Pain medicine : the official journal of the American Academy of Pain Medicine
-
Randomized Controlled Trial Multicenter Study
Randomized Double-Blind Controlled Trial Comparing the Effectiveness of Lumbar Transforaminal Epidural Injections of Particulate and Nonparticulate Corticosteroids for Lumbosacral Radicular Pain.
To compare equivalent doses of a nonparticulate (dexamethasone) with a particulate (betamethasone) corticosteroid in lumbar transforaminal epidural steroid injections (TFESIs) in terms of pain, function, and complications. ⋯ According to this study, pain relief and functional improvement are similar for both dexamethasone and betamethasone at 3 months. Considering its safety profile, dexamethasone could be considered as first choice for TFESI. However, given that the study was underpowered, more research is needed to support a recommendation of systematically using dexamethasone in TFESI.
-
Painful diabetic neuropathy (PDN) is a debilitating complication of diabetes that greatly affects the quality of life of those afflicted. There are many treatment options for neuropathic pain. Recent studies show a promising analgesic effect using botulinum toxin-A (BTX-A) for neuropathic pain. ⋯ Tests for significance, low overall risk of bias, and almost no statistical heterogeneity suggests that there is a correlation between BTX-A and improvement of pain scores in PDN. Further large-scale controlled trials are needed.
-
Review Case Reports
Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment Part III: Fibromyalgia Syndrome.
To present the third in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. The series presents CLBP as a syndrome, a final common pathway for the expression of multiple contributors rather than a disease localized exclusively to the lumbosacral spine. Each article addresses one of 12 important contributors to pain and disability in older adults with CLBP. This article focuses on fibromyalgia syndrome (FMS). ⋯ Recognition of FMS as a common contributor to CLBP in older adults and initiating treatment targeting both FMS and CLBP may lead to improved outcomes in pain and disability.