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Rev Med Suisse 2022 06;18(787):1254-1258

Centre d'antalgie, Service d'anesthésiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne.

Intrathecal drug delivery appeared in the early eighties and allows to administer high concentrate analgesic medications in the cerebrospinal fluid with higher efficacy and a limited incidence of systemic side effects. Opioids are still the first line treatment with high-quality evidence for chronic cancer pain, and limited evidence for chronic non-cancer pain, being often considered as a last resort therapy. Device implantation requires a strict patient's selection with a close follow-up in order to adapt therapy, refill the reservoir and detect and prevent potential severe complications. Read More

Harefuah 2022 Jun;161(6):367-370

Spine Surgery Unit, Meir Medical Center, Kfar Saba.

Introduction: Anterior cutaneous nerve entrapment syndrome (ACNES) is one of the causes of chronic abdominal pain. Symptoms include intense focused chronic abdominal pain, affected by posture changes and exertion. Particularly noticeable are the lack of pathological findings in laboratory and imaging tests, from the most basic to the more advanced. Read More

Front Pharmacol 2022 2;13:894963. Epub 2022 Jun 2.

Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, China.

Chronic pain after bone fracture and orthopedic surgery is often refractory to most analgesics currently in use, thus emphasizing the urgent need for improved therapeutic medications. Chemokine-dependent neuroinflammation is critical for excitatory synaptic plasticity and central nociception sensitization. Recent studies have focused on the inhibition of inflammatory responses by artesunate, the first anti-malaria drug extracted from artemisinin. Read More

Neurosurg Clin N Am 2022 Jul 25;33(3):305-309. Epub 2022 May 25.

Department of Neurological Surgery, New York University Grossman School of Medicine, 1530 Front Street, Suite 400, East Meadow, NY 11554, USA. Electronic address:

Intrathecal pumps deliver analgesic medication directly into the central nervous system. In patients with chronic nonmalignant pain, intrathecal therapy using morphine or ziconotide has been shown to be an effective option when traditional noninvasive methods do not provide adequate relief. There has been increasing use of intrathecal drug administration in the management of patients with nonmalignant pain in recent years given the advances in technology and research on the topic. Read More

Clin Orthop Surg 2022 Jun 26;14(2):162-168. Epub 2022 Apr 26.

Department of Orthopedic Surgery, Loma Linda Medical Center, Loma Linda, CA, USA.

Background: Intertrochanteric hip fractures are among the most common and most expensive diagnoses in the Medicare population. Liposomal bupivacaine is a novel preparation of a commonly used analgesic agent that, when used intraoperatively, decreases narcotic requirements and hospital length of stay and increases the likelihood of discharge to home. The purpose of this investigation was to determine whether there was an economic benefit to utilizing intraoperative liposomal bupivacaine in patients with fragility intertrochanteric hip fractures in comparison to a group of patients who did not receive liposomal bupivacaine. Read More

Biomed Res Int 2022 26;2022:8952220. Epub 2022 May 26.

Department of Anesthesiology, Hubei Provincial Armed Police Corps Hospital, Wuhan 430060, China.

Aims: To compare the effectiveness of cervical epidural injections of local anesthetic with vs. without a steroid.

Methods: Three databases (PubMed, Embase, and Cochrane library) were used to search and assess all clinical randomized controlled trials regarding the clinical efficacy of epidural injections from January 01, 2009, to October 31, 2020. Read More

Best Pract Res Clin Anaesthesiol 2022 May 25;36(1):179-189. Epub 2022 Jan 25.

Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.

Epidural analgesia, commonly used to alleviate labor pain, is not without complication. The most common complication associated with labor epidural analgesia (LEA) is Unintentional Dural Puncture (UDP), where many professionals go on to develop a Post Dural Puncture Headache (PDPH). Spinal anesthesia can also result in PDPH. Read More

J Contemp Dent Pract 2021 Dec 1;22(12):1434-1437. Epub 2021 Dec 1.

Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, Tamil Nadu, India.

Aim: This study aimed to discern if a prior intake of a natural sweet remedy (honey) impacted pain perception during intraoral injections.

