow users to print additional certificates.

Syllabus: An Intensive Review of Pain Management

This syllabus contains the slides from the 2009 Pain Review Course presented in Chicago, Illinois, in August 2009. While this syllabus is not available for credit, it is informative and captures the highlights of the course itself. For those who attended, it provides an invaluable overview of the course and a good way to help keep the content fresh in your mind; for those who weren't able to attend, the syllabus may help you decide whether you want to go ahead and purchase the DVD set for the credits you need while giving you an overview of current trends in pain management.

Method of Participation

The healthcare provider who purchases this product (DVD ROM) will be considered the Registered Owner of the Program. Only registered owners may obtain CME/CE credit for completion of the activities included in this program. To receive CME/CE credit for completed lectures, you must enter your individual User ID when you access the online Post Test and Evaluation Website. Please ensure that you protect this password.

Your individual password was provided with your welcome letter when you ordered this material.

This activity contains 52 lectures with audio and slides. The participant should:

  1. Read the learning objectives and other CME information.
  2. Select a topic from the table of contents.
  3. Listen to the audio while viewing the slides.
  4. Take the post-test after each lecture.
  5. The participant must answer 80% of the questions correctly in order to receive credit.
  6. Complete the evaluation: Participants who complete the post-test and evaluation will be issued a certificate, which may be printed at your location. No additional certificate will be mailed. If you have any questions, you may contact Dannemiller at editor@dannemiller.com or by calling 800-328-2308.
  7. *No credit will be given after May 30, 2012.

Statement of Need

Dannemiller is an organization dedicated to the presentation of postgraduate education courses for the purpose of update and review of all areas in the specialties of anesthesia and pain management. For more than a decade, Dannemiller has sponsored numerous CME activities in the area of pain management. As a result of this experience, Dannemiller has had the opportunity to recruit the experts from all of the disciplines involved in pain management. Through evaluation of the Outcomes Studies Reports of previously sponsored activities, which incorporated feedback from both attendees and experts, Dannemiller has carefully planned this CME activity to provide information that will enhance the attendee's ability to recognize, evaluate, and treat the patient with chronic pain.

Faculty

Bernard M. Abrams, M.D.
Clinical Professor of Neurology, University of Missouri School of Medicine at Kansas City, Kansas City, Missouri

Jennifer E. Bolen, J.D.
The Legal Side of Pain, A Division of the J. Bolen Group, LLC, Knoxville, Tennessee

Kenneth D. Candido, M.D
Professor and Chair, Department of Anesthesiology, Illinois Masonic Medical Center, Chicago, Illinois

Daniel M. Doleys, Ph.D.
Program Director, Pain and Rehabilitation Institute at Montclair, Birmingham, Alabama

F. Michael Ferrante, M.D., FABPM
Professor of Clinical Anesthesiology and Medicine, David Geffen School of Medicine at UCLA; Director, UCLA Pain and Spine Care, Los Angeles, California

Maunak Rana, M.D.
Assistant Professor of Anesthesiology, Division of Pain Management, Loyola University Health System, Maywood, Illinois

Oren Sagher, M.D.
Associate Professor of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan

Steven M. Simon, M.D., R.Ph
Clinical Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center; Clinical Assistant Professor, Kansas City University of Medicine and Biosciences, Department of Family Practice, Kansas City, Missouri

Matthew T. Walker, M.D.
Chief of Neuroradiology, Associate Professor of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

Edward A (Ted) Yaghmour, M.D.
Assistant Professor of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

Tony L. Yaksh, Ph.D.
Professor of Anesthesiology and Pharmacology and Vice Chairman for Research, Department of Anesthesiology, University of California, San Diego, La Jolla, California

Purpose

This course is intended to present the pain management specialist and other healthcare providers who treat patients in pain with an overview of the diagnosis and the comprehensive treatment of a wide range of painful disorders. Areas covered include:

Course Objectives

After attending this review course, participants should be able to:

  1. Identify painful entities, both regional and generalized, and their anatomical and pathophysiological basis for diagnosis and treatment.
  2. Develop strategies for pharmacological intervention in pain states based on sound pharmacological principles.
  3. Explain the anatomical and physiological basis of painful states and their management.
  4. Describe the place of interventional pain management procedures in pain management based on evidence-based medicine.
  5. Describe the ethical and legal requirements for undertaking pain management.

Target Audience

This activity is intended for pain medicine specialists and pain physicians preparing for certification or recertification in Pain Medicine. This activity is also intended for primary care physicians, nurse practitioners, and other allied health care professionals interested in expanding their knowledge and improving their practice in pain medicine. Accreditation Statement Dannemiller is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physicians

Dannemiller designates this enduring activity for a maximum of 52 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Registered Nurses

Dannemiller is a provider approved by the California Board of Registered Nursing, Provider Number 4229 for 62.5 contact hours.

Disclosures

In accordance with the Accreditation Council for Continuing Medical Education (ACCME), Dannemiller requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest. Accordingly:

Bernard M. Abrams, M.D. - has indicated no financial interest or other relationship with commercial interests.

