As if one pain problem was not enough: prevalence and patterns of coexisting chronic pain conditions and their impact on treatment outcomes

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients' use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary trial device, permanent implant or both. Patients were divided for assessment based on the nature of their procedure(s). Primary outcome was change in morphine equivalent dose (MED), ascertained from preoperative and postoperative medication reports. Results: Postoperative MED was significantly lower in patients who received some form of neuromodulation therapy. Pretrial patients reported an average MED of 41.01 ± 10.23 mg per day while post-trial patients reported an average of 13.30 ± 5.34 mg per day (p < 0.001). Pre-implant patients reported an average MED of 39.14 ± 13.52 mg per day while post-implant patients reported an average MED of 20.23 ± 9.01 mg per day (p < 0.001). There were no significant differences between pre-trial and pre-implant MED, nor between post-trial and post-implant MED. Of the 42 study subjects who reported some amount of pre-intervention opioid use, 78.57% indicated a lower MED (n = 33; p < 0.001), 16.67% indicated no change (n = 7) and 4.76% (n = 2) indicated a higher MED, following intervention. Moreover, SCS therapy resulted in a 26.83% reduction (p < 0.001) in the number of patients with MED >50 mg per day. Conclusion: Spinal cord stimulation may reduce opioid use when implemented appropriately. Neuromodulation may represent alternative therapy for alleviating chronic pain which may avoid a number of deleterious side effects commonly associated with opioid consumption.

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Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine

The Lancet Rheumatology ◽

10.1016/s2665-9913(21)00032-1 ◽

2021 ◽

Vol 3 (5) ◽

pp. e383-e392

Author(s):

Jo Nijs ◽

Steven Z George ◽

Daniel J Clauw ◽

César Fernández-de-las-Peñas ◽

Eva Kosek ◽

...

Keyword(s):

Chronic Pain ◽

Precision Medicine ◽

Central Sensitisation ◽

Chronic Pain Conditions

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An Innovative National Programme for Comprehensive Chronic Wound Therapy and Its Impact on Treatment Outcomes

World Journal of Surgery ◽

10.1007/s00268-020-05901-8 ◽

2021 ◽

Author(s):

Kryspin Mitura

Keyword(s):

Treatment Outcomes ◽

Chronic Wound ◽

Wound Therapy ◽

National Programme ◽

Impact On Treatment

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The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes

Current Addiction Reports ◽

10.1007/s40429-020-00352-6 ◽

2021 ◽

Author(s):

R. Ross MacLean ◽

Suzanne Spinola ◽

Gabriella Garcia-Vassallo ◽

Mehmet Sofuoglu

Keyword(s):

Chronic Pain ◽

Treatment Outcomes ◽

Opioid Use Disorder ◽

Opioid Use ◽

Disorder Treatment ◽

The Impact

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Interdisciplinary Teams in Endometriosis Care

Seminars in Reproductive Medicine ◽

10.1055/s-0040-1718943 ◽

2020 ◽

Vol 38 (02/03) ◽

pp. 227-234

Author(s):

Catherine Allaire ◽

Alicia Jean Long ◽

Mohamed A. Bedaiwy ◽

Paul J. Yong

Keyword(s):

Chronic Pain ◽

Interdisciplinary Team ◽

Multidisciplinary Care ◽

Complex Problem ◽

Interdisciplinary Teams ◽

Team Approach ◽

Team Care ◽

Psychological Therapies ◽

Published Evidence ◽

Chronic Pain Conditions

AbstractEndometriosis-associated chronic pelvic pain can at times be a complex problem that is resistant to standard medical and surgical therapies. Multiple comorbidities and central sensitization may be at play and must be recognized with the help of a thorough history and physical examination. If a complex pain problem is identified, most endometriosis expert reviews and guidelines recommend multidisciplinary care. However, there are no specific recommendations about what should be the components of this approach and how that type of team care should be delivered. There is evidence showing the effectiveness of specific interventions such as pain education, physical therapy, psychological therapies, and pharmacotherapies for the treatment of chronic pain. Interdisciplinary team models have been well studied and validated in other chronic pain conditions such as low back pain. The published evidence in support of interdisciplinary teams for endometriosis-associated chronic pain is more limited but appears promising. Based on the available evidence, a model for an interdisciplinary team approach for endometriosis care is outlined.

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