Interventions in Chronic Pain Management. 6. Interventional Approaches to Chronic Pain Management

Overton, E. Anthony; Kornbluth, Ira D.; Saulino, Michael; Holding, Michele Y.; Freedman, Mitchell K.

doi:10.1016/j.apmr.2007.12.007

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…This three‐month limit may seem arbitrary, but it can actually provide an opportune moment for a general reassessment of the patient's care plan. This reassessment should not only consider which other physiotherapy techniques could be used to treat the patient, but it should also rethink the entire diagnostic process (Overton et al, 2008). This is because persistent chronic pain can lead to Chronic Pain Syndrome (CPS).…”

Section: Interventions For Patients With Chronic Non‐malignant Paimentioning

confidence: 99%

Pain and physical medicine

Toffola

Bejor

2009

Eur Journal of Pain Supp

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The first stage of any physical medicine intervention for a patient with pain is an accurate diagnosis. This allows a decision on the proposed therapy to be made according to the clinical picture. Recent classifications of pain allow us to divide pain management treatment into three specific groups, aimed at: (1) cancer pain, (2) pain (acute, sub‐acute or chronic) as a symptom of a specific pathology, and (3) chronic non‐malignant pain. In this article, we offer a summary of our clinical experience regarding the drafting of rehabilitation plans for patients with pain who have been referred to us.

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Section: Interventions For Patients With Chronic Non‐malignant Paimentioning

confidence: 99%

Pain and physical medicine

Toffola

Bejor

2009

Eur Journal of Pain Supp

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“…[14,24,26] The underlying mechanism of PEA is thought to involve the alleviation of adhesions or compression, which may mechanically hider the direct spread of drugs to the target site. [6,7,10,14,16,17,23,25–27] Therefore, PEA may be effective in pain reduction and functional improvements in patients with chronic low back pain resulting from L-HIVD. [3,6,7,14,24–27] Generally, PEA is performed by a caudal or transforaminal approach.…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of percutaneous epidural adhesiolysis for different sacrum types in patients with chronic pain due to lumbar disc herniation

et al. 2016

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For percutaneous epidural adhesiolysis (PEA) in patients with chronic low back and/or leg pain, comparative efficacy of lumbar PEA between the sacral types has not yet been investigated. This study aimed to determine the comparative efficacy of lumbar PEA between the sacral types in chronic pain with lumbosacral herniated intervertebral disc (L-HIVD).A total of 1158 chronic low back and/or leg pain patients who diagnosed with L-HIVD and underwent PEA between February 2011 and March 2015 were retrospectively examined. All enrolled patients were divided into 2 types: dome-sacral type and flat type. To avoid confounding bias, propensity score analysis was used. Numeric rating scales (NRS) and Patients’ Global Impression of Change (PGIC) were compared between the 2 types at baseline and at 3 months post-PEA.After conducting a propensity score matching analysis, 114 patients were included in each type. The mean sacral angle significantly differed between the flat-sacral and dome-sacral types (P < 0.001). A linear mixed effect model analysis showed that the adjusted NRS score at baseline was 7.58 [95% confidence interval (CI): 7.40–7.76] for the flat-sacral type and 7.47 (95% CI: 7.29–7.64) for the dome-sacral type. The adjusted NRS score after 3 months post-PEA was 4.27 (95% CI: 3.77–4.77) for the flat-sacral type and 3.71 (95% CI: 3.21–4.21) for the dome-sacral type. We detected no significant differences in NRS at baseline (P = 0.371) and after 3 months (P = 0.121) between the 2 groups. No significant differences were observed in terms of the NRS score between the 2 groups during the 3 months follow-up (omnibus P = 0.223). There were no significant differences in PGIC between flat-sacral and dome-sacral types at 3 months after the follow-up period (4.40 ± 2.17 and 4.67 ± 1.88, respectively, P = 0.431).PEA provides sufficient pain relief for chronic pain due to L-HIVD at 3 months postprocedure. The sacral type might not affect the outcome of lumbar PEA in chronic pain associated lumbar HIVD.

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Rehabilitation medicine approaches to spinal disorders

Lasak

Fast

2012

Spine Secrets Plus

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Interventions in Chronic Pain Management. 6. Interventional Approaches to Chronic Pain Management

Cited by 3 publications

References 36 publications

Pain and physical medicine

Pain and physical medicine

Comparative effectiveness of percutaneous epidural adhesiolysis for different sacrum types in patients with chronic pain due to lumbar disc herniation

Rehabilitation medicine approaches to spinal disorders

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