ABSTRACT
Although interventional procedures should be used cautiously in the setting of chronic pain, there is a role for a variety of injections to facilitate a patient's overall rehabilitation program. There are many resources available, including a prior issue of Physical Medicine and Rehabilitation Clinics of North America, which discuss the more conventional spinal injections. The focus of this article is on lesser-known injection options for treating chronic pain. The authors separately discuss trigger point injections, regenerative injections (prolotherapy), and injections using botulin toxins.
Subject(s)
Chronic Pain/drug therapy , Injections , Analgesia, Epidural , Botulinum Toxins/therapeutic use , Humans , Pain Management , Pain Measurement , Trigger Points , Zygapophyseal JointABSTRACT
Although most patients recover from acute whiplash injuries, those with chronic whiplash syndrome develop signs of central nervous system (CNS) amplification of pain and have a poor prognosis. In this context, specific pain generators from acute whiplash have been identified through clinical, biomechanical, and animal studies. This article gives a clinical perspective on current understanding of these pain generators, including the phenomenon of CNS sensitization.
Subject(s)
Central Nervous System/physiopathology , Chronic Pain/physiopathology , Whiplash Injuries/physiopathology , Animals , Chronic Pain/therapy , Humans , Pain Measurement , Prognosis , Whiplash Injuries/therapyABSTRACT
BACKGROUND: In April 2014, the Food and Drug Administration (FDA) issued a Drug Safety Communication requesting that corticosteroid labeling include warnings that injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death. RESULTS: The International Spine Intervention Society spearheaded a collaboration of more than a dozen other medical societies in submitting the letter below to the FDA on November 7, 2014. We are publishing the letter to ensure that the readership of Pain Medicine is aware of the multisociety support for the safety and effectiveness of these procedures. A special note of thanks to all of the societies who signed on in support of the message.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Injections, Epidural/adverse effects , Adrenal Cortex Hormones/adverse effects , Humans , Societies, Medical , United States , United States Food and Drug AdministrationSubject(s)
Dancing , Synovitis/diagnosis , Adolescent , Arthroscopy , Chronic Disease , Female , Humans , Knee Joint , Synovitis/pathology , Synovitis/surgeryABSTRACT
Cutaneous myiasis caused by Dermatobia hominis, the human botfly, involves the infestation of human tissue with fly larvae, and is common in Central and South America. We report a case of a 57-year-old man with cutaneous myiasis imported into the US from Belize. The epidemiology, biological life cycle, clinical presentation, and various methods of larval extraction, including incision and drainage, are discussed.
