Pain physician
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At present, there are many surgical treatments for primary hyperhidrosis (PH), but their medium- and long-term effects remain unclear. ⋯ This is the first clinical study to evaluate the efficacy of RFS and compare it with PES in treating primary hyperhidrosis. RFS significantly decreased hyperhidrosis and had a higher 2-year effective rate compared to PES.
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Prescription opioid misuse is an ongoing epidemic in the United States. Though the number of people misusing prescription opioids is declining, the prevalence of abuse and dependence remains stable. This highlights the need to identify and intervene in factors leading to the escalation of prescription opioid misuse. ⋯ Study results suggest the importance of the frequency of prescription opioid misuse as a possible risk factor for dependence and emphasize the need to monitor for misuse even in instances of acute pain.
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Guidelines for low back pain (LBP) management recommend addressing psychosocial risk factors such as stress and depression, which have been shown to play a prognostic role in nonspecific LBP. LBP management has been found to diverge from published recommendations. The reasons why remain unclear and may be related to patient views and expectations regarding the causes and treatment of LBP. ⋯ A significant portion of patients did not agree that psychosocial aspects should be addressed in LBP. Pain severity, health status, level of education, and previous treatment experience appear to affect patient views. These results highlight the importance of careful patient counseling regarding psychosocial factors and screening for psychosocial problems in LBP, when indicated. Additionally, educational initiatives may help bring patient expectations into agreement with recommendations.
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Ultrasound-guided (ULSD-g) genicular nerve blocks (GNB) using pharmacological agents for pain control in chronic knee osteoarthritis (OA) are gaining in popularity. There lacks a systematic review to evaluate the ULSD techniques and pharmacological agents used during the intervention, and to assess the knee's function postintervention. ⋯ There is fair evidence to at least target the superior medial genicular nerve, inferior medial genicular nerve, and Inferior medial genicular nerve using local anesthetics, corticosteroids, or alcohol to reduce pain and to improve knee function in patients with chronic knee OA under ULSD guidance. The procedure is safe but more research is needed to determine the optimal interventional approach.