The Clinical journal of pain
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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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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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Spinal cord stimulation was undertaken in 45 patients referred to the University Hospital in Ghent. Failed back surgery was the major indication for implantation. Raynaud's phenomenon, causalgia, polyneuropathy, phantom limb pain, and diverse causes were the other indications. ⋯ Eight patients stopped using the stimulation system. To ensure good results, strict selection criteria and many surgical reinterventions seemed to be necessary. Although spinal cord stimulation is a nonablative technique, many complications may occur.
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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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Review Comparative Study
Comparison of clinical characteristics in myogenic, TMJ internal derangement and atypical facial pain patients.
Temporomandibular joint (TMJ) disorders have been collectively grouped as myofascial pain-dysfunction syndrome (MPDS) or temporomandibular joint dysfunction syndrome (TMJDS). In the past, these terms have been used synonomously to describe a set of clinical signs and symptoms that include pain in the TMJ and muscles of mastication, limited or deviant opening of the mandible, and/or joint sounds. The present study segregated two major subgroups subsumed within this diagnostic classification and assigned them to a myogenic facial pain (MFP) group and a TMJ internal derangement (TMJID) group. ⋯ Minnesota Multiphasic Personality Inventory (MMPI) scores from 95 subjects were compared with self-report measures of depression and anxiety. It was concluded that subcategorization of myofascial pain dysfunction patients into a MFP and TMJID group is justified on the basis of psychometric differences, clenching habits, masseter EMG levels, and male:female ratio. Furthermore, psychopathological factors are more significant among MFP and AFP subjects than TMJID patients.