Articles: pain-management-methods.
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Observational Study
8% Capsaicin Patch in Treatment of Peripheral Neuropathic Pain.
Neuropathic pain is a complex condition that is difficult to control and has a high impact on quality of life. 8% Capsaicin patch can be a therapeutic strategy in the treatment of peripheral neuropathic pain. ⋯ Treatment of peripheral neuropathic pain with 8% capsaicin patch seem to be effective in the short and medium term, both in decreasing pain intensity and in reducing the painful area. Its application is tolerated by most patients.
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Observational Study
Interventional Management of Refractory Trigeminal Neuropathic Pain: A Prospective Audit of a Novel Management Pathway in 70 Patients.
Trigeminal neuropathic pain (TNP) can present as a constant, unremitting unilateral facial pain. Current management is based on expert recommendation that includes pharmacologic agents and psychological therapy. However, treatment success with pharmacologic management is poor. We adopted a novel strategy that proved to be effective in providing durable relief. ⋯ Standard treatment of TNP is ineffective. The novel set of interventions based on empirical evidence may have a role in managing patients with refractory TNP.
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Abdominal myofascial pain syndrome is an important cause of refractory chronic abdominal pain. It causes severe functional impairment resulting in significant patient distress and substantial health care costs, and it can be a challenge to treat. Opioid consumption is a recognized challenge in this cohort. ⋯ The authors present the first prospective practice-based evidence report on the long-term outcomes in patients diagnosed with abdominal myofascial pain syndrome. There was significant reduction in opioid consumption at 12 months and over two-thirds of patients reported significant durable relief on long-term follow-up. The authors present their recommendation for managing this complex group of patients.
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Sacroiliac joint is one of the proven causes of low back and lower extremity pain. Prevalence estimates of sacroiliac joint pain range from 10% to 25% in patients with persistent axial low back pain without disc herniation, discogenic pain, or radiculitis based on multiple diagnostic studies and systematic reviews. Over the years, utilization patterns of sacroiliac joint injections have been increasing in comparison to other interventional techniques. Further, the development of new current procedural terminology (CPT) codes and coverage policies for sacroiliac joint nerve blocks, sacroiliac joint radiofrequency neurotomy, and evolving evidence for sacroiliac joint fusion will further increase the utilization patterns. ⋯ This study shows increases in utilization patterns of sacroiliac joint injections; however, at a significantly lower rate with an annual increase of 16.6% prior to 2009 and only 1.2% from 2009 to 2018 per 100,000 Medicare beneficiaries.
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Total knee arthroplasty (TKA) is known to be a painful orthopedic procedure and moderate to severe pain is common, especially immediately postoperatively and during active motion. The aim of the present study was to compare epidural analgesia (EA) and adductor canal block (ACB) techniques with regard to early period pain levels, need for additional opioids, and ambulation and functional scores in patients who had undergone primary TKA. ⋯ We hypothesized that standard ACB would be as effective as EA for postoperative pain management following TKA.