Pain Medicine最新文献

{"title":"Comparison of tibial nerve pulsed radiofrequency and intralesional radiofrequency thermocoagulation in the treatment of painful calcaneal spur and plantar fasciitis: A randomized clinical trial.","authors":"Gokhan Yildiz, Gevher Rabia Genç Perdecioğlu, Damla Yuruk, Ezgi Can, O. Akkaya","doi":"10.1093/pm/pnae029","DOIUrl":"https://doi.org/10.1093/pm/pnae029","url":null,"abstract":"OBJECTIVE\u0000Ultrasound-guided tibial nerve pulsed radiofrequency (US-TN PRF) and fluoroscopy-guided intralesional radiofrequency thermocoagulation (FL-RFT) adjacent to the painful calcaneal spur are two interventions for pain management in painful calcaneal spur (PCS) and plantar fasciitis (PF). This study aimed to compare the effectiveness of the two procedures.\u0000\u0000\u0000DESIGN\u0000A prospective, randomized, single-blind study.\u0000\u0000\u0000SETTING\u0000Single-center pain clinic.\u0000\u0000\u0000SUBJECTS\u0000Forty-nine patients who met the inclusion criteria were randomized into two groups.\u0000\u0000\u0000METHODS\u000025 patients (group U) received US-TN PRF at 42 °C for 240 s, while 24 patients (group F) received intralesional FL-RFT at 80 °C for 90 s. The most severe Numeric Rating Scale (NRS) score during the first morning steps and the American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot scores were used to evaluate the effectiveness of the procedures. The study's primary outcome assessed treatment effectiveness using the NRS, whereas the secondary outcomes included changes in the AOFAS score and the incidence of procedure-related mild adverse events.\u0000\u0000\u0000RESULTS\u0000NRS and AOFAS scores significantly improved in groups U and F at 1 and 3 months compared to baseline (p < 0.05), and there was no significant difference between the groups. At month 1, 50% or greater pain relief was achieved in 72% of patients in group U and 75% in group F. No significant difference was observed in the incidence of mild adverse events between the groups.\u0000\u0000\u0000CONCLUSIONS\u0000US-TN PRF and intralesional FL-RFT have shown significant effectiveness in the treatment of PCS and PF. Larger randomized controlled trials are needed.","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140669144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 10-Year Analysis of Application and Match Rates for Pain Medicine Training in the United States","authors":"Jason Silvestre, Ameet Nagpal","doi":"10.1093/pm/pnae026","DOIUrl":"https://doi.org/10.1093/pm/pnae026","url":null,"abstract":"Objective We analyzed application and match rates for pain medicine training in the United States (US) and hypothesized that there would be 1.) greater growth in the number of training positions than applicants, 2.) higher match rates among US allopathic graduates relative to non-US allopathic graduates, and 3.) greater number of unfilled training positions over time. Design Retrospective, cross-sectional study of all applicants for pain medicine training in the US Method National Resident Matching Program (NRMP) data were obtained over a ten-year period (2014-2023). Match rates and applicant-to-position ratios were calculated and compared over time with linear regression. Comparisons were made with chi square tests. Results Growth in the number of annual training positions (261 to 377, 44% increase) exceeded growth in the number of interested applicants (398 to 415, 4% increase) (P &amp;lt; 0.001). Annual applicant-to-training position ratios decreased (1.5 to 1.1, P &amp;lt; 0.001). The representation of US allopathic graduates among incoming pain medicine fellows decreased over the study period (73% to 58%, P &amp;lt; 0.001) while US osteopathic graduates increased (9% to 28%, P &amp;lt; 0.001). Match rates increased for both US allopathic graduates (71% to 91%, P &amp;lt; 0.001) and non-US allopathic graduates (51% to 81%, P &amp;lt; 0.001). From 2018 to 2023, US allopathic graduates (79%) had higher match rates than US osteopathic graduates (60%, P &amp;lt; 0.001) and international medical graduates (57%, P &amp;lt; 0.001). More available annual training positions went unfilled over the study period (2% to 5%, P = 0.006). Conclusions Stagnant annual applicant volume and increasing number of available training positions have led to increasing match rates for pain medicine fellowship training. Fewer US allopathic graduates are pursuing pain medicine training. The increasing percentage of unfilled training positions warrants ongoing surveillance.","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140597456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle infiltration assisted explantation technique for peripheral nerve stimulator leads","authors":"Sam Nia, Alexandra Adler, Pascal Scemama, Bhavana Yalamuru","doi":"10.1093/pm/pnae025","DOIUrl":"https://doi.org/10.1093/pm/pnae025","url":null,"abstract":"Introduction Peripheral nerve stimulation is a neuromodulation modality that is increasing used to treat chronic pain. The permanent peripheral nerve stimulator systems, while easy to place are designed to stay in place and scar at the implantation site. There is a paucity of literature on explantation techniques for peripheral nerve stimulators. Methods In this report describe a needle infiltration assisted technique for lead explantation. This novel technique is minimally invasive, cost effective and utilizes a combination of fluoroscopy and ultrasound imaging. We describe the successful use of this technique in 3 cases in our practice without any adverse events Conclusion There are many situations which might require a permanent peripheral nerve stimulator to be explanted such as infection, lead erosion, patient request or need for patient to undergo magnetic resonance imaging (MRI). In these scenarios, we propose a novel needle infiltration assisted technique of explantation that is safe, effective and easy to replicate.","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140597272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain relief and dermatological changes in