Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Single Intradiscal Administration of the Tumor Necrosis Factor-Alpha Inhibitor, Etanercept, for Patients with Discogenic Low Back Pain.
To examine the analgesic effect of intradiscal administration of a tumor necrosis factor-αα (TNF-α) inhibitor in patients with discogenic low back pain (LBP). ⋯ Single intradiscal administration of a TNF-α inhibitor can alleviate intractable discogenic LBP for up to 8 weeks. TNF-α may be involved in discogenic pain pathogenesis. This procedure is a novel potential treatment; longer-term effectiveness trials are required in the future.
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Despite the growth of the economic impact of pain and pain management, there remains a lack of knowledge about disparities, especially, evidence regarding individual attitudes and beliefs about accepting pain treatments. This study provides preliminary information on the prevalence of public concerns about pain management and a better understanding of factors that may ultimately lead to improved pain management and treatment adherence. ⋯ These components are useful for future research on the willingness to use pain medicine and may have implications for assessing cognitive barriers toward pain and pain management among the general public.
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Previous studies examining opioid dose and overdose risk provide limited granularity by milligram strength and instead rely on thresholds. We quantify dose-dependent overdose mortality over a large spectrum of clinically common doses. We also examine the contributions of benzodiazepines and extended release opioid formulations to mortality. ⋯ Dose-dependent opioid overdose risk among patients increased gradually and did not show evidence of a distinct risk threshold. There is urgent need for guidance about combined classes of medicines to facilitate a better balance between pain relief and overdose risk.