Journal of pain research
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Ambulatory resources such as telephone calls, secure messages, nurse visits, and telephone triage are vital to the management of patients on chronic opioid therapy (COT). They are also often overlooked as health care services and yet to be broadly studied. The aim of the present study was to describe the Veterans Affairs (VA) health care utilization by patients based on COT, type, and amount of opioids prescribed. ⋯ The results are despite having a Patient Aligned Care Team, which is the VA's patient-centered medical home. This suggests that reducing health care utilization for patients on COT may not be possible with just a primary care involvement.
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Journal of pain research · Jan 2018
Comparing the injectate spread and nerve involvement between different injectate volumes for ultrasound-guided greater occipital nerve block at the C2 level: a cadaveric evaluation.
The spread patterns between different injectate volumes have not yet been investigated in ultrasound-guided greater occipital nerve (GON) block at the C2 level. This cadaveric study was undertaken to compare the spread pattern and nerve involvements of different volumes of dye using this technique. ⋯ The clinical efficacy of this technique using the 5-mL injectate seems unlikely to arise from the blockade of GON alone. Instead, its efficacy likely arises from the blockade of most nerves originating from the dorsal ramus of the upper cervical spinal nerve at the suboccipital area. Even using 1 mL of injectate may not guarantee blockade of the GON alone.
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Journal of pain research · Jan 2018
Clinical efficacy of calcitonin compared to diclofenac sodium in chronic nonspecific low back pain with type I Modic changes: a retrospective study.
The objective of this study was to compare the efficacy of calcitonin with diclofenac sodium in the treatment of patients with nonspecific low back pain (LBP) and type I Modic changes (MC1). ⋯ There was greater short-term efficacy of calcitonin compared with diclofenac in patients with LBP and MC1 on MRI.
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Journal of pain research · Jan 2018
Appropriateness of sham or placebo acupuncture for randomized controlled trials of acupuncture for nonspecific low back pain: a systematic review and meta-analysis.
To establish whether sham acupuncture (SA) or placebo acupuncture (PA) is more efficacious for reducing low back pain (LBP) than other routine treatments and to discuss whether SA or PA is appropriate for randomized controlled trials of acupuncture for LBP. ⋯ Compared with routine care or a waiting list, SA or PA was more efficacious for pain relief post-intervention. Concluding that SA or PA is appropriate for acupuncture research would be premature. Guidelines evaluating SA or PA control methods are needed to determine the specific effect of acupuncture over placebo.
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Journal of pain research · Jan 2018
Patient-delivered tDCS on chronic neuropathic pain in prior responders to TMS (a randomized controlled pilot study).
Successful response to repetitive transcranial magnetic stimulation (rTMS) of the motor cortex requires continued maintenance treatments. Transcranial Direct Current Stimulation (tDCS) may provide a more convenient alternative. ⋯ This study did not show a beneficial effect of tDCS in this group of patients and does not support the need for a larger definitive study using the same experimental paradigm.