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Chronic pain

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25 papers 1000+ followers
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
https://www.readbyqxmd.com/read/19879174/use-of-oral-ketamine-in-chronic-pain-management-a-review
#1
REVIEW
Maren I Blonk, Brigitte G Koder, Patricia M L A van den Bemt, Frank J P M Huygen
The analgesic effect of ketamine is primarily based on the antagonism of the N-methyl-d-aspartate (NMDA) receptor. Activation of NMDA receptors may play a crucial role in the pathogenesis of chronic pain. Little formal research has been performed on the efficacy and safety of ketamine in chronic pain, especially concerning long-term oral administration. This review provides an overview of the available clinical data on the use of oral ketamine in chronic pain management. A literature search was performed in MEDLINE, EMBASE and the Cochrane Library, resulting in 22 relevant articles...
May 2010: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/23432384/ketamine-for-chronic-pain-risks-and-benefits
#2
REVIEW
Marieke Niesters, Christian Martini, Albert Dahan
The anaesthetic ketamine is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Low dose ketamine produces strong analgesia in neuropathic pain states, presumably by inhibition of the N-methyl-D-aspartate receptor although other mechanisms are possibly involved, including enhancement of descending inhibition and anti-inflammatory effects at central sites. Current data on short term infusions indicate that ketamine produces potent analgesia during administration only, while three studies on the effect of prolonged infusion (4-14 days) show long-term analgesic effects up to 3 months following infusion...
February 2014: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/18222627/mexiletine-therapy-for-chronic-pain-survival-analysis-identifies-factors-predicting-clinical-success
#3
Ian R Carroll, Kimberly M Kaplan, Sean C Mackey
Mexiletine, a sodium channel blocker, treats neuropathic pain but its clinical value has been questioned due to its significant side effects and limited efficacy. We hypothesized that ongoing therapy with mexiletine would have limited patient acceptance, but that an analgesic response to intravenous (IV) lidocaine (a pharmacologically similar drug) would identify patients most likely to choose ongoing therapy with mexiletine. We identified a cohort of 37 patients with neuropathic pain who underwent IV lidocaine infusions at our institution and were subsequently prescribed mexiletine...
March 2008: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/16514327/a-randomized-double-masked-placebo-controlled-pilot-trial-of-extended-iv-lidocaine-infusion-for-relief-of-ongoing-neuropathic-pain
#4
RANDOMIZED CONTROLLED TRIAL
Ivo W Tremont-Lukats, Paul R Hutson, Misha-Miroslav Backonja
OBJECTIVES: To determine the dose-response effect and safety of IV lidocaine at different dose infusion rates on spontaneous ongoing neuropathic pain. METHODS: In this double-masked, placebo-controlled, parallel study conducted in an outpatient clinical research center, patients with peripheral neuropathic pain received a 6-hour infusion of three doses (1, 3, and 5 mg/kg) of lidocaine or placebo. The main outcome measure was relief of pain intensity (percentage pain intensity difference [PID %])...
March 2006: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29016948/tertiary-care-clinical-experience-with-intravenous-lidocaine-infusions-for-the-treatment-of-chronic-pain
#5
Eli Iacob, Emily E Hagn, Jill Sindt, Shane Brogan, Scott C Tadler, Konrad S Kennington, Bradford D Hare, Christina E Bokat, Gary W Donaldson, Akiko Okifuji, Scott R Junkins
Objective: To evaluate the safety of and long-term pain relief due to intravenous lidocaine infusion for the treatment of chronic pain in a tertiary pain management clinic. Design: Retrospective chart review. Methods: Medical records were reviewed from 233 adult chronic pain patients who underwent one to three lidocaine infusions. The initial lidocaine challenge consisted of 1,000 mg/h administered intravenously for up to 30 minutes until infusion was complete, full pain resolution, the patient requested to stop, side effects (SEs) became intolerable, and/or if there were any safety concerns...
June 1, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/23703410/intravenous-infusions-in-chronic-pain-management
#6
REVIEW
Boleslav Kosharskyy, Wilson Almonte, Naum Shaparin, Marco Pappagallo, Howard Smith
In the United States, millions of Americans are affected by chronic pain, which adds heavily to national rates of morbidity, mortality, and disability, with an ever-increasing prevalence. According to a 2011 report titled Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research by the Institute of Medicine of the National Academies, pain not only exacts its toll on people's lives but also on the economy with an estimated annual economic cost of at least $560 - 635 billion in health care costs and the cost of lost productivity attributed to chronic pain...
