The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Radiofrequency denervation of lumbar facet joints in the treatment of chronic low back pain: a randomized, double-blind, sham lesion-controlled trial.
Radiofrequency facet joint denervation procedures have been common practice for 2 decades in treatment of chronic low back pain. We designed this multicenter, randomized, double-blind, sham treatment controlled trial to determine the efficacy of radiofrequency facet joint denervation, as it is routinely performed. ⋯ The combined outcome measure and VAS showed no difference between radiofrequency and sham, though in both groups, significant VAS improvement occurred. The global perceived effect was in favor of radiofrequency. In selected patients, radiofrequency facet joint denervation appears to be more effective than sham treatment.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Local steroid injections for tennis elbow: does the pain get worse before it gets better?: Results from a randomized controlled trial.
To compare the early effects of local corticosteroid injection, naproxen, and placebo as treatments for tennis elbow in primary care. Specifically, to find out whether the extra pain reduction experienced by patients who are given the steroid injection in the short-term would be realized within the first 5 days of treatment and to attempt to assess how much extra pain may be associated with the injection initially. ⋯ Steroid injection was associated with an increase in reported pain for the first 24 hours of treatment, but the therapeutic benefits compared with naproxen and placebo were evident 3 to 4 days after the start of treatment.
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Comparative Study
Is temporomandibular pain in chronic whiplash-associated disorders part of a more widespread pain syndrome?
The prevalence of temporomandibular disorders in patients with chronic whiplash-associated disorder is a controversial issue that may be influenced by the widespread pain character and psychologic distress frequently observed in patients with chronic pain. The aim of this study was to determine the prevalence of temporomandibular disorder pain, widespread pain, and psychologic distress in persons with chronic whiplash-associated disorder pain, using a controlled, single blind study design. The prevalence of temporomandibular disorder pain in the chronic whiplash-associated disorder pain group was compared with 2 control groups: a chronic neck pain group and a no neck pain group. ⋯ The higher prevalence of widespread pain and psychologic distress in patients with chronic whiplash-associated disorder suggests that the higher prevalence of temporomandibular disorder pain in these patients is part of a more widespread chronic pain disorder.
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Comparative Study Clinical Trial
A prospective cost-effectiveness study of trigeminal neuralgia surgery.
Approximately 8000 patients with trigeminal neuralgia undergo surgery each year in the United States at an estimated cost exceeding $100 million. We compared 3 commonly performed surgeries (microvascular decompression, glycerol rhizotomy, and stereotactic radiosurgery) to evaluate the relative cost-effectiveness of these operations for patients with idiopathic trigeminal neuralgia. ⋯ This analysis supports the practice of percutaneous surgeries for older patients with medically unresponsive trigeminal neuralgia. At longer follow-up intervals, microvascular decompression is predicted to be the most cost-effective surgery and should be considered the preferred operation for patients if their risk for general anesthesia is acceptable. More data are needed to assess the role that radiosurgery should play in the management of patients with trigeminal neuralgia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tiagabine and gabapentin for the management of chronic pain.
Agents that modulate gamma-aminobutyric acid transmission, such as gabapentin, are widely used for the management of chronic pain disorders/syndromes; however, the usefulness of the selective gamma-aminobutyric acid reuptake inhibitor tiagabine in this therapeutic area has yet to be investigated. This study evaluated the effectiveness and safety of tiagabine and gabapentin for the treatment of chronic pain. ⋯ These results suggest that tiagabine and gabapentin are effective in the management of chronic pain, with tiagabine having a greater beneficial effect on sleep quality.