Pain practice : the official journal of World Institute of Pain
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Adhesive capsulitis and disorders of the intra-articular portion of the long head of the biceps brachii tendon are common causes of shoulder pain. Sonographic findings, coupled with clinical evaluation and medical history, are paramount for prompt diagnosis. Herewith, either to precisely confirm the pain generator(s) or to appropriately treat relevant cases, ultrasound-guided interventions are often required in daily clinical practice. Targeting the anatomical structures involved in the aforementioned pathological conditions, we briefly describe some technical tips and tricks as regards ultrasound-guided hydrodilatation of the shoulder capsule at the rotator interval.
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Randomized Controlled Trial
Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial.
The ophthalmic branch of the trigeminal nerve is one of the most frequently involved sites of postherpetic neuralgia. A single-center randomized controlled study was conducted to evaluate the efficacy of local methylcobalamin injection for subacute ophthalmic herpetic neuralgia (SOHN). ⋯ This study indicates that local injection of methylcobalamin produces significant pain relief from SOHN and is superior to systemic administration.
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Randomized Controlled Trial
Randomized pragmatic pilot trial comparing perpendicular thin electrodes versus parallel thick electrodes approaches for lumbar medial branch neurotomy in facetogenic low back pain.
Although there are different ways of performing medial branch neurotomy on facetogenic low back pain, few studies have compared clinical outcomes of a parallel technique over the medial branch vs. a perpendicular technique. We investigated differences in pain outcome with both techniques. ⋯ There were differences at 6 months in the categorical analysis of the evolution of pain, Oswestry Disability Index score, Roland Morris Questionnaire score, and some functional Likert scale scores, all in favor of the parallel group.
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Responses of spinal progenitors to spinal cord stimulation (SCS) following spinal cord injury (SCI) in rats were assessed to reveal their potential contribution to SCS-induced analgesia. ⋯ Spinal progenitor cells appear to be activated by SCS via descending pathways, which may be enhanced by gabapentin and potentially contributes to relief of SCI-induced neuropathic pain.
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The situation generated in the health system by the COVID-19 pandemic has provoked a crisis involving the necessity to cancel non-urgent and oncologic activity in the operating room and in day-to-day practice. As the situation continues, the need to reinstate attention for patients with chronic pain grows. The restoration of this activity has to begin with on-site appointments and possible surgical procedures. On-site clinical activity has to guarantee the safety of patients and health workers. ⋯ We describe procedures to implement these recommendations for individual clinical situations, the therapeutic possibilities and safety guidelines for each center, and government recommendations during the COVID-19 pandemic.