Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Meta Analysis
The effectiveness of lumbar transforaminal injection of steroids: a comprehensive review with systematic analysis of the published data.
To determine the effectiveness of lumbar transforaminal injection of steroids in the treatment of radicular pain. ⋯ In a substantial proportion of patients with lumbar radicular pain caused by contained disc herniations, lumbar transforaminal injection of corticosteroids is effective in reducing pain, restoring function, reducing the need for other health care, and avoiding surgery. The evidence supporting this conclusion was revealed by comprehensive review of all published data and found to be much more compelling than it would have been if the literature review had been of the limited scope of a traditional "systematic review" of randomized, controlled trials only.
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Review Multicenter Study Meta Analysis
Systematic safety review and meta-analysis of procedural experience using percutaneous access to treat symptomatic lumbar spinal stenosis.
This systematic safety review reports multicenter safety results of symptomatic lumbar spinal stenosis (LSS) patients treated with percutaneous lumbar decompression. ⋯ In this safety review, percutaneous lumbar decompression proved to be a safe procedure. Compared with other more invasive lumbar decompression techniques, percutaneous lumbar decompression has demonstrated significantly better safety. This high level of safety is particularly vital for the rapidly growing elderly LSS patient population with increased treatment risks related to comorbid medical issues.
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Review Meta Analysis Comparative Study
Placebo response changes depending on the neuropathic pain syndrome: results of a systematic review and meta-analysis.
To compare placebo responses in neuropathic pain syndromes. ⋯ Placebo response is influenced by the pain syndrome evaluated. These differences should be considered when evaluating novel compounds for the treatment of neuropathic pain conditions.
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Review Meta Analysis Comparative Study
Experimental approaches in the study of pain in the elderly.
The present review summarizes experimental data on age-related changes in pain processing. These data suggest an increase in pain threshold and a decrease in tolerance threshold, which both are dependent on the physical nature of the stressor, as well as a developing deficiency in endogenous pain inhibition, which might be paralleled by an enhanced disposition to central sensitization (stronger temporal summation). These findings are arranged in a model that allows for explaining the two seemingly divergent perspectives: age both dulls the pain sense and increases the prevalence of pain complaints. This model is based on the assumption that both excitatory and inhibitory processes are dampened with age but that the later processes age at a faster rate, leading to increasingly unbalanced pain excitation.
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Review Meta Analysis
Time to take stock: a meta-analysis and systematic review of analgesic treatment disparities for pain in the United States.
The recent Institute of Medicine Report assessing the state of pain care in the United States acknowledged the lack of consistent data to describe the nature and magnitude of unrelieved pain and identify subpopulations with disproportionate burdens. ⋯ Our study quantifies the magnitude of analgesic treatment disparities in subgroups of minorities. The size of the difference was sufficiently large to raise not only normative but quality and safety concerns. The treatment gap does not appear to be closing with time or existing policy initiatives. A concerted strategy is needed to reduce pain care disparities within the larger quality of care initiatives.