Pain practice : the official journal of World Institute of Pain
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Radiofrequency denervation of the cervical medial branches is a possible treatment for chronic cervical facet pain syndrome when conservative management has failed. According to the literature, complications after radiofrequency denervation of the cervical medial branches are rare. We report a case of possible phrenic nerve injury after ipsilateral radiofrequency denervation of the cervical medial branches following a posterolateral approach.
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Randomized Controlled Trial
Twelve-Month Follow-Up of a Randomized Trial Assessing Cooled Radiofrequency Denervation as a Treatment for Sacroiliac Region Pain.
The objective of this study was to report the long-term outcomes of cooled radiofrequency (CRF) lateral branch neurotomy (LBN) as a treatment for sacroiliac (SI) region pain. Whereas the 1-, 3-, 6-, and 9-month outcomes of this procedure compared to sham treatment were previously reported, this current report shows the 12-month outcomes of CRF/LBN treatment for SI region pain. ⋯ These favorable 12-month results illustrate the durability of effective CRF/LBN-mediated treatment of SI region pain for selected patients. Furthermore, successful CRF/LBN treatments in unblinded crossover study subjects demonstrate the unlikelihood that such positive outcomes are attributable to a "placebo" effect, and suggest that CRF/LBN is an effective therapeutic option for alleviating pain, and improving physical function and quality of life, with few complications.
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Nerve growth factor (NGF) was first discovered approximately 60 years ago by Rita Levi-Montalcini as a protein that induces the growth of nerves. It is now known that NGF is also associated with Alzheimer's disease and intractable pain, and hence, it, along with its high-affinity receptor, tropomyosin receptor kinase (Trk) A, is considered to be 1 of the new targets for therapies being developed to treat these diseases. ⋯ Interestingly, local anesthetics also possess TrkA inhibitory effects. This manuscript describes the development of an analgesic that suppresses NGF/TrkA signaling, which is anticipated to be 1 of the new methods to treat intractable pain.
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Case Reports
Coblation of Femoral and Sciatic Nerve for Stump Pain and Phantom Limb Pain: A Case Report.
There is currently no reliable treatment for stump pain and phantom limb pain. Peripheral factors play a significant role in the pathophysiology of stump pain and phantom limb pain. Coblation technology is a relatively new technology that has shown promise in treating neuropathic pain. ⋯ Our report suggests that coblation technology may be useful treatment for stump pain and phantom limb pain. Treatments focusing on peripheral nerves may be more effective than those focusing on the neuroma. This finding needs additional study for confirmation.
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The patient health questionnaire (PHQ) is designed for screening psychopathology in primary care settings. However, little is known about its clinical utility in other chronic pain populations, which usually have high psychiatric comorbidities. ⋯ The strong specificity of the PHQ appears to be its primary strength for this cohort. Due to its high specificity, the PHQ could be employed as an additional screening tool to help rule out potential psychiatric comorbidity in patients with CDOMD. The low sensitivity of the PHQ in this population, however, remains a weakness of the PHQ.