Industry Articles
Read the articles below for more information about non-opioid treatment options for pain.
Cervical sympathetic block, COVID, parosmia, dysgeusia, dysautonomia
One hundred ninety-five patients presenting with post-COVID symptomology, including parosmia and dysgeusia, underwent reversible stellate ganglion blockade. Stellate ganglion blockade was performed at an outpatient facility, and patients were evaluated via survey at seven days post-injection. Of the 195 participants, ages ranged from 18– 69 years of age with the breakdown of sexes being females n = 157 and males n = 38. The most significant finding was a reported improvement in olfaction post-injection in 87.4% of subjects. The effectiveness of this novel treatment for post-COVID is promising and warrants further investigation. Read Article >>
Knee pain, osteoarthritis, ultrasound, radiofrequency denervation
Genicular nerve radiofrequency (RF) denervation appears to be a promising treatment for knee pain in patients with degenerative osteoarthritis of the knee, when candidates are not suitable for arthroplasty. This study aimed to assess the accuracy and reliability of ultrasound-guided placement of RF cannulas in cadavers for genicular nerve treatment, by measuringthe needle-to-nerve proximity. Read Article >>
Occipital nerve blocks, pulsed radiofrequency, chronic headaches
Occipital neuralgia is a condition manifested by chronic occipital headaches and is thought to be caused by irritation or trauma to the greater occipital nerve (GON). Treatment for occipital neuralgia includes medications, nerve blocks, and pulsed radiofrequency ablation (PRFA). Landmark-guided GON blocks are the mainstay in both the diagnosis and treatment of occipital neuralgia. Ultrasound is being utilized more and more in the chronic pain clinic to guide needle advancement when performing procedures; however, there are no reports of ultrasound used to guide a diagnostic block or PRFA of the GON. We report two cases in which ultrasound was used to guide diagnostic greater occipital nerve blocks and greater occipital nerve pulsed radiofrequency ablation for treatment of occipital neuralgia. Two patients with occipital headaches are presented. In Case 1, ultrasound was used to guide diagnostic blocks of the greater occipital nerves. In Case 2, ultrasound was utilized to guide placement of radiofrequency probes for pulsed radiofrequency ablation of the greater occipital nerves. Both patients reported immediate, significant pain relief, with continued pain relief for several months. Read Article >>
Migraines
Migraine headaches are common, with a worldwide prevalence ranging between 8 and 18%. Migraines cause significant disability, even during periods between attacks, and are responsible for $1 billion in medical costs and $16 billion in lost productivity per year in the US alone. The diagnostic criteria for migraine headaches have evolved over time. Currently, the International Headache Society (IHS) diagnostic criteria for migraine includes having at least 5 attacks that last 4–72 hours, that are unilateral, pulsating, moderate or severe in intensity and aggravated by or cause avoidance of routine physical activity and are also accompanied by nausea and/or vomiting, photophobia or phonophobia. IHS further classifies migraine as with or without an aura and as episodic or chronic. Chronic migraine is defined as more than 15 migraine headaches per month for more than 3 months. Chronic migraines result in significantly greater disability than episodic migraines. READ ARTICLE >>
Axillary nerve block, suprascapular nerve block, shoulder joint replacement
A 36-year-old female with severe juvenile rheumatoid arthritis presented for right total shoulder joint replacement. She also had spina bifida with an associated ventriculo-peritoneal shunt coursing along the right side of the neck. She had severe kyphoscoliosis of her spine, and severe restrictive lung disease. She had known difficult intubation. Significant contraindications to the use of an interscalene block included the VP shunt perhaps distorting the anatomy of the interscalene groove, as well as being vulnerable to needle puncture. Diaphragmatic paresis could significantly compromise the patient's ventilatory capacity postoperatively. READ ARTICLE >>
Chronic headache, headache management
Physicians have used several interventional techniques to treat primary headaches. While many can be treated pharmacologically, those who continue to suffer from refractory or severe headaches may see tremendous benefit from a range of more invasive treatments which focus on directly inhibiting the painful nerves. While there is a plethora of evidence suggesting these methods are effective and possibly durable interventions, there is still a need for large, prospective, randomized trials to clearly demonstrate their efficacy. READ ARTICLE >>
Headache management, opioids
Although many patients who suffer from headaches can be treated with conservative, less-invasive treatments, there still remains at present an ever-increasing need for those patients who are refractory to conservative measures and thus require interventional treatments. These procedures are continually evolving to become safer, more precise, and more readily available for clinicians to provide to their patients. READ ARTICLE >>
Chronic migraines, ultrasound, pulsed radiofrequency, occipital nerve
Although various oral medications and procedures are applied for managing migraine, their efficacy remains limited. To control migraine that does not respond to conventional treatments, we conducted pulsed radiofrequency (PRF) stimulation to the greater occipital nerve (GON) in 2 patients. Two weeks after applying PRF, the pain was reduced to NRS 3 in both patients, who also reported that the headache became bearable after PRF. The effectiveness of PRF on GON lasted for at least 3 months in both patients, and no adverse effects were observed. READ ARTICLE >>
Migraine, SPG, Nerve Block
The sphenopalatine ganglion (SPG) is associated with the trigeminal nerve, the major nerve involved in headache disorders. The mechanism behind migraines is not fully understood, but it’s thought that blocking the SPG may help relieve migraine pain. The SPG is the main source of cranial and facial parasympathetic innervation. The autonomic nerves of the SPG supply the lacrimal glands, which produce tears, as well as the sinuses, which can produce the nasal discharge or congestion associated with some migraines. READ ARTICLE >>
Nerve blocks, sympathetic blocks
The autonomic nervous system is composed of the sympathetic and parasympathetic nervous systems. The sympathetic nervous system is implicated in situations involving emergent action by the body and additionally plays a role in mediating pain states and pathologies in the body. Painful conditions thought to have a sympathetically mediated component may respond to blockade of the corresponding sympathetic fibers. The paravertebral sympathetic chain has been targeted for various painful conditions. Although initially injected using landmark-based techniques, fluoroscopy and more recently ultrasound imaging have allowed greater visualization and facilitated injections of these structures. In addition to treating painful conditions, sympathetic blockade has been used to improve perfusion, treat angina, and even suppress posttraumatic stress disorder symptoms. This review explores the anatomy, sonoanatomy, and evidence supporting these injections and focuses on ultrasound-guided/assisted technique for the performance of these blocks. READ ARTICLE >>
Knee pain, joint pain, ultrasound
Most routine intra-articular and extra-articular knee infiltrations performed in pain management are carried out by means of blind techniques or fluoroscopy-guided techniques. Alternatively, ultrasound-guided techniques are a safer and more precise way to perform these procedures. An extensive knowledge of knee anatomy will help us to obtain high-quality real-time ultrasound images before performing any infiltrations. In the current article, we present how to systematically examine the knee sonoanatomy and also describe the ultrasound-guided interventional basis for knee joint pain management. READ ARTICLE >>
Postmastectomy pain, breast cancer, serratus plane block, nerve block
Postmastectomy pain syndrome is common after surgical treatment for breast cancer and may be challenging to manage. Currently, there are a wide variety of approaches to treat this type of pain, including medications, physical therapy, and interventional procedures. However, because of the complexity of innervation of the breast, the serratus plane block may better target the web of nerves innervating the anterior chest wall including the breast. We present a case series of 8 patients who were successfully treated with serratus plane block for pain after treatment for breast cancer. We feel that this particular application for the serratus plane block deserves further investigation, as it is relatively easy to perform and has good clinical utility for this type of pain. READ ARTICLE >>