Pain medicine : the official journal of the American Academy of Pain Medicine
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To determine the effectiveness of cervical medial branch thermal radiofrequency neurotomy in the treatment of neck pain or cervicogenic headache based on different selection criteria. ⋯ Higher degrees of relief from cervical medial branch thermal radiofrequency neurotomy are more often achieved, to a statistically significant extent, if patients are selected on the basis of complete relief of index pain following comparative diagnostic blocks. If selected based on lesser degrees of relief, patients are less likely to obtain complete relief.
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Most studies on chronic noncancer pain (CNCP) in people who use drugs (PWUD) are restricted to people attending substance use disorder treatment programs. This study assessed the prevalence of CNCP in a community-based sample of PWUD, identified factors associated with pain, and documented strategies used for pain relief. ⋯ CNCP was common among PWUD, and a good proportion of them used substances other than prescribed pain medication to relieve pain. Close collaboration of pain and addiction specialists as well as better pain assessment and access to nonpharmacological treatments could improve pain management in PWUD.
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Numerous forces shape the practice of pain management: scientific advances, technical advances, societal expectations, public health crises, reimbursement factors, and the parameters of who gets trained and what motivates the trainees. In this observational study, we sought to determine expressed motivations for entering the subspecialty of pain management, and in particular whether applicants were more interested in procedural skills (our hypothesis) or rehabilitative and cognitive practices. ⋯ If pain specialty training is going to meet the needs of prospective residents, patients, and society, we should do more to attract women and neurology and psychiatry residents. We should include more opportunities for research and the flexibility to educate trainees who may not pursue a procedural practice.
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Nociception caused by injuries may sensitize central mechanisms causing expanded pain areas. After recovery, the status of such pain distribution and sensitivity mechanisms is unknown. The present study investigated whether individuals who have fully recovered from a distal radius fracture demonstrate increased pain sensitivity and expanded distribution of pressure-induced pain. ⋯ Prolonged pain and recovered prior painful injuries like fractures may sensitize pain mechanisms manifested as expanded pain distribution. Pressure-induced referred pain can be a simple pain biomarker for clinical use.