Current pain and headache reports
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To identify the efficacy of radiofrequency ablation of pericranial nerves in treating headache. ⋯ Recent studies by the same group showed promising results in treating headache using radiofrequency ablation. Pericranial nerves can be a therapeutic target for treating headache. Our results showed efficacy of radiofrequency ablation. More studies using other modalities as neuromodulation are needed and may show efficacy as well.
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Curr Pain Headache Rep · Feb 2020
ReviewAn Analysis of Predictors of Persistent Postoperative Pain in Spine Surgery.
This review aims to identify perioperative patient-related factors that are associated with the development of persistent postoperative pain (PPP) in patients undergoing spine surgery. ⋯ Twenty-one studies published between 2000 and 2019 were included in this literature review. The following five patient-related factors were identified to be associated with the development of PPP after spine surgery: anxiety, depression, pain catastrophizing, pain sensitivity, and preoperative opioid consumption. The existing literature suggests that the risk factors for developing chronic pain after spine surgery appear to be similar to those for other types of surgery. Psychological factors and preoperative opioid consumption are associated with developing chronic pain after spinal surgery. Other factors such as gender, age, preoperative pain intensity, and immediate postoperative pain may also be involved but the evidence on this is limited.
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Curr Pain Headache Rep · Feb 2020
ReviewPatient and Surgery-Related Predictors of Acute Postoperative Pain.
The purpose of the present investigation is to provide a comprehensive review of both patient and procedure specific predictors of acute postoperative pain. ⋯ As the global number of surgeries continues to increase, as well as evidence of worse patient outcomes in those who suffer from poorly controlled postoperative pain, it is becoming more critical for perioperative physicians to have a deep understanding of the risks which might lead to increased pain in the immediate postoperative settings. It is also important to recognize potential tools to prevent the development and intensity of surgical pain. This manuscript begins with an investigation of the theorized mechanisms of postoperative pain, at the peripheral and central levels, which is followed by a discussion of current pain evaluation in humans. Additionally, an evaluation of patient- and procedure-specific predictors for the development of acute pain is summarized. As operative and patient specific risk factors continue to be revealed, they will ultimately serve as important tools to provide high-quality individualized patient care aimed at reducing incidence of severe postsurgical pain.
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Curr Pain Headache Rep · Feb 2020
ReviewMinimally Invasive Lumbar Decompression and Interspinous Process Device for the Management of Symptomatic Lumbar Spinal Stenosis: a Literature Review.
Symptomatic lumbar spinal stenosis (LSS) is a condition affecting a growing number of individuals resulting in significant disability and pain. Traditionally, treatment options have consisted of conservative measures such as physical therapy, medication management, epidural injections and percutaneous adhesiolysis, or surgery. There exists a treatment gap for patients failing conservative measures who are not candidates for surgery. Minimally invasive lumbar decompression (MILD®) and interspinous process device (IPD) with Superion® represent minimally invasive novel treatment options that may help fill this gap in management. We performed a literature review to separately evaluate these procedures and assess the effectiveness and safety. ⋯ The available evidence for MILD and Superion has been continuously debated. Overall, it is considered that while the procedures are safe, there is only modest evidence for effectiveness. For both procedures, we have reviewed 13 studies. Based on the available evidence, MILD and Superion are safe and modestly effective minimally invasive procedures for patients with symptomatic LSS. It is our recommendation that these procedures may be incorporated as part of the continuum of treatment options for patients meeting clinical criteria.
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Curr Pain Headache Rep · Feb 2020
ReviewTranscutaneous Electrical Nerve Stimulation in Relieving Neuropathic Pain: Basic Mechanisms and Clinical Applications.
Transcutaneous electrical nerve stimulation (TENS) is widely used as a non-pharmacological approach for pain relief in a variety of clinical conditions. This manuscript aimed to review the basic mechanisms and clinical applications regarding the use of TENS for alleviating the peripheral (PNP) and central neuropathic pain (CNP). ⋯ Basic studies on animal models showed that TENS could alleviate pain by modulating neurotransmitters and receptors in the stimulation site and its upper levels, including the spinal cord, brainstem, and brain. Besides, many clinical studies have investigated the efficacy of TENS in patients with CNP (caused by spinal cord injury, stroke, or multiple sclerosis) and PNP (induced by diabetes, cancer, or herpes zoster). Most clinical trials have demonstrated the efficacy of TENS in attenuating neuropathic pain and suggested that appropriate stimulation parameters (e.g., stimulation frequency and intensity) were critical to improving the analgesic effects of TENS. However, there are some conflicting findings related to the efficacy of TENS in relieving neuropathic pain. With optimized stimulation parameters, TENS would be effective in attenuating neuropathic pain. To obtain sufficient evidence to support the use of TENS in the clinic, researchers recommended performing multicenter clinical trials with optimized TENS protocols for the treatment of various CNP and PNP.