scholarly journals Clinical management of patients with vertebral lumbosacral radiculopathy. Description clinical cases

Author(s):  
N.I. Ingula

Lumbosacral radiculopathy one of the most difficult choices vertebrogenic pain syndromes characterized especially intense and prolonged pain, usually accompanied by a sharp restriction of mobility, and is the most common cause of disability. Most of the destruction of roots of spinal nerves caused by vertebral reasons the presence of a herniated disc, degenerative changes in the intervertebral joints, narrow spinal canal. This article describes a clinical case of practice management of patients with chronic vertebral lumbosacral radiculopathy. The main causes of pain in the lower back, the main approaches to the diagnosis and treatment of chronic pain. Special attention is paid to the differential diagnosis of chronic pain in his back and leg.

2019 ◽  
Vol 13 (1-4) ◽  
pp. 10-16
Author(s):  
V. V. Khinovker ◽  
V. V. Yushkova ◽  
D. А. Fedorov

The treatment of chronic pain is one of the most important and unresolved medical problems in the world. The aim of the study was to assess the demographic characteristics of patients with chronic pain who applied to a specialized center for the treatment of pain syndromes of Federal Siberian Research Clinical Centre FMBA of Russia. Material and methods. A retrospective analysis of 316 outpatient patient records was performed. The demographic characteristics of the patients, the frequency of types of pain syndromes and the results of the examination (PainDetect questionnaire, visual analogue scale) were evaluated. Results. The age of patients ranged from 18 to 90 years, while patients with working age accounted for 56.7% of the total. The number of women significantly exceeded the number of men: 68.4% vs 31.6%. More than 70% of cases were diagnosed with chronic pain. 73% of patients had lower back pain, radicular and facet pain syndromes were recorded in 34.6% and 36.7%, respectively. Conclusion. Significantly more often women sought help. 70% of patients were diagnosed with chronic pain. The most common radicular and facet pain syndromes.


2017 ◽  
Vol 17 (1) ◽  
pp. 252-255 ◽  
Author(s):  
Hamid Assadeck ◽  
Moussa Toudou Daouda ◽  
Fatimata Hassane Djibo ◽  
Djibo Douma Maiga ◽  
Eric Adehossi Omar

AbstractIntroductionChronic pain is a major health problem, considered as a disease in its own right. The prevalence of chronic pain is estimated to be between 2% and 40% in adult populations. In Niger, there are no data on chronic pain.AimsThis study was designed to provide the demographic, clinical and etiological profile of chronic pain in patients from Niger in order to create a database on chronic pain in Niger.Patients and methodsOur study is prospectively conducted at the department of external consultation of the Hôpital National de Niamey over a period of 10 months from 31 May 2016 to 30 January 2017 collecting all cases of chronic pain. The demographic, clinical and etiological characteristics of all patients were collected and analyzed.ResultsDuring the period of the study, 1927 patients consulted at the department of external consultation of the Hôpital National de Niamey, among which 411 patients had chronic pain (21.33% [95% CI: 19.53% and 23.13%]). The average age was 48.28 years (±12.84) with 51.6% of patients aged over 50 years. The male sex was predominant (61.8%). The most common sites of chronic pain were legs (25.5%), back (14.4%), neck (13.6%), knees (13.4%) and feet (13.1%). Osteoarthritis was the most common cause of chronic pain (35.5%), followed by herniated disc (22.2%), spondylodiscitis (14.6%) and migraine (4.1%). Significantly patients aged 50-59 years suffered from neck and legs pain (p value < 0.001). Significantly chronic headaches and rheumatoid arthritis were more common in women while osteoarthritis, herniated disc and spondylodiscite were more common in men (p value = 0.001). Significantly osteoarthritis and herniated disc were more common in patients older than 40 years (p value < 0.001).ConclusionOur study provides demographic, clinical and etiological data of chronic pain in patients from Niger, and shows that chronic pain is a common reason for consultation in Niger concerning 1 in 5 patients with a high prevalence among men and patients aged over 40 years.


TRAUMA ◽  
2016 ◽  
Vol 17 (2) ◽  
pp. 78
Author(s):  
V.I. Romanenko ◽  
I.V. Romanenko ◽  
Yu.I. Romanenko

Molecules ◽  
2021 ◽  
Vol 26 (9) ◽  
pp. 2431
Author(s):  
Natalia A. Shnayder ◽  
Marina M. Petrova ◽  
Tatiana E. Popova ◽  
Tatiana K. Davidova ◽  
Olga P. Bobrova ◽  
...  