Jennifer E. Bolen, J.D. - is on the speakers' bureau for: King Pharmaceuticals; Calloway Labs; Cephalon; Purdue Pharma; PriCara; Millenium Labs; Avee Labs; and Streamline MD. Ms. Bolen is a consultant/advisory board member for King Pharmaceuticals; Cephalon; PriCara; Abbott; Calloway Labs; Millenium Labs; Avee Labs; and Streamline MD. She also reports being a stockholder in King Pharmaceuticals and Abbott. Ms. Bolen is Special Counsel to the American Academy of Pain Medicine.

Kenneth D. Candido, M.D. - is on the speakers' bureau for Sonosite and Pfizer.

Daniel M. Doleys, Ph.D. - is on the speakers' bureau for Medtronic.

F. Michael Ferrante, M.D., FABPM - is on the speakers' bureau for Medtronic and Allergan; is a consultant for Medtronic and Allergan; is an investigator for Medtronic and Allergan.

Maunak Rana, M.D. -is stockholder at St. Jude Medical and Medtronic.

Oren Sagher, M.D. - is an investigator for Medtronic.

Steven Simon, M.D., RPh. - is on the speakers' bureau for Pfizer, Lilly, Cephalon, Accorda, King, Victory, Meda; is an investigator for Pfizer and Cephalon.

Matthew T. Walker, M.D. - has indicated no financial interest or other relationship with commercial interests.

Edward A. Yaghmour, M.D. - has indicated no financial interest or other relationship with commercial interests.

Tony L. Yaksh, Ph.D. - is an investigator for Solace, Ironwood, Sepractor, Vistagen, Isis, Xenone, Inset, and Pfizer; is consultant for Solace, Xenome, Inset, and Pfizer; is on speakers' bureau for Inset; and Stockholder for Solace.

Dannemiller staff and all others involved in the development of this activity have no financial relationships with commercial interests. To resolve identified conflicts of interest of the faculty, the proposed educational content was fully reviewed by the Program Director, Bernard M. Abrams, M.D., Clinical Professor of Neurology, University of Missouri, School of Medicine at Kansas City, Kansas City, Missouri. Dr. Abrams has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence-based and free of commercial bias.

Off Label Statement

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

Disclaimer

The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Dannemiller. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

Table of Contents

Bernard M. Abrams, MD
Clinical Professor of Neurology, University of Missouri School of Medicine at Kansas City, Kansas City, Missouri

  1. Central Pain States: Diagnosis and Management
    a. Review central pain states.
  2. Specific Neuromuscular Syndromes
    a. Review the diagnosis and treatment of common and uncommon neuromuscular entities.
  3. Antidepressants and Anticonvulsants
    a. Review the pharmacology, indications, patient selection and side effects of anticonvulsants and antidepressants.
  4. Clinical Neurophysiology: Relevance to Pain Diagnosis
    a. Review clinical neurophysiology of relevance to pain patients and their diagnosis.
  5. Facial Pain Syndromes
    a. Review the mechanisms, classification, diagnosing and treatment of chronic facial pain.
  6. Headaches: Review of Mechanisms, Classification, Management and Treatment
    a. Review the mechanisms, classification, management, and treatment of the headache patient.

Jennifer E. Bolen, J.D
The Legal Side of Pain, A Division of the J. Bolen Group, LLC, Knoxville, Tennessee

  1. Ethical Issues in Pain Management
    a. Review the ethics pertaining to pain management including hospice care.
  2. Laws Impacting the Prescribing of Controlled Substances
    a. Review federal and state regulatory materials on the use of controlled substances to treat pain.
    b. Provide a general framework for the body of legal material impacting the use of controlled substances in the United States.
    c. Describe how these laws impact prescribing for pain management.
  3. Proper Prescribing Basics
    a. Review the legal regulations in pain management concerning controlled substances, record keeping, and outcome measures.

Kenneth D. Candido, MD
Professor and Chair, Department of Anesthesiology, Illinois Masonic Medical Center, Chicago, Illinois

  1. Nociceptive Pain
    a. Review the diagnosis and management of the patient with acute nociceptive pain.
  2. Sympathetic Nervous System Related Pain
    a. Review the diagnosing and treatment of sympathetic pain.
  3. Trauma Pain Management
    a. Review the pain management of the trauma/surgical patient.
  4. Pelvic Pain: Diagnosis and Management I and II
    a. Review the diagnosing and management of pelvic pain.
  5. Pharmacology and Clinical Use of Steroids in the Management of Pain
    a. Review the usage of steroids in the treatment of pain.
  6. Upper Extremity Blocks for Managing Pain of the Upper Limb
    a. Review the use of regional nerve blocks in pain management.
  7. Lower Extremity Regional Blocks for Lower Extremity Surgery
    a. Review the use of regional nerve blocks in pain management.
  8. Nerve Blocks for Pain of the Head and Neck
    a. Review the different nerve blocks for head and neck pain.
  9. Spinal and Epidural Blocks
    a. Review the epidural and subarachnoid injections for pain relief.

