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Chronic intractible pain

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https://www.readbyqxmd.com/read/28527055/cluster-headache-present-and-future-therapy
#1
Massimo Leone, Alessandro Giustiniani, Alberto Proietti Cecchini
Cluster headache is characterized by severe, unilateral headache attacks of orbital, supraorbital or temporal pain lasting 15-180 min accompanied by ipsilateral lacrimation, rhinorrhea and other cranial autonomic manifestations. Cluster headache attacks need fast-acting abortive agents because the pain peaks very quickly; sumatriptan injection is the gold standard acute treatment. First-line preventative drugs include verapamil and carbolithium. Other drugs demonstrated effective in open trials include topiramate, valproic acid, gabapentin and others...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28522185/orofacial-complex-regional-pain-syndrome-pathophysiologic-mechanisms-and-functional-mri
#2
Yeon-Hee Lee, Kyung Mi Lee, Hyug-Gi Kim, Soo-Kyung Kang, Q-Schick Auh, Jyung-Pyo Hong, Yang-Hyun Chun
Complex regional pain syndrome (CRPS) is one of the most challenging chronic pain conditions and is characterized by burning pain, allodynia, hyperalgesia, autonomic changes, trophic changes, edema, and functional loss involving mainly the extremities. Until recently, very few reports have been published concerning CRPS involving the orofacial area. We report on a 50-year-old female patient who presented with unbearable pain in all of her teeth and hypersensitivity of the facial skin. She also reported intractable pain in both extremities accompanied by temperature changes and orofacial pain that increased when the other pains were aggravated...
March 14, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28521018/stereotactic-radiosurgery-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#3
Dustin G Roberts, Nader Pouratian
BACKGROUND: Since the advent of neuromodulation, the role and efficacy of stereotactic radiosurgery (SRS) for chronic pain has not been carefully scrutinized. OBJECTIVE: To perform a systematic review to evaluate the clinical efficacy, both short- and long-term, of SRS for the treatment of chronic intractable pain. METHODS: A systematic search in PubMed, Web of Science, and PsycINFO was performed using keywords and controlled vocabulary. The search included peer-reviewed articles reporting clinical outcomes of SRS for chronic pain with a minimum 3-mo follow-up for nonmalignant and 1 mo for malignant pain...
May 17, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28501595/corticolimbic-circuitry-in-the-modulation-of-chronic-pain-and-substance-abuse
#4
REVIEW
Anna M W Taylor
The transition from acute to chronic pain is accompanied by increased engagement of emotional and motivational circuits. Adaptations within this corticolimbic circuitry contribute to the cellular and behavioral maladaptations associated with chronic pain. Central regions within the corticolimbic brain include the mesolimbic dopamine system, the amygdala, and the medial prefrontal cortex. The evidence reviewed herein supports the notion that chronic pain induces significant changes within these corticolimbic regions that contribute to the chronicity and intractability of pain...
May 10, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#5
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28479215/local-injection-to-sciatic-nerve-of-dex-reduces-pain-behaviors-sgcs-activation-ngf-expression-and-sympathetic-sprouting-in-cci-rats
#6
Jing-Ru Wu, Hui Chen, Deng-Xin Zhang, Kai Jiang, Ying-Ying Yao, Ming-Ming Zhang, Bo Zhou, Jie Wang
Neuropathic pain has become an intractable health threat, with its profound effect on quality of life. Dorsal root ganglia (DRG) is evidenced to play a crucial role in neuropathic pain. The peripheral nociceptive afferents seem to be essential not only to initiate the process of neuropathic pain, but also to maintain and modulate it. Dexmedetomidine (DEX), a highly selective agonist of α2-adrenergic receptor (α2-AR), has provided significant analgesia in neuropathic pain. In the present study, we found that local injection to sciatic nerve of DEX alleviated heat hypersensitivity induced by chronic constriction injury (CCI)...