Chronic pain syndromes are an important medical problem generated by various molecular, genetic, and pathophysiologic mechanisms. Back pain, neuropathic pain, and posttraumatic pain are the most important pathological processes associated with chronic pain in adults. Standard approaches to the treatment of them do not solve the problem of pain chronicity. This is the reason for the search for new personalized strategies for the prevention and treatment of chronic pain. The nitric oxide (NO) system can play one of the key roles in the development of peripheral pain and its chronicity. The purpose of the study is to review publications devoted to changes in the NO system in patients with peripheral chronical pain syndromes. We have carried out a search for the articles published in e-Library, PubMed, Oxford Press, Clinical Case, Springer, Elsevier, and Google Scholar databases. The search was carried out using keywords and their combinations. The role of NO and NO synthases (NOS) isoforms in peripheral pain development and chronicity was demonstrated primarily from animal models to humans. The most studied is the neuronal NOS (nNOS). The role of inducible NOS (iNOS) and endothelial NOS (eNOS) is still under investigation. Associative genetic studies have shown that single nucleotide variants (SNVs) of NOS1, NOS2, and NOS3 genes encoding nNOS, iNOS, and eNOS may be associated with acute and chronic peripheral pain. Prospects for the use of NOS inhibitors to modulate the effect of drugs used to treat peripheral pain syndrome are discussed. Associative genetic studies of SNVs NOS1, NOS2, and NOS3 genes are important for understanding genetic predictors of peripheral pain chronicity and development of new personalized pharmacotherapy strategies.


Author(s):  
Jay Karri ◽  
Laura Lachman ◽  
Alex Hanania ◽  
Anuj Marathe ◽  
Mani Singh ◽  
...  

2008 ◽  
Vol 74 (4) ◽  
pp. 285-296 ◽  
Author(s):  
Nalini Vadivelu ◽  
Maggie Schreck ◽  
Javier Lopez ◽  
Gopal Kodumudi ◽  
Deepak Narayan

Breast cancer is a potentially deadly disease affecting one in eight women. With the trend toward minimally invasive therapies for breast cancer, such as breast conserving therapies, sentinel node biopsies, and early treatments of radiation and chemotherapy, life expectancy after breast cancer has increased. However, pain after breast cancer surgery is a major problem and women undergoing mastectomy and breast reconstruction experience postoperative pain syndromes in approximately one-half of all cases. Patients post mastectomy and breast reconstruction can suffer from acute nociceptive pain and chronic neuropathic pain syndromes. Several preventative measures to control acute post operative pain and chronic pain states such as post mastectomy pain and phantom pain have been tried. This review focuses on the recent research done to control acute and chronic pain in patients receiving minimally invasive therapies for breast cancer, such as breast conserving therapies of mastectomies and breast reconstruction, sentinel node biopsies, and early treatments of radiation and chemotherapy.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Luke Furtado O'Mahony ◽  
Arnav Srivastava ◽  
Puja Mehta ◽  
Coziana Ciurtin

Abstract Background/Aims  The aetiology of primary chronic pain syndromes (CPS) is highly disputed. One theory suggests that pain is due to a pro-inflammatory cytokine milieu leading to nociceptive activation. We performed a systematic review and meta-analysis aiming to assess differences in cytokines levels in CPS patients versus healthy controls (HC). Methods  Human studies published in English from PubMed, MEDLINE/Scopus and Cochrane databases were searched from inception up to January 2020. We included full text cross-sectional or longitudinal studies with cytokine measurements in CPS patients and HC. We excluded studies with underlying organic pathology. Quality assessment was completed using a modified version of the Newcastle-Ottawa Scale. Random-effects meta-analysis models were used to report pooled effects and 95% CIs. Study registered with PROSPERO (CRD42020193774). Results  Initial search yielded 324 papers, 36 studies (3229 participants) eligible for systematic review and 26 studies (2048 participants) suitable for metaanalysis. There were reproducible findings supporting trends of cytokine levels comparing CPS patients with HC. Eotaxin (chemokine) however was consistently raised in CPS. Meta-analysis showed significantly increased tumour necrosis factor (TNF) (SMD=0.39, p = 0.0009, %95I=0.16-0.63, p &lt; 0.001; I2=70%, Q2 p &lt; 0.001), interleukin (IL)-6 (SMD=0.15, 8 (SMD=0.26, p = 0.01, 95%CI =0.05-0.47; I2=61%, Q2 p = 0.005) and IL-10 (SMD=0.61; %95 = 0.34-0.89, p &lt; 0.001; I2 = 10%, Q2 p = 0.34) in CPS compared to HC. Conclusion  We found significant differences in peripheral blood cytokine profiles of CPS patients compared to HC. However, the distinctive profile associated with CPS includes both pro-inflammatory (TNF-α, IL-6, IL-8), and anti-inflammatory cytokines (IL-10) in pooled analysis, as well as chemokine (eotaxin) signatures. Disclosure  L. Furtado O'Mahony: None. A. Srivastava: None. P. Mehta: None. C. Ciurtin: None.


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