May 2013: Pain Physician
https://www.readbyqxmd.com/read/29178034/pharmacotherapy-for-neuropathic-pain-a-review
#7
REVIEW
Diego Fornasari
Neuropathic pain, comprising a range of heterogeneous conditions, is often severe and difficult to manage, and this may result in a chronic condition that negatively affects the overall functioning and quality of life in patients. The pharmacotherapy of neuropathic pain is challenging and for many patients effective treatment is lacking; therefore, evidence-based recommendations are essential. Currently, there is general agreement on which drugs are appropriate for the first-line treatment of neuropathic pain, whereas debate continues regarding second- and third-line treatments...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/26727925/management-of-lumbar-spinal-stenosis
#8
REVIEW
Jon Lurie, Christy Tomkins-Lane
Lumbar spinal stenosis (LSS) affects more than 200,000 adults in the United States, resulting in substantial pain and disability. It is the most common reason for spinal surgery in patients over 65 years. Lumbar spinal stenosis is a clinical syndrome of pain in the buttocks or lower extremities, with or without back pain. It is associated with reduced space available for the neural and vascular elements of the lumbar spine. The condition is often exacerbated by standing, walking, or lumbar extension and relieved by forward flexion, sitting, or recumbency...
January 4, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/16030082/a-multicentre-randomized-controlled-trial-of-epidural-corticosteroid-injections-for-sciatica-the-west-study
#9
RANDOMIZED CONTROLLED TRIAL
N K Arden, C Price, I Reading, J Stubbing, J Hazelgrove, C Dunne, M Michel, P Rogers, C Cooper
OBJECTIVE: To determine the effectiveness and predictors of response to lumbar epidural corticosteroid injections (ESI) in patients with sciatica. We performed a 12-month, multicentre, double-blind, randomized, placebo-controlled, parallel-group trial in four secondary pain-care clinics in the Wessex Region. METHODS: Two hundred and twenty-eight patients with a clinical diagnosis of unilateral sciatica of 1-18 months' duration were randomized to either three lumbar ESIs of triamcinolone acetonide or interligamentous saline injections at intervals of 3 weeks...
November 2005: Rheumatology
https://www.readbyqxmd.com/read/27105466/patient-priority-weighting-of-the-roland-morris-disability-questionnaire-does-not-change-results-of-the-lumbar-epidural-steroid-injections-for-spinal-stenosis-trial
#10
RANDOMIZED CONTROLLED TRIAL
Una E Makris, Todd C Edwards, Danielle C Lavallee, Zoya Bauer, Bryan A Comstock, Jeffrey G Jarvik, Donald L Patrick, Mahshid Lotfi, Janna L Friedly
STUDY DESIGN: Secondary analysis of lumbar epidural steroid injections for spinal stenosis randomized controlled trial data. OBJECTIVE: To reevaluate whether outcomes for older adults receiving epidural steroid injections with or without corticosteroid improve after using patient-prioritized Roland-Morris Disability Questionnaire (RDQ) items. SUMMARY OF BACKGROUND DATA: Epidural corticosteroid injections are commonly used to treat lumbar spinal stenosis symptoms, despite limited evidence for their effectiveness in clinical trials...
January 1, 2017: Spine
https://www.readbyqxmd.com/read/26610278/is-epidural-steroid-injection-effective-for-degenerative-lumbar-spinal-stenosis
#11
Sebastián Flores, Marcelo Molina
There are several nonsurgical alternatives to treat radicular pain in degenerative lumbar spinal stenosis. Epidural steroid injections have been used for several decades, but the different studies have shown variable effects. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified nine systematic reviews including seven pertinent randomized controlled trials. We concluded epidural steroid injection probably leads to little or no effect on reducing radicular pain of spinal stenosis...
November 16, 2015: Medwave
https://www.readbyqxmd.com/read/28363270/hip-pain-dry-needling-versus-cortisone-injections
#12
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Greater trochanteric pain syndrome (GTPS) is chronic, intermittent pain and tenderness on the outside of the hip. The medical community once thought that a swollen hip bursa was the source of such pain, which led to the use of corticosteroid injections to the bursa to help decrease swelling and pain. However, researchers now believe that injuries to the muscles and tendons around the hip are the actual cause of this pain, and that inflammation is often not involved. A study published in the April 2017 issue of JOSPT explores dry needling as an alternative to cortisone injections to reduce pain and improve function in patients with GTPS...
