Current pain and headache reports
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Curr Pain Headache Rep · Jan 2025
ReviewPain Management Services Can Be a Cost-Effective Option over Surgery for the Treatment of Chronic Pain.
The number of facilities and physicians that offer pain management services has grown significantly since the 1970s. Despite the rise in prevalence of individuals with chronic pain during that time, interventional pain physicians remain underutilized. One reason why this may be the case is a large number of patients are referred directly to surgical specialists prior to being seen by an interventional pain physician. With the rising cost of healthcare, a shift away from surgical specialists and towards pain specialists as part of a multidisciplinary care team may help reduce the cost of care for chronic pain patients. ⋯ Through comparing the costs for patients with various types of chronic back pain, it was found that those who were treated by a pain physician rather than a surgeon saved up to over $8000 USD. Despite the cost benefits, it is important to recognize that healthcare disparities still exist which prevent patients from accessing interventional pain physicians. These disparities include patient location and insurance coverage. Overall, the treatment paradigm should start with non-invasive treatments, followed by minimally invasive procedures, with surgical interventions reserved as a last resort for when less invasive measures fail. Early incorporation of a multidisciplinary care team that includes chronic pain management services is critical for providing appropriate and cost-effective patient care.
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Curr Pain Headache Rep · Jan 2025
ReviewFamilial Mediterranean Fever (FMF): Emerging Concepts in Diagnosis, Pain Management, and Novel Treatment Options: A Narrative Review.
Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disorder predominantly affecting individuals of Mediterranean and Middle Eastern descent, including those with certain heritages including Sephardic Jewish, Armenian, Turkish, and Arab. The disorder affects up to 1 in 200 people making it a very common etiology for pain states worldwide, including serositis mediated painful states of the chest, joint, and abdomen. ⋯ Defined by recurrent episodes of fever and inflammation, FMF can lead to not only severe pain, but complications such as renal amyloidosis, if untreated. This narrative review explores the genetic basis, clinical manifestations, diagnostic criteria, and current management strategies for FMF. Mutations in the MEFV gene result in the dysregulation of the pyrin inflammasome, leading to excessive production of inflammatory cytokines. Diagnosis primarily relies on clinical criteria supported by genetic testing. Colchicine remains the cornerstone of treatment, effectively preventing inflammatory attacks and complications. For colchicine-resistant patients, IL-1 antagonists like anakinra and canakinumab show promise, although their long-term benefits require further investigation. The present investigation underscores the importance of early diagnosis and integrated treatment approaches to improve patient outcomes, pain management, and quality of life.
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This review aims to understand the foundations of cognitive behavioral therapy (CBT) and biofeedback, their indications for therapy, and evidence-based support. ⋯ Both CBT and biofeedback are noninvasive therapy options for patients who are suffering from a variety of chronic pain conditions, including chronic low back pain, headache, fibromyalgia, and temporomandibular disorder (TMD). CBT has been shown to be effective in treating multiple chronic pain conditions.
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Curr Pain Headache Rep · Jan 2025
ReviewDiagnosis and Management of Mild Traumatic Brain Injury (mTBI): A Comprehensive, Patient-centered Approach.
The purpose of this review is to provide an update regarding recent research and recommendations in the care of mild traumatic brain injury (mTBI). ⋯ New diagnostic criteria for mTBI have recently been developed by the American Congress of Rehabilitation Medicine through the Delphi method and this will help to standardize assessment, diagnosis, and treatment. Symptoms of mTBI are diverse and can sometimes become persistent. Treatment of mTBI should be patient-centered and may require subspeciality referral and coordinated, inter-disciplinary, or multi-disciplinary treatment.
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Curr Pain Headache Rep · Jan 2025
ReviewPost-laparoscopic Shoulder Pain Management: A Narrative Review.
Post-laparoscopic shoulder pain (PLSP) can slow patient recovery and extend hospital stays, making its management crucial for patients undergoing laparoscopic surgery. Current consensus guidelines say little about how to prevent or manage PLSP. In this context, a multimodal approach to PLSP management that maybe extend beyond the pharmaceutical interventions currently employed. A variety of devices comprising both invasive and noninvasive approaches are available to patients, serving as adjuvants to analgesics. In this review, we explore the potential causes of PLSP. Additionally, by searching relevant databases and reviewing existing literature, we provide a comprehensive summary of current PLSP management strategies excluding analgesics. ⋯ A total of 30 articles were reviewed. The review identified a number of different treatments for PLSP, including trendelenburg position, discharge of residual gas, pulmonary recruitment manoeuvre, low-pressure pneumoperitoneum and phrenic nerve block, among others. However, the inconsistencies in the study designs resulted in disparate conclusions. While the current studies provide valuable insights, there is a clear need for further research in this area.