Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Clinically significant placebo analgesic response in a pilot trial of botulinum B in patients with hand pain and carpal tunnel syndrome.
We conducted a pilot trial to assess the effect of botulinum toxin B on palmar pain and discomfort in carpal tunnel syndrome (CTS) patients. Design. Randomized, double-blind, placebo-controlled. ⋯ Botulinum toxin B is not dramatically superior to placebo for the relief of CTS symptoms. Possible explanations of the improvements in each study group are explored.
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Chronic noncancer pain includes a heterogeneous group of disorders and is often refractory to treatment. Cannabis products have historically been used for chronic pain and are attracting renewed pharmaceutical interest. Nabilone is a synthetic cannabinoid licensed in Canada for the treatment of severe nausea and vomiting associated with cancer chemotherapy. ⋯ Beneficial effects on sleep and nausea were the main reasons for continuing use. Intolerable side effects were experienced in three patients (palpitations, urinary retention, dry mouth). Nabilone may be a useful addition to pain management and should be further evaluated in randomized controlled trials.
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Case Reports
Discitis after lumbar epidural corticosteroid injection: a case report and analysis of the case report literature.
The primary objective is to document the first case report of discitis after a lumbar epidural corticosteroid injection. The second objective is to analyze the case report literature to identify clinical features and trends of patients with infectious complications after spinal injections. ⋯ The identified clinical features and trends could prove useful to the practitioner when an infectious complication is suspected or has occurred.