Pain physician
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Treatment of intermediate-stage painful degenerative disc disease is controversial, with few reliable options. Allogenic mesenchymal stem cells (MSCs)are an alternative to autologous stem cell transplantation. Allogeneic MSCs in the treatment of discogenic low back pain have some practical advantages, ranging from availability to ease of treatment in a procedure-room setting. ⋯ The results of our feasibility study suggest that the injection of allogeneic MSCs to treat patients with painful intermediate-stage degenerative disc disease has merit. No adverse reactions were observed. The authors recommend further study in a randomized prospective study setting with a placebo control group or a natural history study group of patients to solidify this research.
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Interlaminar epidural injection (ILEI) is used to relieve low back pain, with or without radiating pain. The distance from the skin to the epidural space determines the needle depth and may be influenced by the patient's body measurements. ⋯ Height combined with weight and BMI can help estimate the optimal needle depth from the skin to the epidural space. Needle depth in L5-S1 and caudal angle in L3-4 and L4-5 of MRI were correlated with those of fluoroscopy of ILEI.
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Postoperative pain is a concern after thoracic and breast surgeries. Recent studies have demonstrated that ultrasound-guided serratus anterior plane block (SAPB) could provide postoperative analgesia. ⋯ Our findings suggest that SAPB not only relieves acute pain after thoracic and breast surgery, but also reduces the incidence of chronic postsurgical pain.
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Randomized Controlled Trial
Effect of Different Frequencies of Electroacupuncture on Chronic Low Back Pain in Older Adults: A Triple-blind, Placebo-controlled, Randomized Clinical Trial.
Acupuncture is one of the most widely used therapies to treat chronic low back pain, whose analgesic effect seems to be potentiated by the addition of electric current (electroacupuncture). However, we are not aware of any clinical trial that has evaluated the effectiveness of this technique in adults > 65 years. ⋯ This study provides evidence that there is no one frequency of electroacupuncture that is most effective in treating chronic low back pain in the elderly and that electroacupuncture is not superior to manual acupuncture or placebo treatment.