The Clinical journal of pain
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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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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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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.
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Does report of craving opioid medication predict aberrant drug behavior among chronic pain patients?
To examine the relationship between the self-report of craving prescription medication and subsequent opioid misuse among chronic pain patients prescribed opioids for pain. ⋯ These results suggest that self-reported craving is a potential marker for identification of those at risk for opioid medication misuse.
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To explore relationships between beliefs and worries held by parents of adolescents with chronic, nondisease specific, musculoskeletal pain and (1) parental pain promoting behaviors, (2) the adolescent's pain-related disability, (3) family functioning, and (4) parenting stress. ⋯ These findings provide insight into the complex interrelationships that exist among parents' beliefs and worries about adolescent pain, parental pain promoting behavior, adolescent disability, family functioning, and parenting stress that may have implications for treatment decisions made on the adolescent's behalf.