Pain practice : the official journal of World Institute of Pain
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Lumbosacral radicular pain is characterized by a radiating pain in one or more lumbar or sacral dermatomes; it may or may not be accompanied by other radicular irritation symptoms and/or symptoms of decreased function. The annual prevalence in the general population, described as low back pain with leg pain traveling below the knee, varied from 9.9% to 25%, which means that it is presumably the most commonly occurring form of neuropathic pain. The patient's history may give a suggestion of lumbosacral radicular pain. ⋯ For refractory lumbosacral radicular pain, adhesiolysis and epiduroscopy can be considered (2 B+/-), preferentially study-related. In patients with a therapy-resistant radicular pain in the context of a Failed Back Surgery Syndrome, spinal cord stimulation is recommended (2 A+). This treatment should be performed in specialized centers.
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Approximately 5% of the patients referred to outpatient pain clinics suffer thoracic pain. Thoracic pain in this article is limited to thoracic radicular pain and pain originating from the thoracic facet joints. Thoracic radicular pain is characterized by radiating pain in the localized area of a nervus intercostalis. ⋯ However, extensive skills are required to perform this procedure above the level of Th7. This treatment should take place in specialized centers. For thoracic facet pain, radiofrequency treatment of the ramus medialis of the thoracic rami dorsales is recommended (2 C+).