The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Tramadol in neuropathic pain after spinal cord injury: a randomized, double-blind, placebo-controlled trial.
To assess the efficacy and safety of tramadol for relieving neuropathic pain after spinal cord injury (SCI). ⋯ Tramadol might be tried for neuropathic pain after SCI after the use of gabapentin/pregabalin, and tricyclic antidepressants have been found to be insufficient. Titration should be slow and individual, to minimize the risk of adverse events.
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Randomized Controlled Trial
Efficacy and tolerability of gastric-retentive gabapentin for the treatment of postherpetic neuralgia: results of a double-blind, randomized, placebo-controlled clinical trial.
To determine the efficacy and safety of a gastric-retentive, extended-release gabapentin (gabapentin ER) taken once or twice daily for treatment of postherpetic neuralgia. ⋯ Gabapentin ER administered twice daily is effective and safe for the treatment of pain associated with postherpetic neuralgia.
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Randomized Controlled Trial
Randomized trial of therapeutic massage for chronic neck pain.
Little is known about the effectiveness of therapeutic massage, one of the most popular complementary medical treatments for neck pain. A randomized controlled trial was conducted to evaluate whether therapeutic massage is more beneficial than a self-care book for patients with chronic neck pain. ⋯ This study suggests that massage is safe and may have clinical benefits for treating chronic neck pain at least in the short term. A larger trial is warranted to confirm these results.
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Randomized Controlled Trial
The effectiveness of clonidine-bupivacaine repeated nerve stimulator-guided injection in piriformis syndrome.
Piriformis syndrome (PS) is often refractory to conventional therapies. Guided injection techniques generally necessitate a computed tomography or fluoroscopic guidance that may not be available in most pain management centers in addition to its relative high cost. The aim of this clinical trial is to investigate whether clonidine-bupivacaine nerve-stimulator guided injections are effective in achieving long-lasting pain relief in PS compared with bupivacaine guided injection. ⋯ Repeated clonidine-guided piriformis injection relieved PS symptoms and reduce analgesic consumption for a 6-month period. It is a cost-effective useful treatment for PS refractory to traditional therapeutic approaches.
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Comparative Study Clinical Trial
Comparison of the effectiveness of interlaminar and bilateral transforaminal epidural steroid injections in treatment of patients with lumbosacral disc herniation and spinal stenosis.
The purpose of this study is to compare the effectiveness of interlaminar (IL) and bilateral transforaminal (TF) epidural steroid injections (ESIs) for pain reduction in patients with axial back pain resulting from herniated intervertebral disc (HIVD) and spinal stenosis (SS). ⋯ Bilateral TF epidural injection allowed the higher concentration of injectates to be delivered into ventral epidural space bilaterally. The IL approach can be more affected by tissue fibrosis, scarring, or hypertrophy, which is more prominently featured in SS than in HIVD; these prevent the injectate delivered via the posterior route from spreading to the ventral epidural space. Consequently, in patients with SS, bilateral TF produces better results than IL.