Pain physician
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Chronic pelvic pain (CPP), defined as a noncyclical pain lasting for more than 6 months can lead to lower physical performance and quality of life in women. CPP is a worldwide problem affecting women of all ages. However, health care professionals and researchers, due to its complex nature and the lack of knowledge surrounding the condition, frequently neglect CPP. Subsequently, basic data and knowledge regarding CPP remain incomplete. ⋯ Based on these articles, prevalence in general ranged between 5.7% and 26.6%. There were many countries and regions without basic data in the field of CPP. This review shows the paucity of studies, especially multidisciplinary researches with multifactorial views on CPP. Multidisciplinary studies would provide more reliable data for estimating the prevalence of CPP and its psycho-socioeconomic burden, as well as finding its etiologies and characteristics. This would be the first step towards better treatment and care for women with CPP.
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Treating pain associated with acute coccyx fractures can be challenging. Intranasal calcitonin has been used to treat acute pain after vertebral fracture, and may even accelerate fracture healing. However, intranasal calcitonin has never previously been published as part of the treatment of acute coccyx fractures. ⋯ We propose that clinicians consider use of intranasal calcitonin for the treatment of pain due to acute coccyx fractures.
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Radiofrequency ablation (RFA) is a safe and effective pain therapy used to create sensory dysfunction in appropriate nerves via thermal damage. While commonly viewed as a simple process, RF heating is actually quite complex from an electrical engineering standpoint, and it is difficult for the non-electrical engineer to achieve a thorough understanding of the events that occur. RFA is highly influenced by the configuration and properties of the peri-electrode tissues. ⋯ A new paradigm for heating target tissue may be of value. Foremost in developing best practices for this procedure is avoiding pitfalls. Good RF heating and medial branch lesioning are the rewards for understanding how the process functions, attention to detail, and meticulous attention to electrode positioning.
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Review Meta Analysis
Nucleoplasty, a minimally invasive procedure for disc decompression: a systematic review and meta-analysis of published clinical studies.
Nucleoplasty, based on Coblation® technology, is a minimally invasive procedure used to decompress herniated discs. Reviews to date--exclusively systematic reviews--recommend nucleoplasty for treating chronic back pain, although with the restriction of limited to fair evidence. We therefore aimed to summarize and interpret our calculated results, where possible comprehensively and quantitatively, using statistical methods in the context of a meta-analysis supplementing a systematic review. In the process, the central question was to statistically determine whether, and to what extent, nucleoplasty can positively affect pain relief and functional mobility as well as lower the complication rate. ⋯ Nucleoplasty reduces pain in the long term and improves patients' functional mobility. It is an effective, low-complication, minimally invasive procedure used to treat disc herniations.
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Multiple reviews have shown that interventional techniques for chronic pain have increased dramatically over the years. Of these interventional techniques, both sacroiliac joint injections and facet joint interventions showed explosive growth, followed by epidural procedures. Percutaneous adhesiolysis procedures have not been assessed for their utilization patterns separately from epidural injections. ⋯ Percutaneous adhesiolysis utilization increased moderately in Medicare beneficiaries from 2000 to 2011. Overall, there was an increase of 47% in the utilization of adhesiolysis procedures per 100,000 Medicare beneficiaries, with an annual geometric average increase of 3.6%.