Pain medicine : the official journal of the American Academy of Pain Medicine
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Multicenter Study
Complementary and alternative medicine use by primary care patients with chronic pain.
To describe the characteristics and attitudes toward complementary and alternative medicine (CAM) use among primary care patients with chronic pain disorders and to determine if CAM use is associated with better pain control. ⋯ Complementary and alternative therapies were popular among patients with chronic pain disorders surveyed in academic primary care settings. When asked to choose between traditional therapies or CAM, most patients still preferred traditional therapies for pain relief. We found no association between reported CAM usage and pain severity, functional status, or self-efficacy.
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Clinical observation has suggested the presence of ventral cervical extra-articular pain pathways in patients with C1-C2 joint pain. However, the existence of ventral innervation to the C1-C2 joint has not been documented. The objective of this study was to determine whether ventral innervation to the lateral C1-C2 joint exists, and to describe its relational anatomy. ⋯ In this study, two cervical prevertebral plexuses (superficial and deep) were identified that have not previously been described. Terminal branches of the plexuses entered the ventral joint capsule of the lateral C1-C2 joint and were seen approaching the dens. Findings provide and explanation for the clinical observation that electrical stimulation in the C2 ventral gutter can reproduce headache in patients with C1-C2 joint pain.
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The block of the obturator nerve is used in pain medicine mostly for the management of acute pain after lower limb surgery or for chronic hip pain. The aim of this study was to define an injection technique based on an anatomical investigation and a magnetic resonance (MRI) analysis. ⋯ Based on the above findings, a technique of block of the obturator nerve could be defined. The method has the potential to enable an efficient and safe identification of the target nerve in clinical practice.
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Fabry disease (FD) is an X-linked lipid storage disorder showing a high prevalence and early occurrence of painful neuropathy. Early detection of this likely underdiagnosed disease is an important approach because a causal therapy is available. ⋯ Thus, somatosensory profiling in male patients with painful extremities may be useful in the detection of FD.
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The aim of this report is to determine the frequency of aberrant drug behaviors and their relationship to substance abuse disorders in a large primary sample of patients receiving opioids for chronic pain. ⋯ Patients who report four or more aberrant drug behaviors are associated with a current substance use disorder and illicit drug use, whereas subjects with up to three aberrant behaviors have a very low probability of a current substance abuse disorder. Four behaviors--oversedated oneself, felt intoxicated, early refills, increase dose on own--appear useful as screening questions to predict patients at greatest risk for a current substance use disorders.