Sleep as a Therapeutic Target for Pain Management
AbstractPurpose of ReviewThe purpose of this review is to provide a summary of the utilization of sleep as a therapeutic target for chronic pain and to evaluate the recent literature on current and proposed pharmacologic and non-pharmacologic sleep interventions used in the management of pain disorders.Recent FindingsSleep is a promising therapeutic target in the treatment of pain disorders with both non-pharmacologic and pharmacologic therapies. Non-pharmacologic therapies include cognitive behavioral therapy and sensory-based therapies such as pink noise, audio-visual stimulation, and morning bright light therapy. Pharma...
Source: Current Pain and Headache Reports - May 10, 2023 Category: Neurology Source Type: research
Shared Decision-Making in Acute Pain Services
AbstractPurpose of ReviewThe implementation of shared decision-making (SDM) in acute pain services (APS) is still in its infancies especially when compared to other medical fields.Recent FindingsEmerging evidence fosters the value of SDM in various acute care settings. We provide an overview of general SDM practices and possible advantages of incorporating such concepts in APS, point out barriers to SDM in this setting, present common patient decisions aids developed for APS and discuss opportunities for further development.SummaryEspecially in the APS setting, patient-centred care is a key component for optimal patient ou...
Source: Current Pain and Headache Reports - May 8, 2023 Category: Neurology Source Type: research
Supraorbital Nerve Stimulation for Facial Pain
We describe the possibility of proposing peripheral nerve stimulation of the supraorbital nerves to treat patients with medically intractable facial pain. Stimulation of the supraorbital nerves is performed using percutaneously inserted electrodes that are positioned in the epi-fascial plane, traversing the course of the supraorbital nerves. The procedure has two phases starting with a trial by temporary electrodes that are inserted under fluoroscopic guidance and are anchored to the skin. This trial usually lasts for a few days to 2 weeks. If successful, we proceed to the insertion of a permanent electrode that is tunne...
Source: Current Pain and Headache Reports - May 2, 2023 Category: Neurology Source Type: research
Treatment of Acute Pain in Patients on Naltrexone: A Narrative Review
AbstractPurpose of ReviewThe tissue damage and trauma associated with surgery almost always result in acute postoperative pain. The intensity of postoperative pain can range from mild to severe. Naltrexone is suitable for patients who do not wish to be on an agonist treatment such as methadone or buprenorphine. However, naltrexone has been shown to complicate postoperative pain management.Recent FindingsMultiple studies have found that the use of naltrexone can increase the opioid requirement for postoperative pain control. Other modalities exist that can help outside of opioids such as ketamine, lidocaine/bupivacaine, dul...
Source: Current Pain and Headache Reports - April 28, 2023 Category: Neurology Source Type: research
Flushing After Lumbar Epidural Steroid Injection with Dexamethasone
AbstractPurpose of ReviewEpidural steroid injections are an accepted treatment for low back pain and radicular symptoms. While epidural steroid injections are routinely performed without complications, side effects can be seen, including flushing. Flushing has been studied using various steroid preparations, including dexamethasone, but at significantly higher doses. This was a prospective cohort study that examines the rate of flushing in ESIs with a lower dose (4 mg) of dexamethasone. Subjects undergoing lumbar epidural steroid injection were asked about the presence of flushing following the procedure prior to dischar...
Source: Current Pain and Headache Reports - April 28, 2023 Category: Neurology Source Type: research
Microbiological and Physiological Effects of Pain
AbstractPain is an important innate defense mechanism that can dramatically alter a person ’s quality of life. Understanding the microbiological and physiological effects of pain may be important in the pursuit of novel pain interventions. The three descriptors of pain recognized by the International Association for the Study of Pain are nociceptive, neuropathic, and nociplastic pain. O ur review examined the current understanding of all three pain types, focusing on the key molecules involved in the manifestation of each type as well as physiological effects. Additionally, we compared the differences in painful and pain...
Source: Current Pain and Headache Reports - April 22, 2023 Category: Neurology Source Type: research
Low-Dose Initiation of Buprenorphine: A Narrative Review
AbstractPurpose of ReviewOpioid use disorder (OUD) is a chronic disorder in which a person loses control over the use of opioids, develops a compulsive behavior, and defends the use despite knowing the negative consequences. There are numerous treatments for OUD, including buprenorphine. Since it is displacing a full agonist opioid, precipitated withdrawal can occur with standard inductions involving buprenorphine.Recent FindingsCase reports have noted success with a low-dose initiation of buprenorphine, which is different from typical protocols, relatively limited by adverse effects when patients were recently administere...
