Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X217491
T. Suto, Makiko Hardy-Yamada, Toshie Kakinuma, Masumi Miyazaki, H. Shimada, J. Sato, S. Saito
{"title":"A case report of a glomus tumour with severe local pain","authors":"T. Suto, Makiko Hardy-Yamada, Toshie Kakinuma, Masumi Miyazaki, H. Shimada, J. Sato, S. Saito","doi":"10.1179/016911107X217491","DOIUrl":"https://doi.org/10.1179/016911107X217491","url":null,"abstract":"Abstract Background: A 70-year-old female patient presented with subungual pain in her left, middle finger. Her sole symptom was severe pain. Methods: Various methods of diagnostic imaging, including X-ray and CT scan, revealed no apparent objective finding. Results: When she came to our clinic, the pain had continued for 10 years without amelioration or decisive diagnosis. Her chief complaint was spontaneous pain in the finger, and severe tenderness. Swelling and redness were not observed around the site of pain. X-rays and CT examinations of her hand showed no abnormality in the phalanx or soft tissues. Since a glomus tumour was strongly suspected due to her clinical history, a fenestration operation was scheduled. A tumour approximately 4 mm in diameter was excised from under her nail bed. Its pathological diagnosis was glomus tumour. Her pain disappeared after surgery, and no recurrence was observed at more than 2 years' follow-up. Conclusions: Pain clinicians should suspect a glomus tumour, when a pa...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"146 ","pages":"41-42"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91446425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X217473
D. Dykstra, M. Stuckey, Scott N. Schimpff, J. Singh, M. Mahowald
{"title":"The effects of intra-articular botulinum toxin on sacroiliac, cervical/lumbar facet and sterno- clavicular joint pain and C-2 root and lumbar disc pain: a case series of 11 patients","authors":"D. Dykstra, M. Stuckey, Scott N. Schimpff, J. Singh, M. Mahowald","doi":"10.1179/016911107X217473","DOIUrl":"https://doi.org/10.1179/016911107X217473","url":null,"abstract":"Abstract Aims and Objective: In this small case series, we evaluated the effects and safety of injecting botulinum toxin type A (BoTN/A; Botox) and botulinum toxin type B (BoTN/B; Myobloc) into the sacroiliac joints, cervical/lumbar facet joints, C-2 roots, sternoclavicular joint and lumbar disc in patients with refractory pain. Methods: Eleven adult patients with refractory pain were injected with BoTN/A or BoTN/B. Results: All 11 patients had either a decrease (8 out of 11) or no change (3 out of 11) in their pain score after BoTN injection. All patients who responded to the injections noted improved function in activities of daily living and range of motion because of pain reduction. No side effects were noted. The mean duration of pain relief for the first BoTN treatments was 2.0 months. The median difference of duration of pain relief between BoTN and previous steroid injection was 1.6 months with BoTN being superior. The median change in pain score (0 to 10) after BoTN injection was −3. Conclusions:...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"4 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81385708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X396916
Sang-Chul Lee
{"title":"Clinical aspects of epidural adhesiolysis","authors":"Sang-Chul Lee","doi":"10.1179/016911107X396916","DOIUrl":"https://doi.org/10.1179/016911107X396916","url":null,"abstract":"AbstractEpiduroscopy is a minimally invasive procedure of the lumbar spine that is performed using a fibre-optic device which is inserted through the sacral hiatus into the lower epidural space. Indications for the epiduroscopy include patients with epidural inflammation, adhesions, or other tissue obstructions which are directly or indirectly causing pain in the back or leg. Epiduroscopy can be recommended as a valuable, safe, and cost-effective technique for relieving chronic, intractable pain non-responsive to all other conservative modalities of treatments. In this review, the development and clinical aspects of epidural adhesiolysis and epiduroscopy will be discussed.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"71 1","pages":"149-153"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76453026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X217437
F. Erdil, N. Gulhas, A. But, Z. Begec, M. O. Ersoy
