Pain physician
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Review
Transcranial Direct Current Stimulation for the Management of Neuropathic Pain: A Narrative Review.
Neuropathic pain (NP) is common and often resistant to conventional analgesics. Among different types of noninvasive brain stimulation techniques, transcranial direct current stimulation (tDCS) has been widely used to mitigate pain in patients with NP. ⋯ The results of the included studies suggest that tDCS may be beneficial in treating patients with NP due to stroke, spinal cord injury, multiple sclerosis, and trigeminal neuralgia. Further studies are recommended to validate the efficacy of tDCS in treating other types of NPs.
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Randomized Controlled Trial
Investigation of Effectiveness of Two Different Kinesiotaping Techniques in Myofascial Pain Syndrome: An Open-Label Randomized Clinical Trial.
Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by trigger points. Although there are widely accepted treatment modalities, there is no gold standard treatment. Kinesiotaping represents an interesting modality in the treatment of musculoskeletal disorders and attracts attention with studies emerging in the recent years, but in spite of the proposed benefits of kinesiotaping, its efficacy is still unclear, thus further studies evaluating the effectiveness of kinesiotaping are needed. ⋯ Both kinesiotaping methods were associated with lower pain intensity levels and better functional status and were effective in increasing quality of life by improving physical functions and general health earlier than the home exercise program. There was no significant difference between the kinesiotaping methods, except for role limitations due to the physical factors domain of SF-36 which was improved in the KMIT group earlier than in the KSCT group and CGs.
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Randomized Controlled Trial
A Randomized Controlled Trial of High Rate rTMS Versus rTMS and Amitriptyline in Chronic Migraine.
The patients with chronic migraine (CM) respond poorly to pharmacological agents including tricyclic antidepressants, beta-blockers, anticonvulsants, calcium channel blockers, flunarizine, and melatonin. The combination of 2 or more pharmacological agents has not shown better efficacy but increased side effects. High rate repetitive transcranial magnetic stimulation (rTMS) has been reported effective in episodic migraine and converts CM to episodic migraine. A combination of high rate rTMS with a pharmacological agent may be more effective compared to rTMS alone. ⋯ Combination of rTMS and amitriptyline is safe and more effective in CM compared to rTMS alone.
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The Added Value of Sensitivity to Nonnoxious Stimuli to Predict an Individual's Sensitivity to Pain.
Simple tools are needed to predict postoperative pain. Questionnaire-based tools such as the Pain Sensitivity Questionnaire (PSQ) are validated for this purpose, but prediction could be improved by incorporating other parameters. ⋯ The predictive potential of the PSQ can be improved by including information about gender, eye color, and light sensitivity. However, there is still a need for a technique suitable for routine clinical use to assess light sensitivity.
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Despite the high prevalence of vertebral compression fractures (VCFs) associated with refractory pain, deformity, or progressive neurological symptoms, minimally invasive vertebral augmentation procedures, including vertebroplasty and kyphoplasty, have been declining in their relative utilization, along with expenditures. ⋯ This study shows a significant decline in relative utilization patterns of vertebroplasty and kyphoplasty procedures, along with reductions in overall expenditures. The inflation-adjusted total expenditures of kyphoplasty and vertebroplasty decreased 21% with an annual decline of 3%. The inflation-adjusted expenditures per 100,000 of Medicare population decreased 40% overall and 5% per year. In addition, vertebroplasty has seen substantial declines in utilization and expenditure patterns compared to kyphoplasty procedures, which showed trends of decline.