Pain physician
-
Case Reports
Redo kyphoplasty with vertebroplasty technique: a case report and review of the literature.
Osteoporosis is a metabolic disorder which may result in devastating medical problems if not treated appropriately. However, even in the best treated patients fractures may occur. The most devastating fractures are spine and hip. ⋯ To this date, this is the first article published regarding the use of vertebroplasty technique over a kyphoplasty treated patient. In this case report, a redo vertebroplasty was performed over a previously treated kyphoplasty or vertebroplasty. This procedure can give a patient significant pain relief when they are suffering with pain after a previously treated fracture.
-
Case Reports
Allogeneic epidural blood patch in the setting of persistent spinal headache and disseminated coccidioidomycosis.
In most cases of post-dural puncture headache, the positional symptoms will resolve spontaneously within 2 weeks. Conservative therapies include oral analgesics and hydration, bed rest, and abdominal binders. For refractory cases, an autologous epidural blood patch remains the treatment of choice. ⋯ Other epidural space interventions such as fibrin glue injection or saline infusions were judged to be too imprecise or ineffective. The patient was successfully treated with allogeneic blood donated by his wife, but only after testing of her blood as is required for any directed blood donation. Allogeneic epidural blood patches are an option for refractory dural puncture headaches when autologous blood may cause meningitis or malignant seeding of the central nervous system.
-
Chronic pain is a debilitating problem with significant impact on healthcare utilization in the US. Many chronic pain patients use complementary or alternative medicine (CAM) in addition to standard pharmacologic therapy. ⋯ Our study demonstrates that CAM is used very frequently in patients with chronic pain. However, it did not show any ethnic or racial differences in CAM utilization.
-
Abuse of prescribed controlled substance has become a serious social as well as health care issue over the past decade. A particularly alarming trend exists among patients aged 12 to 17. Common abuse behaviors include doctor shopping, drug theft, feigned pain symptoms to gain health care access, drug sharing, prescription forgery, and improper prescription practices. In response to this epidemic of abuse, many states have adopted prescription monitoring programs (PMPs). Such programs first originated in the early twentieth century. As of 2006, 38 states had such programs, many of which are supported by federal grants. As PMPs become more widespread, they have also increased in sophistication. By keeping a record of the prescription and dispensing of narcotics, these programs are able to build a comprehensive data network for tracking prescription medications. These databases aid law enforcement agencies in investigations of narcotic trafficking; they also help state regulatory boards to monitor improper prescription practices. ⋯ Many states have developed PMPs to help regulatory agencies as well as physicians detect prescription drug abuse. Limited data so far suggest that such programs reduce abuse practices. In addition, proactive usage of the data further prevents abuse.