scholarly journals Caudal Epidural for Pain Management of Prostate Cancer

2020 ◽  
Vol 3 (2) ◽  
pp. 64-67
Author(s):  
Rajesh Kumar Muniandy ◽  
Nagarajan Nagalingam

Prostate cancer is the second commonest cancer found in men. Pain can occur in both early and advanced stages of prostate cancer, with an incidence of 30-50%. The pain can be caused directly by the cancer or related to the cancer treatment. Currently, pain in prostate cancer is managed with surgery, medication, radiotherapy or chemotherapy. It can also be managed by intra-thecal morphine, psoas sheet catheter and superior hypogastric block. However, all these procedures involve risks. We present a case of Stage 4 Prostate Cancer who presented with severe lower back pain. We performed a caudal epidural, which was very successful to reduce the patient's pain and improve his quality of life. We recommend a caudal epidural should be considered as an option to manage metastatic bone pain in prostate cancer patients.

Ozone Therapy ◽  
2016 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Maria Laura Rosato ◽  
Marco Mainini ◽  
Margherita Luongo ◽  
Luigi Mascolo ◽  
Silvana Mattera ◽  
...  

Lower back pain and sciatica are clinical symptoms with debilitating effects on the quality of life; they are extremely common in the population. The treatment of patients affected by sciatica, and in particular of those incurred by herniated discs, may be medical, physiatric, percutaneous minimally invasive surgery. In recent years, for the treatment of disc-radicular conflicts the Oxygen-Ozone (O<sub>2</sub>-O<sub>3</sub>) therapy is spreading to a more and more significant extent. We report our experience with O<sub>2</sub>-O<sub>3</sub> therapy in the treatment of herniated lumbar discs, evaluating the efficacy of the therapy in lower back pain and sciatica. We treated 32 patients with paravertebral intramuscular infiltrations of about 15 cc of the mixture of O<sub>2</sub>-O<sub>3</sub> at a concentration of 30 µg/cc: 66.6 % of the patients had a positive response to the treatment.


2020 ◽  
Author(s):  
Stefan Schmidt ◽  
Nicolas Keim ◽  
Claudia Schultz ◽  
Dieter Sielmann ◽  
Roman Huber ◽  
...  

AbstractBackgroundChronic lower back pain is the most frequent medical problem and the condition with the most years lived with disability. A pragmatic RCT was performed to assess a new treatment, Medi-Taping, which aims at reducing complaints by treating pelvic obliquity with a combination of manual treatment of trigger points and kinesio taping.Methods110 patients were randomized at two study centers either to Medi-Taping or to a standard treatment consisting of psychoeducation and physiotherapy as control. Treatment duration was three weeks. Measures were taken at baseline, end of treatment and at follow-up after two months. Main outcome criteria were lower back pain measured with VAS, the Chronic Pain Grade Scale and the Oswestry Low Back Pain Disability Questionnaire.ResultsPatients of both groups benefited from the treatment by medium to large effect sizes. All effects were pointing towards the intended direction with patients receiving Medi-Taping doing better. But at end of treatment and follow-up there were no significant differences for the primary endpoints between groups. Health related quality of life was significantly higher (p=.004) in patients receiving Medi-Taping compared to controls.ConclusionsMedi-Taping, a purported way of correcting pelvic obliquity and chronic tension resulting from it, is a treatment modality similar in effectiveness as a complex physiotherapy and patient education program.SignificanceThis RCT evaluated the effect of a combined therapy consisting of manual treatment and kinesio tape in patients with lower back pain. Patients receiving this treatment benefitted substantially but so did patients in the active control condition receiving physiotherapy and patient education. However, patients receiving the combined treatment had a significant higher quality of life.


2019 ◽  
Vol 9 (5) ◽  
pp. 475-482 ◽  
Author(s):  
Ronaldo Fernando de Oliveira ◽  
Junior Vitorino Fandim ◽  
Iuri Fioratti ◽  
Lívia Gaspar Fernandes ◽  
Bruno Tirotti Saragiotto ◽  
...  