May 4, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#7
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#8
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28399549/cost-effectiveness-data-regarding-spinal-cord-stimulation-for-low-back-pain
#9
Christian Hoelscher, Jonathan Riley, Chengyuan Wu, Ashwini Sharan
STUDY DESIGN: Review of published literature pertaining to spinal cord stimulation cost data analysis. OBJECTIVE: To acquire, organize, and succinctly summarize the available literature regarding the costs associated with, and the cost-effectiveness of, spinal cord stimulation. SUMMARY OF BACKGROUND DATA: Chronic back and limb pain is a pervasive complaint in modern society, with estimated annual costs of medical care greater than $100 billion...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28370989/specialty-based-variations-in-spinal-cord-stimulation-success-rates-for-treatment-of-chronic-pain
#10
Syed Mohammed Qasim Hussaini, Kelly Ryan Murphy, Jing L Han, Aladine A Elsamadicy, Siyun Yang, Alykhan Premji, Beth Parente, Jichun Xie, Promila Pagadala, Shivanand P Lad
OBJECTIVES: Spinal cord stimulation (SCS) has emerged as an appropriate modality of treatment for intractable chronic pain. The present study examines variations in SCS trial-to-permanent conversion rates based on provider types performing the procedure. MATERIALS AND METHODS: We designed a large, retrospective analysis using the Truven MarketScan data base analyzing adult SCS patients with provider information available, with or without IPG implantation from the years 2007-2012...
April 2, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28368982/spinal-cord-stimulation-in-chronic-pain-mode-of-action
#11
Ricardo Vallejo, Kerry Bradley, Leonardo Kapural
OBJECTIVE: A review of the literature that presents a perspective on mechanisms of actions behind spinal cord stimulation (SCS) therapy for chronic pain. SUMMARY OF BACKGROUND DATA: SCS is an effective therapeutic alternative for the treatment of intractable chronic pain. Its application has been mostly based on the Gate Control Theory (GCT) of pain. Computational models have been fundamental on the understanding of clinical observations and the design of therapies that provide optimal neuromodulation...
March 31, 2017: Spine
https://www.readbyqxmd.com/read/28327190/primary-pain-generator-identification-by-ct-spect-in-a-patient-with-low-back-pain-a-case-report
#12
Gabriel Tender, Adriana Constantinescu, Andrew Conger, Anthony DiGiorgio
BACKGROUND: Chronic low back pain is one of the most common conditions encountered in the middle-age population. Identifying the primary pain generator is notoriously difficult. The computed tomography-single-photon emission computed tomography (CT-SPECT) is emerging as a new diagnostic modality for this purpose. CASE PRESENTATION: This 68-year-old Caucasian male presented with intractable low back pain refractory to maximal conservative treatment, including medication and extensive physical therapy...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28299231/chronic-osteoporotic-pain-in-mice-cutaneous-and-deep-musculoskeletal-pain-are-partially-independent-of-bone-resorption-and-differentially-sensitive-to-pharmacological-interventions
#13
Miyako Suzuki, Magali Millecamps, Lina Naso, Seiji Ohtori, Chisato Mori, Laura S Stone
Although the pathological changes in osteoporotic bones are well established, the characterization of the osteoporotic pain and its appropriate treatment are not fully elucidated. We investigated the behavioral signs of cutaneous and deep musculoskeletal pain and physical function; time-dependent changes in bone mineral density (BMD) and the emergence of the behavioral phenotype; and the effects of pharmacological interventions having different mechanisms of action (chronic intraperitoneal administration of pamidronate [0...
2017: Journal of Osteoporosis
https://www.readbyqxmd.com/read/28266756/high-frequency-spinal-cord-stimulation-in-surgery-na%C3%A3-ve-patients-a-prospective-single-center-study
#14
Sebastian A Ahmadi, Jan Vesper, Stefan Schu, Philipp J Slotty
INTRODUCTION: A multitude of evidence supporting the beneficial effects of spinal cord stimulation (SCS) in patients suffering from chronic pain syndromes following spinal surgery has been published in the last decade. Evidence is scarce, however, for the use of high frequency SCS (HF-SCS) in the treatment of surgery naïve patients suffering from lower back pain (LBP). METHODS: From June 2014 to April 2015, we prospectively enrolled patients suffering from LBP alone or in conjunction with leg pain in a trial of HF-SCS...
