Pain physician
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Randomized Controlled Trial
Effects of transforaminal balloon treatment in patients with lumbar foraminal stenosis: a randomized, controlled, double-blind trial.
Lumbar spinal stenosis is a common condition in the elderly. Although balloon treatment is a well-known therapeutic method in specific pain conditions, applying the balloon treatment in patients with lumbar spinal stenosis is not yet well established. ⋯ Transforaminal balloon treatment leads to both significant pain relief and functional improvement in a subset of patients with refractory spinal stenosis. INSTITUTIONAL REVIEW: This study was approved by the Institutional Review Board of the Asan Medical Center.
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Randomized Controlled Trial
Stimulation of the greater occipital nerve: anatomical considerations and clinical implications.
Stimulation of the greater occipital nerve has been employed for various intractable headache conditions for more than a decade. Still, prospective studies that correlate stimulation of the greater occipital nerve with outcome of patients with respect to alleviation of headache are sparsely found in literature. ⋯ From our study we conclude that a reproducible stimulation of the greater occipital nerve can be achieved by placing the electrodes parallel to the atlas, at about 30 mm distance to the external occipital protuberance. The response to the stimulation is not correlated to the field width of the paraesthesia. We, therefore, consider stimulation of the main trunk of the greater occipital nerve to be more important than a large field of stimulation on the occiput. Still, an individual response to the occipital nerve stimulation cannot be predicted even by optimal electrode placement.
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Randomized Controlled Trial
Anatomical basis of ulnar approach in carpal tunnel injection.
Local steroid injection may be an effective conservative treatment for carpal tunnel syndrome; however, the use of a blind injection technique can increase the chance of median nerve or ulnar artery injury due to median nerve swelling or the close proximity of the median nerve and ulnar artery around the distal wrist crease. ⋯ It is important to recognize the risk of blind local steroid injection for carpal tunnel syndrome, which is most likely a result of swelling and/or flattening of the median nerve around the distal wrist crease. A real time, ultrasound-guided local steroid injection is preferred as a safe and accurate technique in carpal tunnel syndrome treatment.
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Patients with chronic whiplash associated disorders (WAD) demonstrate altered central pain processing and impaired endogenous analgesia. In addition, previous research reported disturbances in the autonomic nervous system and the presence of post-traumatic stress reaction in patients with chronic WAD. The autonomic nervous system, in particular the autonomic stress response, might modulate central pain processing in this population. ⋯ Results of this study refute autonomic dysfunction in response to pain in patients with chronic WAD. The autonomic nervous system activity or reactivity to acute pain appears unrelated to either pain thresholds or endogenous analgesia in patients with chronic WAD.
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Randomized Controlled Trial Multicenter Study
Tapentadol immediate release versus oxycodone immediate release for treatment of acute low back pain.
Tapentadol has demonstrated analgesic efficacy across a range of pain conditions. ⋯ NCT00986180.