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Pain Physician

Alan D Kaye, Laxmaiah Manchikanti, Matthew B Novitch, Imran N Mungrue, Muhammad Anwar, Mark R Jones, Erik M Helander, Elyse M Cornett, Matthew R Eng, Jay S Grider, Michael E Harned, Ramsin M Benyamin, John R Swicegood, Thomas T Simopoulos, Salahadin Abdi, Richard D Urman, Timothy R Deer, Cyrus Bakhit, Mahendra Sanapati, Sairam Atluri, Ramarao Pasupuleti, Amol Soin, Sudhir Diwan, Ricardo Vallejo, Kenneth D Candido, Nebojsa Nick Knezevic, Douglas Beall, Sheri L Albers, Richard E Latchaw, Hari Prabhakar, Joshua A Hirsch
BACKGROUND: Interventional pain management involves diagnosis and treatment of chronic pain. This specialty utilizes minimally invasive procedures to target therapeutics to the central nervous system and the spinal column. A subset of patients encountered in interventional pain are medicated using anticoagulant or antithrombotic drugs to mitigate thrombosis risk. Since these drugs target the clotting system, bleeding risk is a consideration accompanying interventional procedures. Importantly, discontinuation of anticoagulant or antithrombotic drugs exposes underlying thrombosis risk, which can lead to significant morbidity and mortality especially in those with coronary artery or cerebrovascular disease...
January 2019: Pain Physician
Annu Navani, Laxmaiah Manchikanti, Sheri L Albers, Richard E Latchaw, Jaya Sanapati, Alan D Kaye, Sairam Atluri, Sheldon Jordan, Ashim Gupta, David Cedeno, Alejandro Vallejo, Bert Fellows, Nebojsa Nick Knezevic, Miguel Pappolla, Sudhir Diwan, Andrea M Trescot, Amol Soin, Adam M Kaye, Steve M Aydin, Aaron K Calodney, Kenneth D Candido, Sanjay Bakshi, Ramsin M Benyamin, Ricardo Vallejo, Art Watanabe, Douglas Beall, Todd P Stitik, Patrick M Foye, Erik M Helander, Joshua A Hirsch
BACKGROUND: Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body's own inherent healing armamentarium in the treatment of patient pathology. This therapy's intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or allogenic biologics. This field is rising like a Phoenix from the ashes of underperforming conventional therapy midst the hopes and high expectations of patients and medical personnel alike...
January 2019: Pain Physician
Scott Buesing, Miranda Costa, Jan M Schilling, Tobias Moeller-Bertram
BACKGROUND: First isolated as cyanocobalamin in 1948, vitamin B12 has been explored for pain treatment almost since its discovery. With the advent of the opioid epidemic, safer treatments for pain are needed. OBJECTIVES: Our objective was to compile the latest information on potential mechanisms from animal studies and clinical trial data on vitamin B12 for the treatment of pain conditions. STUDY DESIGN: We conducted a narrative review. METHODS: PubMed was searched using the terms "methylcobalamin pain", "hydroxycobalamin pain", "cyanocobalamin pain", and "vitamin B12 pain...
January 2019: Pain Physician
Jaakko Maatta, Antti Martikainen, Maarit Pakarinen, Tiina-Mari Ikaheimo, Mette Nissen, Mikael von Und Zu Fraunberg, Heimo Viinamaki, Jukka Huttunen
BACKGROUND: Spinal cord stimulation (SCS) relieves pain by delivering doses of electric current to the dorsal column of the spinal cord and has been found to be most effective in the treatment of neuropathic pain. Psychological distress is a significant risk factor for the development of chronic pain and has been found to affect the outcome of SCS. Childhood trauma is a risk factor for chronic pain, but has not previously been studied in SCS patients. OBJECTIVES: The objective of this prospective registry-based study was to investigate the prevalence of 5 domains of childhood trauma (emotional neglect, emotional abuse, physical neglect, physical abuse, and sexual abuse) and their relationship with the outcome of spinal cord stimulation on patients suffering from treatment-resistant chronic pain...
January 2019: Pain Physician
Andrea M Trescot, Helen W Karl
BACKGROUND: Temple headaches are common, yet the anatomic etiology of headaches in this region is often confusing. One possible cause of temple headaches is dysfunction of the auriculotemporal nerve (ATN), a branch of the third division of the trigeminal nerve. However, the site of pain is often anterior to the described path of the ATN, and corresponds more closely to a portion of the path of a small branch of the second division of the trigeminal nerve called the zygomaticotemporal nerve (ZTN)...