{"title":"Does single dose premedication of dexmedetomidine reduce pain during injection of propofol","authors":"F. Erdil, N. Gulhas, A. But, Z. Begec, M. O. Ersoy","doi":"10.1179/016911107X217437","DOIUrl":"https://doi.org/10.1179/016911107X217437","url":null,"abstract":"Abstract Background and objective: Pain on injection is still a major problem with propofol. In this study, we compared the efficacy of single-dose premedication of dexmedetomidine for pain on injection of propofol and its effect on the incidence and the severity of the pain after propofol injection. Methods: We conducted a prospective, randomized and double-blind study of 100 patients scheduled to undergo surgery. Patients were randomly assigned to one of two groups, either receiving dexmedetomidine (Group D) or saline (Group C) before the injection of propofol. Patients in Group D (n = 50) were given dexmedetomidine infusion 0.6 μg/kg for 10 min. Patients in Group C (n = 50) were given saline infusion in an identical manner. Pain perception was assessed during injection of propofol in all patients. Results: The median pain score on injection of propofol was significantly lower in Group D than in Group C (median pain score 2 [1–3] vs 1 [0–2]; P < 0.006). The number of patients with pain in Group D decrea...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"1 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73079093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X268800
J. Richardson
{"title":"Clinical results and combined medication of epiduroscopy","authors":"J. Richardson","doi":"10.1179/016911107X268800","DOIUrl":"https://doi.org/10.1179/016911107X268800","url":null,"abstract":"AbstractIn chronic radiculopathic pain and back pain associated with epidural fibrosis, spinal endoscopy is potentially a powerful weapon. Its usefulness in diagnosis has not been realised but its therapeutic role is effective. The generation of radiculopathic pain is complex and there are a number of manoeuvres within this technique that are potentially beneficial. Recent evidence has shown that the most important component is safe and effective adhesiolysis. Recent outcomes of three prospective case series, two retrospective evaluations and a randomized, double-blind controlled trial have been positive for improvements in pain and physical function in patients who had previously obtained inadequate pain relief with traditionally placed caudal or lumbar epidural steroids. Saline is used in spinal endoscopy in order for direct vision to be achieved but also to aid with an adhesiolytic distension effect. Inflammatory chemicals leaking from degenerate intervertebral discs or zygapophysial joints may be wash...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"14 1","pages":"155-162"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75739724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X217446
J. Colthurst, P. Giddings
{"title":"A retrospective case note review of the Fenzian electrostimulation system: a novel non-invasive, non-pharmacological treatment","authors":"J. Colthurst, P. Giddings","doi":"10.1179/016911107X217446","DOIUrl":"https://doi.org/10.1179/016911107X217446","url":null,"abstract":"Abstract Background: A non-invasive, non-pharmacological device has been developed (the Fenzian system) to explore, electronically, the effects of using skin expression of underlying neurological activity to communicate repair signals to the neurological network. We have explored the efficacy of Fenzian electrostimulation over a range of patient conditions to help select further groups for future studies. Methods: This was a retrospective review of the medical notes of 600 consecutive patients who were treated with the Fenzian system in clinical practice. Results: Of the 600 case notes reviewed, data from 591 patients were included in the analysis. Of these, 58% were female and the mean age was 41.4 years (range, 0.25–86 years). Most patients (77.8%) received up to five treatments. Median outcome overall was 'much better' and outcomes were significantly better than 'no change' both overall and in all subcategories defined by duration of complaint, diagnostic category, age, and sex (P ≤ 0.0001). Patients w...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"5 1","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78795228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X376918
L. Saberski
