Pain practice : the official journal of World Institute of Pain
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Review
Efficacy of Botulinum Toxin in Tension-Type Headaches: A Systematic Review of the Literature.
Botulinum toxin is approved to treat chronic migraine and has been shown to confer significant benefit in refractory cases. Due to its effect on pain by sensory modulation, there may also be efficacy in its use in chronic tension-type headache (CTTH). ⋯ This systematic review demonstrates variable study designs contributing to the low quality of evidence available regarding botulinum toxin in TTH, but some data suggest efficacy. There does not appear to be irrefutable evidence of a lack of efficacy of botulinum toxin in TTH. Using the paradigm for botulinum toxin in chronic migraine may prove fruitful in treating CTTH. Further studies are warranted to evaluate the utility of botulinum toxin in this common debilitating condition.
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Chronic low back pain (CLBP) has become a worldwide health concern, and emotional distress is an important issue for CLBP management. However, it remains poorly understood how emotional distress happens and develops. This study aimed to systematically explore the correlates of emotional distress in patients with CLBP. ⋯ This study aimed to explored the correlates of emotional distress of patients with chronic low back pain (CLBP) by hierarchical linear regression analysis. The study found that patients' demographic factors, psycho-behavioral factors, and social support were associated with their emotional distress, uniquely explaining 16.5%, 18.4%, and 6.2% of the variance, respectively. Pain intensity, passive coping, active coping, self-efficacy, and social support were detected as significant correlates.
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Randomized Controlled Trial
Ultrasound-Guided Cervical Nerve Root Block for the Treatment of Acute Cervical Herpes Zoster: A Randomized Controlled Clinical Study.
To evaluate the efficacy and safety of ultrasound-guided cervical nerve root block (CRB) on acute pain and its preventive effects on post-herpetic neuralgia (PHN) in patients with cervical herpes zoster (HZ). ⋯ Ultrasound-guided CRB represented an early intervention and preventive strategy to reduce the BOI due to acute HZ in the cervical dermatome region, and might be feasible to reduce the incidence of PHN.
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A better understanding of gender differences can assist clinicians in further developing therapeutic programs in tension type headache (TTH). ⋯ This study described gender differences in the presence of TrPs in TTH. Women with TTH showed lower PPTs than men. The association between TrPs, anxiety levels, and pressure pain hyperalgesia seems to be more pronounced in women than in men with TTH.
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Case Reports
Continuous Bilateral Erector of Spine Plane Block at T8 for Extensive Lumbar Spine Fusion Surgery: Case Report.
Supplementary strategies, in combination with conventional analgesia, for pain control after lumbar fusion surgery remain limited. ⋯ A 79-year-old woman experienced excruciating pain on post-operative day 1 after undergoing L2 to S1 spine fusion. Bilateral continuous erector spinae plane (ESP) blocks were performed at T8 and, after a bolus of ropivacaine 0.2% (20 mL) per side, a continuous infusion (5 mL/hour) of ropivacaine 0.2% per side was maintained for 48 hours, which provided effective analgesia. During this period, two boluses (15 mL) per day of ropivacaine 0.2% were administered bilaterally to maintain optimal analgesia. ESP catheterizations at T8, placed remotely from surgical site, may be considered in extensive lumbar spinal fusion cases.