Pain medicine : the official journal of the American Academy of Pain Medicine
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To evaluate the diagnostic usefulness of repeating sacroiliac joint (SIJ) provocative tests post-block. ⋯ Multiple positive pre-block SIJ provocative tests have diagnostic utility however post-block normalization of SIJ provocative tests does not.
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This study examined the assessment of the negative emotional constructs of depression, anxiety and stress with the short version (21 items) of the Depression Anxiety Stress Scales (DASS-21) in elderly patients (age > 60 years) with persistent pain. ⋯ Overall, the DASS-21 is a reliable and valid measure of depression, anxiety and stress in elderly patients with persistent pain. There are some age differences in the normative values for the reporting of mood symptoms and these need to be taken into account when assessing pain-related mood disturbance in older populations.
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Randomized Controlled Trial
Subcutaneous injection of botulinum toxin a is beneficial in postherpetic neuralgia.
To assess the benefits of subcutaneous injection of botulinum toxin A (BTX-A) for the treatment of postherpetic neuralgia (PHN). ⋯ Subcutaneous administration of BTX-A significantly decreased pain in PHN and reduced opioid use compared with lidocaine and placebo at day 7 and 3 months post-treatment. It also increased subjects' sleep times.
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The primary aim was to evaluate the prevalence of inadvertent intradiscal injection during fluoroscopically guided contrast-enhanced lumbar transforaminal epidural steroid injections. The secondary aim was to determine if there are any risk factors for or adverse events as a result of inadvertent intradiscal contrast injection. ⋯ Intradiscal contrast injection is an infrequently reported event during lumbar transforaminal epidural steroid injections. Our data support that the prevalence is very low and there might be an association with ipsilateral foraminal stenosis. Although there is potential for significant adverse complications with intradiscal injection, our data set did not show serious sequelae.
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"They don't want anything to do with you": patient views of primary care management of chronic pain.
Chronic pain is one of the most frequent complaints of patients in primary care, yet both patients and providers report low satisfaction with chronic pain care. This study was designed to explore the views held by a diverse sample of patients with chronic pain complaints about their care experiences to identify ways to improve care. ⋯ Implementing patient-centered approaches in caring for individuals with chronic pain and using principles drawn from the chronic disease management model to improve care systems may improve both patient and provider satisfaction with chronic pain care.