{"title":"gammaCore Device for Chronic Posttraumatic Headache Pain Management in Veterans With Comorbid Mood Disorders: A Case Report.","authors":"Jason Parmar, Darlene Makulski","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic posttraumatic headache (CPTHA) is a prevalent condition following traumatic brain injury, especially among veterans, with a significant impact on quality of life. Traditional treatments often lack efficacy and evidence-based support.</p><p><strong>Case report: </strong>We report the case of a 46-year-old male veteran with CPTHA, nonresponsive to standard therapies, including botulinum toxin A and oral medications. The patient underwent treatment with the gammaCore vagus nerve stimulator, a US Food and Drug Administration-cleared device intended for migraine and cluster headache management.</p><p><strong>Conclusions: </strong>Following initiation of gammaCore therapy, the patient experienced a marked reduction in headache intensity and frequency, alongside significant improvements in anxiety levels. These outcomes suggest that gammaCore may be a promising noninvasive treatment option for CPTHA, particularly in patients with coexisting mood disorders. Further research is warranted to validate these findings and establish gammaCore's role in CPTHA management.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 2","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001981","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}
{"title":"Multilevel Compression Fracture Initiated by Unrestrained Electroconvulsive Therapy for Treatment Resistant Depression Case Report.","authors":"Andrew Hyde, Brenda Ventura-Gomez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Depression is the most common cause of emotional disorders in older adults with electroconvulsive therapy (ECT) as the preferred treatment for older adults. ECT utilizes a controlled therapeutic seizure resulting in repetitive muscle contractions, which carries the risk of fractures and dislocations.</p><p><strong>Case report: </strong>This is an unusual case of a 69-year-old man with a history of treatment-resistant depression developing severe midback pain and a multilevel compression fracture after treatment without a well-defined incidence following utilization of ECT. Anteroposterior and lateral x-rays of the thoracic spine demonstrated a 2-level compression. The patient was a candidate for kyphoplasty. Bone density was age appropriate. On follow-up, the patient denied pain with healing of the fracture without augmentation. Initiation of physical therapy was recommended.</p><p><strong>Conclusions: </strong>Individuals with age-appropriate nonosteoporotic bones can develop fractures during ECT. Back pain following ECT may be associated with a vertebral compression fracture, especially in older adults.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 2","pages":"93-96"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038112","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}
{"title":"Sternal Nonunion Treated by Radiofrequency Thermocoagulation of the Anterior Cutaneous Branch of the Intercostal Nerve: A Case Report.","authors":"Tatsunori Watanabe, Hiroshi Baba","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>For painful sternal nonunion, conservative treatment by radiofrequency thermocoagulation nerve block of the anterior cutaneous branch of the intercostal nerve can be indicated when surgery is not feasible.</p><p><strong>Case report: </strong>A 44-year-old man with a history of open-heart surgery was referred to our department due to a complaint that was strongly suspected to be associated with stress. He wished to restart archery, however, doing so was difficult due to the painful sternal nonunion. Surgical treatment and external fixation were not appropriate due to his past medical history and desire to resume archery. Radiofrequency thermocoagulation (90°C, 120 seconds) of the anterior cutaneous branch of the intercostal nerve was performed because he had only 2 tender points. After performing thermocoagulation several times to achieve long-term analgesia, the patient was allowed to resume archery.</p><p><strong>Conclusions: </strong>Radiofrequency intercostal nerve thermocoagulation is an effective conservative treatment for sternal nonunion pain.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 2","pages":"123-126"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038382","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}