{"title":"The history of epiduroscopy (spinal canal endoscopy)","authors":"L. Saberski","doi":"10.1179/016911107X376918","DOIUrl":"https://doi.org/10.1179/016911107X376918","url":null,"abstract":"AbstractThe technology of spinal canal endoscopy has developed slowly over the 20th and 21st centuries. Contributions have been made by many innovators; however, only recently has this technique been developed and refined sufficiently to be used clinically. Further study is needed to determine whether this technique holds advantages over alternative, currently used techniques of medication delivery into the epidural space. Real-time, direct visual examination of epidural anatomy currently enables the identification of epidural pathology and localization of pain generators. This ability to examine epidural pathology apart from operative trauma and to direct the delivery of medication is not duplicated by any other technique currently available. The future may hold the promise of minimally invasive and effective therapy for both radicular and perhaps other forms of disabling back pain.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"92 1","pages":"141-148"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80310737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X396862
T. Igarashi
{"title":"Current and potential use of spinal canal endoscopy/epiduroscopy","authors":"T. Igarashi","doi":"10.1179/016911107X396862","DOIUrl":"https://doi.org/10.1179/016911107X396862","url":null,"abstract":"AbstractWith the recent ageing of society, we frequently encounter patients with lower back and leg pain. In most patients, various conservative treatment methods are initially selected according to their pathological physiology. For patients who do not respond to conservative treatment, invasive treatment such as surgery is considered. However, patients that cannot be successfully treated conservatively do not always tolerate surgery. In recent years, minimally invasive treatment methods lying between conservative and invasive methods have shown favourable effects.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"265 1","pages":"140-140"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77689302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X217455
Zhaoxin Ma, Ming Li
{"title":"Surgical treatment of trigeminal neuralgia caused by the cerebellopontine angle tumour","authors":"Zhaoxin Ma, Ming Li","doi":"10.1179/016911107X217455","DOIUrl":"https://doi.org/10.1179/016911107X217455","url":null,"abstract":"Abstract Objective: To explore the diagnosis and treatment of secondary trigeminal neuralgia with cerebellopontine angle tumour. Methods: Twelve cases of secondary trigeminal neuralgia were treated during 2001–2004, and 7 were analyzed with regard to clinical manifestations, diagnosis and treatment. Twelve patients with trigeminal neuralgia associated with cerebellopontine angle tumour were studied, including 7 patients with epidermoid cysts of cerebellopontine angle and 5 patients with the meningioma of cerebellopontine angle. Pre-operative magnetic resonance imaging (MRI) showed space-occupying at cerebellopontine angle. Results: With cerebellopontine angle tumours removed through the retrosigmoid sinus approach, the secondary trigeminal neuralgia in all patients was completely relieved without surgical complications postoperatively. The follow-up period was 1–3 years. Recurrent trigeminal neuraligia occurred only in one patient at 1.5 years postoperatively (after operation at 1.5 years). Conclusions: M...","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"15 12 1","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86664074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain ClinicPub Date : 2007-08-01DOI: 10.1179/016911107X217482
M. Komori, K. Nishiyama, I. Kondo, Y. Sone, A. Fukuuchi, Tomoko Mae, M. Kawamata, M. Ozaki
{"title":"Effects of treatment with oral prostaglandin E1 on lumbar spinal canal stenosis","authors":"M. Komori, K. Nishiyama, I. Kondo, Y. Sone, A. Fukuuchi, Tomoko Mae, M. Kawamata, M. Ozaki","doi":"10.1179/016911107X217482","DOIUrl":"https://doi.org/10.1179/016911107X217482","url":null,"abstract":"Abstract Background: We studied the clinical effects of oral treatment with prostaglandin E1, which improves the microcirculation, on lumbar spinal canal stenosis associated mainly with symptoms such as neurological intermittent claudication and lower extremity pain. Methods: Oral prostaglandin E1 was given for 6 weeks to 30 patients with lumbar spinal canal stenosis who did not respond to physical therapy or nerve block. Results: The mean continuous walking distance significantly increased from 132 ± 45 to 698 ± 254 m. The mean severity score of lower extremity pain, evaluated on a 11-point (0–10) verbal rating scale (VRS), significantly decreased from 7.3 ± 1.3 to 4.6 ± 2.4. Thermography revealed a significant elevation of lower extremity peripheral temperature. Conclusions: These results suggested that oral prostaglandin E1 is useful for the treatment of lumbar spinal canal stenosis.","PeriodicalId":19808,"journal":{"name":"Pain Clinic","volume":"63 1","pages":"37-39"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76662743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}