Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
A randomized, placebo-controlled study to assess the efficacy of lateral branch neurotomy for chronic sacroiliac joint pain.
The objective of this study was to compare the efficacy of lateral branch neurotomy using cooled radiofrequency to a sham intervention for sacroiliac joint pain. ⋯ The treatment group showed significant improvements in pain, disability, physical function, and quality of life as compared with the sham group. The duration and magnitude of relief was consistent with previous studies, with current results showing benefits extending beyond 9 months.
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Although effective alone, opioids are often used in combination with other drugs for relief of moderate to severe pain. Guidelines for acute perioperative pain recommend the use of multimodal therapy for pain management, although combinations of opioids are not specifically recommended. Mu opioid drugs include morphine, heroin, fentanyl, methadone, and morphine 6β-glucuronide (M6G). ⋯ These differences among the drugs raise the question of whether combinations might result in better pain relief with fewer side effects. This concept has already been demonstrated between two mu opioids in preclinical studies and clinical trials on other combinations are ongoing. This article reviews the current state of knowledge about mu opioid receptor pharmacology, summarizes preclinical evidence for synergy from opioid combinations, and highlights the complex nature of the mu opioid receptor pharmacology.
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Randomized Controlled Trial
Addressing both depression and pain in late life: the methodology of the ADAPT study.
To describe the methodology of the first NIH-funded clinical trial for seniors with comorbid depression and chronic low back pain. ⋯ The results of this trial will inform the care of these complex patients and further understanding of comorbid pain and depression in late life.
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The objective of this study was to investigate whether pressure hypersensitivity over deep tissues is a feature of acute inversion ankle sprain. ⋯ This study showed the presence of localized pressure pain hypersensitivity over ankle ligaments in patients with unilateral acute inversion ankle sprain, confirming the presence of localized peripheral sensitization.
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The article aims to evaluate the long-term effectiveness and safety of pulsed radiofrequency (PRF) on the dorsal root ganglion (DRG) in patients with chronic cervical radicular pain refractory to repeated transforaminal epidural steroid injections (TFESIs). ⋯ Application of PRF to the DRG appears to be an effective and relatively safe intervention technique for chronic cervical radicular pain refractory to repeated TFESIs.