January 2019: Pain Physician
Roy La Touche, Monica Grande-Alonso, Paloma Arnes-Prieto, Alba Paris-Alemany
BACKGROUND: Low back pain (LBP) is the most prevalent musculoskeletal problem among adults. Individuals with chronic LBP (CLBP) can present a psychological disorder and a lack of pain self-efficacy. OBJECTIVES: The objective of this study was to compare the process of repetition-induced summation of activity-related pain, the lumbar range of motion, and the postural stability of patients with non-specific LBP (NSLBP) based on their level of self-efficacy. STUDY DESIGN: This research used a descriptive, cross-sectional study design...
January 2019: Pain Physician
Daniel Lopez-Lopez, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Alfredo Soriano-Medrano, Patricia Palomo-Lopez, Angel Morales-Ponce, David Rodriguez-Sanz, Cesar Calvo-Lobo
BACKGROUND: Heel pain is one of the most frequent complaints in medical clinical practice for conditions affecting the feet during weight-bearing tasks. OBJECTIVE: The goal of this study was to measure and compare the thickness of the fat pad in a sample of patients with current unilateral heel pain and patients without unilateral heel pain with normalized reference parameters. STUDY DESIGN: This was an observational case-control study. SETTINGS: The research took place in the podiatry department within a medical health care center...
January 2019: Pain Physician
Cesar Margarit, Purificacion Ballester, Maria-Del-Mar Inda, Reyes Roca, Luis Gomez, Beatriz Planelles, Raquel Ajo, Domingo Morales, Ana M Peiro
BACKGROUND: The experience of chronic non-cancer pain (CNCP) is one of the most common reasons individuals seek medical attention. Patients with CNCP frequently experience concomitant sleep-related problems. OBJECTIVES: The aim was to evaluate sleep problems in opioid naïve CNCP patients, before and after opioid titration, analyzing the influence of OPRM1 gene variants. STUDY DESIGN: A prospective, cohort, observational study. SETTING: This study was performed at the Pain Unit of the Alicante University General Hospital...
January 2019: Pain Physician
Martin Avellanal, Gonzalo Diaz-Reganon, Alejandro Orts, Lucio Gonzalez-Montero, Irene Riquelme
BACKGROUND: Epiduroscopy is a useful diagnostic and therapeutic tool for managing failed back surgery syndrome (FBSS). The conventional approach is via either the sacral hiatus or the interlaminar. Major causes of FBSS include epidural fibrosis, disc herniation, and stenosis. When these problems are located at the intervertebral foramen level, it can be difficult to reach the lateral recess and the foramen with the epiduroscope. Transforaminal epiduroscopy could be a useful alternative approach in patients with FBSS located at the foraminal level...
January 2019: Pain Physician
Solomon Kamson, Dawei Lu, Paul D Sampson, Yiyi Zhang
BACKGROUND: Open transforaminal lumbar interbody fusion (TLIF) is the gold standard treatment for back pain due to degenerative disc disease and lumbar instability. Traditional open TLIF has been associated with extensive tissue dissection, excessive blood loss, and slow recovery time. Full-endoscopic transforaminal lumbar interbody fusion (FE-TLIF) is an evolving treatment. OBJECTIVES: This study aims to review outcomes of FE-TLIF performed in an ambulatory surgery center (ASC) on patients with advanced disc disease with minimal spinal deformity...
January 2019: Pain Physician
Jaspal R Singh, Vincent F Miccio, Devas J Modi, Michael T Sein
BACKGROUND: Pain arising from the lumbar facet joints is a common cause of axial back pain in adults. Radiofrequency neurotomy (RFN) of the medial branches of the spinal dorsal rami has been used as a treatment option. The most common side effect is transient, localized, burning, neuritic-type pain, termed post-neurotomy neuritis (PNN). Corticosteroids have been administered through the radiofrequency cannula after neurotomy to prevent PNN, but no study has examined the effects of this on PNN...
