Botulinum Toxin for Chronic Lateral Epicondylitis (LE).

Botulinum Toxin for Chronic Lateral Epicondylitis (LE). Z Orthop Unfall. 2020 Aug 03;: Authors: Grüner S, Schulz A, Schlüter-Brust K, Lippert-Grüner M Abstract Lateral epicondylitis is a common disease in orthopaedic practice. Although the majority of cases do not become chronic, patients who do not respond to the initial treatment may suffer from pain in the long term and effective treatment is challenging. The off-label use of botulinum toxin is one of the common potential indications for the substance in orthopaedics and traumatology. In a literature review of 2000 - 2019, eight EBM ≥ level 3 studies evaluating the use of botulinum toxin in lateral epicondylitis were found. Five of these studies evaluated botulinum toxin versus placebo in chronic cases; two other studies compared botulinum toxin with corticosteroids in acute cases and classic Hohmann surgery in chronic cases; the eighth study compared botulinum toxin in two different injection sites and corticosteroids by classic injection. Our findings suggest that the use of this substance may be a treatment option in refractory chronic cases before surgery is indicated. The working group on botulinum toxin in O & T of the International Musculoskeletal Pain Society (IMPS/IGOST) introduced an alternative injection schedule, which combines findings from the recent clinical literature with practical experience in order to reduce the risk of side effects while ensuring...
Source: Zeitschrift fur Orthopadie und Unfallchirurgie - Category: Orthopaedics Tags: Z Orthop Unfall Source Type: research

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More than 25 million Americans suffer from daily chronic pain, a highly debilitating medical condition that is complex and difficult to manage. In recent decades, there has been an overreliance on the prescription of opioids for chronic pain, contributing to a significant and alarming epidemic of opioid overdose deaths and addiction. Innovative scientific solutions to develop non-opioid, non-addictive alternative treatment options are thus urgently needed. One of the goals of the Helping to End Addiction Long-term (HEAL) Initiative is to accelerate the discovery and preclinical development of new medications and devices t...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
More than 25 million Americans suffer from daily chronic pain, a highly debilitating medical condition that is complex and difficult to manage. In recent decades, there has been an overreliance on the prescription of opioids for chronic pain, contributing to a significant and alarming epidemic of opioid overdose deaths and addiction. Innovative scientific solutions to develop non-opioid, non-addictive alternative treatment options are thus urgently needed. One of the goals of the Helping to End Addiction Long-term (HEAL) Initiative is to accelerate the discovery and preclinical development of new medications and devices t...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
AbstractObjectiveThe SUNBURST study was a prospective, multicenter, randomized crossover trial of a single device delivering burst and tonic spinal cord stimulation (SCS) for chronic trunk and/or limb pain. We performed apost hoc analysis of opioid consumption at baseline and after device implantation.Materials and MethodsAfter implantation, 100 patients were randomized to one mode (tonic or burst) for 12  weeks, and the other mode for the subsequent 12 weeks. After the crossover period (24 weeks), patients chose their preferred mode and were assessed for one year. We analyzed 69 patients who took opio...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research
AbstractIn 2015, the United States of America (USA) Department of Health and Human Services (HHS) released an issue brief that addressed opioid addiction, opioid overdoses, and opioid-related deaths as a public health concern within the country. After collaboration with state and stakeholder organizations, the HHS identified three target initiatives aimed to mitigate the negative consequences of opioid use within the USA. One initiative included implementation of guidelines to help reduce inappropriate opioid prescribing with a goal to reduce morbidity and mortality. The aim of this commentary is to discuss the misapplicat...
Source: International Journal of Clinical Pharmacy - Category: Drugs & Pharmacology Source Type: research
AbstractPurpose of ReviewThe following review will highlight recent studies reporting associations between alcohol and tobacco use with non-medical opioid use in the post-operative period, as well as patients with chronic non-malignant and cancer pain.Recent FindingsThe use of alcohol, tobacco, and other illegal substances are associated with an increased risk of opioid use disorder in the post-operative setting and in patients with chronic non-malignant and cancer pain.SummaryOpioid overdoses are at a national epidemic afflicting the general population. A comprehensive assessment of the risk for opioid use disorder is adv...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
AbstractOpioid-related death and overdose have now reached epidemic proportions. In response to this public health crisis, the National Institutes of Health (NIH) launched the Helping to End Addiction Long-term InitiativeSM, or NIH HEAL InitiativeSM, an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. Herein, we describe two NIH HEAL Initiative programs to accelerate development of non-opioid, non-addictive pain treatments: The Preclinical Screening Platform for Pain (PSPP) and Early Phase Pain Investigation Clinical Network (EPPIC-Net). These resources are pro...
Source: Neurotherapeutics - Category: Neurology Source Type: research
Antiepileptics include various groups of drugs that have different mechanisms of actions and adverse effects. They are often also used to treat other disorders such as psychosis, chronic pain, and migraine. The most common drugs implicated in overdose incl...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Home and Consumer Product Safety Source Type: news
Physicians the world over have come to understand the role we have played in contributing to the current opioid epidemic. There are an estimated 2 million patients in the United States who have an opioid use disorder, with approximately 90 deaths occurring every day in the United States from an opioid overdose.1 However, the roots of this crisis are deeper than a single factor would explain. This issue of Otolaryngologic Clinics of North America, guest edited by Drs Eloy, Svider, and Pashkova, takes the reader on a journey to understanding acute and chronic pain, pain psychology, and opportunities for improvement of the qu...
Source: Otolaryngologic clinics of North America - Category: ENT & OMF Authors: Tags: Foreword Source Type: research
Abstract The opioid and pain crises affect every domain of family and community life with two million Americans living with opioid addiction, and 46,802 people dying from opioid overdoses in 2018 alone (National Center for Health Statistics, 2019). In addition, over 50 million Americans experience chronic pain, and half of those people suffer from chronic pain daily. Opioids are widely used to treat acute and chronic pain, and the lack of widespread access to nonpharmacological strategies to manage pain has contributed to the misuse of opioids. In fiscal year 2018, Congress added $500 million to the NIH's base app...
Source: The American Psychologist - Category: Psychiatry & Psychology Authors: Tags: Am Psychol Source Type: research
Abstract Chronic pain is considered a public health crisis due to its high prevalence, impact, costs, and disparities in pain prevalence and treatment. In parallel, drug overdose, particularly due to opioids, has become an epidemic in the United States, prompting a public health crisis concerning harms associated with both prescribed opioid therapy for chronic pain and illicit opioid use. The purpose of this special issue is to highlight state-of-the-art psychological research that addresses the combined issues of chronic pain and harms associated with opioids. Articles included in this special issue focus on 2 re...
Source: The American Psychologist - Category: Psychiatry & Psychology Authors: Tags: Am Psychol Source Type: research
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