Current review of pain
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Current review of pain · Jan 2000
ReviewNeuromodulation: spinal cord and peripheral nerve stimulation.
Spinal cord and peripheral nerve stimulation for relief of chronic intractable pain have been used since the mid-1960s. Multiple mechanisms of action have been theorized without a clear-cut winner. ⋯ Efficacy studies consistently show an overall 50% improvement in long-term pain control in patients who have failed conservative or other invasive modalities. With improvements in today's technology, one hopes that better analgesia will be attainable.
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Current review of pain · Jan 2000
Comparative Study Clinical Trial Controlled Clinical TrialThe diagnostic validity and therapeutic value of lumbar facet joint nerve blocks with or without adjuvant agents.
Facet joints have been described as an important source of low back pain. The value of medial branch blocks in the diagnosis of facet joint mediated pain is considered important. However, the therapeutic value of medial branch blocks has not been determined. ⋯ Group I was treated with local anesthetic only, Group II with the addition of Sarapin, and Group III with the addition of Depo-medrol along with Sarapin. The prevalence of facet joint pain in chronic low back pain was determined as 36%, with a false-positive rate of 25%. Comparison of duration of relief in days with each block in the three groups showed that the relief was significantly superior in Group III compared with Group I and Group II, whereas Group II was superior to Group I.
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Pain is one of the cardinal presenting symptoms in cancer patients and often seems to progress in the natural history of the disease. In light of the past neglect of this problem, it is becoming crucial for clinicians and researchers in the fields of oncology, pain management, and others dealing with this patient population to have a thorough understanding of the often complex pain syndromes that are relevant to managing cancer. In this article we briefly review the important topics related to cancer pain syndromes with some emphasis on those that typically generate localized pain.
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Current review of pain · Jan 2000
ReviewPain complaints in patients with fibromyalgia versus chronic fatigue syndrome.
Individuals with fibromyalgia (FM) and/or chronic fatigue syndrome (CFS) report arthralgias and myalgias. However, only persons with FM alone exhibit abnormal pain responses to mild levels of stimulation, or allodynia. We identify the abnormalities in the neuroendocrine axes that are common to FM and CFS as well as the abnormalities in central neuropeptide levels and functional brain activity that differentiate these disorders. These two sets of factors, respectively, may account for the similarities and differences in the pain experiences of persons with FM and CFS.
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Current review of pain · Jan 2000
ReviewClinical and experimental aspects of temporomandibular disorders.
Temporomandibular disorders (TMDs) are currently viewed as a family of related pain conditions in the craniofacial muscles, temporomandibular joint, and associated structures. The etiology and pathophysiology of pain is still far from being known, but several important neurobiological aspects have emerged in the last decade. This article reviews the present knowledge on three clinically relevant topics in TMD: referred pain mechanisms, somatosensory changes, and sensory-motor integration in the craniofacial region. It is proposed that the synthesis of this information from systematic studies in experimental animals and healthy human volunteers together with controlled clinical trials in well-defined patient populations is an essential prerequisite in order to advance the diagnostic procedure and management of TMD pain.