complex regional pain syndrome with peripheral nerve stimulation.","authors":"Peter D Vu, Jamal J Hasoon, Grant H Chen","doi":"10.1093/pm/pnad163","DOIUrl":"10.1093/pm/pnad163","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to the Editor regarding \"Ultrasound-guided genicular nerve radiofrequency treatment: prospective randomized comparative trial of a 3-nerve protocol versus a 5-nerve protocol\".","authors":"Selin Guven Kose, Zeynep Kırac Unal, Halil Cihan Kose, Feyza Celikel, Omer Taylan Akkaya","doi":"10.1093/pm/pnad161","DOIUrl":"10.1093/pm/pnad161","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of emergency medicine-trained physicians in multidisciplinary pain medicine.","authors":"Sean Snyder, Danielle Zheng, Scott Brancolini, Jessica Oswald, Trent Emerick","doi":"10.1093/pm/pnad168","DOIUrl":"10.1093/pm/pnad168","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of prescription opioid tapering in patients with chronic non-cancer pain: a retrospective cohort study, 2015-2020.","authors":"Monica Jung, Ting Xia, Jenni Ilomäki, Christopher Pearce, Suzanne Nielsen","doi":"10.1093/pm/pnae002","DOIUrl":"10.1093/pm/pnae002","url":null,"abstract":"<p><strong>Objective: </strong>To identify common opioid tapering trajectories among patients commencing opioid taper from long-term opioid therapy for chronic non-cancer pain and to examine patient-level characteristics associated with these different trajectories.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>Australian primary care.</p><p><strong>Subjects: </strong>Patients prescribed opioid analgesics between 2015 and 2020.</p><p><strong>Methods: </strong>Group-based trajectory modeling and multinomial logistic regression analysis were conducted to determine tapering trajectories and to examine demographic and clinical factors associated with the different trajectories.</p><p><strong>Results: </strong>A total of 3369 patients commenced a taper from long-term opioid therapy. Six distinct opioid tapering trajectories were identified: low dose / completed taper (12.9%), medium dose / faster taper (12.2%), medium dose / gradual taper (6.5%), low dose / noncompleted taper (21.3%), medium dose / noncompleted taper (30.4%), and high dose / noncompleted taper (16.7%). A completed tapering trajectory from a high opioid dose was not identified. Among patients prescribed medium opioid doses, those who completed their taper were more likely to have higher geographically derived socioeconomic status (relative risk ratio [RRR], 1.067; 95% confidence interval [CI], 1.001-1.137) and less likely to have sleep disorders (RRR, 0.661; 95% CI, 0.463-0.945) than were those who didn't complete their taper. Patients who didn't complete their taper were more likely to be prescribed strong opioids (eg, morphine, oxycodone), regardless of whether they were tapered from low (RRR, 1.444; 95% CI, 1.138-1.831) or high (RRR, 1.344; 95% CI, 1.027-1.760) doses.</p><p><strong>Conclusions: </strong>Those prescribed strong opioids and high doses appear to be less likely to complete tapering. Further studies are needed to evaluate the clinical outcomes associated with the identified trajectories.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: Ultrasound-guided genicular nerve radiofrequency treatment: prospective randomized comparative trial of a 3-nerve protocol versus a 5-nerve protocol.","authors":"Mauricio Forero, Laura J Olejnik","doi":"10.1093/pm/pnad157","DOIUrl":"10.1093/pm/pnad157","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to a patient with chemotherapy-induced peripheral neuropathy: problem-based learning discussion.","authors":"Mark P Pressler, Brian Brenner, Ariunzaya Amgalan, Andrew M Mendelson","doi":"10.1093/pm/pnad164","DOIUrl":"10.1093/pm/pnad164","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weekly pain trajectories among people with knee or hip osteoarthritis participating in a digitally delivered first-line exercise and education treatment.","authors":"Ali Kiadaliri, Helena Hörder, L Stefan Lohmander, Leif E Dahlberg","doi":"10.1093/pm/pnad167","DOIUrl":"10.1093/pm/pnad167","url":null,"abstract":"<p><strong>Objective: </strong>Digital self-management programs are increasingly used in the management of osteoarthritis (OA). Little is known about heterogeneous patterns in response to these programs. We describe weekly pain trajectories of people with knee or hip OA over up to 52-week participation in a digital self-management program.</p><p><strong>Methods: </strong>Observational cohort study among participants enrolled between January 2019 and September 2021 who participated at least 4 and up to 52 weeks in the program (n = 16 274). We measured pain using Numeric Rating Scale (NRS 0-10) and applied latent class growth analysis to identify classes with similar trajectories. Associations between baseline characteristics and trajectory classes were examined using multinomial logistic regression and dominance analysis.</p><p><strong>Results: </strong>We identified 4 pain trajectory classes: \"mild-largely improved\" (30%), \"low moderate-largely improved\" (34%), \"upper moderate-improved\" (24%), and \"severe-persistent\" (12%). For classes with decreasing pain, the most pain reduction occurred during first 20 weeks and was stable thereafter. Male sex, older age, lower body mass index (BMI), better physical function, lower activity impairment, less anxiety/depression, higher education, knee OA, no walking difficulties, no wish for surgery and higher physical activity, all measured at enrolment, were associated with greater probabilities of membership in \"mild-largely improved\" class than other classes. Dominance analysis suggested that activity impairment followed by wish for surgery and walking difficulties were the most important predictors of trajectory class membership.</p><p><strong>Conclusions: </strong>Our results highlight the importance of reaching people with OA for first-line treatment prior to developing severe pain, poor health status and a wish for surgery.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}