Does advanced imaging guide therapy
I’m a PMR/spine specialist and was curious if MRIs help you all when treating chronic neck and/ or low back pain? If so can you give specific examples of how it would guide your treatment plan in both the neck and low back.
Appreciate all that you do (Source: Student Doctor Network)
Source: Student Doctor Network - September 22, 2023 Category: Universities & Medical Training Authors: clubdeac Tags: Physical Therapy Source Type: forums
DISTINCT Study: Changing the Game in Pain
Once you see the results, you literally can't un-see them.
Neuromodulation. 2023 Aug 28;S1094-7159(23)00712-2.
doi: 10.1016/j.neurom.2023.07.009. Online ahead of print.
Treatment of Refractory Low Back Pain Using Passive Recharge Burst in Patients Without Options for Corrective Surgery: Findings and Results From the DISTINCT Study, a Prospective Randomized Multicenter Controlled TrialTimothy Deer 1, Christopher Gilligan 2, Steven...
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Source: Student Doctor Network - September 10, 2023 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
What would you do?
I have an 80 year old woman with osteoporosis and prior compression fractures. She developed significant acute axial low back pain February 18th without any inciting event. This was so severe that it resulted in a short hospitalization for pain control. Workup was negative except for chronic L3 and L4 compression fractures (I have included sagittal STIR and T2 lumbar spine MRI images below from 2/19/2023). Patient was referred to me in March. Pain was facetogenic on examination. I ended up...
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Source: Student Doctor Network - June 14, 2023 Category: Universities & Medical Training Authors: No_Pain_No_Gain Tags: Pain Medicine Source Type: forums
Back pain management
I'm almost 2 years out of training, still have some doubts regarding managing nontraumatic lower back pain in the ER:
Obviously in people with no red flags, treat symptomatically and discharge.
The main problem are these patient who usually have some worsening of their chronic back pain, coming in with some mild neuro complaint like one leg is starting to feel numb or a little weak, or some numbness in the groin. Assuming infectious workup is negative and they get a MRI non-con, always...
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Source: Student Doctor Network - June 6, 2023 Category: Universities & Medical Training Authors: ACal Tags: Emergency Medicine Source Type: forums
Re: Comparative effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain: systematic review and network meta-analysis
(Source: BMJ Comments)
Source: BMJ Comments - May 11, 2023 Category: General Medicine Source Type: forums
Cochrane review on scs debunked
Conclusions of the…
Striking Errors in the Methodology, Execution, and Conclusions of the Cochrane Library Review of Spinal Cord Stimulation for Low Back Pain by Traeger et al.
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Source: Student Doctor Network - April 19, 2023 Category: Universities & Medical Training Authors: lobelsteve Tags: Pain Medicine Source Type: forums
Re: Comparative effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain: systematic review and network meta-analysis
(Source: BMJ Comments)
Source: BMJ Comments - April 12, 2023 Category: General Medicine Source Type: forums
Inconclusive results of comparative safety/efficacy of analgesics - need to look into complementary and alternative medicine (CAM) therapies for acute Low back pain (LBP)
(Source: BMJ Comments)
Source: BMJ Comments - April 11, 2023 Category: General Medicine Source Type: forums
Re: Comparative effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain: systematic review and network meta-analysis
(Source: BMJ Comments)
Source: BMJ Comments - April 6, 2023 Category: General Medicine Source Type: forums
SPRINT PNS for low back pain
Who does it? What pathology? What are the results? (Source: Student Doctor Network)
Source: Student Doctor Network - March 17, 2023 Category: Universities & Medical Training Authors: cameroncarter Tags: Pain Medicine Source Type: forums
Cochrane review concludes SCS is ineffective for chronic low back pain
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014789.pub2/full
“Authors' conclusions
Data in this review do not support the use of SCS to manage low back pain outside a clinical trial. Current evidence suggests SCS probably does not have sustained clinical benefits that would outweigh the costs and risks of this surgical intervention.” (Source: Student Doctor Network)
Source: Student Doctor Network - March 9, 2023 Category: Universities & Medical Training Authors: Agast Tags: Pain Medicine Source Type: forums
Extrapedicular Vertebral Augmentation
First time I have reason to do a true extrapedicular kypho. 60 y/o M on chronic glucocorticoids presents with severe low back pain. Edema noted at L3 and L4, patient with prior instrumented fusion at L4-5.
Screws are fairly superior at L4, so I was planning on using Beall's extrapedicular inferior end plate access, aka low and outside (3rd picture).
Since I hadn't augmented a fused level before, Stryker connected me to one of their KOLs. He was...
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Source: Student Doctor Network - February 10, 2023 Category: Universities & Medical Training Authors: manowar rules Tags: Pain Medicine Source Type: forums
Anyone using ChatGPT for Insurance Appeals?
I'm three for three. Total game changer and timesaver:
Dear Insurance Review Committee,
I am writing to appeal the denial of coverage for radiofrequency lumbar denervation for my patient, who has experienced significant improvement in their low back pain following a series of medial branch blocks.
As you may be aware, medial branch blocks are a diagnostic procedure used to determine the source of low back pain. In my patient's case, the blocks provided an 80% improvement in their pain...
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Source: Student Doctor Network - December 22, 2022 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
