Pain medicine : the official journal of the American Academy of Pain Medicine
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Individuals seeking treatment for chronic pain in multidisciplinary pain management services are typically already on high doses of pain medications. This cross-sectional cohort study of patients with long-term chronic pain examined profiles of polypharmacy and pain medication-related harm exposure. ⋯ While treatment with multiple medications for synergistic or adjunctive effects may assist in medical management of chronic pain, this approach generates increased potential harm exposure. We show that the majority of detriment comes from medications other than opioids and highlight the importance of profiling all pain medications contributing to polypharmacy in clinical pain studies.
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Clinicians and educators rely on the published medical information. They trust that original research and narrative or systematic reviews are reliable and the authorship is transparent, but this is not always the case. Disclosure of conflicts of interest by authors is required by most journals, disclosure will not detect ghost or guest authorship. ⋯ Industry, universities, research centers, and professional medical associations should be clear and unequivocal in condeming these practices. Processes need to be in place to investigate and, if need be, deal with violations. Clearly, we must all participate in this endeavor for professional, ethical, and most importantly, best patient care reasons.
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Randomized Controlled Trial
Treatment of chronic lumbosacral radicular pain using adjuvant pulsed radiofrequency: a randomized controlled study.
The objective of this study was to determine the effects of combining pulsed radiofrequency (PRF) treatment and transforaminal epidural injection (TFEI) to treat patients with chronic refractory lumbar radicular pain caused by lumbar spinal stenosis. ⋯ The TFEI provided significant short-term pain relief and PRF can be applied in conjunction with TFEI to achieve higher treatment efficacy compared with TFEI alone.