Current review of pain
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Postherpetic neuralgia (PHN) is the most common complication of herpes zoster, and as such has been an area of extensive medical research for the past three decades. The patients at highest risk for PHN include those older than 50 years, those with severe acute cases of zoster, and those with shingles in a trigeminal distribution. As persons with malignancy are at a high risk for developing zoster itself, PHN is a complication that will be faced by many of these patients and their caregivers. This article reviews the available treatments and preventative measures for this debilitating condition.
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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.
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Over the years, a number of treatments for persistent low back pain following spine surgery, the failed back surgery syndrome (FBSS), have been developed. The complexity of the clinical problem, the multidimensional nature of chronic pain, and general lack of rigorous study design, however, have obscured outcome assessment and hampered efforts to optimize patient selection criteria. Recent work has focused on refinement of existing therapies for FBSS and identification of factors that influence outcome and improve patient selection criteria. In combination with more rigorous study methodology, these efforts have led to improved understanding of the clinical response to a number of pharmacologic, surgical, and neuromodulation therapies for FBSS.
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Current review of pain · Jan 2000
ReviewReflex sympathetic dystrophy: a sympathetically mediated pain syndrome or not?
Because of the controversy concerning the manner in which the sympathetic nervous system is involved in reflex sympathetic dystrophy (RSD), its name was changed to one having no mechanistic connotations. This article reviews the relevant literature in support of not only the taxonomical changes to complex regional pain syndrome (CRPS) but also provides evidence of sympathetic dysfunction demonstrated in animal models of neuropathic 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.