Articles: pain-clinics.
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Previous studies have reported an association between hypertension (HTN) and osteoarthritis (OA). However, limited research has examined the association between HTN and symptoms, such as pain severity, in people with OA. Therefore, the aim was to investigate the prevalence of HTN in individuals with OA and the association between HTN and pain severity in this population. ⋯ Hypertension is prevalent in individuals with OA and is significantly associated with pain severity in this population. Future research should consider the effect of HTN control and medication on symptoms in people with OA. Clinicians may implement screening for HTN among individuals with OA because of the association between HTN and symptoms, such as pain, in this population.
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Traumatic peripheral nerve injuries are at high risk of neuropathic pain for which novel effective therapies are urgently needed. Preclinical models of neuropathic pain typically involve irreversible ligation and/or nerve transection (neurotmesis). However, translation of findings to the clinic has so far been unsuccessful, raising questions on injury model validity and clinically relevance. ⋯ The partially crushed nerve was characterized by the sparing of small-diameter myelinated axons and intraepidermal nerve fibers, fewer dorsal root ganglia expressing the injury marker activating transcription factor 3, and lower serum levels of neurofilament light chain. By day 30, axons showed signs of reduced myelin thickness. In summary, the escape of small-diameter axons from Wallerian degeneration is likely a determinant of chronic pain pathophysiology distinct from the general response to complete nerve injury.
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Lumbar spondylolysis is one of the most common causes of low back pain and primarily affects children and adolescents. Traditional posterior lumbar fixation and interbody fusion surgery has always been the most effective method to treat spondylolysis. However, traditional surgical management has limitations of large trauma, complex operation, high cost, postoperative biomechanical deterioration, and resulting complications. ⋯ A novel minimally invasive therapeutic approach is presented herein of an SEC injection guided by C-arm fluoroscopy to treat lumbar spondylolysis. We describe a novel technique applied in a patient with lumbar spondylolysis, who showed significantly improved low back pain symptoms and a computed tomography scan, including osseous fusion of the bilateral isthmus at L4 after SEC therapy. This is the first reported case description of using an SEC injection to treat lumbar spondylolysis with a successful clinical outcome.
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Wrist pain on the ulnar side is often caused by ulnar impaction syndrome (UIS). Idiopathic UIS requires surgical treatment when conservative treatment fails. The 2 main surgical procedures used are the wafer procedure and ulnar shortening osteotomy (USO) of the metaphysis or diaphysis. This review aimed to analyze comparative studies of the 2 procedures in UIS to determine clinical outcomes and complications. ⋯ There was no difference in pain improvement or the postoperative functional score between the groups. Nevertheless, postoperative complications were the major pitfalls of USO. As the specialized shortening system advances further, a high-level study will be necessary to determine the surgical option in UIS.
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A variety of medications are available to manage painful diabetic peripheral neuropathy (DPN), but the proper treatment remains challenging. Accordingly, various neuromodulation modalities have been used. However, no prospective clinical trials have evaluated the use of scrambler therapy (ST) in painful DPN. This study aimed to explore the long-term effects of ST in managing painful DPN. ⋯ ST may have short-term effects and limited long-term effects on painful DPN.