Pain practice : the official journal of World Institute of Pain
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To develop consensus on a position paper on the use of intramuscular stimulation (IMS) for the treatment of myofascial pain syndrome (MPS) by physicians in Israel. ⋯ The position paper is a basis for clinical work and education programs for physicians interested in a better understanding and ability to treat patients with a musculoskeletal complaint or manifestation of disease.
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Complex regional pain syndrome (CRPS) is a painful, debilitating affliction that is often difficult to treat. It has become common international practice to use spinal cord stimulation (SCS) for the treatment of CRPS as other therapies fail to provide adequate relief, quality of life, or improvement in function. This comprehensive outcome-specific systematic review of the use of SCS for CRPS was performed to elucidate the available evidence with focus on clinically relevant patient-specific outcomes. ⋯ Spinal cord stimulation remains a favorable and effective modality for treating CRPS with high-level evidence (1B+) supporting its role in improving CRPS patients' perceived pain relief, pain score, and quality of life. A paucity of evidence for functional improvements, resolution of CRPS signs, sleep hygiene, psychological impact, and analgesic sparing effects mandate further investigation before conclusions can be drawn for these specific outcomes.
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The styloid process arising from the temporal bone is normally about 2.5 cm in length. For various reasons, including trauma and inflammation, it may become elongated. This elongated styloid process, when symptomatic with clinical signs and symptoms suggestive of local compression or neuropathic pain, is termed Eagle syndrome. ⋯ Interventional and surgical options are pursued when these fail. Fluoroscopy is usually used to position the needle adjacent to the styloid process for injecting steroid and or local anesthetic. We describe a case of a 41-year-old woman with Eagle syndrome who failed conservative management and subsequently underwent an ultrasound-guided peristyloid steroid injection with short-duration pain relief.
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Multicenter Study Observational Study
Evaluation of the Effectiveness of Percutaneous Octapolar Leads in Pain Treatment with Spinal Cord Stimulation of Patients with Failed Back Surgery Syndrome During a 1-Year Follow-Up: A Prospective Multicenter International Study.
To evaluate the effectiveness and safety of percutaneous octapolar (8-contact) leads in spinal cord stimulation (SCS) treatment of failed back surgery syndrome (FBSS) patients who have not reached their therapy goals with other treatment interventions. ⋯ Use of percutaneous octapolar SCS leads gives significant long-term pain relief and improvement in quality of life and sleep in FBSS patients. The outcomes are better than reported on 4-contact leads and indicate that the progress in SCS technology that has taken place during the past decade correlates with therapy improvements.
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Rheumatic and joint diseases, as exemplified by osteoarthritis and rheumatoid arthritis, are among the most widespread painful and disabling pathologies across the globe. Given the continuing rise in life expectancy, their prevalence is destined to grow. Osteoarthritis, a degenerative joint disease, is, in particular, on its way to becoming the fourth leading cause of disability worldwide by 2020, with the rising incidence of obesity in addition to age being important factors. ⋯ In addition, persistent activation of mast cells facilitates the development of spinal neuroinflammation mediated through their interaction with microglia. Unfortunately, current treatment strategies for rheumatic and articular disease are symptomatic and do little to limit disease progression. Research now should be directed at therapeutic modalities that target osteoarticular structural elements and thereby delaying disease progression and joint replacement.