Pain practice : the official journal of World Institute of Pain
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To explore the potential diagnostic utility of musculoskeletal ultrasonography (USG) changes in complex regional pain syndrome type 1 (CRPS-1) of the upper extremity. ⋯ Ultrasonography provides useful anatomical information, regarding structure, kinesiology, and gross pathological changes of muscle, that may prove useful in understanding the motor impairment associated with CRPS-1. USG shows promise as a cost-effective bedside tool for the diagnosis of CRPS-1 and in guiding physical therapy.
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Previous studies demonstrated the efficacy of Intramuscular Nerve (IMN) therapy with a 4-lead percutaneous, peripheral nerve stimulation (PNS) system in reducing hemiplegic shoulder pain (HSP). This case series investigates the feasibility of a less complex, single-lead approach in reducing HSP. ⋯ This case series demonstrates the feasibility of a single-lead, 3-week IMN therapy for the treatment of chronic HSP. Additional studies are needed to further demonstrate safety, efficacy, and long-term benefit, define optimal prescriptive parameters and dose, and expand clinical indications.
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The literature contains numerous studies on the diagnosis, pathogenesis, atypical locations, and clinical (hormonal) and surgical management of the disorder. However, no information is available on the management of endometriosis involving pain refractory to the usual treatment from the perspective of a pain unit. Our hospital has a pain unit specifically dedicated to pain in gynecology and obstetrics. ⋯ Endometriosis is present in 48% of all patients with CPP and is the most prevalent pathology in our practice. It moreover poses an important challenge in view of its enormous complexity. A descriptive study was made of the management of 44 patients with endometriosis refractory to therapy, evaluated and treated over a period of 3 years in the Pain Unit of the Maternity Center of La Paz University Hospital (Madrid, Spain).
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A potential association might exist between atherosclerosis and migraine. Carotid intima-media thickness (CIMT) is a marker of generalized atherosclerosis; hence, we aimed to assess CIMT in migraine patients. This study included 30 patients and 60 healthy controls aged between 20 and 40 years. ⋯ There is a relationship between atherosclerosis and inflammation in migraine patients. The risk of cranial inflammatory arteriopathy increases in repeated attacks of migraine. Our study also supports that high number of attacks and attack duration are important in the development of atherosclerosis.
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Osteoarthritis is a chronic debilitating condition affecting many adults in the United States. This study was to compare pharmacologic treatments and costs for newly diagnosed and existing osteoarthritis patients to assess unmet medication treatment needs and economic burden. ⋯ Newly diagnosed osteoarthritis patients incurred higher annual costs, but lower pain-related prescription drug costs in the year following diagnosis than patients with existing osteoarthritis.