Articles: neuralgia.
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Semin. Arthritis Rheum. · Aug 2017
Review Meta AnalysisPrevalence of neuropathic pain in knee or hip osteoarthritis: A systematic review and meta-analysis.
Discordance between radiographic and pain severity in osteoarthritis (OA) has led researchers to investigate other pain mechanisms, including neuropathic pain. Accurate identification of any neuropathic pain in hip or knee OA is important for appropriate management, but neuropathic pain prevalence is unknown. We aimed to obtain an overall prevalence estimate by systematically reviewing and meta-analysing the prevalence of neuropathic pain in people with hip or knee OA. ⋯ Neuropathic pain prevalence in people with knee or hip OA is considerable at 23%, and may be higher after other potential causes of neuropathic pain are excluded. Concerns regarding the validity of neuropathic pain questionnaires, selection bias, methodological quality and study heterogeneity suggest caution with interpretation of these findings. Prevalence studies using standardised criteria for neuropathic pain are required.
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The apparent failure of pudendal nerve surgery in some patients has led us to suggest the possibility of entrapment of other adjacent nerve structures, leading to the concept of inferior cluneal neuralgia. Via its numerous collateral branches, the posterior femoral cutaneous nerve innervates a very extensive territory including the posterior surface of the thigh, the infragluteal fold, the skin over the ischial tuberosity, but also the lateral anal region, scrotum or labium majus via its perineal branch. ⋯ Cluneal neuralgia constitutes a distinct entity of perineal pain, which must be identified and distinguished from pudendal neuralgia. Surgery should be performed via a transgluteal approach. A lateral ischial obstacle must be investigated, in the form of a constant fibrous expansion, which, like a retinaculum, can cause nerve entrapment.
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Musculoskelet Sci Pract · Aug 2017
Comparative StudyThe diagnostic accuracy and test-retest reliability of the Dutch PainDETECT and the DN4 screening tools for neuropathic pain in patients with suspected cervical or lumbar radiculopathy.
It is important to identify neuropathic pain early to guide treatment decisions and prevent chronicity. There is lack of evidence whether the Dutch painDETECT questionnaire and Douleure Neuropathique en 4 questions (DN4) can adequately assess neuropathic pain. ⋯ Diagnosis, Level 1B.
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Randomized Controlled Trial
Effect of Repetitive Intracutaneous Injections with Local Anesthetics and Steroids for Acute Thoracic Herpes Zoster and Incidence of Postherpetic Neuralgia.
Treatment of established postherpetic neuralgia (PHN) is difficult and often disappointing. In this study, we assessed the efficacy of repetitive intracutaneous injections with local anesthetics and steroids in acute thoracic herpes zoster (HZ) pain, herpetic eruption, and incidence of PHN. ⋯ Repetitive intracutaneous injections with local anesthetics and steroids along with standard treatment significantly reduce the duration of pain and herpetic eruption and incidence of PHN.
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The perception of the media is that chemotherapy is mainly associated with nausea, vomiting and hair loss. In the longer term the development of peripheral neuropathy, i.e. chemotherapy-induced peripheral neuropathy (CIPN) is often more important for patients. ⋯ In addition to many interventions, which have been shown to be ineffective, physiotherapeutic measures and possibly the prophylactic application of cold are helpful for prevention. Randomized studies on the treatment of painful CIPN provided positive data for duloxetine and to a lesser extent for venlafaxine.