Pain medicine : the official journal of the American Academy of Pain Medicine
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There are several types of lumbar stenosis, such as central, lateral recess, foraminal. The symptoms of lumbar stenosis are neurogenic claudication, numbness, tingling, etc. The treatment modality is medication, physical therapy, intervention, and surgery. The epidural steroid injection has been used for treatment of low back pain/radiculopathy. However, we could not predict what percent had pain relief after epidural steroid injection. The purpose of this study was to evaluate the usefulness of high sensitivity C-reactive protein (hsCRP) as a marker for predicting the efficacy of lumbar transforaminal epidural steroid injection. ⋯ The results suggest that there was no correlation between pretreat hsCRP and posttreat VAS. Therefore, hsCRP may not be useful as predictor of response to TFESI in patients with spinal stenosis.
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Investigate whether percutaneous spinal cord stimulator (SCS) leads migrate significantly during a 3-day trial, and determine whether the skin anchoring method influences lead migration. ⋯ Percutaneous SCS trial electrodes migrate significantly, inferiorly, during a 3-day trial. Anchoring the trial electrodes to the skin with a suture and tape results in significantly greater inferior migration when compared with anchoring the lead with tape only.
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The objective of this study was to examine the associations between chronic pain and psychiatric morbidity using interview-based assessments of psychiatric symptomatology. We compared the prevalence of common mental disorder (CMD; consistent with neurotic and somatic symptoms, fatigue, and negative affect), depression, and anxiety disorder(s), and associated factors with these psychiatric illnesses among Chinese patients with chronic pain attending specialist orthopedics clinic and multidisciplinary pain clinic. ⋯ Chronic pain is associated with psychiatric morbidity. The higher rate of depression than anxiety disorder(s) among patients with chronic pain is consistent with previous studies that have found depression to be highly prevalent in chronic pain.
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To review clinical strategies for long-term opioid management as well as strategies to assess and monitor patients with moderate to severe chronic pain who may be at risk for aberrant drug-related behaviors. ⋯ Vigilance and frequent interactions may sometimes be inadequate to prevent problematic behaviors; therefore, pharmacologic strategies designed to deter abusive behaviors are also discussed.
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To assess the effects of preclinic group education sessions and system redesign on tertiary pain medicine units and patient outcomes. ⋯ The introduction of STEPS was associated with reduced wait-times and costs at public pain medicine units and increased both the use of active pain management strategies and patient satisfaction.