Materials And Methods: One hundred healthy children who needed the same treatment bilaterally in either arch which required local anesthetic administration (infiltration in maxillary arch and inferior alveolar nerve block in mandibular arch) were recruited. The patients' demographic details were recorded. Read More

Can Vet J 2022 Jun;63(6):597-602

Guarda Nacional Republicana (Portuguese Gendarmerie), Lisbon, Portugal (Alves, Santos, Jorge); MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal (Alves); UNIR-Universidad Internacional de La Rioja, Logroño, Spain (Lafuente).

The aim of this study was to document the effects of mesotherapy in working dogs diagnosed with hip osteoarthritis (OA) and related pain. Ten police working dogs with hip OA and related pain were treated with a combination of lidocaine, piroxicam, and thiocolchicoside, injected in multiple intradermal points. Seven treatment sessions were conducted. Read More

Pain Physician 2022 05;25(3):E414-E425

Department of Pain Medicine, The James Cook University Hospital, Middlesbrough - UK.

Background: Cancer pain prevalence remains high with more than 60% of patients with advanced cancer experiencing cancer-related pain. The undertreatment of pain due to concerns of opioid dependence or diversion, as well as the potential effect of opioids on tumor neogenesis, add to the suffering among cancer populations.

Objectives: The aim of this narrative review was to assess evidence on the effectiveness, safety, cost-effectiveness, and advances of Intrathecal (IT) Drug Delivery Systems (IDDS) for the management of cancer pain. Read More

Pain Physician 2022 05;25(3):239-250

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Among the multiple causes of low back and lower extremity pain, sacroiliac joint pain has shown to be prevalent in 10% to 25% of patients with persistent axial low back pain without disc herniation, discogenic pain, or radiculitis. Over the years, multiple Current Procedural Terminology (CPT) codes have evolved with the inclusion of intraarticular injections, nerve blocks, and radiofrequency neurotomy, in addition to percutaneous sacroiliac joint fusions. Previous assessments of utilization patterns of sacroiliac joint interventions only included sacroiliac joint intraarticular injections, since the data was not available prior to the introduction of new codes. Read More

Pain Physician 2022 05;25(3):223-238

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Multiple publications have shown the significant impact of the COVID-19 pandemic on US healthcare and increasing costs over the recent years in managing low back and neck pain as well as other musculoskeletal disorders. The COVID-19 pandemic has affected many modalities of treatments, including those related to chronic pain management, including both interventional techniques and opioids. While there have not been assessments of utilization of interventional techniques specific to the ongoing COVID-19 pandemic, previous analysis published with data from 2000 to 2018 demonstrated a decline in utilization of interventional techniques from 2009 to 2018 of 6. Read More

Clin Orthop Relat Res 2022 May 31. Epub 2022 May 31.

Department of Orthopedics and Sports Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.

Background: Hemophilic knee arthritis is one of the most common presenting symptoms of hemophilia, and its management continues to be challenging to practitioners. Preliminary research has suggested that platelet-rich plasma (PRP) may have short-term efficacy in the treatment of hemophilic knee arthritis, but evidence for this treatment is limited.

Questions/purposes: What is the effectiveness of PRP compared with placebo in (1) reducing pain and improving knee joint function (as measured by WOMAC, VAS, and Hemophilia Joint Health Score [HJHS]) and (2) improving quality of life (as measured by SF-36 scores) in patients with hemophilic knee arthritis through 24 months of follow-up?

Methods: This was a prospective, parallel-group, double-blinded, single-center, placebo-controlled randomized clinical trial that included participants from a tertiary care center starting January 1, 2019, with follow-up completed on November 30, 2021. Read More

Regen Med 2022 Aug 31;17(8):521-531. Epub 2022 May 31.

Pain Management, Ventura County Medical Center, Ventura, CA 93003, USA.

To describe the successful treatment of bone marrow edema in the setting of hip osteoarthritis using ultrasound-guided injection of photoactivated leukocyte-rich platelet-rich plasma (LR-PRP). Outpatient clinic. 65-year old female with antalgic and listing gait. Read More

Arch Gynecol Obstet 2022 May 28. Epub 2022 May 28.

