Abstract Cancer-related pain is progressive and therefore requires a stepwise approach to management, such as the World Health Organization’s Pain Ladder. This approach calls for increasingly strong pain medications in addition to interventional options for patients with medication-refractory pain or intolerable medication side effects. Here, we discuss a case involving cancer-related pain which ultimately required intrathecal drug delivery system placement for optimal pain management.
Myofascial Inflammation Due to Intervertebral Disc Herniation
Pain Medicine | February 9, 2020 | Volume: 21 | Issue: 6 | Pages: 1295-1297
A Systematic Review and Meta-analysis of Unguided Electronic and Mobile Health Technologies for Chronic Pain—Is It Time to Start Prescribing Electronic Health Applications?
Pain Medicine | June 11, 2019 | Volume: 20 | Issue: 11 | Pages: 2238-2255
Abstract Objective Electronic (eHealth) and mobile (mHealth) technologies may be a useful adjunct to clinicians treating patients with chronic pain. The primary aim of this study was to investigate the effects of eHealth and mHealth interventions that do not require clinician contact or feedback on pain-related outcomes recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) guidelines in adults with chronic pain. Methods We searched four databases and included English language randomized controlled trials of ambulatory adults with chronic pain from January, 1 2000, to January 31, 2018, with interventions that are independent of clinician contact or feedback. In the meta-analysis, outcomes were assessed at short- (three months or less), intermediate- (four to six months), and long-term (seven or more months) follow-up. Results Seventeen randomized controlled trials (N = 2,496) were included in the meta-analysis. Both eHealth and mHealth interventions had a significant effect on pain intensity at short- and intermediate-term follow-up. Similarly, a significant but small effect was observed for depression at short- and intermediate-term follow-up and self-efficacy at short-term follow-up. Finally, a significant effect was observed for pain catastrophizing at short-term follow-up. Conclusions eHealth and mHealth interventions had significant effects on multiple short- and intermediate-term outcome measures recommended in the IMMPACT guidelines. Given widespread availability and low cost to patients, clinicians treating patients with chronic pain could consider using eHealth and mHealth interventions as part of a multidisciplinary pain treatment strategy.