April 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/27408698/mechanisms-of-low-back-pain-a-guide-for-diagnosis-and-therapy
#13
REVIEW
Massimo Allegri, Silvana Montella, Fabiana Salici, Adriana Valente, Maurizio Marchesini, Christian Compagnone, Marco Baciarello, Maria Elena Manferdini, Guido Fanelli
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety...
2016: F1000Research
https://www.readbyqxmd.com/read/27028915/opioid-abuse-in-chronic-pain-misconceptions-and-mitigation-strategies
#14
REVIEW
Nora D Volkow, A Thomas McLellan
No abstract text is available yet for this article.
March 31, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26834359/the-effects-of-gluteus-muscle-strengthening-exercise-and-lumbar-stabilization-exercise-on-lumbar-muscle-strength-and-balance-in-chronic-low-back-pain-patients
#15
Ui-Cheol Jeong, Jae-Heon Sim, Cheol-Yong Kim, Gak Hwang-Bo, Chan-Woo Nam
[Purpose] The aim of this study was to examine the effects of exercise to strengthen the muscles of the hip together with lumbar segmental stabilization exercise on the lumbar disability index, lumbar muscle strength, and balance. [Subjects and Methods] This study randomly and equally assigned 40 participants who provided written consent to participate in this study to a lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus group (SMG + LES group) and a lumbar segmental stabilization exercise group...
December 2015: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/17342295/comparison-of-two-doses-of-corticosteroid-in-epidural-steroid-injection-for-lumbar-radicular-pain
#16
RANDOMIZED CONTROLLED TRIAL
M B Owlia, A Salimzadeh, Gh Alishiri, A Haghighi
INTRODUCTION: Low back pain and lumbar radicular pain are the leading causes of job loss worldwide. Therapeutic approaches to lumbar radicular pain, including sciatica and spinal canal stenosis, are diverse. Many clinicians use 80 mg long-acting glucocorticoids in epidural steroid injections (ESI). The aim of this study is to compare the clinical response of 80 mg versus 40 mg methylprednisolone in ESI. METHODS: 84 patients with newly exacerbated lumbar radicular pain were randomly al located into two groups...
March 2007: Singapore Medical Journal
https://www.readbyqxmd.com/read/26000680/low-back-pain-guidelines-for-the-clinical-classification-of-predominant-neuropathic-nociceptive-or-central-sensitization-pain
#17
REVIEW
Jo Nijs, Adri Apeldoorn, Hank Hallegraeff, Jacqui Clark, Rob Smeets, Annaleen Malfliet, Enrique L Girbes, Margot De Kooning, Kelly Ickmans
BACKGROUND: Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial low back pain), neuropathic (e.g., lumbar radiculopathy), and central sensitization pain. In order to select an effective and preferably also efficient treatment in daily clinical practice, LBP patients should be classified clinically as either predominantly nociceptive, neuropathic, or central sensitization pain. OBJECTIVE: To explain how clinicians can differentiate between nociceptive, neuropathic, and central sensitization pain in patients with LBP...
May 2015: Pain Physician
https://www.readbyqxmd.com/read/25376753/effects-of-mindfulness-meditation-on-chronic-pain-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Peter la Cour, Marian Petersen
OBJECTIVE: This randomized controlled clinical trial investigated the effects of mindfulness meditation on chronic pain. DESIGN: A total of 109 patients with nonspecific chronic pain were randomized to either a standardized mindfulness meditation program (mindfulness-based stress reduction [MBSR]) or to a wait list control. METHODS: Pain, physical function, mental function, pain acceptance, and health-related quality of life were measured...
April 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/25351967/encouraging-couples-to-change-a-motivational-assessment-to-promote-well-being-in-people-with-chronic-pain-and-their-partners
#19
Lisa Renee Miller-Matero, Annmarie Cano
OBJECTIVE: Motivating people with chronic pain to engage in therapy can be difficult, especially when individuals have not experienced adequate pain management. Therefore, it may be useful for clinicians to use a motivational assessment as a part of treatment to help patients achieve immediate benefits. Additionally, because the social context impacts chronic illness, the significant other should be included in the assessment. This article describes a motivational assessment that was developed for people with chronic pain and their partners...
February 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/25218599/sympathetic-blockade-for-complex-regional-pain-syndrome
#20
EDITORIAL
Peter D Drummond, Philip M Finch
No abstract text is available yet for this article.
November 2014: Pain
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