Articles: back-pain.
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Multicenter Study Clinical Trial Observational Study
Prospective, Multicenter Feasibility Study to Evaluate Differential Target Multiplexed SCS Programming in Subjects with Chronic Intractable Back Pain with or Without Leg Pain.
This prospective, open-label, multicenter study evaluated the feasibility of spinal cord stimulation (SCS) therapy programming for chronic low back pain that uses multiple electrical pulsed signals (Differential Target Multiplexed). ⋯ In this difficult-to-treat patient population, subjects reported significant reduction in chronic back pain when using multiplexed programming. A randomized clinical trial is needed to confirm the results from this feasibility study.
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Reg Anesth Pain Med · Sep 2020
Case ReportsSuccessful transforaminal epidural blood patch in a patient with multilevel spinal fusion.
Epidural blood patch (EBP) is a vital tool in treating postdural puncture headache (PDPH). Traditional interlaminar epidural needle insertion into the epidural space, however, may be challenging due to anatomical variations. As an alternative method, we successfully performed an EBP via transforaminal approach. ⋯ To our knowledge, this is the first case reported of a transforaminal EBP in a patient with diffuse epidural adhesive fibrosis secondary to multilevel laminectomies and spinal fusion. This case report highlights potential risks and benefits of this novel technique and also discusses its therapeutic mechanism of action. We believe that a transforaminal EBP should be considered in patients who are poor candidates for the traditional interlaminar EBP.
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Wien. Klin. Wochenschr. · Sep 2020
Randomized Controlled Trial Multicenter StudyEQ-5D-5L questionnaire as suitable assessment of quality of life after epiduroscopy : Multicenter randomized double-blind pilot study.
Epiduroscopy is a well-established diagnostic and to certain level therapeutic tool in complex situations, where conventional methods such as magnetic resonance imaging (MRI) lack power or resolution to detect pathological changes. Such a situation is primarily failed back surgery syndrome (FBSS) but also radicular pain without surgery. The aim of this study was to determine the effectiveness of epiduroscopic treatment in patients with FBSS. ⋯ Epiduroscopy appears to be a beneficial procedure for both patient groups, especially after 6 months, with some benefit remaining after 12 months. The EQ-5D-5L questionnaire seems to be a suitable and comprehensive way to assess patient health in chronic pain states.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2020
Review[Psychotherapy in the Context of Interdisciplinary Multimodal Pain Therapy: Update].
Interdisciplinary multimodal pain therapy (IMPT) is based on the biopsychosocial model of pain and describes an integrated treatment for patients with chronic pain. IMPT incorporates a close cooperation of different disciplines, including physicians, psychotherapists, physiotherapists, and others. IMPT mainly aims to restore and increase patients' physical, social and psychological functional capacity. ⋯ Research into the efficacy of pain psychotherapy is rather sparse and studies have mostly focused on chronic back pain, yet existing results show promising evidence both for psychotherapy within IMPT and for psychotherapy as a monotherapy. This paper aims at providing an overview of (a) commonly employed cognitive-behavioral psychotherapeutic approaches and strategies in the treatment of chronic pain, and (b) the existing empirical evidence of pain psychotherapy both within the framework of IMPT and as a monotherapy. Future research should include a wider range of pain diagnoses and also investigate the potential benefit of individually-tailored treatments.
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Case Reports
Ultrasound-guided transgluteal sciatic nerve analgesia for refractory back pain in the ED: A case series.
Sciatic radicular back pain is a painful condition resulting in approximately 2% of emergency department (ED) visits a year. Typically, the ED treatment has been limited to various analgesic regimens with limited success sometimes resulting in hospital admissions for pain control. ⋯ The transgluteal sciatic nerve block (TGSNB) is a procedure that can provide effective analgesia for lower extremity pain. Herein, we present the first technical description and clinical response to ultrasound-guided TGSNB performed by emergency physicians for acute pain control of sciatic back pain through a series of cases.