Pain practice : the official journal of World Institute of Pain
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Review Meta Analysis
Intradiscal Methylene Blue Injection for Discogenic Low Back Pain: A Meta-Analysis.
The purpose of this study was to assess the effects of intradiscal methylene blue (MB) injection on discogenic low back pain (DLBP). ⋯ Intradiscal MB injection can reduce pain severity and improve the ODI score in individuals with discogenic low back pain. Although intradiscal MB injection seems to be a safe and effective treatment for discogenic low back pain, the clinical benefits for patients with discogenic low back pain need to be further appraised in larger samples and more in-depth studies.
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This study was designed to address the current relative void of valid measures by developing evidence-based quality indicators for pain management of chronic nonmalignant pain. ⋯ The created set has tested to be feasible, reliable, and useful, with the capacity to serve as the baseline for developing the necessary strategies to improve the management of chronic nonmalignant pain, by monitoring and evaluating quality of care.
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Review Practice Guideline
Safe Use of Epidural Corticosteroid Injections: Recommendations of the WIP Benelux Work Group.
Epidural corticosteroid injections are used frequently worldwide in the treatment of radicular pain. Concerns have arisen involving rare major neurologic injuries after this treatment. Recommendations to prevent these complications have been published, but local implementation is not always feasible due to local circumstances, necessitating local recommendations based on literature review. ⋯ Raising awareness about possible neurological complications and adoption of safety measures recommended by the work group aim at reducing the risks for these devastating events.
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Hip denervation comprising radiofrequency lesioning of the obturator and femoral articular branches is used in adults with refractory hip pain who are not surgical candidates. Persistent hip pain occurs infrequently in pediatric patients, and there are limited data on the safety and efficacy of this procedure in a pediatric population. We provide a case report of a successful ultrasound and fluoroscopic-guided hip denervation procedure in an 11-year-old girl with persistent right hip pain after septic arthritis refractory to conservative and surgical management. At an 18-week follow-up, hip denervation provided improvement in pain, mobility, and reduced opioid consumption by 20%.
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Pain is one of the most devastating symptoms for cancer patients. One third of patients who experience pain do not receive effective treatment. A key barrier to effective pain management is lack of routine measurement and monitoring of pain. Patient-reported outcome measures (PROMs) are recommended for measuring cancer pain. However, evidence to guide the selection of the most appropriate measure to identify and monitor cancer pain is limited. A systematic review of measurement properties of PROMs for pain in cancer patients is needed to identify the best validated measure for adoption to an electronic platform. ⋯ The BPI-SF was the best performing measure across all properties evaluated through COSMIN. Better quality validation studies of PROMs for cancer pain are needed to explore the full range of measurement properties. Utilizing mHealth applications to measure pain in cancer patients is an innovative approach worthy of further investigation.