Medicinal and injection therapies for mechanical neck disorders

Peloso, Paul M.; Gross, Anita; Haines, Ted; Trinh, Kien; Goldsmith, Charles H.; Burnie, Stephen J

doi:10.1002/14651858.cd000319.pub5

Cited by 4 publications

(1 citation statement)

References 149 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 Recalcitrant cervical radicular pain is commonly treated with epidural steroid injections. 2 Cervical interlaminar epidural steroid injection (CIESI) is the most common technique to access the epidural space. [3][4][5][6] The majority of the literature on the effectiveness of CIESI includes the use of low-dose local anesthetic as a diluent for the steroid injectate with the intention of providing immediate pain relief.…”

Section: Introductionmentioning

confidence: 99%

Effect of low-dose lidocaine on objective upper extremity strength and immediate pain relief following cervical interlaminar epidural injections: a double-blinded randomized controlled trial

McCormick

Burnham

Cunningham

et al. 2020

Reg Anesth Pain Med

View full text Add to dashboard Cite

BackgroundLow-dose lidocaine is a common diluent for analgesia following cervical interlaminar epidural steroid injection (CIESI). Concerns with this practice exist. A single-arm cohort reported that 20% of patients develop postprocedural upper extremity weakness when using lidocaine as a diluent. Furthermore, a high-cervical spinal block with unintended intrathecal or subdural administration is possible.ObjectiveDetermine if low-dose lidocaine as a diluent during CIESI causes clinically meaningful (1) upper extremity weakness and (2) immediate pain relief when compared with saline.DesignDouble-blinded randomized control trial.MethodsPatients with cervical radicular pain scheduled for CIESI were enrolled. Participants received lidocaine (CIESI-L) or saline (CIESI-S) as a diluent for the epidural injectate. Myotomal strength was measured with dynamometry before and between 20 and 30 min after CIESI. Pre-pain and post-pain scores were obtained. Primary and secondary outcomes were post-CIESI weakness of ≥20% (minimal clinically important difference (MCID)) in >1 myotome and ≥50% pain reduction on the numerical scale.Results120 participants (64 females (53%), mean age, 56 (SD 13.7) years) completed the study and were analyzed (CIESI-L n=60; CIESI-S n=60). There was no significant between-group difference in the proportion of participants with postprocedural weakness, CIESI-L 41.7% (95% CI, 29.8% to 54.5%), CIESL-S 50% (95% CI, 37.5% to 62.5%). Between-group comparison showed no significant difference in pain reduction, relative risk 1.53 (95% CI, 0.82 to 2.86).ConclusionLow-dose lidocaine as a diluent in CIESI does not significantly increase the risk of post-CIESI myotomal weakness when compared with saline, but also does not substantially increase the likelihood of immediate, meaningful pain relief.Trial registration detailsClinicalTrials.gov (NCT03127137); December 26, 2017.

show abstract

Section: Introductionmentioning

confidence: 99%

Effect of low-dose lidocaine on objective upper extremity strength and immediate pain relief following cervical interlaminar epidural injections: a double-blinded randomized controlled trial

McCormick

Burnham

Cunningham

et al. 2020

Reg Anesth Pain Med

View full text Add to dashboard Cite

show abstract

Integrative medicine for back and neck pain: Exploring cost-effectiveness alongside a randomized clinical pilot trial

Sundberg

Hagberg

Zethraeus

et al. 2014

European Journal of Integrative Medicine

View full text Add to dashboard Cite

Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders

Teslim¹

2014

AJHR

View full text Add to dashboard Cite

Non-steroidal anti-inflammatory drugs (NSAIDs) are of choice for acute pain management in musculoskeletal disorders (MSDs) but they are not without side effects. The primary aim of this study was to investigate user's experience of side effects of oral NSAIDs among patients with MSDs. Multi-stage sampling technique was used to select 296 patients with MSDs from physiotherapy outpatient clinics of five selected hospitals. A structured and close ended questionnaire was administered to investigate the side effects experienced by respondents. Descriptive statistics (mean, standard deviation, frequency and percentages) and Chi-square were used to compare the mean percentage difference in the knowledge of NSAIDs and their side effects. Only 15% of the respondents were able to recognize the listed side effects. A significant number of the respondents (58.7%) were not informed of the side effects of the NSAIDs at the time of prescription (Ӽ2 = 8.82, p = 0.003). About 33.4% and 31% of respondents identified dizziness and abdominal pain respectively as side effects. Sixty two (22.3%) respondents had experienced dizziness while 15.9% experienced abdominal pains. Diclofenac was the most frequently prescribed NSAID (153 [51.7%]). Only 2.0% and 2.7% of respondents were aware of phonophoresis and iontophoresis respectively as alternative means of administering NSAIDs where applicable. The Chi-square test revealed that the number of respondents that preferred alternative means of administration (where applicable) was significantly higher than those who preferred the oral routes (x2 = 74.5, p = 0.001). We concluded that this sample of Nigerian patients was not informed of the side effects of NSAIDs by the prescribers. Dizziness and abdominal pains were the most experienced side effects. The role of alternative methods to administer NSAIDs need to be made available to patients where applicable to increase their health care choices.

show abstract

Medicinal and injection therapies for mechanical neck disorders

Cited by 4 publications

References 149 publications

Effect of low-dose lidocaine on objective upper extremity strength and immediate pain relief following cervical interlaminar epidural injections: a double-blinded randomized controlled trial

Effect of low-dose lidocaine on objective upper extremity strength and immediate pain relief following cervical interlaminar epidural injections: a double-blinded randomized controlled trial

Integrative medicine for back and neck pain: Exploring cost-effectiveness alongside a randomized clinical pilot trial

Side Effects of Non-Steroidal Anti-Inflammatory Drugs: The Experience of Patients with Musculoskeletal Disorders

Contact Info

Product

Resources

About