Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jun 2017
ReviewPathophysiology of Trigger Points in Myofascial Pain Syndrome.
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. Trigger point pathophysiology in myofascial pain syndrome, which involves muscle stiffness, tenderness, and pain that radiates to other areas of the body, is considered. The causes of trigger points and several theories about how they develop are reviewed, and treatment approaches, including stretching, physical therapy, dry needling, and injections, are offered.
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J Pain Palliat Care Pharmacother · Jun 2017
Case ReportsIntrathecal Injection of Gadobutrol: A Tale of Caution.
In the field of interventional pain medicine a radiocontrast agent is commonly used in conjunction with fluoroscopy. Limited work has been published regarding the use of gadolium based contrast agents (GBCA) in the intrathecal space. We report a case of an intrathecal gadobutrol injection resulting in neurotoxic manifestations. ⋯ Less than five minutes after the injection of gadobutrol, the patient reported spastic pain of the lower extremities. There is a lack of evidence as it relates to the use of GBCA specifically gadobutrol in the intrathecal space. The use of gadobutrol in the intrathecal space should be used with caution.
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J Pain Palliat Care Pharmacother · Jun 2017
Conversations on Dying: A Palliative Care Pioneer Faces His Own Death.
Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com .
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J Pain Palliat Care Pharmacother · Jun 2017
Editorial Historical ArticleMedical Cannabis for Pain: Anecdote or Evidence.
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J Pain Palliat Care Pharmacother · Jun 2017
ReviewOral Versus Topical Diclofenac Sodium in the Treatment of Osteoarthritis.
Osteoarthritis (OA) is one of the most common causes of joint pain in the United States and non-steroidal anti-inflammatories (NSAIDs), such as Diclofenac sodium, which is currently available in two main routes of administration; oral and topical distribution have been established as one of the standard treatments for OA. Generally, oral NSAIDs are well tolerated; however our narrative review suggests that the topical solution had a better tolerability property than oral Diclofenac sodium, especially due to side effects of gastrointestinal bleeding with the utilization of the oral format. ⋯ Most studies reviewed comparing oral versus topical solution of Diclofenac sodium revealed comparable efficacy, with minimal side effects utilizing the topical route. The key point of this narrative review is to help clinicians that currently must decide between very inexpensive diclofenac oral presentations and expensive topical presentations especially in the elderly population and the pros and cons of such decision-making process.