{"title":"Imaging Considerations for Patients With Chronic Low Back Pain: A Case Report.","authors":"Kennedy Kirkpatrick, Jay D Shah, Krishna Shah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The incidence of low back pain, a leading cause of global disability, has increased significantly. Spinal cord stimulation (SCS) is US Food and Drug Administration-approved for treating intractable back pain, particularly in patients with prior surgical interventions.</p><p><strong>Case report: </strong>A 43-year-old woman was referred for SCS implantation following 3 prior lumbar spinal surgeries with continued, right-sided radicular back pain. Additional diagnostic imaging was obtained, and a magnetic resonance imaging with and without contrast revealed a recurrent disc despite 3 lumbar microdiscectomies. The patient was then referred for lumbar spinal fusion, specifically anterior lumbar interbody fusion.</p><p><strong>Conclusions: </strong>This case underscores the importance of comprehensive imaging and clinical assessment to identify structural abnormalities that may mimic or exacerbate pain. It highlights the need for tailored evaluations to determine SCS candidacy and advocates for careful consideration of imaging modalities in managing chronic low back pain, particularly in patients with a history of failed back surgery.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 2","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057651","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}
Shemar Crawford, Mateusz Graca, Robin Mata, Danielle Horn
{"title":"Peripheral Nerve Stimulation for Rotator Cuff-Induced Chronic Shoulder Pain: A Literature Review.","authors":"Shemar Crawford, Mateusz Graca, Robin Mata, Danielle Horn","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic shoulder pain is one of the most common musculoskeletal complaints in a primary care setting, with a worldwide prevalence ranging from 10.8% to 55.2%. Peripheral nerve stimulation (PNS) was discovered in the 1960s; however, it is a newly emerging treatment for chronic shoulder pain secondary to rotator cuff pathology.</p><p><strong>Methods: </strong>Patients in these studies had chronic shoulder pain, lasting 12 months or more, attributable to rotator cuff etiology. The search was limited to studies published between 2010 and 2023.</p><p><strong>Results: </strong>All 4 studies reported a substantial reduction in pain ranging from 40% to 100%, observed between 42 and 407 days post-PNS placement. Three patients also noted a 29% to 75% reduction in opioid use.</p><p><strong>Conclusions: </strong>Preliminary studies suggest that PNS may be an effective treatment option for chronic shoulder pain due to rotator cuff etiology. To accurately assess the effect of PNS on chronic shoulder pain due to rotator cuff pathology significantly more data, including prospective trials, are required and warrant pursuit.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 1","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061587","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}
Andre Asperti, Nicholas Peterson, John Casnovsky, Mahmood Gharib
{"title":"Peripheral Nerve Stimulation at the Spinoglenoid Notch May Have Advantages Over Suprascapular Notch - Case Report.","authors":"Andre Asperti, Nicholas Peterson, John Casnovsky, Mahmood Gharib","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Modulation of the suprascapular nerve (SSN) and axillary nerves using peripheral nerve stimulation (PNS)is increasingly being used to treat patients with chronic shoulder pain.</p><p><strong>Case report: </strong>Our patient presented with chronic shoulder pain secondary to glenohumeral joint osteoarthritis. Ultrasound guidance was used for PNS lead placement at the spinoglenoid notch and at the deltoid for suprascapular and axillary nerve modulation, respectively. After a 60-day treatment period with PNS, the patient had clinically significant pain reduction. No complications were observed.</p><p><strong>Conclusions: </strong>Stimulating the suprascapular nerve (SSN) at the spinoglenoid notch offers optimal patient positioning and has a lower risk of pneumothorax, intravascular injection, and residual motor block compared to the suprascapular notch approach. PNS of the SSN at the spinoglenoid notch is a safe, alternative, and novel use of PNS.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 1","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035161","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}
{"title":"Basivertebral Nerve Ablation in the Setting of Existing Fusion Hardware Case Report.","authors":"Rhett Layman, Frankie Prologo, Mamerhi Okor, Jesse Jones, Meghana Muppuri, Junjian Huang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic low back pain (LBP) is a widespread disease particularly as the population continues to age. The most common type of chronic LBP is axial LBP caused by disc degeneration leading to vertebrogenic back pain. Recently, the concept of vertebrogenic LBP has become more mainstream as has its treatment, basivertebral nerve ablation (BVNA). Herein, we report a case where BVNA was performed in the setting of existing hardware at the treatment levels.</p><p><strong>Case report: </strong>Sixty-eight-year-old woman with chronic LBP status post anterior L5/S1 instrumented fusion presents with persistent chronic LBP centralized to L5/S1. Preoperative imaging demonstrates increased signal on bone scan at L5/S1 and BVNA was performed adjacent to the screws, resulting in significant relief of LBP and without complication.</p><p><strong>Conclusions: </strong>BVNA is feasible to perform at levels where existing spine hardware is present.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040573","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}
