Pain practice : the official journal of World Institute of Pain
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Phantom limb pain (PLP) affects a high percentage of amputees. Since treatment options are limited, low quality of life and addiction to pain medication frequently occur. New treatments, such as mirror therapy or electrical sensory discrimination training, make use of the brain's plasticity to alleviate this centrally derived pain. ⋯ Home-based TDT could achieve a sustained reduction in PLP and should be considered as a possible alternative to established treatment methods.
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As a bio-psycho-social issue, chronic low back pain (CLBP) has been a significant topic in health management, and patients' quality of life (QOL) is gaining extensive attention. Self-efficacy, pain fear-avoidance belief (FAB), and coping styles play important roles in the QOL of CLBP patients. However, it remains unclear how self-efficacy and FAB influence QOL through specific coping styles. This study aimed to explore the influencing paths of self-efficacy, FAB, and coping styles on the QOL of patients with CLBP. ⋯ Self-efficacy and FAB are both directly and indirectly related to global QOL, and coping styles are important mediating variables. Self-efficacy and active coping are protective factors for the QOL of CLBP patients, while FAB and passive coping are risk factors. Health education strategies are recommended by medical personnel to enhance CLBP patients' pain self-efficacy, decrease pain FAB, and modify pain coping styles, so that their global QOL can be improved.
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Hemiplegic shoulder pain (HSP) following stroke significantly affects the individual's function and quality of life. The mechanism of HSP is not clearly understood; hence, it is unclear why HSP resolves spontaneously or following routine care in some patients, while in others it becomes persistent. The aim was therefore to study whether HSP is associated with deficient pain modulation. ⋯ The results suggest that HSP is associated with a lack of pain adaptation, characteristic not only of the painful shoulder but also of the affected side. Although we cannot determine whether lack of pain adaptation precedes the HSP or results from it, interventions that enhance descending pain inhibition may improve management and prevent HSP chronification.
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Transforaminal epidural steroid injections (TFESIs) and facet joint blocks can be performed under fluoroscopy or computed tomography (CT) guidance. The purpose of this retrospective cohort study was to compare patient radiation dose for lumbar TFESIs and facet joint blocks under CT guidance vs. fluoroscopic guidance. ⋯ The study results suggest that TFESIs and facet joint blocks performed with CT guidance are associated with more than 8 times higher patient radiation dose exposure compared to fluoroscopic guidance. There needs to be more vigilance with regards to CT guidance in interventional pain procedures.
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Case Reports
Treatment of Chronic Refractory Neuropathic Pelvic Pain with High Frequency 10 Kilohertz Spinal Cord Stimulation.
Chronic neuropathic pelvic pain remains a recalcitrant problem in the field of pain management. Case series on application of 10 kHz spinal cord stimulation is presented. High frequency stimulation can improve chronic neuropathic pain states that are known to be mediated at the conus medullaris and offers another avenue for the treatment of these patients.