Articles: neuralgia.
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Randomized Controlled Trial
Efficacy of Duloxetine in Chronic Low Back Pain with a Neuropathic Component: A Randomized, Double-blind, Placebo-controlled Crossover Trial.
Among patients with chronic low back pain (CLBP), approximately 37% show signs of a neuropathic pain component (radicular pain). Treatment of this condition remains challenging. Therefore, the current study aimed to investigate the efficacy of duloxetine in the treatment of CLBP patients with neuropathic leg pain. ⋯ In this crossover study, duloxetine proved to be superior to placebo for the treatment of CLBP with a neuropathic leg pain.
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Chronic neuropathic pain has been recognized as contributing to a significant proportion of chronic pain globally. Among these, spinal pain is of significance with failed back surgery syndrome (FBSS), generating considerable expense for the health care systems with increasing prevalence and health impact. ⋯ There is significant (Level I to II) evidence of the efficacy of spinal cord stimulation in lumbar FBSS; whereas, there is moderate (Level II to III) evidence for high frequency stimulation; there is limited evidence for adaptive stimulation and burst stimulation.
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Multicenter Study Observational Study
A Novel Mini-invasive Approach to the Treatment of Neuropathic Pain: The PENS Study.
Peripheral neuromodulation is often used as chronic neuropathic pain treatment. Percutaneous electrical nerve stimulation (PENS) is generally utilized with several probes at the same time and repeated treatments. ⋯ PENS therapy produced significant and long-lasting pain relief in chronic peripheral neuropathic pains of different etiology. The present study confirms the feasibility, safety, and repeatability of this minimally invasive technique.
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Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. ⋯ This article will report clinical and imaging findings for each pathology type and the association with treatment decision. In addition, we will describe in detail all possible treatment techniques for low back pain and neuralgia, and we will report recently published results of these techniques summarizing the data concerning safety and effectiveness as well as the level of evidence. Finally, we will try to provide a rational approach for the therapy of low back pain and neuralgia by means of minimally invasive imaging-guided percutaneous techniques.