Pain practice : the official journal of World Institute of Pain
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Post-herpetic neuralgia is a chronic neuropathic pain disorder that is the sequela of the varicella zoster virus reactivation in the dorsal root ganglion. A variety of treatment modalities have been implemented, but pharmacologic treatments are often limited due to side effects and interventional procedures have yielded mixed results without promising long-term benefits being consistently seen. A dorsal root ganglion stimulator for treatment of post-herpetic neuralgia is a novel treatment option as it is able to specifically target the area affected. We present 3 patients who underwent implantation of permanent dorsal root ganglion stimulators and had a greater than 50% decrease in scoring on numerical rating scale (NRS) up to 18 months post-procedure and significantly reduced analgesic requirements.
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Randomized Controlled Trial
Comparison of the effects of corticosteroid and hyaluronic acid-carboxylmethylcellulose (HA-CMC) solution on selective nerve root block (SNRB) for lumbar radiculopathy: A prospective, double-blind, randomized controlled clinical trial.
Selective nerve root block (SNRB) was shown to effectively control radiating pain and reduce the need for surgical intervention. However, repetitive injections may trigger corticosteroid-induced side effects (hypercorticism, hyperglycemia, or fluid retention). This study aims to compare the potency of hyaluronic acid-carboxymethylcellulose (HA-CMC) solution versus that of corticosteroids regarding lower leg radiating pain (LLRP) improvement and functional outcome. ⋯ Considering the adverse effects of corticosteroids, and the similar LLRP improvements, functional outcome, and quality of life, the HA-CMC solution may be an alternative option to corticosteroid in SNRB.
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Review Meta Analysis
Pressure pain thresholds in office workers with chronic neck pain. A systematic review and meta-analysis.
The purpose of this study was to (a) compare pressure pain threshold (PPT) values between office workers with chronic neck pain and asymptomatic controls; (b) establish reference PPT values in chronic neck pain; and (c) evaluate associations between PPTs and pain intensity, and disability. ⋯ This meta-analysis found that all the PPT measurements were not significantly reduced in office workers with chronic neck pain compared with healthy workers. These assumptions were based on a small sample of existing studies, and therefore further studies are necessary to quantify the differences in PPTs. Hypersensitivity PPT reference values are proposed for localized and extrasegmental sites in office workers with chronic neck pain.
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One of the most widely used instruments to identify symptoms that may be related to central sensitization is the Central Sensitization Inventory (CSI). Although this instrument has been translated and validated in Spanish patients with chronic musculoskeletal pain, no psychometric analysis has been carried out in breast cancer survivors. The aim of this study was to perform a psychometric analysis of the Spanish version of the Central Sensitization Inventory (CSI-Sp) in Spanish breast cancer survivors. ⋯ The CSI-Sp has demonstrated to be a psychometrically strong measure for assessing central sensitization symptoms in breast cancer survivors based on internal consistency, test-retest reliability, and structural validity. Further studies that analyze other measurement properties in different Spanish clinical populations are needed.