Articles: pain-management.
-
Journal of neurosurgery · Sep 1991
Treatment of chronic pain by epidural spinal cord stimulation: a 10-year experience.
Epidural spinal cord stimulation by means of chronically implanted electrodes was carried out on 121 patients with pain of varied benign organic etiology. In 116 patients, the pain was confined to the back and lower extremities and, of these, 56 exhibited the failed-back syndrome. Most patients were referred by a pain management service because of failure of conventional pain treatment modalities. ⋯ Three patients in this series died due to unrelated causes. Epidural spinal cord stimulation has proven to be an effective and safe means of controlling pain on a long-term basis in selected groups of patients. The mechanism of action of stimulation-produced analgesia remains unclear; further studies to elucidate it might allow spinal cord stimulation to be exploited more effectively in disorders that are currently refractory to this treatment modality.
-
Successful treatment of sympathetic pain is directed at the restoration of normal function. This can be achieved in the majority of cases with a combination of appropriate sympathetic or somatic nerve block, usually coupled with aggressive physiotherapy. ⋯ Other non-invasive techniques such as stimulation-produced analgesia and pharmacology, particularly the use of adrenergic blocking agents, hold some promise of future benefit. Here too, more effort should be made to carry out properly designed studies, as there is scepticism about the place of permanent or potentially destructive therapy in any painful condition.
-
The aim of the study was to evaluate an educational video designed to modify the pain concept of chronic pain patients. It is commonly described that chronic pain patients foster an illness model which is dominated by purely medical assumptions about causes of pain and its modulation and treatment. Furthermore the mostly unrealistic hope for total pain relief which is expected from the pain expert guides the patients' seek for help. ⋯ The Ss participating in the study were 47 chronic pain patients of a pain ambulance and 42 patients of a pain clinic (inpatient setting). The results showed that after viewing the pain video the groups differed significantly in their pain concept as predicted. The use of an educational video, like the one evaluated, seems useful to initiate first steps in illness concept modification by expanding and enriching the patients attitude by assumptions about the influence of psychological factors on pain maintenance and management and shaping realistic attitudes towards treatment.