Source: Current Pain and Headache Reports - April 21, 2023 Category: Neurology Source Type: research
ERAS Protocol Options for Perioperative Pain Management of Substance Use Disorder in the Ambulatory Surgical Setting
AbstractEven prior to the COVID-19 pandemic, rates of ambulatory surgeries and ambulatory patients presenting with substance use disorder were increasing, and the end of lockdown has further catalyzed the increasing rates of ambulatory patients presenting for surgery with substance use disorder (SUD). Certain subspecialty groups of ambulatory procedures have already established protocols to optimize early recovery after surgery (ERAS), and these groups have subsequently enjoyed improved efficiency and reduced adverse outcomes as a result. In this present investigation, we review the literature as it relates to substance us...
Source: Current Pain and Headache Reports - April 20, 2023 Category: Neurology Source Type: research
Utilization of Truncal Fascial Plane Nerve Blocks for Chronic Pain Management: A Narrative Review
AbstractPurpose of ReviewNerve blocks constitute an integral portion in the management of chronic pain. The widespread use of ultrasound imaging opened the door to a flood of newer blocks especially truncal plane nerve blocks. We reviewed the current medical literature for studies and case reports utilizing the two most common truncal plane nerve blocks, transversus abdominis plane and erector spinae plane blocks, to manage chronic pain.Recent FindingsWe found some evidence, mostly in case reports and retrospective observational studies, that supports the use of transversus abdominis plane and erector spinae plane nerve bl...
Source: Current Pain and Headache Reports - April 20, 2023 Category: Neurology Source Type: research
Peripheral Nerve Stimulation for Low Back Pain: A Systematic Review
AbstractPurpose of ReviewLow back pain (LBP) is a prevalent condition that is associated with diminished physical function, poor mental health outcomes, and reduced quality of life. Peripheral nerve stimulation (PNS) is an emerging modality that has been utilized to treat LBP. The primary objective of this systematic review is to appraise the level of evidence on the efficacy of PNS for treatment of LBP.Recent FindingsTwenty-nine articles were included in this systematic review, consisting of 828 total participants utilizing PNS as the primary modality for LBP and 173 participants using PNS as salvage or adjunctive therapy...
Source: Current Pain and Headache Reports - April 15, 2023 Category: Neurology Source Type: research
Evidence-Based Treatment of Pain in Chemotherapy-Induced Peripheral Neuropathy
AbstractPurpose of ReviewChemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and often painful condition that occurs after administration of chemotherapeutic agents. The primary objective of this systematic review was to appraise the literature on conservative, pharmacological, and interventional treatment options for CIPN pain.Recent FindingsThere is level I evidence supporting modest to moderate improvement in CIPN pain from duloxetine treatment, as well as short-term modest improvement from physical therapy and acupuncture. Although opioid and cannabis administration may provide short-term modest improve...
Source: Current Pain and Headache Reports - April 14, 2023 Category: Neurology Source Type: research
The Use of Oxytocin for the Treatment of Opioid Use Disorder
AbstractNearly 27 million people have an opioid use disorder (OUD) according to the 2016 Global Burden of Disease study, most of which occur in the US where opioids are a common class of medication used to treat acute and chronic pain. In 2016 alone, more than 60 million patients had at least one prescription for opioids filled or refilled. Over the past decade, prescription rates have risen astronomically and have created an epidemic in the US dubbed the “opioid crisis.” In this regard, there has been an increase in overdoses and OUD diagnoses. Several studies have found dysregulation of balance between several neurot...
Source: Current Pain and Headache Reports - April 6, 2023 Category: Neurology Source Type: research
Algorithms to Identify Nonmedical Opioid Use
AbstractThe rise in nonmedical opioid overdoses over the last two decades necessitates improved detection technologies. Manual opioid screening exams can exhibit excellent sensitivity for identifying the risk of opioid misuse but can be time-consuming. Algorithms can help doctors identify at-risk people. In the past, electronic health record (EHR) –based neural networks outperformed Drug Abuse Manual Screenings in sparse studies; however, recent data shows that it may perform as well or less than manual screenings. Herein, a discussion of several different manual screenings and recommendations is contained, along with su...
Source: Current Pain and Headache Reports - April 6, 2023 Category: Neurology Source Type: research
Retraction Note: Gut Microbiome Dysbiosis and Depression: A Comprehensive Review
(Source: Current Pain and Headache Reports)
Source: Current Pain and Headache Reports - March 27, 2023 Category: Neurology Source Type: research
The Relationship of Tobacco Use and Migraine: A Narrative Review
AbstractPurpose of ReviewTobacco use is associated with significant health consequences especially for people with medical conditions. Although lifestyle strategies (e.g., sleep, diet) are commonly recommended as part of migraine treatment, tobacco-related strategies (e.g., smoking cessation) are rarely included. This review is aimed at elucidating what is known about tobacco use and migraine and at identifying gaps in the research.Recent FindingsThe prevalence of smoking is higher among people with migraine, and people with migraine believe that smoking makes migraine attacks worse. There is also evidence that smoking may...
Source: Current Pain and Headache Reports - March 11, 2023 Category: Neurology Source Type: research
