PAIN IN PERSPECTIVE Edited by Subhamay Ghosh Pain in Perspective http://dx.doi.org/10.5772/2627 Edited by Subhamay Ghosh Contributors Subhamay Ghosh, Jørgen Riis Jepsen, David M. Hallman, Eugene Lyskov, David McBride, Helen Harcombe, Ayse Ozcan Edeer, Hulya Tuna, Julio José Contreras Fernández, Rodrigo Liendo Verdugo, Matías Osorio Feito, Francisco Soza Rex, Mario Pribicevic, Sherif Hosny, W. McClatchie, Nidhi Sofat, Caroline B. Hing, Longinus N. Ebirim, Omiepirisa Yvonne Buowari, Subhamay Ghosh, Kenji Sato, Satoshi Fukumori, Kantaro Miyake, Daniel Obata, Akio Gofuku, Kiyoshi Morita Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Vedran Greblo Typesetting InTech Prepress, Novi Sad Cover InTech Design Team First published October, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Pain in Perspective, Edited by Subhamay Ghosh p. cm. ISBN 978-953-51-0807-8 Contents Preface IX Chapter 1 Introduction to Pain, Religion and Analgesia 1 Subhamay Ghosh Chapter 2 Work-Related Upper Limb Pain and Its Diagnosis: Contribution from the Neurological Examination 11 Jørgen Riis Jepsen Chapter 3 Autonomic Regulation in Musculoskeletal Pain 35 David M. Hallman and Eugene Lyskov Chapter 4 Work Related Musculoskeletal Pain and It’s Management 63 David McBride and Helen Harcombe Chapter 5 Management of Chronic Musculoskeletal Pain in the Elderly: Dilemmas and Remedies 93 Ayse Ozcan Edeer and Hulya Tuna Chapter 6 Shoulder Pain in Swimmers 119 Julio José Contreras Fernández, Rodrigo Liendo Verdugo, Matías Osorio Feito and Francisco Soza Rex Chapter 7 The Epidemiology of Shoulder Pain: A Narrative Review of the Literature 147 Mario Pribicevic Chapter 8 Knee Pain in Adults & Adolescents, Diagnosis and Treatment 187 Sherif Hosny, W. McClatchie, Nidhi Sofat and Caroline B. Hing Chapter 9 Physical and Psychological Aspects of Pain in Obstetrics 219 Longinus N. Ebirim, Omiepirisa Yvonne Buowari and Subhamay Ghosh VI Contents Chapter 10 A Novel Application of Virtual Reality for Pain Control: Virtual Reality-Mirror Visual Feedback Therapy 237 Kenji Sato, Satoshi Fukumori, Kantaro Miyake, Daniel Obata, Akio Gofuku and Kiyoshi Morita Preface I admit it is a painful climb, but the pain of it is a positive pleasure for me. Each step upward makes me feel stronger and fit for the next. Mahatma Gandhi Pain has been there since man has existed and whatever the method or technique of its relief, if successful will always lead to a special place in the heart of the person receiving it and also to the person delivering it. ‘Pain in Perspective’ takes us into a journey of how it all began and then leads us to understand the various concepts of pain relief today. From musculoskeletal pain to complex shoulder pain and from neurological examination to charting out pain, this book describes new ideas and latest descriptions of pain concepts and their treatment. The origin and genesis of this work evolves from my work as an anaesthetist and daily encounters with pain in individuals. It is very difficult to put down in words the painful experiences patients go through during their stay at hospitals or at home. Equally difficult is the depiction of euphoria upon relief of pain and all the unpleasant experiences surrounding it. The purpose of this book is to describe some areas, if not several, of acute and chronic pain and methods to alleviate it with modern ideas and latest concepts. Since pain is not restricted to any particular sub-specialty or group, this book is targeted to medical students, nursing staff, general practitioners, specialists like anaesthetists, surgeons and residents of all specialties. ‘Pain in Perspective’ has taken over a year to collect, combine and refine all the chapters. The resources used for this book have been latest articles published in peer reviewed journals and easily accessible on pubmed and other medical databases. I advise readers to brush up the very basic concepts of biology, physiology and anatomy before reading this book. Writing this book has given me more insight into pain and has chiselled several corners to allow me to see several ideas about pain that I had not dealt with earlier. It has definitely taken me closer to understanding my patients both professionally and psychologically. X Preface I remember an incident while writing the book and I believe sharing it would be beneficial to our readers. During the early stages of writing my chapter, my two year old daughter came running to me that she had bruised her hand and that she was in pain. I could not see any swelling, laceration, cut or any sign of injury. I took her hand and caressed it and put a wet cloth over it. She smiled and said that it didn’t hurt anymore. I hope ‘Pain in Perspective’ will give our readers the same energy and joy in reading that it has given us as authors of this book in writing it. I would like to thank all the authors for their dedication and hard work in completing this book and to the publishing team to help us publish our works. As a special note of gratitude, I would like to thank my wife Boglarka, my daughter Sarolta and my son Samrat for their support, patience, love and understanding which was my motivation for this book. Subhamay Ghosh Anaesthetics and Intensive Care Kettering General Hospital University of Leicester, UK [...]