(A) Anatomy and Physiology

Peripheral Mechanism

Central Mechanism

Pain Modulation

Pain Measurement

(B) Pharmacology of pain transmission and modulation

Peripheral Mechanism

Synaptic transmission in dorsal horn

Central sensitization

Neurotransmitters in pain modulation

(C) Psychosocial aspect of pain

Definition and measurement of pain

Individual differences

Behavioral processes

Emotional problem and psychiatric disorders associated with pain

(D) General principles of pain evaluation

Diagnosis; Clinical History Patient Examination , Investigation: Interpretation in reference to various Pain Syndromes:

PCR (Tuberculosis)/ Anti–ccp / HLA B-27

Radiological: X-Ray, MRI,CT, CT angio, Bone Scan, BMD/DEXA

Neurological:NCV/ H-Reflex

Plethysmography

(E) Drug treatment
*Analgesics,* NSAID,* Antidepressant, anticonvulsant and miscellaneous agents :

Narcotics Morphine, Oxycodone, Hydromorphone, buprenorphine, Methadone, Tramadol,Fentanyl

Adjuvants: TCA, SSRI , Dothiapine, Milcipram, Duloxitine, Gabapentine, pregabalin

Bisphonates, Calcitonin, Parath. Hormone

Neurotropic / Vitamin: Methocobalamine, Vit E, Vit D, Folic Acid

Musle relaxanats: Baclof

Miscellaneous: L-Carnitine, Botulinum Toxin, Hylaronate, Synvis one

Anti rheumatoid(DMRD): Lefrunomide, Shalazopyrin,Methotrexate,

Biologicals, Steroid

Neurolytic Drugs: Alcohol, Phenol, Chlorocresol, Hypertonic Saline, anhydrous Glycerol, Ozone , RadioFrequency(Auto/ Pulse) , CryoLesion

Anti Tubercular Drugs

(F) Aetiopathogenesis,
clinical history, Examination, Diagnosis , D/D, Management , complications and Follow Up of following Pain Syndromes:

Headache/ Migraine/ Trigeminal Neuralgia

Discogenic Pain / IDD( Intradisclal Disc Disruption)

Lumbar Canal Stenosis(LCS)

Facet Joint Arthropathy, Kochs Spine, Discitis (tubercular/ Pyogenic))

Osteoarthritis,Osteoporosis,Ankylosing Spondylitis,Rheumatoid Arthritis

Sacroilitis,Coccidynia

Urogenital Pain Syndromes

Lowbackache

Neuropathic Pain

Complex Regional Pain Syndromes(CRPS)

Management of Cancer Pain:

Magnitude of problem, Aetio pathogenesis, Clinical presentation, Diagnosis and Management of Cancer Pain

Medication: NSAID, Narcotics( Morphine,Codiene, Tramadol,Oxycodone,Hydrmorphone,Methadone,Fentanyl( Patch/Nebulised)

Adjuvants

WHO Analgesic Ladder / WHO Cancer Pain relief Programme

Neuroablative Procedures

Vertebroplasty

Percutaneous Chordotomy

Intrathecal/ Epidural Infusion Device

(G) Non surgical neuroaugmentative technique

Stimulation techniques

TENS

Acupuncture

Vibration

Nerve blocks

Surgical approaches

Physical medicine and rehabilitation

Psychiatric and Psychological treatments

Multidisciplinary management

Spinal Cord Stimulation

(H) Interventional pain medine

Radiofrequency (RF) Ablation technique

Gasserian Ganglion RF Lesion

Balloon Compression of Trigeminal Ganglion

Cervical Discectomy ( Ozone/ RF)/ MBB RF lesion

Stellate Ganglion RF lesion

Celiac Plexus Block ( Trans Discal/ Trans Aortic

Splanchnic Nerve RF lesion

Supra scapular RF lesion

RF Discectomy/ Nucleotomy(APLD)

Medial branch RF lesion

Sacroiliac Inj., Ganglion impar RF lesion

Superior Hypo gastric Plexus Block( Trans Discal)

Post-operative pain – PCA/PCEA

Endoscopic Pain Medicine

Pain in children

Obstetric analgesia

Physiotherapy

Psychotherapy, Counselling

Hypnotherapy, Yoga

Stem Cell Therapy/ Genetic Basis of Pain

Ethical aspect of pain medicine

Euthanesia

Research( Pain medicine)

Palliative Care: Cancer/ AIDS/ Motor Neurone Disease:

Cancer Pain: Prevalence , magnitude of problem , current status , WHO cancer Pain Relief Programme

Definition , essentials of Palliative Care

Physical aspect

Disease process

Symptom control: Pain, Anxiety, depression, anorexia, asthenia, Lymphoedema, ascites

Pharmacological management of cancer pain

Management of terminally ill patients- last 24 hours

Family and social background

Communication skills, breavement

Religious and cultural aspects

Ethical aspect

Team work

Organizational aspect: Home, Hospice and Hospital based Palliative care

Research in Palliative care

Training and teaching schedule:

Clinical training:

Candidates will be posted 3 days in OPD (Tuesday, Wednesday, Friday) and three days in PainOT( Monday, Thursday, Saturday)

Ward teaching

Seminar, Journal Club, Case presentation, Clinical Audit

Lectures by Faculty / Sister departments

Neurology

Radiology

Psychiatry

Physiotherapy

Log Book

(I)LIST of Books Recommended

Pain Medicine & Regional Anesthesia- Benzon

Chronic Pain- Mareus

Pain Medicine- Requisite in Anesthesiology; Stephen E Abram

Bonica Management of Pain; Third Edition; Lippincotts, William & Wilkins

The Management of Chronic Pain; A W Diamond; IInd Edition; Oxford University Press

Image Guided Pain Medicine; Sebastian Thomas; Lippincott-Raven

The Treatment of Chronic Pain; F Dudley Hart

Waldman’s Atlas of Uncommon Pain Syndrome; Saunders

Pain Procedures of Clinical Practice; Luinardd; IInd Edition

Principals & Practice of Regional Anesthesia; IIIrd Edition; J A W Wild smith; Churchill Livingstone

Regional Anesthesia- An Illustrated Procedural Guide; IIIrd Edition; Michael F Mulray; Lippincotts, William & Wilkins

Textbook of Pain; IVth Edition; Wall & Melzack; Churchill Livingstone

Textbook of Pain; IIIrd Edition; Wall & Melzack; Churchill Livingstone

The Pain System; Wiliams & Willis; Karger

Prithviraj Practical management of Pain; P Prithviraj; IIIrd Edition;

Chronic Pain; Benzamin L Crue; S P Medical & Scientific Books

Advances in Pain Research & Therapy; Vol.-1; John J Bonika; Raven Presss

The Physiology of Pain; Richard A Steinbach; Raven Press

Interventional Pain Medicine; Steven D Waldman

OXFORD Textbook of Palliative Medicine; by Derek Doyle; Oxford Medical Publication

Textbook of Pain Medicine; IInd Edition; by Murlidhar Joshi; Joshi Institute of Pain

Radiographic Imaging for Regional Anesthesia and Pain Medicine; by P Prithviraj; Churchill Livingstone

(J)Journals

Pain-Official Journal of International Association for Study of Pain

Indian Journal of Pain, Indian Journal of Palliative Care