Pain physician
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Observational Study
Influence of Handgrip Strength and Psoas Muscle Index on Analgesic Efficacy of Epidural Steroid Injection in Patients With Degenerative Lumbar Spinal Disease.
Handgrip strength (HGS) and psoas muscle index (PMI) are widely used protocols for screening or diagnosing sarcopenia by measuring muscle strength and mass. Epidural steroid injection (ESI) is a common intervention for the treatment of spinal pain; however, the influence of pre-procedural sarcopenic status on therapeutic effects after ESI has not been investigated. ⋯ In the present study, pre-procedural HGS was an independent predictor of analgesic efficacy after ESI in elderly patients with degenerative lumbar spinal disease. However, the PMI was not associated with pain relief after injection.
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Legg-Calvé-Perthes disease (LCPD) and slipped capital femoral epiphysis (SCFE) can result in painful deformation of the hip joint with impaired range of motion and early development of secondary osteoarthritis. It has not been investigated whether having LCPD or SCFE is associated with increased use of pain or antidepressant drug prescriptions later in life. ⋯ During childhood, patients with LCPD or SCFE seem to suffer long-term pain and have an increased risk of requiring analgesic medication in adulthood, including opioids. It is important to assess the causes, type, and severity of pain to optimize pain management to counteract possible overuse in these patients. Seemingly, patients with LCPD do not have an increased risk for antidepressant drug therapy in adulthood whereas we did see an increased risk for that in patients with previous SCFE compared with the general population.