Pain practice : the official journal of World Institute of Pain
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Lumbar spinal stenosis (LSS) is characterized by narrowing of the spinal canal with impingement of the spinal cord by surrounding tissues of bones. Current management options for LSS include rest, medications, physical therapy, epidural steroid injections, alternative medicine, and surgical decompression. ⋯ The effect is debulking of tissue that is a contributor to lumbar canal narrowing with minimal trauma to surrounding tissue. This literature review presents a brief review of the pathophysiology, clinical presentation, and current treatment options for LSS and reviews the current literature regarding the efficacy, safety, and cost-effectiveness of the mild procedure.
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Chronic pain--especially that which is refractory to conventional treatment--presents particular challenges to physicians and patients. Examination of the molecular and cellular mechanisms involved in this pathophysiology suggests that spinal instillation of therapeutic agents may offer an effective treatment option through the modification of the processing and sensation of chronic pain. ⋯ This article reviews chronic pain pathophysiology and the mechanisms whereby spinally administered analgesics may modify chronic pain. Available treatment options are also considered, including recommendations from the 2007 Polyanalgesic Consensus Conference (PACC) guidelines on the use of intrathecal agents for nociceptive, neuropathic, and mixed pain.
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The terms "opioid" and "narcotic" are often used interchangeably by healthcare providers. The purpose of this study was to compare understanding "narcotics" vs. "opioids." ⋯ While more women were more familiar with narcotic, many identified negative connotations with this term. Future research should explore how to improve patient understanding and attitudes regarding both the terms opioids and narcotics.