March 7, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28261110/the-neuroinflammatory-etiopathology-of-myalgic-encephalomyelitis-chronic-fatigue-syndrome-me-cfs
#15
Julian A G Glassford
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating multi-systemic chronic illness of unknown etiology, classified as a neurological disorder by the World Health Organization (WHO). The symptomatology of the condition appears to emanate from a variety of sources of chronic neurological disturbance and associated distortions, and chronicity, in noxious sensory signaling and neuroimmune activation. This article incorporates a summary review and discussion of biomedical research considered relevant to this essential conception perspective...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#16
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28220381/pharmacological-management-of-people-living-with-end-stage-chronic-obstructive-pulmonary-disease
#17
Victoria Dalgliesh, Hilary Pinnock
Supportive care and pharmacological treatment can improve the quality of life of people with end-stage chronic obstructive pulmonary disease (COPD) who cope on a daily basis with substantial physical, psychological, social and spiritual morbidity. Smoking cessation is the only intervention that reduces the rate of progression of COPD, but evidence-based drug treatments and non-pharmacological strategies can relieve symptoms and reduce the impact of exacerbations. People with severe COPD live with increasingly troublesome breathlessness and other symptoms such as fatigue, pain, sputum production and weight loss...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28202302/short-term-outcomes-of-patients-being-treated-for-chronic-intractable-pain-at-a-liaison-clinic-and-exacerbating-factors-of-prolonged-pain-after-treatment
#18
Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Toshifumi Ozaki
BACKGROUND: Although a multidisciplinary approach is often recommended to treat intractable pain, this approach does not completely prevent uncontrolled pain in some patients. The aim of this retrospective study was to investigate the exacerbating factors of prolonged, intractable pain among patients being treated at a pain liaison clinic. METHODS: The participants of this study were 94 outpatients (32 men, 62 women) with chronic intractable pain who visited our hospital between April 2013 and February 2015...
February 12, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28143718/comparative-efficacy-of-bilateral-thoracoscopic-splanchnicectomy-for-intractable-pain-secondary-to-pancreatic-cancer-vs-chronic-pancreatitis
#19
Neal Bhutiani, Gerald A Cheadle, Michael H Bahr, Gary C Vitale
BACKGROUND: Splanchnicectomy has been evaluated for treatment of chronic pain in both pancreatic cancer and chronic pancreatitis patients, although its efficacy has not been compared in these 2 patient populations. This study aimed to compare bilateral thoracoscopic splanchnicectomy in treatment of abdominal pain secondary with pancreatic cancer and chronic pancreatitis. STUDY DESIGN: A University of Louisville database was evaluated from July 1998 to March 2016 for patients undergoing bilateral thoracoscopic splanchnicectomy for intractable pain secondary to pancreatic cancer (n = 48) or chronic pancreatitis (n = 75)...
January 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28096589/water-cooled-radiofrequency-neuroablation-for-sacroiliac-joint-dysfunctional-pain
#20
Binay Kumar Biswas, Samarjit Dey, Saumya Biswas, Varinder Kumar Mohan
Sacroiliac (SI) joint dysfunction is a common source of chronic low-back pain. Recent evidences from different parts of the world suggest that cooled radiofrequency (RF) neuroablation of sacral nerves supplying SI joints has superior pain alleviating properties than available existing treatment options for SI joint dysfunctional pain. A 35-year-old male had intractable bilateral SI joint pain (numeric rating scale [NRS] - 9/10) with poor treatment response to intra-articular steroid therapy. Bilateral water cooled = RF was applied for neuroablation of nerves supplying both SI joints...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
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