Pain physician
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Complex regional pain syndrome type I (CRPS-I), also called algodystrophy, is a complex syndrome characterized by limb pain, edema, allodynia, hyperalgesia and functional impairment of bone with a similar clinical picture of osteoporosis, including an increased release of various pro-inflammatory neuropeptides and cytokines. Several treatments have been proposed for CRPS-I, but due to the poor outcome of conventional drugs and the invasiveness of some techniques, expectations are now directed towards new resources that could be more effective and less invasive. ⋯ The present review underlined the rationale for the use of PEMFs in the complex contest of CRPS-I syndrome, in combination with conventional drugs. Key words: Complex regional pain syndrome type I, algodystrophy, pulsed electromagnetic field stimulation, osteoporosis, inflammation, osteoclasts, osteoblasts, pain.
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Randomized Controlled Trial
The Dose-Dependent Effects of Ketoprofen on Dynamic Pain after Open Heart Surgery.
Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce postoperative pain, in both static (i.e., at rest) and dynamic contexts (e.g., during coughing or mobilization), and reduced doses could improve their efficacy/tolerance balance. ⋯ Although we failed to demonstrate any analgesic effects with low doses of ketoprofen, we confirmed the good efficacy/tolerance balance with this propionic NSAID of intermediate COX2-selectivity. Lower doses of NSAIDs, potentiated by a loading dose, should be tested in the future.IRB approval: CPP Sud-Est VI (Clermont-Ferrand, France), on 12/23/2013.Clinical trial registry: EudraCT (2013-003878-27); ClinicalTrials.gov (NCT02180087).Key words: Non-steroidal anti-inflammatory drugs, ketoprofen, cyclooxygenase, pain, postoperative, sternotomy, postoperative rehabilitation, analgesia, side effects.
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Randomized Controlled Trial
1-Year Results of a Randomized Controlled Trial of Conservative Management vs. Minimally Invasive Surgical Treatment for Sacroiliac Joint Pain.
Low back pain (LBP) emanating from the sacroiliac joint (SIJ) is a common finding. Devices to fuse the SIJ are now commercially available, but high-quality evidence supporting their effectiveness is limited. ⋯ For patients with chronic LBP originating from the SIJ, minimally invasive SIJF with triangular titanium implants was safe and more effective than CM in relieving pain, reducing disability, and improving patient function and quality of life. Our findings will help to inform decisions regarding its use as a treatment option in this patient population.Key words: Sacroiliac joint dysfunction, pelvic girdle pain, randomized controlled trial, quality of life, spine implants.
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A high degree of inter-individual differences was noted in human basal pain as well as the reporting of clinical pain, such as postoperative pain. Understanding the effects of common epidemiological variations and preoperative experimental methods of human pain perception may contribute to individualized pain treatment for patients. ⋯ Preoperatively determining the smoking status and history of surgery might serve as predictors for postoperative analgesia in the Chinese population. Additional preoperative pressure pain measurements might be an effective experimental method for predicting postoperative pain.Key words: Epidemiologic, pressure pain, smoking, predicting, surgery, postoperative pain, inadequate analgesia, Chinese population.
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Comparative Study Observational Study
Comparison of Intraarticular Pulsed Radiofrequency and Intraarticular Corticosteroid Injection for Management of Cervical Facet Joint Pain.
Disorders of the facet joints are some of the most common sources of chronic spinal pain. Facet joint pain is responsible for approximately 50% of patients with chronic neck pain. Pulsed radiofrequency (PRF) stimulation, after placing needle electrodes into the joint space, has been recently reported for the management of joint pain. ⋯ IA PRF stimulation is as effective as IA corticosteroid injection in attenuating CFJ pain. The use of PRF could decrease CFJ pain, while avoiding the adverse effects of steroids.Key words: Cervical facet joint pain, pulsed radiofrequency, intraarticular stimulation, chronic pain, corticosteroid injection, numeric rating scale.