January 2019: Pain Physician
Zi-Feng Huang, Shao-Xiong Xiao, Kun Liu, Wei Xiong
OBJECTIVE: To investigate the therapeutic effectiveness of percutaneous kyphoplasty (PKP) combined with zoledronic acid in treatment of primary osteoporotic vertebral compression fractures. STUDY DESIGN: A perspective cohort study was conducted at a single institution for patients, who received PKP operation due to primary osteoporotic vertebral compression fracture between January 2014 and January 2015. SETTING: According to whether they received postoperative zoledronic acid or not, patients were divided into treatment or control groups, with 30 randomly-selected cases per group...
January 2019: Pain Physician
Parisa Nejati, Afsaneh Safarcherati, Farshid Karimi
BACKGROUND: The sacroiliac joint dysfunction (SIJD) has been found to be the primary culprit for lower back pain (LBP), but it is still overlooked and treated as LBP. There are no guidelines or appropriate therapeutic protocols for SIJD. Thus, there is a need for an effective treatment strategy for SIJD. OBJECTIVE: To compare exercise therapy (ET), manipulation therapy (MT), and a combination of the 2 (EMT) in terms of their effectiveness in treating SIJD. STUDY DESIGN: A comparative, prospective, single-blind randomized controlled trial ...
January 2019: Pain Physician
Peng-Fei Wu, Ya-Wei Li, Bing Wang, Bin Jiang, Zhi-Ming Tu, Guo-Hua Lv
BACKGROUND: Recently posterior cervical foraminotomy (PCF) performed using a minimally-invasive surgery (MIS) approach for cervical radiculopathy due to lateral disc herniation or osseous foraminal stenosis has gained popularity. As 2 dominating MIS techniques, whether FE-PCF or MI-PCF provides superior clinical outcomes remains controversial. OBJECTIVES: To compare clinical success rate, overall incidence of complications and reoperation rate between full-endoscopic posterior cervical foraminotomy (FE-PCF) and microendoscopic posterior cervical foraminotomy (MI-PCF) for cervical radiculopathy...
January 2019: Pain Physician
Zung Vu Tran, Anna Ivashchenko, Logan Brooks
BACKGROUND: Sacroiliac (SI) joint fusion represents a unique area of orthopedic surgery with procedural literature dating to the early 1920s, showing limited innovation in either technique or hardware over the last 90 years. Recent improvements in the diagnosis and treatment of SI joint dysfunction warrant comparisons to older surgical techniques. OBJECTIVE: To evaluate treatment efficacies and patient outcomes associated with minimally invasive joint fusion in comparison to screw-type surgeries...
January 2019: Pain Physician
Cui Zhiyong, Tian Yun, Feng Hui, Yang Zhongwei, Liu Zhaorui
BACKGROUND: There have been many meta-analyses and systematic reviews that have discussed the differences between unilateral and bilateral balloon kyphoplasty. However, their conclusions regarding the efficacy and safety of bilateral balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures (OVCFs) are discordant. OBJECTIVE: We attempted to select the best evidence review to determine the differences between unilateral and bilateral balloon kyphoplasty, and we wanted to determine the best treatment approach for OVCFs...
January 2019: Pain Physician
Sjors H Wagemakers, Joanne M van der Velden, A Sophie Gerlich, Alinde W Hindriks-Keegstra, Jacqueline F M van Dijk, Joost J C Verhoeff
BACKGROUND: Assessment of pain is important in daily clinical practice and as an endpoint in clinical studies. Because pain perception is highly subjective, pain measurement is complex. Self-rating pain scales are currently of great importance but have limitations. They depend on many more factors than pain, which could lead to an incorrect assessment of therapies or clinical studies. Therefore, there is need for valid, reliable, safe, and low-cost methods to determine and quantify patients' pain more objectively...
January 2019: Pain Physician
Li Song, Weidong Yan
No abstract text is available yet for this article.
November 2018: Pain Physician
David W Lee, Christopher Huston
BACKGROUND: There is a paucity of literature studying therapeutic intraarticular zygapophyseal (commonly referred to as facet) joint injections in the atraumatic patient population. As a result of this, intraarticular injections have been dismissed as a possible treatment for cervical zygapophyseal joint-mediated pain. Radiofrequency neurotomy (RFN) is currently the accepted treatment for facet joint neck pain. OBJECTIVE: This prospective observational study investigated injection response in an atraumatic population to determine treatment viability and whether injections reduce the need for RFN in neck pain patients...
November 2018: Pain Physician
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