Articles: pain-management.
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Objective. To present a novel treatment approach for intractable inguinal neuralgia utilizing percutaneous peripheral electrostimulation. Materials and Methods. ⋯ Both patients who were on disability due to inguinal pain have been able to return to full-time employment. Conclusion. These preliminary results suggest that the technique described is effective and safe, and may be cost-effective as well.
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Objectives. To report complications associated with implant of the intrathecal drug delivery systems (IDDS). Patients and Methods. ⋯ Conclusion. IDDS are effective and safe devices for pain management. The complications associated with implants are mostly pharmacological and transient.
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Reg Anesth Pain Med · Jul 2001
Case ReportsRepeated psoas compartment blocks for the management of long-standing hip pain.
The psoas compartment block is used to produce analgesia of the lumbar plexus mainly for hip and knee surgery. It has also been used for the management of a long-standing pain due to hip joint degeneration. ⋯ We successfully performed repeated psoas compartment blocks with a local anesthetic and subsequently with added opioids, which produced substantial pain relief, especially after the addition of opioids.
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Spinal endoscopy with epidural adhesiolysis is an interventional pain management technique which emerged during the 1990s. It is an invasive but important treatment modality in managing chronic low back pain that is nonresponsive to other modalities of treatment, including percutaneous spring guided adhesiolysis and transforaminal epidural injections. ⋯ Percutaneous endoscopic lysis of epidural scar tissue has been shown to be cost effective and a safe modality. This review discusses various aspects of endoscopic adhesiolysis, including clinical effectiveness, complications, rationale, and indications.
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Biochemical mechanisms to explain pain generation began relatively recently. Evaluating pain originating from the spine can be challenging because no historical or physical examination findings are sufficiently sensitive or specific for identifying each of the myriad of potential pain generators. These discrete anatomic structures include the nerve root, disc annulus, posterior longitudinal ligament, sacroiliac joint, and facet joint. ⋯ However, this test may not be necessary in the patient when the specific radiculopathy level diagnosis is apparent; this is the case when a characteristic history and physical examination have a corroborative single-level imaging lesion. Determining which level is generating symptoms has implications for subsequent physical therapy, therapeutic injections, and surgery. This review of selective nerve root blocks describes the relevant anatomy, pathophysiology, rationale, clinical utility, and complications.