Pain medicine : the official journal of the American Academy of Pain Medicine
-
While provocation lumbar discography has been used to identify discs responsible for low back pain, the biomechanical effects of disc injection have received little attention. The purpose of this study was to assess the motion of the functional spinal unit including the endplate and facet/pedicle region during disc injection including comparison between normal and degenerative discs. ⋯ Disc injection expands the disc space inducing endplate motion, pedicle motion, and facet translation in almost all normal and most degenerate levels. Disc injection therefore biomechanically "provokes" the entire functional spinal unit. When provoked pain is encountered during lumbar discography, contribution from the associated facet joint and myotendinous insertions should be considered.
-
Headache represents about 25% of the total neurological consultations at the emergency department (ED). Up to 80% of these consultations are represented by primary headaches, in which an accurate and directed history-taking may help reach the specific diagnosis avoiding unnecessary complementary tests and reducing diagnostic latencies. ⋯ Educational interventions can improve history-taking in headache patients in the ED. This fact grants them as potential efficient measures to optimize patient management at Emergency Room.
-
Review Randomized Controlled Trial
Efficacy and Tolerability of Calcitonin Gene-Related Peptide Targeted Monoclonal Antibody Medications as Add-on Therapy to OnabotulinumtoxinA in Patients with Chronic Migraine.
We examined the efficacy and tolerability of calcitonin gene-related peptide-targeted monoclonal antibodies (CGRP-targeted mAbs) as add-on therapy for patients with chronic migraine (CM) undergoing treatment with onabotulinumtoxinA (onabot) who require additional preventive therapy. ⋯ Adding a CGRP-targeted mAb to onabot in patients with CM was associated with further reductions in MHDs without major tolerability issues across a range of mAbs. This retrospective review supports the conduct of a well-designed double-blind study adding a CGRP-targeted mAb or placebo to onabot.
-
Randomized Controlled Trial
A Phase 1, Randomized, Double-blind, Placebo-controlled, Crossover Study to Evaluate the Pharmacodynamic Effects of VX-150, a highly selective NaV1.8 inhibitor, in Healthy Male Adults.
To evaluate the analgesic potential, safety, tolerability, and pharmacokinetics of VX-150, a pro-drug of a highly selective NaV1.8 inhibitor, in healthy subjects. ⋯ Results of this proof-of-mechanism study are supportive of the potential of VX-150, a highly selective NaV1.8 channel inhibitor, to treat various pain indications.