Retrospective Review of Long-term Transcutaneous Nerve Stimulation in the Management of Chronic Back Pain

Physiotherapy ◽  
1988 ◽  
Vol 74 (3) ◽  
pp. 149-151 ◽  
Author(s):  
Merian L Denning
2021 ◽  
Author(s):  
Alexandre Lacombe ◽  
Kristi Downey ◽  
Xiang Y. Ye ◽  
Jose C.A. Carvalho

Introduction: Epidural analgesia is the preferred method to manage pain during labor and delivery. The insertion of the epidural catheter can be complicated by unintentional dural puncture that may result in postdural puncture headache. There is limited evidence on the long term implications of this complication. We sought to investigate if women who sustained a dural puncture have a higher risk of developing chronic headache, low back pain and visual or auditory impairment. Methods: We conducted a 1:1 case-control study with women who delivered at our institution from January 2015 to December 2019. Cases were women who received epidural analgesia and sustained an unintentional dural puncture and controls were women who received epidural analgesia but did not sustain such complication. We matched cases and controls for date of delivery, age, and BMI. All women completed an online survey with validated questionnaires for diagnosis of chronic headache and chronic back pain. We used dichotomic (yes/no) questions to look for the presence of chronic visual and auditory impairment. Results: Sixty-three case-control pairs were studied. Women who sustained a dural puncture during their epidural catheter insertion had a higher risk of developing chronic headache [14.3%, versus 4.8%, p=0.049, AOR: 3.36 (1.05, 12.82)] and chronic back pain [39.7% versus 19.1%, p=0.009, AOR: 2.67 (1.25, 5.72)] than women who did not sustain a dural puncture. The incidence of chronic auditory impairment was also higher in the dural puncture group [14.3% versus 1.6%, p=0.007, AOR: 9.98 (1.21, 82.62)]. Conclusions: An unintentional dural puncture during epidural catheter insertion in parturients is associated with increased risk of chronic headache, back pain and auditory impairment.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lilit Floether ◽  
Michael Bucher ◽  
Ralf Benndorf ◽  
Anna-Maria Burgdorff

Abstract Background Chronic back pain is a multifactorial disease that occurs particularly in adults and has many negative effects on the quality of daily life. Therapeutic strategies are often multimodal and designed for a long-term therapy period. In some cases, one option is joint infiltration or intrathecal injection with local anaesthetics. An adverse effect of this intervention may be necrotic fasciitis, a disease with high mortality and few therapeutic options. Case presentation This case shows a 53-year-old female patient who developed necrotic fasciitis after infiltrations of the sacroiliac joint and after epidural-sacral and intrathecal injections. Conclusion Thanks to early and aggressive surgical intervention, antibiotic treatment and hyperbaric oxygenation, she survived this serious complication and was able to return to life.


Nanomaterials ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 537 ◽  
Author(s):  
Alyah Shamsah ◽  
Sarah Cartmell ◽  
Stephen Richardson ◽  
Lucy Bosworth

Treatments to alleviate chronic lower back pain, caused by intervertebral disc herniation as a consequence of degenerate annulus fibrosus (AF) tissue, fail to provide long-term relief and do not restore tissue structure or function. This study aims to mimic the architecture and mechanical environment of AF tissue using electrospun fiber scaffolds made from synthetic biopolymers-poly(ε-caprolactone) (PCL) and poly(L-lactic) acid (PLLA). Pure polymer and their blends (PCL%:PLLA%; 80:20, 50:50, and 20:80) are studied and material properties-fiber diameter, alignment, % crystallinity, tensile strength, and water contact angle-characterized. Tensile properties of fibers angled at 0°, 30°, and 60° (single layer scaffolds), and ±0°, ±30°, and ±60° (bilayer scaffolds) yield significant differences, with PCL being significantly stiffer with the addition of PLLA, and bilayer scaffolds considerably stronger. Findings suggest PCL:PLLA 50:50 fibers are similar to human AF properties. Furthermore, in vitro culture of AF cells on 50:50 fibers demonstrates attachment and proliferation over seven days. The optimal polymer composition for production of scaffolds that closely mimic AF tissue both structurally, mechanically, and which also support and guide favorable cell phenotype is identified. This study takes a step closer towards successful AF tissue engineering and a long-term treatment for sufferers of chronic back pain.


Pain ◽  
1999 ◽  
Vol 82 (1) ◽  
pp. 9-13 ◽  
Author(s):  
David Jonathan Grant ◽  
Jane Bishop-Miller ◽  
David Magnus Winchester ◽  
Margaret Anderson ◽  
Steven Faulkner

Spine ◽  
1995 ◽  
Vol 20 (7) ◽  
pp. 801-806 ◽  
Author(s):  
Tom C. Lanes ◽  
Eugene F. Gauron ◽  
Kevin F. Spratt ◽  
Theodore J. Wernimont ◽  
Ernest M. Found ◽  
...  

2014 ◽  
Vol 17;1 (1;17) ◽  
pp. 9-19
Author(s):  
Haili Wang

Background: There is a growing number of patients worldwide being treated with longterm opioids for chronic non-cancer pain, although there is limited evidence for their effectiveness in improving pain and function. Opioid-use related adverse effects, especially in cognitive functioning in these patients, are rarely evaluated. Objectives: The present study investigated the cognitive functions of patients with chronic back pain who underwent long-term opioid treatment in comparison with those patients without opioid usage and healthy controls. Study Design: A prospective, nonrandomized, cross-sectional study. Setting: Multidisciplinary pain management clinic, specialty referral center, University Hospital in Germany. Methods: In a prospective cross-sectional design, 37 patients with chronic back pain who underwent long-term opioid therapy (OP) were compared with 33 patients with chronic back pain without opioid therapy (NO) and 25 healthy controls (HC). Assessment of primary outcome included cognitive function such as information processing speed, choice reaction time, pattern recognition memory, and executive function. Other data included pain, back function, depression and anxiety, use of medication, and education status. The relationship between cognitive functions and anxiety/depression was analysed. Results: Both patient groups needed significantly longer time in information processing when compared to HC (Group 1: 41.87 ± 20.47 Group 2: 38.29 ± 19.99 Group 3: 30.25 ± 14.19). Additionally, OP patients had significantly reduced spatial memory capacity, flexibility for concept change, and impaired performance in working memory assessment compared to NO patients and HC. The impaired cognitive outcomes were significantly associated with pain intensity, depression scores, and medication use. Limitations: Limitations include small number of patients with heterogeneous opioid therapy and the nonrandomized observational nature of the study. Conclusions: Our findings give a differential view into the cognitive changes from chronic back pain with and without long-term opioids treatment. Chronic back pain itself impairs some distinct cognitive functions. Long-term opioid therapy adds further cognitive impairment. Key words: Long-term opioid therapy, chronic back pain, cognitive dysfunction


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