Pain practice : the official journal of World Institute of Pain
-
This study aimed to identify characteristics of individuals who are most likely to benefit from long-term opioid therapy in terms of reduction in pain severity and improved mental health-related quality of life (mQoL) without considering potential risks. ⋯ The analysis failed to identify clinically meaningful predictors of opioid therapy effectiveness, making it difficult to inform clinicians about which patients with chronic non-cancer pain are most likely to benefit from long-term opioid therapy.
-
Evaluating the effectiveness of stellate ganglion blockades (SGBs) proves challenging, since the criteria defining a successful blockade are controversial. This may be one reason for the scarcity of studies on this topic, thus forcing clinical guidelines to remain conservative in recommending SGBs. Moreover, factors to predict which patients will benefit from blockade series are not yet available. ⋯ Data indicate that us-SGBs are safe and effective in reducing sympathetically maintained pain in patients with CRPS and neuropathic pain syndromes. Pain reduction after the first blockade may predict total pain reduction after a blockade series. Other clinical measures seem unsuitable to predict effectiveness.
-
The assessment of painful areas through printed body charts is a simple way for clinicians to identify patients with widespread pain in primary care. However, there is a lack in the literature about a simple and automated method designed to analyze pain drawings in body charts in clinical practice. ⋯ PainMAP software is reliable and valid for quantification of the number of pain sites and the pain area in patients with low back pain.
-
Case Reports
Cervical spinal cord stimulator lead migration and transection adjacent to the Foramen Magnum: A case report.
Spinal cord stimulation (SCS) is a relatively safe therapy for the treatment of pain but has the potential for several complications, including lead migration and breakage. While instances of lead breakage and electrode shearing have been described, there are no reported cases of stimulator lead transection and migration to the foramen magnum. ⋯ Given the location of the transected portion of the lead, we recommended avoiding MRI imaging. In addition, we advised the patient that a repeat x-ray may be necessary if she has increased neck pain or any other concerning symptoms. In this report, we discuss the known complications with SCS, as well as management of a retained lead fragment.