Pain practice : the official journal of World Institute of Pain
-
Review Meta Analysis
Assessment of research quality of telehealth trials in pain management: a meta-analysis.
Although telehealth-based pain management research has grown over the last decade, it is difficult to determine the state of the research because of methodological differences and variability in quality among existing studies. In a previous systematic review, we outlined these differences and preliminarily explored the promise of telehealth for pain intervention. We completed a PRISMA compliant meta-analysis of telehealth pain management research to more precisely describe the state of the research and to uncover gaps in the existing literature that highlight directions for future research. ⋯ However, some of the reviewed studies found no benefit for telehealth over control conditions. Some methodological concerns among the examined research included poor research quality, small sample sizes, and the examination of telehealth pain interventions without proven efficacy for in-person treatment. Recommendations for future studies are reviewed.
-
Patient perception of healthcare quality is of growing interest. It has been shown that patient satisfaction is associated with compliance with medical advice and clinical outcome. The 3-fold purpose of this study was to identify which attributes of the patient-physician interaction most strongly correlated with patients' perceptions of provider quality of care, to identify key drivers that move patients' perception of overall provider quality from "very good" to "excellent," and to identify features of the pain clinic experience that were most important to patients but were simultaneously perceived as lacking. ⋯ These results may guide pain clinic physicians as they seek to improve patient perceptions of their care and ultimately patient outcomes.
-
Percutaneous cervical nucleoplasty (PCN) is a safe and effective treatment in symptomatic patients with contained cervical herniated disks. It provides simple and efficient disk decompression, using a controlled and highly localized ablation, but evidence regarding long-term efficacy is limited. We conducted a retrospective study to investigate the long-term efficacy and safety of PCN, and the influence of ideal selection settings. ⋯ These results show long-term effectiveness and safety of PCN in patients with a one-level contained cervical herniated disk, and the reliance of selecting patients meeting ideal criteria for successful PCN.
-
Eagle (Arch Otolaryngol. 1937;25:584 and Arch Otolaryngol. 1949;49:490) first identified elongation of the styloid process and ossification of the stylohyoid ligament as a cause of orofacial pain. The elongated styloid process presses on the internal carotid artery and adjacent structures, including branches of the glossopharyngeal nerve and this produce orofacial pain. Some authors define an elongated styloid process as longer than 4 cm because this length is associated with an increase in the incidence of Eagle's syndrome. ⋯ The length of the stylohyoid process was 63 mm on the left side and 64 mm on the right. Treatment was performed by applying pulsed radiofrequency to the glossopharyngeal nerve with satisfactory results. The technique was performed twice on an outpatient basis, produced no complications or side effects, and proved effective in the short and medium term in decreasing the intensity of pain.
-
Difficulties in diagnosing neuropathic pain in routine clinical practice support the need for validated and easy-to-use diagnostic tools. The DN4 neuropathic pain diagnostic questionnaire aims to discriminate neuropathic pain from nociceptive pain, but needs clinical validation. A total of 269 patients with chronic pain in three pain clinics were included in the study of which 248 had analyzable data. ⋯ The items "brushing," "painful cold," and "numbness" were most discriminating. The DN4 is an easy-to-use screening tool that is reliable for discriminating between neuropathic and nociceptive pain conditions in daily practice. Item-specific scores provide important information in addition to the total score.