Daniel M. Doleys, Ph.D.
Program Director, Pain and Rehabilitation Institute at Montclair, Birmingham, Alabama

  1. Psychological Assessment of Pain
    a. Review the assessment tools used to measure pain and pain relief in the pain patient.
  2. "Psychogenic" Pain: Clinical Diagnosis…OR DSM and Pain
    a. Review the clinical diagnosis of psychogenic pain in the management of the pain patient.
  3. Psychological Treatment of Pain
    a. Review the psychological treatment of pain.

F. Michael Ferrante, MD, FABPM
Professor of Clinical Anesthesiology and Medicine, David Geffen School of Medicine at UCLA; Director, UCLA Pain and Spine Care, Los Angeles, California

  1. Anatomy of the Spine
    a. Review the anatomy of the spine.
  2. Interventional Spine Medicine
    a. Review the anatomy, diagnosis and treatment of chronic neck and back pain.
  3. Cancer Pain and Symptom Management
    a. Review pain and symptom management for cancer pain patients.
  4. Fluoroscopy and Radiation Safety
    a. Review fluoroscopy and radiation safety.
  5. Neuropathic Pain: Diagnosis and Management
    a. Review the diagnosis and management of a patient with neuropathic pain.
  6. Pain in the ICU
    a. Review of pain in the ICU.
  7. Painful Medical Conditions
    a. Review painful medical conditions
  8. Anatomy of the Thorax and Abdomen
    a. Review the anatomy of the thorax and abdomen.
  9. Painful Conditions: Thorax and Abdomen
    a. Review the clinical diagnosis and treatment of the thoracic and abdominal pain patient.
  10. Intraspinal Analgesic Pharmacology
    a. Review the pharmacology of intraspinal analgesics.
  11. Neurolysis: Chemical, Cryoanalgesia and Radiofrequency in Pain Management
    a. Review the neurolytic agents and techniques along with the complications in the use of neurolysis in pain management.
  12. Opioid Pharmacology
    a. Review the use of opioids in the pain patient.
  13. NSAID Pharmacology
    a. Review the use of NSAIDs in pain management.

Maunak Rana, MD
Assistant Professor of Anesthesiology, Division of Pain Management, Loyola University Health System, Maywood, Illinois

  1. Pediatric Pain Management
    a. Review appropriate pain management in children.
  2. Geriatric Pain Management
    a. Review the management of geriatric pain.

Oren Sagher, MD
Associate Professor of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan

  1. Discectomy and Minimally Invasive Spine Surgery
    a. Review indications, contraindications and risks of invasive spine surgery
  2. Neuromodulation
    a. Review neuromodulatory techniques regarding pain patients.
  3. Overview of Neurosurgical Invasive Techniques
    a. Review neurosurgical approaches to pain relief in the pain patient.

Steven M. Simon, MD, R.Ph
Clinical Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center; Clinical Assistant Professor, Kansas City University of Medicine and Biosciences, Department of Family Practice, Kansas City, Missouri

  1. Anatomy of the Upper and Lower Extremities
    a. Review the anatomy of the upper and lower extremities.
  2. Extremity Pain: Clinical Diagnosis and Treatment
    a. Review the diagnosis and treatment of extremity pain in pain management.
  3. The Concepts of Function, Impairment, Disability and Handicap
    a. Review the concept of function impairment disability and handicap.
  4. Rehabilitation Medicine Including Soft Tissue Injections and Modalities I & II
    a. Review rehabilitation medicine in the pain patient including soft tissue injections and also other treatment modalities.
  5. Complementary and Alternative Medicine
    a. Discuss multidisciplinary/alternative therapies in the management of chronic pain: Acupuncture, Chiropractic, Herbals and other modalities.

Matthew T. Walker, MD
Chief of Neuroradiology, Associate Professor of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

  1. Imaging: Radiological Approaches to Pain Diagnosis Part I (X-ray & CT)
    a. Review the radiological approaches to pain diagnosis.
  2. Radiological Approaches to Pain Diagnosis Part II (MRI)
    a. Review the radiological approaches to pain diagnosis.

Edward A. (Ted) Yaghmour, MD
Assistant Professor of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

  1. Obstetric Pain Management
    a. Review pain management on the obstetrical patient.
  2. Special Concerns in Pregnancy and Lactation in the Management of Pain
    a. Review pain management in the pregnant patient with special concerns.

Tony L. Yaksh, Ph.D.
Professor of Anesthesiology and Pharmacology and Vice Chairman for Research, Department of Anesthesiology, University of California, San Diego, La Jolla, California

  1. Biology of Pain Processing
    a. Review the organizational anatomy of pain pathways.
  2. Physiology and Pharmacology of Post Tissue Injury Processing
    a. Review the post tissue injury pain state.
  3. Mechanisms of Neuropathic Pain
    a. Review the neuropathic pain states.
  4. Pharmacology of (some) Analgesic Drugs
    a. Review the pharmacology of opioid and non analgesics.

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