Articles: back-pain.
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Patients with pain conditions place significant demands on health care services globally. Health economists have reported the annual economic cost of pain in the United States as high as $635 billion. A common challenge in treating patients suffering from chronic pain conditions is accurate diagnosis and treatment. ⋯ The demographic differences and similarities within the subgroups highlighted the concept that pain diagnoses should be considered as separate, but related entities. The present study helps us to better understand the frequency of specific pain diagnoses, and directs future studies to appropriately focus on pain diagnoses based on prevalence. This will allow increased understanding of the variation in pain diagnoses and prevent over-generalization in studies examining pain patients to more accurately reflect the varied subtypes and their economic impact.Duke University Institutional Review Board Protocol: 00053624Key words: Pain diagnoses, CRPS, neuritis, radiculitis, limb pain, degenerative spine disease, back pain, chronic pain, post-laminectomy pain, prevalence, MarketScan.
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Case report. ⋯ N/A.
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Suprascapular nerve block is performed in the management of chronic shoulder pain and frozen shoulder. ⋯ This is the first study investigating the effect of ultrasound-guided suprascapular block on shoulder limitation in breast cancer survivors. The results demonstrate that it may be a promising treatment approach for rapid recovery of shoulder motion in women with breast cancer before radiation treatment.Key words: Breast cancer, upper extremity, shoulder pain, range of motion, disability, ultrasound, injection, triamcinolone, local anesthetics.
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Osteoporosis is an important problem in those of advanced age. Osteoporosis can induce sacral insufficiency fractures (SIFs). As average life expectancy increases, the number of patients with osteoporotic SIFs also increases. Osteoporotic SIFs cause severe low back pain and immobilization. Treatment of SIFs varies from analgesia to surgery. ⋯ Percutaneous sacroplasty is an effective minimally invasive treatment for osteoporotic SIFs refractory to conservative management. The study patients experienced significant relief of pain and increased mobility.Key words: Sacrum, sacroplasty, insufficiency fractures, osteoporosis, minimally invasive surgery.
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Review Meta Analysis
Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta-analysis.
Muscle relaxants are commonly prescribed for low back pain (LBP); however, there is limited evidence of their clinical efficacy and tolerability. This review evaluated the efficacy and tolerability of muscle relaxants in people with LBP. We searched online databases including Medline, EMBASE, CENTRAL and PsycINFO (inception to end October 2015) and performed citation tracking for eligible randomized controlled trials (RCTs). ⋯ Prolonged use of these medicines in LBP cannot be guided by trial evidence. WHAT DOES THIS REVIEW ADD?: Muscle relaxants provide clinically significant pain relief for acute low back pain. Caution must be taken with the interpretation of the findings as the evidence comes from specific muscle relaxant medicines.