The Clinical journal of pain
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The mild lumbar decompression procedure is a minimally invasive therapy for the treatment of symptomatic lumbar spinal stenosis (LSS). Mild offers LSS patients an early alternative after failed conservative therapy and before open surgery. This report describes 6-month safety and efficacy of mild patients treated at a single center. ⋯ The safety profile of mild, combined with the significant improvement in quality of life for these patients at 6-months is remarkable. Having failed conservative therapy, the high level of effectiveness of the mild procedure is particularly important in this patient population. In this series, mild has been shown to be a safe, effective, and cost-effective treatment for LSS patients with neurogenic claudication.
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The objective of the study was to examine patients' experiences of pain in Hospital in the Home (HITH) programs and identify the issues related to providing optimal pain management for acute care patients in the home environment. ⋯ Treatment of pain at home was suboptimal with patients experiencing moderate-to-severe pain and discomfort during the treatment phase of their illness. Lack of appropriate discharge planning strategies meant that patients went home without adequate analgesia and use of nonprescribed pain medication was common. The number of patients transferred home without analgesics indicates a worrying underrecognition of the need for analgesia in this care context and poses a risk to patient safety that is no less significant because patients are at home.
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Cochrane meta-analyses have shown significant benefit in bone pain from bisphosphonate therapy in adults with bone diseases such as multiple myeloma, Paget disease, breast and prostate cancer. Our aim was to assess if bisphosphonate treatment could alleviate severe pain in children with Ollier disease and hereditary multiple exostoses that are refractory to standard analgesics. ⋯ One can consider bisphosphonate therapy in children with Ollier disease and hereditary multiple exostoses who have debilitating pain that is refractory to standard analgesic treatment.
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The aim of this study was to culturally adapt into Spanish and validate the painDETECT questionnaire, a brief self-administered instrument designed to screen the presence of a neuropathic pain component in usual clinical practice. ⋯ The culturally adapted version of the painDETECT presents good psychometric properties and shows to be a valid patient-reported outcome for measuring the presence of a neuropathic component in patients with chronic pain.
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Multicenter Study
Addressing parental concerns about pain during childhood vaccination: is there enough time to include pain management in the ambulatory setting?
Pain from vaccine injections remains undertreated, despite the availability of numerous pain-relieving strategies. Healthcare providers report lack of time within current office workflows as a major barrier to routine pain management. The objective was to document the total time involved in outpatient vaccine appointments to test the hypothesis that offering pain-relieving strategies can be practically implemented when considering the element of time to vaccine injection. ⋯ Contrary to healthcare provider perceptions, the timing of outpatient childhood vaccine appointments allows for the inclusion of pain management interventions. Efforts should now focus on educating healthcare providers and parents about the value of pain management and how to implement evidence-based strategies.