Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Meta Analysis
The effectiveness of lumbar transforaminal injection of steroids: a comprehensive review with systematic analysis of the published data.
To determine the effectiveness of lumbar transforaminal injection of steroids in the treatment of radicular pain. ⋯ In a substantial proportion of patients with lumbar radicular pain caused by contained disc herniations, lumbar transforaminal injection of corticosteroids is effective in reducing pain, restoring function, reducing the need for other health care, and avoiding surgery. The evidence supporting this conclusion was revealed by comprehensive review of all published data and found to be much more compelling than it would have been if the literature review had been of the limited scope of a traditional "systematic review" of randomized, controlled trials only.
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Review Meta Analysis
The effectiveness of lumbar transforaminal injection of steroids: a comprehensive review with systematic analysis of the published data.
To determine the effectiveness of lumbar transforaminal injection of steroids in the treatment of radicular pain. ⋯ In a substantial proportion of patients with lumbar radicular pain caused by contained disc herniations, lumbar transforaminal injection of corticosteroids is effective in reducing pain, restoring function, reducing the need for other health care, and avoiding surgery. The evidence supporting this conclusion was revealed by comprehensive review of all published data and found to be much more compelling than it would have been if the literature review had been of the limited scope of a traditional "systematic review" of randomized, controlled trials only.
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In recent years, the field of acute pain medicine (APM) has witnessed a surge in its development, and pain has begun to be recognized not merely as a symptom, but as an actual disease process. This development warrants increased education of residents both in the performance of regional anesthesia as well as in the disease course of acute pain and the biopsychosocial mechanisms that define interindividual variability. ⋯ The scope and practice of APM must be expanded to include pre-pain/pre-intervention risk stratification and extended through the phase of subacute pain.