The Pain Processing Pathways

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

Statement of Need
The task of health care is to preserve and restore health and relieve suffering. An understanding of all aspects of pain is essential for both of these goals. Because pain is universally recognized as a signal of disease, it is the most common symptom that brings patients into the health care system. Physicians, nurses and pharmacists need to understand the mechanism of pain to appropriately manage patients with pain. This slide presentation provides an overview of pain definitions, a brief history of concepts of pain perception, the physiological and pathophysiological processes of nociception, as well as the processes of pain perception through the spinal cord and brain. This slide set will also discuss neurochemistry and neurotransmission of pain.

Intended Audience
This program is intended for physicians, nurses, clinical pharmacists, and other associated healthcare professionals who care for patients experiencing acute or chronic pain.

Learning Objectives
Upon completion of this activity, the participant should be able to:

1. State the definition of pain.
2. Review the history of concepts of pain perception.
3. Describe four events leading to pain perception.
4. Discuss nociceptor activation in the body.
5. Identify three fiber types in a typical sensory nerve.
6. Discuss nerve impulse transmissions.
7. Describe classes of transmitter compounds and their action.
8. Discuss classes of nerve transmitters and their effects on pain perception.

Accreditation Statement:
The Dannemiller Memorial Educational Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physicians
The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s).^TM Each physician should claim only those credits that he/she actually spent in the activity.

Nursing
The Dannemiller Memorial Educational Foundation is an approved provider of the California Board of Registered Nursing. Provider approved by the California Board of Registered Nursing, Provider Number 4229 for 1.8 contact hours.

RNs outside California must verify with their licensing agency for approval of this course.

Method of participation:
The activity should take approximately 1.5 hours to complete with 95 minutes of recorded material. The participant should, in order, read the objectives and other introductory CME information, review the slides and listen to the accompanying audio, complete the registration form, post-test, and evaluation form. To access the registration form and post-test, click on the "CME Post-Test" button on the final slide in the presentation. To receive credit for this activity, follow the instructions provided on the post-test. This credit is valid through December 31, 2009. No credit will be given after this date. There is no fee associated with this CME activity.

In the event you are unable to print the certificate, please submit the post-test and then e-mail editor@dannemiller.com; a certificate will be mailed within 2 weeks.

Faculty disclosure
In accordance with the Accreditation Council for Continuing Medical Education (ACCME), the Dannemiller Memorial Educational Foundation 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, MD has indicated that he has no financial relationships that impact on this activity.

To resolve identified conflicts of interest, the educational content was fully reviewed by a physician member of the Dannemiller Clinical Content Review Committee who has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence based and commercially balanced.

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, 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 contents and views presented in this educational activity are those of the authors and do not necessarily reflect those of the Dannemiller Memorial Educational Foundation or Purdue Pharma, LP. 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.

For questions regarding the content of this activity and technical assistance, contact Dannemiller Memorial Educational Foundation, accredited provider for this CME activity, at editor@dannemiller.com.