Pain medicine : the official journal of the American Academy of Pain Medicine
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The sacroiliac joint is a common source of chronic low back pain. We recently described the use of cooled radiofrequency (RF) electrodes for performing lateral branch neurotomy to treat sacroiliac joint pain. The procedure involves lesioning the lateral branches of the posterior primary rami at S1-S3, and the L5 dorsal ramus (L5DR). While the cooled RF electrode has been adopted as a means for lesioning the lateral branches, conventional RF electrodes are used to lesion the L5DR. The objective of this technical report is to evaluate the acute safety of denervating the L5DR using cooled RF electrode. ⋯ This review demonstrates the acute safety of using cooled RF for L5DR denervation with no report of significant or unusual patient complications. To establish frequency of complication associated with the treatment, a larger registry is required.
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This study aims to evaluate the effectiveness of trans-electric nerve stimulation (TENS) for phantom limb pain applied to contralateral limb (nonamputated limb). ⋯ Both patients showed a significant improvement in their perception of phantom limb pain and sensations that was maintained at one-year follow-up. A randomized blinded controlled trial to confirm these positive outcomes is required.
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Randomized Controlled Trial
A new muscle pain detection device to diagnose muscles as a source of back and/or neck pain.
Trigger point (TrPs) identification has become the mainstay of diagnosis for the treatment of Myofascial Pain Syndrome; however, manual pressure (MP) to identify TrPs by determining low-pressure pain threshold has low interrater reliability and may lack validity since it is done on inactive muscles. To elicit contractions and mimic an active muscle or movement that "causes" pain, a Muscle Pain Detection Device (MPDD) has been developed. A selected muscle is stimulated and painful muscles are precisely detected, allowing distinctions between primary and referred muscle pain as well as distinguishing other functional muscle pain thought to cause MPS. ⋯ Using the MPDD appears to be more valid and potentially more reliable than palpation to identify muscles causing regional pain that could benefit from injections.
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This study aimed to describe prescribing and administration of opioids in a tertiary referral teaching hospital. Secondary aims were assessment of staff knowledge of opioid pharmacology and available preparations, and of perceived barriers limiting opioid use. ⋯ The majority of participants had incomplete pain relief and the maximum prescribed doses of opioids were not administered. Reported barriers included staff knowledge of opioid dose titration and opioid preparations, and time constraints. Identified barriers included poor knowledge of opioid preparations.
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The present study builds on research to model abusers' perceptions of particular analgesics' attractiveness for abuse and extends these methods to derive an estimate of attractiveness for abuse of a not-yet-marketed abuse-deterrent formulation (ADF) of a prescription opioid (Remoxy), Pain Therapeutics, Inc., San Mateo, CA, and King Pharmaceuticals, Inc., Bristol, TN). In a previous study, the Opioid Attractiveness Technology Scaling (OATS) method identified, from a drug abuser's point of view, the particular features of a prescription opioid relevant to its attractiveness for recreational use. A second online sample rated the extent to which these features applied to particular products they had actually used/abused. These data were used to model the abusers' overall preference for prescription opioids they had used/abused. ⋯ The OATS method shows promise for providing pre-marketing estimates of attractiveness for abuse of not-yet-marketed ADFs.