Pain medicine : the official journal of the American Academy of Pain Medicine
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Caudal epidural steroid injections (ESIs) are commonly used to treat lumbar radicular pain. Touhy needles are placed under live fluoroscopic guidance to ensure epidural administration of medication. This is a case report of direct needle and catheter placements into and through the filum terminale during a caudal approach to the epidural space. ⋯ Although caudal ESI is a relatively safe and routine intervention, care must be taken to ensure proper placement of needle, catheter, and injectate. While contrast is injected to ensure appropriate epidural spread, it serves also to reveal unexpected and unwanted spread. We present the first report of a needle being inserted directly into the filum terminale during a caudal ESI.
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To investigate the trigeminal somatosensory (thermal, pain, tactile, vibratory, and electric), gustative (salty, bitter, sweet, sour), and olfactory thresholds in healthy women during the menstrual cycle and investigate any association with estradiol and progesterone levels in saliva. ⋯ Estrogen and progesterone seem to be involved in sensory neuromodulation in women during the menstrual cycle.
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Letter Case Reports
Serratus Anterior Muscle Pain Syndrome: A Diagnostic Conundrum.
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Multicenter Study Observational Study
Spinal Cord Stimulation (SCS) with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain Relief Compared to Traditional SCS-LUMINA Study.
The aim of this study was to determine whether spinal cord stimulation (SCS) using 3D neural targeting provided sustained overall and low back pain relief in a broad routine clinical practice population. ⋯ Our results suggest that 3D neural targeting SCS and its associated hardware flexibility provide effective treatment for both chronic leg and chronic axial low back pain that is significantly superior to traditional SCS.
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More than 100 million adults in the United States experience chronic pain, and prescription opioids are the third most widely prescribed class of medications. Current opioid overdose prevention efforts almost exclusively target illicit opioid users, and little is known about the experience of overdose among patients being treated for chronic pain (CP) with a prescription opioid. ⋯ Opioid overdose occurs at a high rate among CP participants, and this group is relatively uninformed about risk factors for overdose. Established SOAPP-R and DSM thresholds provide an opportunity to identify participants at elevated risk for having experienced an opioid overdose. These data support development of additional concentrated efforts to prevent overdose among chronic pain patients.