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Pain Management

Rodney A Gabriel, Matthew W Swisher, Brian M Ilfeld
Peripheral nerve stimulation or peripheral neuromodulation is a modality utilized for decades to manage chronic pain. There have been recent studies published describing its use in managing acute surgical pain for orthopedic surgery. The postoperative acute pain associated with several types of surgeries often outlasts the analgesia duration provided by single and continuous peripheral nerve blocks. Ultrasound-guided percutaneous peripheral nerve stimulation has the potential to provide much longer analgesia for acute pain while avoiding some limitations associated with local anesthetic-based peripheral nerve blocks...
May 17, 2019: Pain Management
Parisa Gazerani
The identification of new indications for approved or failed drugs is a process called drug repositioning or drug repurposing. The motivation includes overcoming the productivity gap that exists in drug development, which is a high-cost-high-risk process. Repositioning also includes rescuing drugs that have safely entered the market but have failed to demonstrate sufficient efficiency for the initial clinical indication. Considering the high prevalence of chronic pain, the lack of sufficient efficacy and the safety issues of current analgesics, repositioning seems to be an attractive approach...
April 5, 2019: Pain Management
Connie Hersch, Camille Denis, Dalma Sugár
AIM: Understand the frequency, nature and over-the-counter (OTC) self-management of patient-reported severe acute pain occasions. PATIENTS & METHODS: A consumer-based survey of adults experiencing acute pain in Australia, Russia and the UK. Participants recorded pain type, frequency and intensity plus action taken to address pain. RESULTS: A total of 2994 participants completed the survey; 1366 provided ≥1 diary entry (total 6527 pain occasions)...
April 2, 2019: Pain Management
Joseph V Pergolizzi, Melanie Rosenblatt, Dean J Mariano, Jo Ann LeQuang
No abstract text is available yet for this article.
March 1, 2019: Pain Management
Blaine Marshall, Michelle K Bland, Ryan Hulla, Robert J Gatchel
This article reviews the complexities of the opioid epidemic, considering recent research involving the current state of the opioid epidemic; chronic pain and its role in the crisis; the properties of opioids and how they interact with human neurobiology; the effectiveness and risks of opioids as a treatment for chronic pain; opioid addiction and dependence; and pharmacological and psychological interventions for opioid addiction, opioid dependence, and chronic pain management. Opioid abuse can be reduced with the availability and access to treatment facilities for opioid detoxification; using interdisciplinary treatment models for chronic pain, opioid addiction and dependence; conducting more research in the areas of opioid addiction and opioid dependence; and shifting to an increase in nonpharmacological, less invasive treatments for pain...
March 1, 2019: Pain Management
Akiko Okifuji, Ariel Neikrug
Chronic pain is a biopsychosocial condition, and behavioral medicine has made significant contributions to the understanding of the phenomenon and optimization of therapeutic outcomes. The objective of this article is to provide future perspectives of behavioral medicine in pain management based upon recent development in the field. We will briefly review the mainstream approach of cognitive-behavioral therapy, its variations and new and innovative approaches that are on the horizon. We also review strategies that address potential barriers to pain management...
March 1, 2019: Pain Management
Andreas Rothgangel, Robin Bekrater-Bodmann
Phantom limb pain (PLP) is a clinically relevant consequence of limb amputation and its treatment is still challenging. Mirror therapy, in other words, observing and engaging in the intact limb's mirrored movements, offers a promising, mechanism-based treatment for PLP. However, intervention and patient characteristics, such as the realism of mirrored exercises and perceptions related to the phantom limb, might influence treatment effectiveness. Novel approaches using augmented and virtual reality setups represent an alternative to traditional mirror therapy...
March 1, 2019: Pain Management
Selaiman A Noori, Rohit Aiyer, James Yu, Robert S White, Neel Mehta, Amitabh Gulati
Chronic pain continues to be a major health issue throughout the world and a huge economic burden for nations around the world. While the use of opioids does have risks, they are still widely used by clinicians as a treatment option for various chronic pain conditions. This review explores and compares the efficacy and safety of opioid and nonopioid agents for the following commonly encountered chronic pain conditions: neuropathic pain, rheumatoid arthritis joint pain, cancer pain and low back pain. Our findings demonstrate that while there are several nonopioid pharmacologic options that are clinically effective, opioids maintain a role in the treatment of certain chronic pain conditions and should continue to have an important place in the armamentarium of clinicians...
March 1, 2019: Pain Management
Mark Connelly, Subhjit Sekhon
Headache disorders subsumed under the term chronic daily headache (CDH), including chronic migraine, chronic tension-type headache and new daily persistent headache, affect up to 4% of the pediatric population and can be highly disabling and challenging to effectively treat. Although historically the knowledge base about this group of headache disorders in children primarily was derived from clinical observation and extrapolation from adult studies, over the past several years there have been important research findings relevant to the development and management of pediatric CDH that can help inform clinical practice...
