Pain practice : the official journal of World Institute of Pain
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Randomized Controlled Trial Comparative Study
A Cost-Effectiveness Analysis of Intradiscal Electrothermal Therapy (IDET) Compared with Circumferential Lumbar Fusion.
Cost-effectiveness analysis. ⋯ Both treatments led to significant improvements in patient outcomes that were sustained for at least 24 months. Costs were lower with IDET, and for appropriate patients IDET is an effective and cost-effective treatment alternative.
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Chronic pain patients show hypersensitivity to sensory nonpainful stimuli. Sensory over-responsiveness (SOR) to innocuous daily stimuli, experienced as painful, is prevalent in 10% of the healthy population. This altered sensory processing may be an expression of overfacilitation, or a less efficient pain-inhibitory process in the pain pathways. We therefore aimed to investigate specifically the pain-inhibitory system of subjects with SOR who are otherwise healthy, not studied as of yet. ⋯ SOR is associated with a pronociceptive state, expressed by amplification of experimental pain, yet with sufficient inhibitory processes. Our results support previous findings of enhanced facilitation of pain-transmitting pathways but also reveal preserved inhibitory mechanisms, although they were slower to react.
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Spinal cord stimulation (SCS) is an effective therapy to reduce pain in patients who suffer from failed back surgery syndrome (FBSS). In order to inform patients optimally prior to this therapy, knowing their expectations is crucial. ⋯ To improve education for patients prior to SCS surgery and to evaluate the effects of SCS, a multidimensional approach needs to be implemented. Possible disadvantages of SCS need to be discussed prior to the treatment.
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Corticosteroids are frequently used for the treatment of postoperative nausea and vomiting, and have also been reported to have an effect on postoperative analgesia. This study was conducted to assess the pain management effect of perioperative intravenous corticosteroids in patients undergoing total knee or hip arthroplasty and evaluate their early rehabilitation. ⋯ Our results show that intravenous corticosteroids have good efficacy and safety when used perioperatively in total knee or hip arthroplasty.
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Although the importance of psychosocial factors has been highlighted in many studies in patients with chronic low back pain (CLBP), there is a lack of research examining the role of illness perceptions in explaining functional disability and physical activity in patients with CLBP. ⋯ Illness perceptions are an important factor for explaining functional disability, but not for explaining habitual physical activity in CLBP patients.