By P.E. Eldridge

Now largely revised with many new themes, Key subject matters in power ache, moment variation presents up to date info at the administration of continual soreness and the issues linked to it. The systematic layout makes this booklet a great reference resource for professional registrars, GPs, Physiotherapists, Psychologists and nursing employees.

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Inside of mouth. External auditory meatus. 2. Palpation • Surface of head. • Temporal arteries. • Temporomandibular joints for tenderness and clicking on closure, areas of reported tenderness, trigger points or neuromata. • Facial sinuses. Relevant neurological examination • • • • Neuralgias for nerve entrapment causing provocation of pain. Trigeminal sensory testing for deficiency and hyperexcitability. The presence of ‘trigger’ points. Cranial nerves (corneal reflex, visual fields and acuity, ocular movements), hearing, motor power.

ASSESSMENT OF CHRONIC PAIN— PSYCHOSOCIAL Andrew Severn, Barrie Tait Chronic pain is a multifaceted experience and any assessment of it must consider the impact of the pain on the sufferer. To consider it as no more than an injury which has run a longer than usual course is to miss the diagnosis of the disease called chronic pain, or ‘the chronic pain syndrome’. Many conditions may present acutely as minor injuries but symptoms do not resolve spontaneously for a variety of reasons. The pain experience can be described as having five dimensions: • • • • The sensation of pain.

Retroperitoneal fibrosis. Tumour (primary or secondary). Gynaecological pathology. Ankylosing spondylitis. Metabolic bone disease. Infection. Osteoporosis. Paget’s disease. Potts’ disease. Myeloma. Detailed discussion of investigation is beyond the scope of this book, but tests such as erythrocyte sedimentation rate (ESR), blood count, bone biochemistry, lumbar spine and sacroiliac joint X-ray or isotope bone scan can be easily organized in the pain clinic. Some clinics have access to magnetic resonance imaging and computed tomography that will provide more information.

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