March 1, 2019: Pain Management
Sara P Khan, Thomas A Pickens, Daniel J Berlau
With the opioid epidemic reaching new heights in the USA, it has become critical to find suitable alternatives to opioids. Cannabis, an antinociceptive, is a strong contender to help patients reduce their opioid usage. A growing literature has been examining the complex effects cannabis has on pain relief and on opioid usage; whether it is a substitute for opioids or increases their use. This review explores the studies that compare cannabis-opioid interactions and presents some challenges of cannabis research and usage...
March 1, 2019: Pain Management
Leonardo Kapural, Nicholas Lee, Harish Badhey, William Porter McRoberts, Suniel Jolly
AIM: Neural blockade at the celiac plexus is less specific compared with splanchnic nerve block. This retrospective study compares duration and potency of celiac versus splanchnic block. Patients & methods: Analyzed were data of 16 consecutive patients with visceral abdominal nonmalignant pain treated using both celiac plexus and T11 splanchnic block. RESULTS: Improvement in pain scores was from 7.24 ± 1.0 to 4.1 ± 2.1 for celiac, and 7.8 ± 0.8 to 2...
March 1, 2019: Pain Management
Praveen Kumar
No abstract text is available yet for this article.
March 1, 2019: Pain Management
Austin M Grinberg, Maya S D'Eon, Jenna K Ellison, Thomas Rutledge, Joel Castellanos, Krishnan V Chakravarthy
Although psychosocial evaluations for implantable pain devices have been consensus recommendations since the 1990s, there is an inconsistent support regarding their ability to identify suitable pain device candidates or to predict clinical outcomes. With the emergence of evidence-based practices and the recent release of pain management guidelines emphasizing functional improvements and safety, the disparity between the recommendations for implantable pain device psychosocial evaluations and the evidence supporting them has only grown...
March 1, 2019: Pain Management
Priyanka E Ghosh, Thomas T Simopolous
This article reviews Nevro Corporation's (CA, USA) Senza System high-frequency spinal cord stimulator (HF10 SCS). HF10 therapy has been shown to be noninferior to traditional low-frequency spinal cord stimulation (SCS), and in some studies, has been shown to have long-term effects that are superior compared with traditional low-frequency SCS in treating both back and leg pain. In addition, safety profiles for the HF10 SCS system were equivalent to traditional SCS. HF10 SCS is based on spinal anatomic mapping and does not require intraoperative paresthesia mapping for placement, thereby improving procedural experience for patients and reducing operating room time...
January 30, 2019: Pain Management
James R Miner, Timothy I Melson, David Leiman, Harold S Minkowitz, Yu-Kun Chiang, Karen P DiDonato, Pamela P Palmer
AIM: To evaluate the pooled safety of sufentanil sublingual tablets (SSTs) administered at 30-mcg dose equivalents over ≤72 h for moderate-to-severe acute pain management in medically supervised settings. PATIENTS & METHODS: Safety data from SST 30 mcg Phase III studies were pooled with an additional patient subset from studies in which two SST 15 mcg were self-administered within 20-25 min (30-mcg dose-equivalent). RESULTS: Analyses included 804 patients...
January 7, 2019: Pain Management
Alice Bough
No abstract text is available yet for this article.
January 2019: Pain Management
John D Loeser
No abstract text is available yet for this article.
January 1, 2019: Pain Management
David Magee, Sabina Bachtold, Matthew Brown, Paul Farquhar-Smith
Increasing numbers of those living with and beyond cancer presents a clinical challenge for pain specialists. A large proportion of these patients experience pain secondary to their disease or its treatment, impeding rehabilitation and significantly impacting upon their quality of life. The successful management of this pain presents a considerable challenge. This review aims to outline current concepts and treatment options, while considering nuances within pain assessment and the use of large-scale data to help guide further advances...
January 1, 2019: Pain Management
Rena Gatzounis, Geert Crombez, Martien G S Schrooten, Johan W S Vlaeyen
Activity interruptions, namely temporary suspensions of an ongoing task with the intention to resume it later, are common in pain. First, pain is a threat signal that urges us to interrupt ongoing activities in order to manage the pain and its cause. Second, activity interruptions are used in chronic pain management. However, activity interruptions by pain may carry costs for activity performance. These costs have recently started to be systematically investigated. We review the evidence on the consequences of activity interruptions by pain for the performance of the interrupted activity...
January 1, 2019: Pain Management
Aliza T Ehrlich, Emmanuel Darcq
No abstract text is available yet for this article.
January 1, 2019: Pain Management
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