The Clinical journal of pain
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This study investigated the value of the sense of coherence (SOC), self-esteem, and the Mental Health Inventory subscales as predictors of response to a brief pain management program. One hundred and seven chronic pain patients who participated in a pain management program, which included education about pain, relaxation training, and stress management, were sent a follow-up questionnaire 6 months after the course. ⋯ The use of relaxation and other techniques taught in the course was correlated with positive affect and well-being. The results suggest that health-promoting variables may offer advantages over pathological measures as predictors of patient response to pain management programs, and SOC is worthy of further study.
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The treatment of trigeminal neuralgia (TN), which is resistant to medical therapy, has benefited from many surgical techniques. It is not possible, in light of the present level of knowledge, to establish exactly which method is the most suitable. It does, however, seem significant that certain side effects appear, in varying percentages, in all kinds of operations. ⋯ The tip of the needle is accurately placed among the roots desired under fluoroscopic control. The clinical effects on the conscious patient of a prognostic block with local anesthetics are evaluated before producing the neurolysis. Follow-up has been long enough to show that SETN is a highly selective procedure, which shouldn't be underrated in the centers that use it routinely.
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Case Reports
Utilization of transcutaneous electrical nerve stimulation in managing craniofacial pain.
This article describes a protocol for clinical application of variable parameter transcutaneous electrical nerve stimulation (TENS) for the management of craniofacial pain. The method described is easily applied and has been used successfully for several years in clinical practice. Several selected cases are presented that demonstrate the use of TENS along the prescribed protocol.
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A retrospective survey of 1,661 patients seen over a 10-year period at a pain clinic yielded 55 patients with intractable neck pain as the presenting complaint. In 89% there was an industrial or motor vehicle accident as the precipitating event, 78% were involved in legal proceedings relating to the accident, and in 87% the pain radiated to neighboring structures. ⋯ Treatment mainly by psychotherapy or tricyclic antidepressants resulted in some benefit for 56% of patients. Legal compensation and change in occupation were not major factors influencing the outcome of treatment.