Pain medicine : the official journal of the American Academy of Pain Medicine
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To evaluate sacroiliac joint (SIJ) injection outcomes with local anesthetic and corticosteroid. ⋯ SIJ steroid injection based on referral clinical diagnosis is unlikely to demonstrate true injection efficacy, and more specific selection criteria are warranted.
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Fibromyalgia patients face particular challenges in building relationships with health care providers. In this study, we examine, from patients' perspectives, factors that influence the formation of effective patient-provider relationships. ⋯ Understanding of the key elements of relationship development between patients and providers can be utilized in various ways to improve clinical care. First, the knowledge gained in this study can inform the design of patient education materials that assist patients to identify providers that fit their needs, prepare for consultations, and develop realistic expectations for providers. The findings of this study can also inform the design of resources and tools to enable clinicians to communicate and relate better with their patients.
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Determine the effectiveness of fluoroscopically guided cervical transforaminal epidural steroid injection (CTFESI) for the treatment of radicular pain. ⋯ Approximately 50% of patients experience ≥50% pain reduction at short- and intermediate-term follow-up after CTFESI. However, the literature is very low quality according the GRADE criteria, primarily due to a lack of studies with placebo/sham or active standard of care control comparison groups.
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Observational Study
Integrating Adjuvant Analgesics into Perioperative Pain Practice: Results from an Academic Medical Center.
Opioid-sparing postoperative pain management therapies are important considering the opioid epidemic. Total knee arthroplasty (TKA) is a common and painful procedure accounting for a large number of opioid prescriptions. Adjuvant analgesics, nonopioid drugs with primary indications other than pain, have shown beneficial pain management and opioid-sparing effects following TKA in clinical trials. We evaluated the adjuvant analgesic gabapentin for its usage patterns and its effects on opioid use, pain, and readmissions. ⋯ When assessed in a real-world setting over a large cohort of TKA patients, gabapentin is an effective pain management therapy that is associated with reduced opioid consumption-a national priority in this time of opioid crisis-while maintaining the same quality of pain management.