Pain medicine : the official journal of the American Academy of Pain Medicine
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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.
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Randomized Controlled Trial
The Association Between Smoking Abstinence and Pain Trajectory among Veterans Engaged in VA Mental Health Care.
To prospectively examine associations between smoking and nicotine abstinence and pain trajectory over 12 months among smokers with low, moderate, and severe pain and to assess whether these associations differ over time. ⋯ In this prospective analysis conducted among veteran smokers engaged in mental health services, 7-day abstinence from smoking and nicotine was associated with significantly lower levels of pain. Education efforts could help better inform smokers on the relationship between smoking and pain.
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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.
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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.