{"title":"Transient Dorsal Cord Syndrome After Splanchnic Neurolysis: A Case Report.","authors":"Haijun Zhang, Tony Lo, Kent H Nouri","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Image-guided splanchnic neurolysis has been performed for decades to relieve abdominal pain due to cancer. Severe complications associated with the procedure are rare but could happen. Different from the previously reported cases of paraplegia due to anterior artery (cord) syndrome, here we presented a case of transient dorsal cord syndrome involving bilateral lower extremities after splanchnic neurolysis.</p><p><strong>Case report: </strong>The patient had numbness and impaired proprioception of both legs, ataxic gait, and bowel and bladder dysfunctions shortly after bilateral splanchnic neurolysis. Magnetic resonance imaging of the spine shows new abnormal signals in the dorsal column. Based on the presentations and image findings, the diagnosis of dorsal cord syndrome was made. The majority of the symptoms were resolved in 2 weeks after the treatment of oral steroids and physical therapy.</p><p><strong>Conclusions: </strong>Severe neurological complications could happen after image-guided splanchnic neurolysis. Close motoring, early imaging, and multidisciplinary collaboration with different services are strongly recommended to promote a speedy recovery and prevent a permanent deficit.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 1","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049321","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}
{"title":"Ultrasound-Guided Pudendal Nerve Dextrose Hydrodissection for Urinary Incontinence: A Clinical Review and Case Reports.","authors":"Helen Gharaei, Teinny Suryadi, Negin Gholampoor","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pudendal nerve (PN) entrapment can result from both mechanical and nonmechanical causes. Mechanically, the nerve may be compressed, transected, or stretched, often during surgical procedures. Nonmechanical causes may include chronic conditions, such as diabetes mellitus.</p><p><strong>Case reports: </strong>These case series include a 66-year-old man with a 3-year history of benign prostatic hyperplasia, who complained of urinary incontinence after surgery, and a 67-year-old woman with a 10-year history of well-controlled type 2 diabetes and diabetic urogenital autonomic neuropathy, whose urinary incontinence responded to ultrasound-guided dextrose hydrodissection of the PN.</p><p><strong>Conclusions: </strong>Ultrasound-guided PN dextrose hydrodissection can be a straightforward and safe treatment option for urinary incontinence.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 1","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035162","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}
Muhammed Zahid Sahin, Ridvan Isik, Sumeyye Sahin, Ayhan Kamanli, Ibrahim Tekeoglu, Kemal Nas
{"title":"Managing Burning Mouth Syndrome With Amitriptyline and Multiwave Locked System Laser Therapy: A Case Report.","authors":"Muhammed Zahid Sahin, Ridvan Isik, Sumeyye Sahin, Ayhan Kamanli, Ibrahim Tekeoglu, Kemal Nas","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Burning mouth syndrome (BMS) is a chronic condition marked by oral pain without visible signs, often associated with neuropathic pain and psychological factors. Its complex and multifactorial nature makes complete symptom relief difficult to achieve.</p><p><strong>Case report: </strong>A 72-year-old woman with a 15-year history of burning sensations on her tongue and gums, along with dry mouth, was diagnosed with BMS after ruling out other conditions. Previous treatments, including medication adjustments and physical therapy during inpatient care, were unsuccessful in improving her symptoms.</p><p><strong>Conclusions: </strong>Amitriptyline was introduced with a gradually increasing dose, and multiwave locked system laser therapy was applied daily to the painful areas of the tongue for 12 sessions. Following 2 weeks of treatment, as well as at the one-month and three-month follow-up postdischarge, a significant reduction in pain was observed. To the best of our knowledge, this treatment combination has not been previously explored, making this an area of interest for future research.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"9 1","pages":"63-66"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061395","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}