Articles: pain-management-methods.
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Curr Pain Headache Rep · Jul 2019
Review Clinical TrialA Multimodal Approach to Pain Management for Patients with Chronic Back Pain: Outcome Measures at 1 Year.
The purpose of this study is to evaluate the effectiveness of a multimodal approach to treating chronic low back pain. ⋯ Chronic non-cancer-related back pain is often a frustrating and poorly managed problem for patients. It poses a significant public health issue worsened by the widespread use of narcotics. In 2016, the CDC released guidelines with noticeably more strict recommendations on prescription of narcotics for pain. Veterans at an interventional pain clinic presenting with chronic back pain refractory to medical and to surgical care were enrolled in an 8-week interdisciplinary pain management program. Pain scores were significantly reduced 1 year after completion of the program. Patients in this study benefitted from lower and sustained pain scores, a reduction in emergency room, and urgent care clinic visits, as well as generally high satisfaction with the interdisciplinary program.
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Curr Pain Headache Rep · Jul 2019
ReviewEmerging Novel Pharmacological Non-opioid Therapies in Headache Management: a Comprehensive Review.
Chronic headache is a significant worldwide problem despite advances in treatment options. Chronic headaches can have significant a detrimental impact on the activities of daily living. ⋯ Patients who do not obtain relief from chronic head and neck pain from conservative treatments are commonly being managed with interventional treatments. These interventional treatment options include botulinum toxin A, injections, local occipital nerve anesthetic and corticosteroid infiltration, occipital nerve subcutaneous stimulation and occipital nerve pulsed radiofrequency (PRF), sphenopalatine ganglion block, and radiofrequency techniques. Recently, evidence has emerged to support non-opioid-based drug and interventional approaches. Overall, more research is necessary to clarify the safety and efficacy of interventional treatments and to better understand the pathogenesis of chronic headache pain.
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Aim: To explore the overall effectiveness of interdisciplinary intensive outpatient treatment programs in adults with chronic pain. The secondary aim was to examine the effect of the intervention on individual outcome measures including pain intensity, pain catastrophizing, depressive symptoms, quality of life and describe its effect on medication use. ⋯ Results: A total of 13 peer-reviewed studies were included in analysis: one randomized controlled trial and 12 observational studies. Conclusion: Although interdisciplinary intensive outpatient programs for chronic pain have only been examined in a limited number of studies, trends suggest that participation in these programs may improve physical, emotional, social and mental health as measured by quality of life measures, while decreasing pain intensity, pain catastrophizing and depressive symptoms in a population with diverse diagnoses.
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Recently, denervation therapy has been applied clinically for the treatment of intractable osteoarthritis (OA). This therapy provides an alternative for patients who are insensitive to conservative therapies or unwilling to receive surgery and general anesthesia. However, therapeutic effect of this method, especially the long-term efficacy, is still controversial. ⋯ Osteoarthritis, denervation therapy, radiofrequency, chronic pain, function, systematic review, meta-analysis.
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Between 2009 and 2011 a series of 26 articles on evidence-based medicine for interventional pain medicine according to clinical diagnoses were published. The high number of publications since the last literature search justified an update. ⋯ This article summarizes the evolution of the quality of evidence and the strength of recommendations for the interventional pain treatment options for 28 clinical pain diagnoses.