Current pain and headache reports
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Curr Pain Headache Rep · Feb 2025
ReviewThe Potential of Wearable, Modular Devices in Monitoring Functional Clinical Metrics in Patients Suffering from Chronic Pain.
This review assesses the role of wearable technologies in pain management, emphasizing their capability to transcend subjective pain evaluations with objective functional outcome tracking. We explore the types and veracity of health metrics wearable devices track, illustrating how this technological evolution can significantly enhance patient care in the context of chronic pain prevention and management. ⋯ The advancements in modular wearable technology offer new avenues to track a variety of health outcomes, including aerobic capacity, physical activity, stress, and sleep quality. This provides objective measurements that can aid in the management of chronic conditions and can offer a more comprehensive assessment of a patient's pain and function. Although the initial approach to pain management that emphasized pain as the fifth vital sign had unintended devastating consequences, leveraging wearable technology for objective outcomes tracking presents an opportunity to optimize pain management strategies. Wearable technologies capture functional metrics that provide insight into many aspects of the biopsychosocial model of pain. Utilizing function as the key performance indicator has the potential to improve treatment outcomes and, ultimately, patient care.
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The purpose of this review is to provide an update on recent developments in the field of regenerative medicine, specifically focusing on emerging data related to biologics, including platelet-rich plasma and mesenchymal cells, for the treatment of discogenic back pain. ⋯ There has been a notable surge of interest in biologics, as evidenced by a wealth of recent reviews and studies. While serious adverse events are generally uncommon, considerable heterogeneity exists in study designs. More robust investigations are warranted to thoroughly evaluate the safety and efficacy of biologics in treating discogenic back pain. Continued research and funding are needed to better understand the underlying mechanisms of disc degeneration and to develop targeted therapies that can alleviate and reduce the burden of this debilitating condition. Biologics may offer effective treatments for discogenic pain; however, more multi-center, prospective, double-blinded, randomized placebo-controlled trials are essential to further establish their effectiveness.
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Curr Pain Headache Rep · Feb 2025
ReviewConsenting for Spinal Cord Stimulation - the Pitfalls and Solution.
To discuss the importance of the consenting process for patients undergoing spinal cord stimulation (SCS) therapy and understanding related complications and effects. ⋯ Litigation for SCS/DRG related complications can be very costly, with the mean average settlement in cases relating to SCS being $303,173 dollars in the USA. According to the US Anaesthesia Closed Claims Project database, 10,546 claims related to pain medicine were made between 1990 and 2013; 43 of which were associated with SCS complications. This article will further explore consenting and complications within the context of SCS. Consenting for SCS is a crucial and very important step which potentially reflect on patients' expectations and outcomes.
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Curr Pain Headache Rep · Jan 2025
ReviewThe Impact of Racial and Low Socioeconomic Status on the Implementation of Spinal Cord Stimulation for Chronic Pain in the United States.
This study aims to review the societal, economic, and racial factors that impact the usage of spinal cord stimulation for chronic pain. Our working hypothesis is that patients of ethnic minority groups or of lower socioeconomic status (SES) status may have lower implantation rates and usage of spinal cord stimulation (SCS). ⋯ White patients are recipients of SCS earlier and more frequently than minority patients in the outpatient setting. There is mixed evidence regarding inpatient SCS and how household income relates to SCS usage. Insurance type and coverage may be more accurately predictive than simple household income for SCS utilization.
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Curr Pain Headache Rep · Jan 2025
ReviewNeuroimage Signature in Post-Stroke Pain: A Systematic Review.
Central Post-Stroke Pain (CPSP) is a debilitating condition with a significant prevalence in stroke survivors. Set apart by its refractory to treatment neuropathic pain, it appears to arise from lesions in the spino-thalamo-cortical pathways, particularly in the thalamus. Despite advances in neuroimaging techniques, the pathophysiology of CPSP remains poorly understood, with limited diagnostic criteria and therapeutic approaches. ⋯ Neuroimaging findings confirm the significance of thalamic and spinothalamic pathway lesions in CPSP pathophysiology. Despite these insights, gaps in research underline the need for larger, multicenter trials to identify reliable biomarkers for diagnosis and therapeutic targets. Advanced neuroimaging combined with machine learning could be the key to understanding and managing CPSP.