High-frequency thermal coagulation to treat middle cluneal nerve entrapment neuropathy
AbstractObjectiveMiddle cluneal nerve entrapment (MCN-E) around the sacroiliac joint can elicit low back pain (LBP). Pain control can be obtained with anesthetic nerve blocks; however, when their effectiveness is transient, surgical release may be necessary. We investigated the efficacy of radiofrequency thermocoagulation (RFTC) in patients with MCN-E.MethodsBetween December 2018 and August 2019, 11 consecutive patients (4 men, 7 women; mean age 76.4 years) with intractable medial buttock pain due to MCN-E underwent MCN RFTC. The mean symptom duration was 49.5 months; pre-RFTC local MCN blocks provided pain relief for a mean of 7.7 days. The severity of pain in the medial buttock due to MCN-E was recorded before and 2, 6, 12, and 24 weeks a fter RFTC on the numerical rating scale (NRS) and the Roland-Morris Disability Questionnaire (RDQ).ResultsAll patients reported pain alleviation; there were no complications. While there was a significant difference in the pre- and post-RFTC treatment NRS (p
Chronic low back pain conditions are highly prevalent and constitute the leading cause of disability worldwide. The Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the US Food and Drug Administration and the American Pain Society (APS), have combined to create the ACTTION-APS Pain Taxonomy (AAPT). The AAPT initiative convened a working group to develop diagnostic criteria for chronic low back pain. The working group identified three distinct low back pain conditions which result in a vast public health burden across the lifespan.
Abstract Low back pain (LBP) represents an important subgroup of vertebrogenic pain with estimated prevalence around 80 %. Locally acting injectable collagen for topical application has recently extended the limited range of treatment options. The aim of the study was to evaluate the efficacy and safety of injectable collagen in patients with LBP. Patients suffering from LBP (
CONCLUSION The study indicates that assessment of altered central pain processing using current QST is unlikely to identify patients at risk of FBSS and is therefore unlikely to inform clinical decisions.
Conclusion: The infraneural (IN) epidural steroid is more favorable than the parasagittal (IL) interlaminar epidural steroid owing to its long-term improvement in physical function than the parasagittal technique with no serious side effects.
For over 20 years, Linda Buonanno lived in fear that her irritable bowel syndrome (IBS) would suddenly interrupt her daily routine with frequent trips to the bathroom and unbearable cramping. Buonanno, now a 71-year-old medical assistant and hairdresser from Methuen, Mass., tried everything from drugs to dairy-free diets. Nothing worked. She remembers a particularly tough period over 10 years ago, when she was working on the factory floor of a medical-device company for up to 10 hours a day, six days a week. When an IBS episode would strike, her co-workers would cover for her as she huddled in a corner, keeled over in pain...
Low back pain, despite the multitude of explanations and increasing disability associated with it, has been with humans since forever. Who knows why and I’m not about to conjecture. What’s interesting is that despite ergonomic solutions (fail), increased fitness amongst many people (also a fail), surgical solutions (fail), hands on solutions (fail, fail), and a whole bunch of “special” exercises (fail, fail, fail) we still don’t have a handle on how to reduce disability from it. I don’t think there will be many people who haven’t seen this: I’ve never quite worked out why, w...
ConclusionIn patients with chronic low back pain consistent with a symptomatic LSTV type II or IV in the Castellvi classification, a local injection of lidocaine with or without cortivazol may provide sustained improvements in pain and function. The underlying mechanism is unclear.
This study provides the details of clinical outcome after the surgery in those age group. METHODS: We retrospectively studied 77 patients aged>60 years; out of these, 45 patients presented with LDH and 22 patients with lumbar spinal stenosis who underwent PTELS. RESULTS: The mean age of the patients who underwent the surgery was 68.33±6.97 years and the mean duration of the surgery and the postoperative duration of hospitalization were 87.31±24.746 minutes and 79±2.711 days, respectively. The pre- and postoperative Oswestry Disability Index were 52.8022±11.98299 and 16.3513±12.97398 (p
CONCLUSIONS Less invasive MCN neurolysis performed under local anesthesia is useful for LBP caused by MCN-E. In patients with intractable LBP, MCN-E should be considered. PMID: 29775161 [PubMed - as supplied by publisher]
Conclusions: We obtained better results with TP injections than only a home exercise program and oral medications in patients with radiculopathy and TPs in the gluteal region. PMID: 29713403 [PubMed]