Articles: back-pain.
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Case Reports
Spontaneous spinal epidural hematoma masquerading as atypical abdominal pain in a child: A case report.
There have been few case reports of abdominal pain as a symptom of spontaneous intraspinal hemorrhage. We herein describe a case involving a girl with paraplegia caused by spontaneous epidural hemorrhage in the thoracic spinal canal, characterized by abdominal pain. ⋯ The symptoms caused by intraspinal hemorrhage are mainly back pain with or without neurological dysfunction. However, sometimes atypical symptoms, such as abdominal and chest pain, can be identified in clinical settings. Emergency surgery is recommended as the treatment of choice for intraspinal hemorrhage with neurological dysfunction.
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While the evolution of technology provides new opportunities to manage chronic refractory pain using different waveform modalities of spinal cord stimulation in failed back surgery syndrome (FBSS), there is no randomized controlled trial available to compare the efficacy of these different stimulations waveforms to date. MULTIWAVE is a prospective, randomized, double-blinded, crossover trial study designed to compare the clinical efficacy of tonic conventional stimulation (TCS), burst stimulation (BURST) and high-frequency stimulation (HF) in FBSS patients over a 15-month period in SCS implanted patients. ⋯ Recruitment began in February 2017 and will continue through 2019.
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To define the relationship between 3D radiological features, psychological factors, and back pain prevalence and intensity in patients with adolescent idiopathic scoliosis (AIS). ⋯ Back pain in AIS is multifactorial and associated with psychological and morphological parameters. Pain catastrophizing is an important construct in AIS-related pain and should be taken into consideration when evaluating these patients.
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Marijuana is increasingly utilized for the treatment of multiple medical problems, including back pain, in the United States. Although there is strong preclinical evidence supporting the promise of cannabinoids in the treatment of back pain, there is a paucity of clinical data supporting their use in clinical practice. ⋯ The significant risk of morbidity, mortality, and dependence secondary to opioid medications have increased the interest in nonopioid medications, including cannabinoid-based pain regimens, in treating back pain. This review will provide an overview on the pharmacology, drug delivery methods, clinical evidence, and safety considerations critical to understanding the potential role of cannabinoids in the treatment of back pain.
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Chronic low back pain (CLBP) prevalence is higher among women and those with low socioeconomic status. Without adequate self-efficacy and subsequent self-management, patients gradually develop chronic multisite pain after one year of having CLBP alone. ⋯ For all predictors of self-efficacy, a significant regression equation was identified (p < .01) with R2 of .413 and variance of .643. Pain catastrophizing was a significant individual predictor (p < .05). A significant regression equation was also found for all predictors of multisite pain (p < .001) with R2 of .528 and variance of .726. Individual predictors (p < .05) were age, physical function, and numbers of pain treatments and chronic medical conditions. Study findings suggest that significant predictors can be key to advancing pain research, education, practice, and healthcare policy toward improving pain management. Particularly among this population, pain catastrophizing needs to be targeted in pain management. To minimize development of multisite pain, further investigation of identified predictors including number of chronic medical conditions and pain treatments received are necessary. Multimodal, but targeted approaches addressing these predictors are recommended, instead of costly, indiscriminate multimodal therapy. Targeted interventions can help reduce pain care disparities among socioeconomically disadvantaged women, identify high risk groups for prompt intervention, facilitate better pain response to treatments, and minimize further disability.