Pain practice : the official journal of World Institute of Pain
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The vast majority of cancer patients experience pain, and treatment with opioids offers the most effective option for pain management. Long-lasting opioid formulations are usually used as cancer pain management strategies. This review surveys the available literature on the only available once-daily sustained-release formulation of hydromorphone, and its use in cancer pain management. ⋯ The pharmacokinetics of OROS hydromorphone are linear and dose-proportional, and only minimally affected by the presence or absence of food. In addition, the SR properties of OROS hydromorphone are maintained in the presence of alcohol, with no dose dumping of hydromorphone. This formulation shows promise as an addition to cancer pain management strategies, although further randomized, double-blind trials are needed to confirm this.
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Cervical radicular pain is defined as pain perceived as arising in the arm caused by irritation of a cervical spinal nerve or its roots. Approximately 1 person in 1,000 suffers from cervical radicular pain. In the absence of a gold standard, the diagnosis is based on a combination of history, clinical examination, and (potentially) complementary examination. ⋯ When its effect is insufficient or of short duration, conventional radiofrequency treatment is recommended (2B+). In selected patients with cervical radicular pain, refractory to other treatment options, spinal cord stimulation may be considered. This treatment should be performed in specialized centers, preferentially study related.