Low back pain (LBP) is extremely common and causes an enormous burden on the society. This perspective article aims to provide an evidence-based summary in the field of LBP. More specifically, we aimed to present epidemiological data on cost, diagnosis, prognosis, prevention and interventions for patients with LBP. It is critical that both clinicians and policymakers follow best practices by using high-value care for patients with LBP. In addition, nonevidence-based procedures must be immediately abandoned. These actions are likely to reduce societal costs and will improve the quality of life of these patients.


2021 ◽  
Vol 11 (4) ◽  
pp. 153-156
Author(s):  
Mansi Manoj Muly ◽  
Hally Shah ◽  
Asmaa Shaikh

Musculoskeletal Pain affects the bones & soft tissue musculatures. It can be acute or chronic. It can be localized or widespread. Lower back pain (LBP) is the most common type of musculoskeletal pain. It is one of the causes of absenteeism of employees from their work and significantly affecting their quality of life (QoL). Security guards usually involves standing for long duration. Therefore LBP is quite common in them. Changes in posture or poor body mechanics may bring about spine related problems, therefore causing other muscles to be misused and become painful. Very few literatures are available worldwide on prevalence of mechanical LBP & its relation to the QoL in standing workers. Therefore, the aim is to find out the correlation of mechanical LBP and QoL in security guards. Cross sectional study design was chosen for the research. From ninety security guards (male & female, aged 30-50 years) were screened on Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Thirty-one security guards were selected after screening, those who met the inclusion criteria (1.5 and above on CMDQ for lower back), informed consent was taken and further assessed on Oswestry LBP Disability Questionnaire (OLBPDQ) and World Health Organization QoL-BREF (WHO-QoL-BREF). In the study, moderately negative correlation was found between the OLBPDQ score & all QoL domains (-0.3, -0.1, -0.5, -0.2), which showed a significant lower QoL domains with severe LBP. Key words: Mechanical Lower back pain, Standing workers, Quality of life.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Philippe Moisan

Between 50 and 80% of adults will experience lower back pain during their life(1). This condition is responsible for a significant portion of emergency room and primary care consultations and it creates a significant burden on the healthcare services and costs. Even if lower back pain causes a significant impact on the quality of life of the patients most causes are benign. This article presents a systematic approach to identifying the cause of lower back pain, summarizes the indications for further workup and presents current evidence for the management of this condition.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15187-e15187 ◽  
Author(s):  
Zeeshan Butt ◽  
Rajiv Mallick ◽  
Mary Frances Mulcahy ◽  
Al B. Benson ◽  
David Cella ◽  
...  

e15187 Background: HCC is the second leading cause of cancer related deaths worldwide and incidence is increasing. Most HCC patients are diagnosed late-stage and with pain. Understanding the nature of pain experienced by HCC patients is complicated by co-morbid (including other liver) diseases and treatment related pain. The purpose of this study was to identify pain symptoms that are important and relevant to HCC patients who have received systemic therapy. Methods: We conducted semi-structured thematic interviews with 10 HCC patients who were currently on or previously had received oral systemic therapy (e.g., sorafenib) and had not received local or loco-regional therapy (e.g., surgery, radiation or chemo-embolization) within 4 weeks of the interview. Interviews included open elicitation of key symptoms, side effects and concerns. Patients also completed selected pain items from the FACT-Hep; items had previously been validated for patients with hepatobiliary cancers. Results: Mean age was 58 years (range 33-77); 2 patients had co-morbid cirrhosis, 1 had co-morbid hepatitis, and 4 patients had cirrhosis and hepatitis. When asked to describe the symptoms, side-effects or other issues that most significantly impact their quality of life, patients most often mentioned fatigue (n=5), diarrhea (n=5), skin toxicities (n=5), and loss of appetite (n=4). Nine patients reported experiencing pain over their HCC treatment course. Abdomen (N=7) and lower back (N=3) were the most common sites of pain; 2 patients reported only experiencing temporary pain from prior chemoembolization. The other 7 patients experienced ongoing pain, partly attributed to systemic therapy, ascites, or metastases. Ongoing abdominal and back pain were frequently not attributed to a specific cause. All patients indicated that FACT-Hep items adequately assessed their pain. Conclusions: Although pain was not a major driver of quality of life and for a few HCC patients it was transient and treatment-related, the majority of patients experienced some persistent pain. Abdominal pain and back pain were the most common pain sites for HCC patients. These results support the relevance of pain symptoms that have been previously identified as important in HCC.


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