Pain practice : the official journal of World Institute of Pain
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Clinical Trial
Internet-based pain self-management for veterans: Feasibility and preliminary efficacy of the Pain EASE program.
To develop and test the feasibility and preliminary efficacy of a cognitive behavioral therapy-based, internet-delivered self-management program for chronic low back pain (cLBP) in veterans. ⋯ Veterans with cLBP may benefit from technology-delivered interventions, which may also reduce pain interference. Overall, veterans found that Pain EASE, an internet-based self-management program, is feasible and satisfactory for cLBP.
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Radiofrequency ablation (RFA) and spinal cord stimulation (SCS) are 2 common modalities used in management of various pain conditions. RFA generates heat and an electromagnetic field that can theoretically interfere with the functionality and longevity of the SCS device. This is problematic for patients who need RFA and have previously undergone implantation of an SCS device. ⋯ We also present device-specific industry guidelines and recommendations for performing RFA in patients following SCS device implantation.
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Regenerative injection-based therapy has established itself as a therapeutic option for the management of a variety of painful musculoskeletal conditions. The aim of this work was to review the current literature regarding regenerative injection therapy for axial/radicular spine pain. ⋯ Currently, there are level I studies to support the use of PRP and MSC injections for discogenic pain; facet joint injections with PRP; epidural injections of autologous conditioned serum and epidural prolotherapy; and PRP and prolotherapy for sacroiliac joint pain. One level I study showed that facet joint prolotherapy has no significant benefit. Notably, no intervention has multiple published level I studies.
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Lumbosacral radicular pain with or without radiculopathy is a fairly common clinical condition. In such cases, lumbosacral transforaminal epidural injection (TFEI) is one of the most commonly performed interventions. Recent studies have explored the effectiveness of ultrasound (US)-guided lumbosacral TFEI. ⋯ S1 TFEI can also be easily performed, since the S1 foramen is more superficial than the lumbar foramen. However, most studies regarding US-guided sacral TFEI use an out-of-plane technique. Therefore, in this report we present a video of US-guided S1 TFEI via an in-plane approach.
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Stimulation of the dorsal root ganglion (DRG-S) has been shown to be an efficacious treatment option for refractory neuropathic pain syndromes. However, placement of the percutaneous leads for trial implantation can be challenging in patients with prior spinal surgical interventions resulting in anatomical changes and adhesions. ⋯ Transgrade lead placement for DRG-S may be an efficacious alternative to traditional anterograde DRG lead placement in cases where interlaminar access below the level of the DRG is not available, or desirable. Further studies are needed to clarify the safety and applicability of this approach.