Medial branch radiofrequency ablation outcomes in patients with centralized pain

Morffi, Dayaris; Larach, Daniel B.; Moser, Stephanie; Goesling, Jenna; Hassett, Afton L.; Brummett, Chad M.

doi:10.1136/rapm-2018-100275

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…Individuals with central sensitization have been shown in numerous studies to be more likely to fail interventional and pharmacologic treatments, including for neck pain. 32,33 clinical Phenotyping…”

Section: Explanation Of Findingsmentioning

confidence: 99%

Multicenter, Randomized, Placebo-controlled Crossover Trial Evaluating Topical Lidocaine for Mechanical Cervical Pain

Cohen,

Larkin,

Weitzner

et al. 2023

Anesthesiology

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Background There are few efficacious treatments for mechanical neck pain, with controlled trials suggesting efficacy for muscle relaxants and topical non-steroidal anti-inflammatory drugs. Although studies evaluating topical lidocaine for back pain have been disappointing, the more superficial location of the cervical musculature suggests a possible role for topical local anesthetics. Methods We performed a randomized, double-blind, placebo-controlled crossover trial at 4 U.S. military, Veterans Administration, academic and private practice sites in which 76 patients were randomized to receive either placebo followed by lidocaine patch for 4-week intervals (group 1) or a lidocaine-placebo patch sequence. The primary outcome measure was mean reduction in average neck pain, with a positive categorical outcome designated as a ≥2-point reduction in average neck pain coupled with a ≥5/7 score on the Patient Global Impression of Change scale at the 4-week endpoint. Results For the primary outcome, the median reduction in average neck pain score was -1.0 (IQR -2.0, 0.0) for the lidocaine phase vs. -0.5 (IQR -2.0,.0) for placebo treatment (p=0.17). 27.7% of patients experienced a positive outcome during lidocaine treatment vs. 14.9% during the placebo phase (p=0.073). There were no significant differences between treatments for secondary outcomes, though a carryover effect on pain pressure threshold was observed for the lidocaine phase (p=0.015). 27.5% of patients in the lidocaine group and 20.5% in the placebo group experienced minor reactions, the most common of which was pruritis (p=0.036). Conclusions The differences favoring lidocaine were small and non-significant, but the trend towards superiority of lidocaine suggests more aggressive phenotyping and applying formulations with greater penetrance may provide clinically meaningful benefit.

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Section: Explanation Of Findingsmentioning

confidence: 99%

Multicenter, Randomized, Placebo-controlled Crossover Trial Evaluating Topical Lidocaine for Mechanical Cervical Pain

Cohen,

Larkin,

Weitzner

et al. 2023

Anesthesiology

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“…Of the 35 body areas denoted in the MBM, 19 correspond with those in the Widespread Pain Index, which is one of two components of the fibromyalgia survey criteria . This latter feature has made the body map a particularly helpful tool for the assessment of fibromyalgia‐like or centralized pain in many populations . The presence of pain that is more widespread, as opposed to localized, has implications for treatment.…”

Section: Michigan Body Mapmentioning

confidence: 99%

Measures for the Assessment of Pain in Adults

Hassett

Whibley

Kratz

et al. 2020

Arthritis Care & Research

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“…Of the 35 body areas, 19 locations correspond with the Widespread Pain Index that is used as one of two elements to calculate the 2011 Fibromyalgia Survey Criteria 13. This latter feature has made the body map a particularly helpful tool for the assessment of fibromyalgia-like or centralized pain 3 5–7 11 12 14 15…”

Section: Introductionmentioning

confidence: 99%

Initial validation of the electronic form of the Michigan Body Map

Hassett

Pierce

Goesling

et al. 2019

Reg Anesth Pain Med

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Background The Michigan Body Map (MBM) was developed to assess pain location in a reliable and valid manner; however, electronic formats have not been validated. This study had two aims: (1) initial validation of the electronic form of the MBM (eMBM) and (2) preliminary test of assessing pain severity within body zones. Methods For the first aim, 68 participants with chronic pain completed paper and electronic forms of the MBM, then underwent scripted interviews to assess preferences among body maps and verbal confirmation of pain locations. For the second aim, a subset of the participants (n=40) completed the Brief Pain Inventory (BPI) pain severity subscale, as well as the eMBM again and endorsed pain severity using additional screens showing body zones that contained areas in which pain was endorsed. Results There were few discrepancies between MBM, eMBM and verbal report (1.9% and 1.6%, respectively), and no difference between forms in perceived ability to indicate areas of pain or ease of completion. Patients accurately indicated their bodily pain on both maps, with 84% and 87% reporting one or no errors on MBM and eMBM, respectively. Participants also reported no preference for which version best-depicted areas of pain or best distinguished left from right. Lastly, the most preferred measure was eMBM with pain severity zones, followed by eMBM without zones, followed by the BPI pain severity subscale. Conclusions These data support the validity of the eMBM for patients with chronic pain. Further, an expanded form of the eMBM that assesses pain severity was preferred by most participants.

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Medial branch radiofrequency ablation outcomes in patients with centralized pain

Cited by 4 publications

References 31 publications

Multicenter, Randomized, Placebo-controlled Crossover Trial Evaluating Topical Lidocaine for Mechanical Cervical Pain

Multicenter, Randomized, Placebo-controlled Crossover Trial Evaluating Topical Lidocaine for Mechanical Cervical Pain

Measures for the Assessment of Pain in Adults

Initial validation of the electronic form of the Michigan Body Map

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