Interventional Techniques in the Management of Chronic Pain: Part 2.0

Interventional Management of Chronic Pain

“…5,6 Due to the risk of complications associated with prolonged use, corticosteroids for interventional procedures are administered not more than 3 to 4 times a year. 2 Local anaesthetics are used to confirm appropriate medication delivery and to provide temporary relief until the corticosteroids reach their therapeutic levels. 7 Alcohol and phenol are nerve protein denaturation agents that act as neurolytics by destroying neural structures involved in the perception of pain.…”

“…Linton et al estimated the prevalence of spinal pain in the general population as 66% -among them 15% reporting thoracic pain, in comparison to 44% and 56% for cervical and lumbar regions, respectively. 2,10 Pain is caused by pathological alterations in the vertebrae, intervertebral discs, spinal cord, nerve roots, facet joints, ligaments or muscles. 2…”

“…Injection of local anaesthetic into a facet joint can aid the clinician in determining the source of pain. 2,13 Deriving at least 50% pain relief after injection is considered a true positive. Corticosteroids may also be added to reduce inflammation and they act by inhibiting synthesis or release of pro-inflammatory substances.…”

“…Chronic non-cancer pain is a common clinical condition afflicting 15% (2% to 40%) of the population 1 with 13% of them experiencing some form of functional disability. 2 It represents a significant drain on the physical, emotional and social state of the individual as well as an economic burden to the healthcare system. In 1998 alone, the United States of America spent US$90 billion to treat chronic noncancer back pain and it was estimated that expenditure for this disease entity was 60% higher than what was spent to treat coronary artery disease and the acquired immunodeficiency syndrome (AIDS) combined.…”

Εκφυλιστική Δισκική Νόσος Οσφυϊκής Μοίρας Σπονδυλικής Στήλης

“…Είναι σημαντικό να καθοριστεί αρχικά, με την κλινική εξέταση, εάν πρόκειται για αμιγώς σωματικό πόνο, ριζιτικό πόνο, ή συνδυασμό αυτών, γιατί έτσι θα σχεδιαστεί το διαγνωστικό και στη συνέχεια το θεραπευτικό πλάνο. Στον πίνακα 1 καταγράφονται λεπτομερώς οι πιθανές αιτίες, τα συμπτώματα και σημεία που παρατηρούνται στις δύο κατηγορίες πόνου της μέσης ή/και του κάτω άκρου (οσφυαλγία/ισχιαλγία) που συνολικά θα πρέπει να εκτιμώνται κατά την λήψη του ιστορικού και την κλινική εξέταση[1].μετεγχειρητικής πεταλεκτομής[8]. Ωστόσο δεν είναι γνωστή η ακριβής Πίνακας 1.3.2 Λεπτομερής δομή του μεσοσπονδύλιου δίσκου.3.2.1.…”