Pain medicine : the official journal of the American Academy of Pain Medicine
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Neck pain is a leading cause of years lived with disability and is often managed with opioid medications in primary care settings, though this is contraindicated by national guidelines. The aim of this study was to determine the prevalence of opioid prescription for neck pain at a primary care visit and to analyze the geographic variation and trends in opioid prescriptions between 2011 and 2017. ⋯ Opioid medication use for neck pain in the primary care setting is significant. Although opioid prescriptions are declining, there remains a need for further standardization in prescription practices.
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Recent guidelines advise limiting opioid prescriptions for acute pain to a three-day supply; however, scant literature quantifies opioid use patterns after an emergency department (ED) visit. We sought to describe opioid consumption patterns after an ED visit for acute pain. ⋯ In this sample, pill consumption varied by illness category; however, overall, patients were consuming low quantities of pills, and the majority had unused pills 10 days after their ED visit.
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Observational Study
Clinical Characteristics and Therapeutic Results in a Series of 68 Patients with Occipital Neuralgia.
Cranial pain is a condition that has a negative impact on human lives, and occipital neuralgia is among its causes. This study aims to evaluate the clinical characteristics and therapeutic results of a series of patients with occipital neuralgia. ⋯ Occipital neuralgia is an uncommon disorder in the sample explored. The prolonged latency between the onset of symptoms and diagnosis suggests that there should be an increased awareness of this disorder.
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Thoracic spinal pain is common, and patients with this type of pain have limited therapeutic options. The cohort in this study received diagnostic intra-articular zygapophysial joint injections leading to thermal neurotomy to the medial branch nerves to demonstrate improved pain as well as physical and psychological function. ⋯ This cohort demonstrates that there is a pragmatic diagnostic and therapeutic option available for patients with thoracic zygapophysial joint pain that can achieve 50-100% of pain relief in 63% of patients with improved physical and psychological function.