Pain medicine : the official journal of the American Academy of Pain Medicine
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Few Australasian studies have evaluated persistent pain after breast cancer surgery. ⋯ The incidence of moderate to severe persistent pain after breast cancer surgery is high with associated pain interference, physical disability, and psychological distress. Important modifiable risk factors were identified to reduce this important condition.
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Glossopharyngeal nerve block is a useful interventional technique for pain management of the head and neck. It is performed with landmark techniques or ultrasound guidance. We propose a novel ultrasound-guided glossopharyngeal nerve block technique. ⋯ We designated the technique as ultrasound-guided selective glossopharyngeal nerve block: posterior mandibular ramus approach. No complications occurred during the bilateral application. This novel approach can be performed at a very shallow position, compared with conventional methods. There is no damage to tissues other than the muscles, which reduces postoperative complications and patient distress. Although our technique requires further safety assessments and technical refinements, it could represent a simpler alternative to conventional methods in daily clinical practice.
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As a member of the Back Pain Consortium (BACPAC), the University of Pittsburgh Mechanistic Research Center's research goal is to phenotype chronic low back pain using biological, biomechanical, and behavioral domains using a prospective, observational cohort study. Data will be collected from 1,000 participants with chronic low back pain according to BACPAC-wide harmonized and study-specific protocols. Participation lasts 12 months with one required in person baseline visit, an optional second in person visit for advanced biomechanical assessment, and electronic follow ups at months 1, 2, 3, 4, 5, 6, 9, and 12 to assess low back pain status and response to prescribed treatments. ⋯ The statistical analysis includes traditional unsupervised machine learning approaches to categorize participants into groups and determine the variables that differentiate patients. Additional analysis includes the creation of a series of decision rules based on baseline measures and treatment pathways as inputs to predict clinical outcomes. The characteristics identified will contribute to future studies to assist clinicians in designing a personalized, optimal treatment approach for each patient.
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Randomized Controlled Trial
A Pragmatic Randomized Prospective Trial of Cooled Radiofrequency Ablation of the Medial Branch Nerves versus Facet Joint Injection of Corticosteroid for the Treatment of Lumbar Facet Syndrome: 12 Month Outcomes.
Lumbar medial branch radiofrequency ablation (LRFA) and intraarticular facet steroid injections (FJI) are commonly performed for recalcitrant facet joint-mediated pain. However, no study has compared clinical outcomes of the two treatments in patients selected using dual medial branch blocks (MBBs) with an 80% relief threshold. ⋯ C-LRFA demonstrated superior success rates compared to FJI across pain and functional outcome domains.