Current pain and headache reports
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Curr Pain Headache Rep · Feb 2013
ReviewPrinciples of electrical stimulation and dorsal column mapping as it relates to spinal cord stimulation: an overview.
The last 30 years have witnessed the growth of spinal cord stimulation as a treatment modality for an increasing number of chronic pain conditions. In spite of this growth, one of the greatest criticisms is the lack of concrete evidence for the mechanism of action. ⋯ This review serves to provide an overview of the key principles of electrical stimulation and dorsal column mapping as it relates to spinal cord stimulation. We aim at enhancing the understanding regarding the basis for successful placement of leads and manipulation of electrical parameters.
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Curr Pain Headache Rep · Feb 2013
ReviewComplementary and alternative treatments for chronic pelvic pain.
Chronic pelvic pain (CPP) is a significant clinical entity that affects both men and women alike. The etiologies of CPP are multifactorial, and treatments are myriad. ⋯ In particular, several recent studies have investigated the efficacy of various CAM practices in the treatment of CPP. The authors systematically evaluated recent literature in this area by searching the PubMed database for English-language studies published between January 2007 and August 2012.
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Neurolytic celiac plexus blocks (NCPB) have been performed for many years for the treatment of cancer and some non-cancer pain conditions associated with the upper gastrointestinal tract. The block can provide adequate pain relief from the area of the distal esophagus to the transverse colon, and can be approached from a variety of ways. This is a review of the anatomy, patient selection, technique, medications used, possible complications, and efficacy of the treatment.
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Curr Pain Headache Rep · Feb 2013
ReviewCervical epidural steroid injections for the treatment of cervical spinal (neck) pain.
Cervical epidural steroid injections (CESI) are an accepted treatment for neck pain with a radicular component, and may be accomplished by using either transforaminal (CTFESI) or interlaminar (CILESI) approaches. CESIs are routinely performed using real-time fluoroscopic-guidance in conjunction with the injection of water soluble, iodine-based contrast media to enhance visualization of intravascular injections. Digital subtraction angiography (DSA) imaging is an adjuvant to fluoroscopic methods for visualizing blood vessels while performing spinal injections. ⋯ Particulate steroids may have a prolonged duration of action but non-particulate steroids are safer for CESIs. Blunt-beveled needles are less likely than sharp-beveled needles to penetrate blood vessels to cause bleeding complications during CTFESI procedures. Small doses of local anesthetics appear to be safe and assist in identifying intravascular injections previously overlooked by conventional techniques.