... something you hated in the past Pleasure and pain, likes and dislikes, these are just notions of the mind They appear and disappear They are impermanent Even heat and cold are just notions of the mind Introduction to Pain, Religion and Analgesia 3 Buddhism explains pain in a deeper perspective by saying that ‘Life is a suffering’ and that Pain and suffering is caused by attachment’ Pain in Buddhism refers... acceptance of pain and suffering as the just working of karma- ones actions in this life or reincarnation as seen in Hinduism and Buddhism By accepting one’s condition, one becomes less attached to changing or altering it Acceptance of pain and detachment from any struggle with the experience of pain means that painful or pain- free states would be accepted equally Detachment from this world, in order to... Suffering and pain refines us We can read in Isaiah 48:10 that "…I have refined you, though not as silver; I have tested you in the furnace of affliction." The meaning of this verse makes it clear that pain and suffering have a way of bringing our strengths and weaknesses to the surface Pain and Suffering produces growth and maturity (James 1:2-4] If we turn toward God in our pain, He can use our suffering... nation [19] Assessment of quality of pain incorporates measuring many dimensions including physiological endpoints, adverse events and psychosocial status The increasing interest in evaluating quality of pain reflects the overall increased interest in patient-focused assessments Unlike the traditional outcomes focusing on morbidity, mortality, quality of recovery from pain assesses other non-traditional... Chapter 1 Introduction to Pain, Religion and Analgesia Subhamay Ghosh Additional information is available at the end of the chapter http://dx.doi.org/10.5772/53922 1 Introduction 1.1 Early history of pain Human beings have always pondered and tried to understand why they feel pain and how to reduce it In the past, pain and disease were thought to be consequences of human wrong doing Whether pain is an independent... brain and changed the idea of pain altogether and paved the way to newer concepts 2 Religious concepts of pain Treating patients clinically with significant pain can be extremely difficult Medicine provides incomplete pain relief for many patients and a significant percentage of them remain in moderate to severe pain, and their lives are drastically changed in areas including relationships, work, and... behind it and only then is it possible to specifically target the source of the pain stimulus The several concepts of evaluating and understanding pain are described in the chapters to follow Here we shall outline the common mediators involved in the mechanism of pain and some of its treatment options Pain and inflammatory stimuli result in a series of diverse effects as seen in figures 1 and 2, including... the bundle of my pains? The whole world is overflowing with pain and suffering" and also "Wherever I look, I see loads of pain and suffering." So, across the whole of the globe, pain and suffering are a major part of life which all who have to traverse through this human existence will have to endure to a lesser or greater extend In Jainism, pain and violence refer primarily to injuring one's own self,... reached the brain [9] This theory changed the perception of pain from a spiritual, mystical experience to a physical, mechanical sensation meaning that a cure for such pain could be found by researching and locating pain fibres within the body rather than a religious view of linking it to the power of God This also moved the centre of pain sensation and perception from the heart to the brain and changed... this pain is following the eightfold path and meditation In Islam, the views of pain and suffering resemble those held by its sister faiths, Judaism and Christianity Pain is either the result of sin, or it is a test meaning that a true Muslim will remain faithful through the trials of life Pain and suffering also reveals the hidden self to God and is a way so that God may see who is truly righteous by . PAIN IN PERSPECTIVE Edited by Subhamay Ghosh Pain in Perspective http://dx.doi.org/10.5772/2627 Edited by Subhamay Ghosh . Buddhism explains pain in a deeper perspective by saying that ‘Life is a suffering’ and that Pain and suffering is caused by attachment’. Pain in Buddhism