Articles: pain-management.
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The organic and psychological problems of patients suffering from chronic abdominal pain are described and three case histories of patients who had undergone multiple surgery for their abdominal pain are presented. All three were treated by lumbar sympathetic lysis, resulting in relief of their pain. The possible reasons for this success are discussed.
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A classification is given of the types of pain emanating from the vertebral column and associated neural structures. Treatment should primarily be conservative, and if this is not successful surgery should be considered. If pain is still resistant to therapy after these steps percutaneous interruption of afferent stimuli by thermocoagulation may be considered. ⋯ The indications, selection of patients, techniques, results and complications of both methods are described. It is concluded that percutaneous facet denervation is an effective method for alleviating posterior mechanical pain. Partial posterior rhizotomy has a worth while success rate considering the fact that there is nothing else to offer to those patients. (Acta anaesth. belg., 1981, 32, 63-80).
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Applied neurophysiology · Jan 1981
Comparative StudyExamination of possible mechanisms by which stimulation of the spinal cord in man relieves pain.
Stimulation of the spinal cord may be very helpful in controlling chronic pain. Traditionally it has been thought that pain control derives from antidromic activation of large-diameter primary afferents in the posterior columns, which inhibits activation of second-order neurons. ⋯ It is suggested that 'frequency-related conduction block' in the spinothalamic tract or in Lissauer's tract may play a role in pain relief. Because of uncertainty about the mechanism it is suggested that the term 'dorsal column stimulation' be replaced by 'spinal axis stimulation'.
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Applied neurophysiology · Jan 1981
Electrical stimulation of the spinal cord and peripheral nerves for pain control. A 10-year experience.
Patients who underwent implantation of dorsal column stimulators from 1970 to 1973 were reviewed 7-10 years following stimulation. The number who achieved satisfactory pain relief was not significant. The criteria for selecting these patients were reviewed utilizing those now used in 1980. 50% of the patients originally selected would now be rejected for psychological or drug-related reasons. ⋯ However, it appears that psychological factors were the most important reasons for failure. A smaller group of patients studied for 3-5 years following implantation of epidural spinal cord stimulators achieved a 70% pain control rate. Selection factors that explain these differences are discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
The acupuncture treatment of neck pain: a randomized controlled study.
Thirty patients with cervical spine pain syndromes persisting a mean of 8 years were assigned randomly into equal treatment and control groups. After 12 weeks, 12 of 15 (80%) of the treated group felt improved, some dramatically, with a mean 40% reduction of pain score, 54% reduction of pain pills, 68% reduction of pain hours per day and 32% less limitation of activity. Two of 15 (13%) of the control group reported slight improvement after 12.8 weeks. The control group had a mean 2% worsening of the pain score, 10% reduction in pain pills, no lessening of pain hours and 12% less limitation of activity.