Pain physician
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Randomized Controlled Trial Comparative Study
Comparison of Ultrasound-guided Transverse Carpal Ligament Release via Different Approaches in Carpal Tunnel Syndrome: A Prospective, Randomized, Controlled Trial.
Ultrasound-guided transverse carpal ligament (TCL) needle release has been demonstrated to be an effective treatment for carpal tunnel syndrome (CTS). However, no existing evidence has investigated the comparative efficacy of different release approaches. ⋯ Ultrasound-guided TCL needle release via the long-axis approach appears to be more effective than the short-axis approach for treating mild to moderate CTS.
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Editorial Review
Delineating the Hurtful, Engaging, Emotive, and Directive (HEED) Dimensions of Pain. Characterization for Clinical Relevance.
Pain is an objective, natural reality among sentient creatures that possess cognition and mobility sufficient for apprehending and acting upon its full significance. Defining pain mostly in mental terms makes sense for self-conscious psychology and vocabulary. Pain as a natural capacity among animals did not evolve merely to be aligned with human semantics and intuitions. ⋯ So delineated, pain evolved to be HEED-ed. Our proposed operational delimitation at first glance appears to be physiological, but its reliance upon the bio-psychosocial actuality of the painient organism renders it inter-theoretically reducible and expandable. This delineation of pain necessitates its being HEED-ed by the organism in which it occurs; and hence ethically heeded by those who profess to study and treat it.
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Review
Older and Better: A Narrative Review of Successful Aging and Adaptation to Pain in Late Life.
"Invariably, the self-assessed QoL was far better than I, as a physician, would have anticipated from the diseases and disabilities that you reported." -Ben Eiseman, MD, based on a survey of his octogenarian Yale University classmates. ⋯ Chronic pain is common in the elderly and is not adequately treated. Data indicate that older persons can benefit from guidance toward distinct attitudes and actions they can employ to cope with persistent pain. Epidemiologic and aging literature describe attitudes and behaviors that facilitate health and wellbeing during aging. Data from gerontology and from research on chronic pain in elderly patients converge upon factors that are common to better adaptation to both aging and late-life pain. I describe these common factors, which I categorize as treatment-factors, traits, attitudes, and actions. Two cases are presented to demonstrate these concepts.
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Randomized Controlled Trial
Percutaneous Intradiscal Radiofrequency Thermocoagulation Combined with Sinuvertebral Nerve Ablation for the Treatment of Discogenic Low Back Pain.
Percutaneous intervertebral radiofrequency thermocoagulation (PIRFT) and sinuvertebral nerve ablation (SVNA) are commonly used clinical treatments for discogenic low back pain (DLBP). However, they have been reported to have low efficacy rates of approximately 16.5%-26.5%, especially in the medium to long term. ⋯ In DLBP, the sinuvertebral nerve (SVN) is the main nerve involved in the lumbar disc pain signaling pathway, and compared with PIRFT and SVNA alone, combined PIRFT and SVNA treatment may provide more satisfactory pain relief and functional improvement at an early stage.
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Observational Study
Long-term Follow-up of the Effectiveness and Safety of High-voltage Pulsed Radiofrequency Treatment for Infraorbital Neuralgia: A Retrospective Study.
Infraorbital neuralgia is a refractory facial pain that may cause various psychological disorders. There is no optimal treatment for infraorbital neuralgia because few relevant studies have been conducted. Pulsed radiofrequency (PRF) is a minimally invasive procedure that has been proven effective in treating trigeminal neuralgia and other painful diseases. Our previous study demonstrated that high-voltage PRF was effective in patients with infraorbital neuralgia. However, there is little literature on the long-term follow-up of infraorbital neuralgia treated with high-voltage PRF with a large sample size. ⋯ Computed tomography-guided high-voltage PRF treatment provides a minimally invasive and effective treatment option for patients with infraorbital neuralgia who fail conservative treatment, which could be considered as a preferred treatment before more invasive treatments.