Articles: chronic-pain.
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Slow-release strong opioids (SRSO) are indicated in patients with severe chronic pain. Side effects, lack of efficacy and risk of dependency limit their use in clinical practice. The aim of this study was to explore prescription patterns of SRSO in Swedish real-world data on patients with a diagnosis related to chronic pain (DRCP). ⋯ In conclusion, fewer patients remain on SRSO in the long-term in clinical practice than reported in previous clinical trials. Oxycodone is the most common first SRSO prescription and one-third of patients get a prescription indicating psychiatric comorbidity. Our interpretation of these findings are that there is need for better treatment options for these patients, and that more effort is needed to improve treatment guidelines and to ascertain that these guidelines are followed.
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Randomized Controlled Trial Multicenter Study Comparative Study
Adjacent level degeneration and facet arthropathy after disc prosthesis surgery or rehabilitation in patients with chronic low back pain and degenerative disc: second report of a randomized study.
Randomized clinical trial with 2-year follow-up. ⋯ In this first study that compared the courses of degeneration after treatment with disc prosthesis surgery or rehabilitation, ALD was observed at similar frequencies at the 2-year follow-up. However, the surgery group had increased FA at the implant level.
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Electrical stimulation of peripheral nerves is an established modality in treatment of chronic pain. Although introduced half a century ago, it has enjoyed rapid growth in popularity and acceptance over the last decade or so. The spectrum of clinical situations where peripheral nerve stimulation (PNS) has been successfully used includes chronic pain in extremities, neck, lower back, chest and abdominal wall, and head and face regions. ⋯ Such administrative recognition of clinical value of PNS necessitates update on PNS status for interested readers. The goal of this article is to provide a comprehensive overview of the different types of peripheral neurostimulation that are used today and providing the most updated information on the current state of the modality. As clinical interest and experience with PNS continue to grow, we expected steady accrual of objective evidence in terms of safety, efficacy, best indications and optimal stimulation parameters, all of which will be necessary for worldwide regulatory approval of PNS and for the benefit of patients who are still suffering from chronic neuropathic pain.
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Randomized Controlled Trial Comparative Study
Specific trunk and general exercise elicit similar changes in anticipatory postural adjustments in patients with chronic low back pain: a randomized controlled trial.
A randomized controlled trial. ⋯ SEG elicited significant reductions in self-rated disability and pain, whereas similar between-group changes in trunk muscle onsets were observed. The motor control adaptation seems to reflect a strategy of improved coordination between the trunk muscles with the unilateral shoulder movement. Trunk muscle onsets during rapid limb movement do not seem to be a valid mechanism of action for specific trunk exercise rehabilitation programs.