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Chronic intractible pain

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https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28072807/occipital-nerve-stimulation-for-refractory-chronic-migraine-results-of-a-long-term-prospective-study
#15
Dolores Rodrigo, Pilar Acin, Pedro Bermejo
BACKGROUND: Refractory chronic migraine affects approximately 4% of the population worldwide and results in severe pain, lifestyle limitations, and decreased quality of life. Occipital nerve stimulation (ONS) refers to the electric stimulation of the distal branches of greater and lesser occipital nerves; the surgical technique has previously been described and has demonstrated efficacy in the treatment of a wide variety of headache disorders. OBJECTIVES: The aim of this study is to evaluate the long-term efficacy and tolerability of ONS for medically intractable chronic migraine...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28066521/interventions-to-manage-residual-limb-ulceration-due-to-prosthetic-use-in-individuals-with-lower-extremity-amputation-a-systematic-review-of-the-literature
#16
M Jason Highsmith, Jason T Kahle, Tyler D Klenow, Casey R Andrews, Katherine L Lewis, Rachel C Bradley, Jessica M Ward, John J Orriola, James T Highsmith
Patients with lower extremity amputation (LEA) experience 65% more dermatologic issues than non-amputees, and skin problems are experienced by ≈75% of LEA patients who use prostheses. Continuously referring LEA patients to a dermatologist for every stump related skin condition may be impractical. Thus, physical rehabilitation professionals should be prepared to recognize and manage common non-emergent skin conditions in this population. The purpose of this study was to determine the quantity, quality, and strength of available evidence supporting treatment methods for prosthesis-related residual limb (RL) ulcers...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28025837/ketamine-infusions-for-treatment-refractory-headache
#17
Jared L Pomeroy, Michael J Marmura, Stephanie J Nahas, Eugene R Viscusi
BACKGROUND: Management of chronic migraine (CM) or new daily persistent headache (NDPH) in those who require aggressive outpatient and inpatient treatment is challenging. Ketamine has been suggested as a new treatment for this intractable population. METHODS: This is a retrospective review of 77 patients who underwent administration of intravenous, subanesthetic ketamine for CM or NDPH. All patients had previously failed aggressive outpatient and inpatient treatments...
February 2017: Headache
https://www.readbyqxmd.com/read/28025370/prognosis-after-surgical-treatment-of-trigeminal-neuropathy-with-a-pga-c-tube-report-of-10-cases
#18
Kenji Seo, Makoto Terumitsu, Yuji Inada, Tatsuo Nakamura, Keiji Shigeno, Yutaka Tanaka
OBJECTIVE: Although surgery using a polyglycolic acid-collagen (PGA-c) tube is effective for peripheral nerve injury-induced chronic hand pain, it has not been applied to trigeminal nerve lesions because of the difficult approach. We used a PGA-c tube during surgery for trigeminal neuropathy and evaluated its prognosis based on the outcomes. DESIGN: Case report. SETTING AND PATIENTS: In the dental anesthesia division of a university hospital, 11 patients with severe dysesthesia underwent surgical repair of a damaged lingual nerve (LN) or inferior alveolar nerve (IAN)...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27994479/transsacrococcygeal-approach-to-ganglion-impar-radiofrequency-application-for-the-treatment-of-chronic-intractable-coccydynia
#19
Cemil Adas, Ugur Ozdemir, Huseyin Toman, Nurettin Luleci, Emel Luleci, Hilal Adas
OBJECTIVE: Coccydynia is defined as pain in the coccygeal region. Among the many causes of coccydynia, the most common cause is trauma as a result of falling on the buttocks, repetitive microtrauma, or childbirth. Several methods are currently used for the treatment of coccydynia, including nonsteroidal anti-inflammatory drugs, intrarectal manipulation, epidural injections, ganglion impar blocks, and radiofrequency treatment (RFT). Wemm and Saberski used the transacrococcygeal methods to reduce tissue trauma...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27929717/patterns-of-chronic-inflammation-in-extensively-treated-patients-with-arachnoiditis-and-chronic-intractable-pain
#20
COMPARATIVE STUDY
John A Bilello, Forest S Tennant
OBJECTIVE: To use biomarkers to gain insight into and gauge the residual (post-treatment) level of inflammation in two groups of intensively treated patients with severe chronic pain. METHODS: Three study groups were analyzed, and included: (i) patients (n = 90) with chronic intractable pain (CIP), (ii) patients (n = 26) with chronic pain and MRI-documented arachnoiditis (ARC) and (iii) normal subjects without a diagnosis of chronic pain (n = 86). We determined and compared the serum concentrations of Alpha-1 Antitrypsin (A1AT), Myeloperoxidase (MPO) and soluble Tumor Necrosis Factor receptor type 2 (sTNFR2) in each of the patient populations studied...
January 2017: Postgraduate Medicine
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