Department of Obstetrics and Gynecology, Acibadem University, Altunizade Hospital, Istanbul, Turkey.

Purpose: Pudendal neuralgia (PN) is an extremely painful neuropathy of the pudendal nerve resulting in a negative impact on a patient's quality of life. The aim of this study is to evaluate the 2-year outcomes of repetitive doses of the transvaginal pudendal nerve injections (PNI), and to compare the success of the PNI concerning anatomical levels (endopelvic and extrapelvic portion) of the pudendal nerve pathology.

Methods: This retrospective longitudinal cohort study consists of patients with PN diagnosed with the first four essential Nantes criteria. Read More

Biomed Pharmacother 2022 Jul 17;151:113052. Epub 2022 May 17.

Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey. Electronic address:

Osteoarthritis (OA) is a musculoskeletal disorder mainly found in elderly individuals. Modern treatment of OA, like nonsteroidal anti-inflammatory drugs, corticosteroids, hyaluronic acid injections, etc., is linked to long-term side effects. Read More

BMC Musculoskelet Disord 2022 May 14;23(1):454. Epub 2022 May 14.

Oral and Maxillofacial Department, Faculty of Dentistry, Al-Sham Syrian Private University, Damascus, Syria.

Background: The temporomandibular joint (TMJ) is one of the most complex joints in the body. Temporomandibular disorders (TMD) are among the most troublesome disorders for patients, as they can cause pain, affect oral functions and disturb dentists on the level of diagnosis and treatment. The most common symptoms of temporomandibular joint disorders are articulated sounds (such as clicking or TMJ crepitation), joint pain in comfort and function situations (jaw movements), pain or strain in masseter and jaw muscles and or restricted mandibular movements. Read More

J Pain Res 2022 5;15:1325-1354. Epub 2022 May 5.

Pain Medicine, Multidisciplinary Pain Fellowship, The University of Kansas Health System, Kansas City, KS, USA.

Introduction: Lumbar spinal stenosis (LSS) is a common spinal disease of aging with a growing patient population, paralleling population growth. Minimally invasive treatments are evolving, and the use of these techniques needs guidance to provide the optimal patient safety and efficacy outcomes.

Methods: The American Society of Pain and Neuroscience (ASPN) identified an educational need for guidance on the prudent use of the innovative minimally invasive surgical therapies for the treatment of symptomatic LSS. Read More

BMJ Case Rep 2022 May 10;15(5). Epub 2022 May 10.

Neurology, All India Institute of Medical Sciences, New Delhi, India.

A woman in her 40s presented with a 3-month history of intermittent bilateral daily headache of moderate intensity. She had severe headaches for almost 1 month prior to the presentation, which was aggravated by standing and relieved by lying down. She underwent a non-contrast CT of the head followed by MRI of the brain and spine. Read More

Phys Med Rehabil Clin N Am 2022 05;33(2):489-517

Pain Division, Department of Anesthesiology, University of Virginia Health System, 475 Ray C Hunt Drive, Charlottesville, VA 22903, USA.

Ultrasound techniques and peripheral nerve stimulation have increased the interest in peripheral nerve injections for chronic pain. The knowledge of anatomy and nerve distribution patterns is paramount for optimal use of peripheral nerve blocks in the management of chronic pain conditions. They are an important tool in an interventional pain physician's armamentarium and can be integrated into pain practices effectively to offer patients pain relief. Read More

Phys Med Rehabil Clin N Am 2022 05;33(2):409-424

Pain Medicine Fellowship, Pain Management Center, Fontaine Research Park, Third Floor, 545 Ray C Hunt Drive, Charlottesville, VA 22908, USA. Electronic address:

Intrathecal drug delivery systems are a well-established intervention for chronic pain. The localized delivery of analgesics allows for reduced side effect profiles and pain scores in patients with chronic pain. Given their proven benefits and the development of novel intrathecal medications, intrathecal drug delivery systems are being used earlier in chronic pain management treatment pathways. Read More

Phys Med Rehabil Clin N Am 2022 05;33(2):267-306

Department of Physical Medicine and Rehabilitation, Ventura County Medical Center, 300 Hillmont Avenue, Ventura, CA 93003, USA.

