The Primary ( ) and Final ( ) FRCA examinations require an extensive knowledge of chronic pain management. We have therefore written a new educational resource section on this topic. The tutorials have been tailored to the FRCA syllabus and we have also added some past questions relevant to these topics.
Read other sections by using the navigation bar on the right side of every page.
Primary FRCA Syllabus
Physiology and Biochemistry
Pain: afferent nociceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms, visceral pain, neuropathic pain… influence of therapy on nociceptive mechanisms…
Q. Primary Viva Question
Describe the principles of management of neuropathic pain
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Final FRCA Syllabus
Pain management
A detailed knowledge of the control of acute pain in the context of postoperative and post-traumatic conditions will be expected, as will an understanding of the principles of chronic pain management in the pain clinic setting.
Anatomy, physiology, pharmacology and basic psychology relevant to pain management
Assessment and measurement of acute pain - including special problems with children, the elderly and patients who are unconscious or in intensive care
Assessment of patients with chronic pain and pain in patients with cancer
Use of medication for pain management; conventional analgesics and adjuvant analgesics; side-effects; problems of drug dependency and addiction
The role of and indications for neural blockade:
Peripheral nerve, plexus, epidural and subarachnoid blocks, techniques of sympathetic blockade, neurolytic agents and procedures, implanted catheters and pumps for drug delivery
Stimulation produced analgesia including transcutaneous techniques and acupuncture
Other treatment modalities:
Physical therapy, surgery, psychological approaches, rehabilitation approaches, pain management programmes Symptom control in terminal illness The organisation of pain management services Principles and ethics of pain research... 
Q. Final Viva Question You are consulted on the management of a 45-year-old woman with invasive cervical carcinoma whose pain is not controlled by oral or parenteral narcotics. What are the therapeutic options? What are the side-effects of these options? How will you manage the side-effects?
A 56-year-old man is referred to your pain clinic because of persistent phantom limb pain 3 weeks after a mid-thigh amputation. What is your management?
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