Pain medicine : the official journal of the American Academy of Pain Medicine
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To summarize and to analyze the available literature on the efficacy of intra-articular injections of corticosteroids for low back pain. ⋯ The apparent efficacy of lumbar intra-articular steroids is no greater than that of a sham injection. There is no justification for the continued use of this intervention. Better outcomes can be achieved with deliberate placebo therapy.
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To review the evidence for dosing and efficacy of oral transmucosal fentanyl citrate in the management of pain and produce dosing guidelines. ⋯ Oral transmucosal fentanyl citrate is a potent opioid delivery system, which, when used appropriately, is an effective treatment option for pain. Adherence to guidelines should promote its safe and efficacious use in a variety of clinical pain management settings.
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Randomized controlled trials in research settings have demonstrated the efficacy of percutaneous radiofrequency neurotomy of the medial branches of the cervical dorsal rami in the palliation of chronic zygapophysial joint pain, a common cause of chronic neck pain, but one that is under-recognized in some quarters. ⋯ Radiofrequency neurotomy is an effective palliative treatment for chronic cervical zygapophysial joint pain when performed in routine clinical practice.
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Fatigue is frequently found in chronic pain patients (CPPs) and may be etiologically related to the presence of pain. Fishbain et al. have recently demonstrated that chronic low back pain (LBP) and chronic neck pain patients are more fatigued than controls. The purpose of this study was to determine whether chronic LBP- and chronic neck pain-associated fatigue responded to multidisciplinary multimodal treatment not specifically targeted to the treatment of fatigue. ⋯ Multidisciplinary multimodal pain facility treatment improves chronic LBP- and neck pain-associated fatigue. At the present time we cannot predict this improvement with significant accuracy.