Peripheral joint injections are a common interventional treatment of peripheral joint-mediated pain, including arthritis, tendinopathy, and bursitis that are not responsive to conservative management. Degenerative changes of articular joints are often related to these symptoms through chronic inflammatory changes, which typically arise due to repetitive trauma, autoimmune disease, or metabolic abnormalities. The primary diagnosis for degenerative disease in the peripheral joints is osteoarthritis but can also include rheumatoid arthritis, gout, and other less common etiologies. Read More

JAMA 2022 05;327(17):1688-1699

Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

Importance: Lumbar spinal stenosis is a prevalent and disabling cause of low back and leg pain in older persons, affecting an estimated 103 million persons worldwide. Most are treated nonoperatively. Approximately 600 000 surgical procedures are performed in the US each year for lumbar spinal stenosis. Read More

J Korean Med Sci 2022 May 2;37(17):e137. Epub 2022 May 2.

Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Ewha Womans University Mokdong Hospital, Seoul, Korea.

Background: Lumbar transforaminal epidural block (TFEB) is an effective treatment modality for radicular pain due to lumbar disc herniation (LDH). The addition of steroids is more effective than local anesthetic alone in TFEBs for patients with LDH. Moreover, the efficacy of TFEBs has been reported to be positively correlated with the volume of injectate. Read More

Ned Tijdschr Geneeskd 2022 04 12;166. Epub 2022 Apr 12.

LUMC, afd. Orthopedie, Leiden.

Frozen shoulder (FS), also known as adhesive capsulitis, is a painful inflammatory fibrotic disease of the glenohumeral joint capsule. While it's frequently self-limiting, patients can be symptomatic for years. The clinical course is often divided into three phases: the freezing phase with predominantly pain, the frozen phase with mainly stiffness, and the thawing phase during which the complaints slowly resolve. Read More

Bone Joint J 2022 May;104-B(5):567-574

Royal Derby Spinal Centre, Derby, UK.

Aims: Cervical radiculopathy is a significant cause of pain and morbidity. For patients with severe and poorly controlled symptoms who may not be candidates for surgical management, treatment with transforaminal epidural steroid injections (CTFESI) has gained widespread acceptance. However, a paucity of high-quality evidence supporting their use balanced against perceived high risks of the procedure potentially undermines the confidence of clinicians who use the technique. Read More

J Pain Res 2022 19;15:1149-1162. Epub 2022 Apr 19.

Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA.

Sacroiliac joint (SIJ) pain is a common cause of low back pain. Traditionally, treatment for SIJ joint pain and dysfunction has consisted of physical therapy, medication management, SIJ injections, and SIJ ablations. Improved recognition of the SIJ as an etiology for back pain has led to advances in treatment options. Read More

Clin Biomech (Bristol, Avon) 2022 May 20;95:105651. Epub 2022 Apr 20.

Department of Materials and Production, Aalborg University, Fibigerstræde 16, DK-9220, Denmark. Electronic address:

Background: Knee osteoarthritis is a progressive disease that may require management for years before knee arthroplasty can be considered. Previously reported musculoskeletal models suggest that rebalancing the strength of the triceps surae muscles can reduce the joint loads.

Methods: A single patient diagnosed with mild/moderate medial left knee osteoarthritis was treated with botulinum toxin injections in the gastrocnemius muscle of the calf, based on the hypothesis that this would rebalance the triceps surae load distribution and reduce tibiofemoral joint loads. Read More

Hand Clin 2022 May;38(2):161-168

Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address:

Thumb arthritis frequently is managed nonoperatively with activity modification, orthotic use, anti-inflammatory medications (oral and/or topical), and intra-articular injections. This article reviews the current literature and touches on novel modalities and future directions in the conservative treatment of thumb arthritis. Read More

Cureus 2022 Mar 12;14(3):e23100. Epub 2022 Mar 12.

Pain Management, Paolo Procacci Foundation, Rome, ITA.

Vaccinations and therapeutics have been developed for COVID-19, but vaccine uptake varies markedly among countries. Public health responses have also varied, in particular, with lockdown efforts and school closing. All over the world, the pandemic exposed healthcare and economic weaknesses. Read More