Pain medicine : the official journal of the American Academy of Pain Medicine
-
The objective of this study was to evaluate the effects of coexisting fibromyalgia syndrome (FS) on pain intensity, disability, and treatment outcome in patients with chronic lateral epicondylitis (LE). ⋯ Coexisting FS may increase the pain intensity and disability, and negatively affect the treatment outcome in patients with chronic LE.
-
Comparative Study
Patient satisfaction with residents vs attending following fluoroscopy-guided pain injections.
Patient satisfaction has been the object of interest in health care for some time and is now increasingly used as the basis for quality management and improvement. This study compares patient satisfaction between residents and attending in a pain clinic setting following fluoroscopy-guided steroid injections. ⋯ Patients treated by residents are more likely to rate their experience as worse compared with the attending. However, majority of patients in both groups were satisfied in that they perceived their procedure as expected or better than expected.
-
Clinical Trial
Pain processing in medication overuse headache: a functional magnetic resonance imaging (fMRI) study.
The primary aim was to investigate functional differences between medication overuse headache (MOH) patients and controls with the purpose of evaluating the presence of a global alteration in the processing of noxious stimuli throughout the pain matrix. The secondary aim was to investigate whether activations in MOH patients normalize after medication withdrawal, which would suggest a possible role of the pain matrix in headache chronification. ⋯ Our findings suggest that significant functional changes occur in the lateral pain pathway in MOH patients. These could result from different processes: 1) cortical down-regulation aimed at reducing painful input to the cortex; 2) activity-dependent plasticity induced by excessive painful input during migraine attacks; and 3) direct effect of medication overuse. At 6 months after withdrawal, activity in these regions normalized, suggesting that no irreversible changes occur due to medication overuse.
-
The objective of this study was to delineate the relationship between noncancer pain and cognitive impairment with social vulnerability. ⋯ Pain and cognitive impairment are independently associated with social vulnerability. Improvements in pain management might mitigate social vulnerability in a growing number of older adults with either or both conditions.
-
Case Reports
Sternal kyphoplasty for metastatic lung cancer: image-guided palliative care, utilizing fluoroscopy and sonography.
Skeletal metastases can cause severe pain and functional impairment, secondary to direct invasion or osteolysis. Direct palliation of these metastases can reduce the burden of pain. Surgical excision or radiotherapy has been used to target these tumors. ⋯ Ultrasound imaging was used with fluoroscopy. Reproducibility, by other providers, is imperative with any emerging technique; this will facilitate wider patient access and device innovation. Hopefully, future multicenter trials will validate the efficacy and safety of this technique.