Pain medicine : the official journal of the American Academy of Pain Medicine
-
Randomized Controlled Trial
Movement Evoked Pain and Mechanical Hyperalgesia after Intramuscular Injection of Nerve Growth Factor: A Model of Sustained Elbow Pain.
Lateral epicondylalgia presents as lateral elbow pain provoked by upper limb tasks. An experimental model of elbow pain provoked by movement/muscle contraction and maintained over several days is required to better understand the mechanisms underlying sustained elbow pain. This study investigated the time course and pain location induced by nerve growth factor (NGF) injection into a wrist extensor muscle, and whether movement and muscle contraction/stretch provoked pain. ⋯ This article presents a novel experimental human pain model suitable to study the sustained effects of lateral elbow pain on sensorimotor function and to probe the mechanisms underlying persistent musculoskeletal pain.
-
Observational Study
Differential Rates of Inadvertent Intravascular Injection during Lumbar Transforaminal Epidural Injections Using Blunt-Tip, Pencil-Point, and Catheter-Extension Needles.
To quantify the incidence of inadvertent vascular penetration during lumbosacral transforaminal epidural injections using blunt-tip, pencil-point, and catheter-extension needles. ⋯ Blunt-tip and pencil-point needles have comparable risk of inadvertent vascular injection during lumbosacral transforaminal injections. Catheter-extension needles demonstrated a reduce incidence of vascular uptake, but also result in a significantly higher rate of functional pitfalls that limits their usefulness in routine practice.
-
Patients who experience their nonmalignant chronic pain as intolerable sometimes present at Emergency Departments (EDs). However, as emergency medical services are set up to provide rapid treatment for acute injury or illness; there is potential for misunderstanding and disappointment. Literature on the topic of ED staff attitudes toward chronic pain patients is minimal, USA-based and methodologically unsatisfying. We carried out an in-depth, qualitative study identifying the attitudes and narratives of ED staff around people in chronic pain. ⋯ ED staff found people presenting at ED with chronic pain to be a challenging and frustrating population to treat. Staff was constrained by the fast-paced nature of their jobs as well as the need to prioritise emergency cases, and so were unable to spend the time needed by chronic pain patients. This was seen as being bad for staff, and for the patient experience. Staff suggested that care could be improved by appropriate information, signposting and with time invested in communication with the patient.