Articles: back-pain.
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A retrospective clinical and radiographical study. ⋯ 3.
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Reg Anesth Pain Med · May 2015
Aberrant analgesic response to medial branch blocks in patients with characteristics of fibromyalgia.
Facet interventions for spine pain have high failure rates, and preprocedural prediction of response is nearly impossible. A potential explanation may be aberrant central pain processing as that existing in conditions like fibromyalgia. To test this hypothesis, we conducted a retrospective study investigating the impact of having characteristics of fibromyalgia on the acute analgesic response to a first diagnostic medial branch block (MBB). ⋯ Characteristics of fibromyalgia may indicate pain that is more centralized in nature, a factor that may explain the aberrant analgesic response to this peripheral intervention. This may have implications for future prediction of treatment response, although prospective studies are needed.
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Few instruments are available that have adequate psychometric properties for assessing daily functioning in patients with musculoskeletal pain. In addition, none of these instruments assesses the perceived decrease in levels of daily activities after the onset of pain. ⋯ The IFI-R appears to be a valid and reliable measurement tool for the assessment of perceived daily functioning and impairment in people with chronic pain.
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Fluoroscopically guided transforaminal epidural steroid injections (FG-TFESIs) have been shown to provide both immediate and long-term improvement in patient's self-reported pain. Administration of the lowest possible dose of epidural betamethasone is desired to minimize side effects while maintaining efficacy. We hypothesize that a 3 mg or a 6 mg dose of betamethasone will demonstrate equivalent analgesic properties. ⋯ Reduction in NRS pain scores and narcotic usage at 4 weeks after FG-TFESI were statistically equivalent between patients who received 3 mg or 6 mg of betamethasone, suggesting that a lower steroid dose has similar analgesic efficacy. IRB Number: Cedars Sinai Medical Center Institutional Review Board Pro00031594
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Analysis of use of magnetic resonance imaging (MRI) in the chronic back and leg pain spinal cord stimulation (SCS)-implanted population was conducted using a propensity-matched cohort population. ⋯ 3.