Conservative Treatments Frequently Used for Chronic Pain Patients in Clinical Practice: A Literature Review

Lee, Hee Jin

doi:10.7759/cureus.9934

Cited by 10 publications

(13 citation statements)

References 23 publications

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“…2 For management of LBP and sciatica, various conservative treatments, including oral pain medication, physical therapy, exercise, and interventions, are being applied. [3][4][5] Of these treatment modalities, epidural steroid injection (ESI) has been applied widely in patients with LBP or sciatica. 6 The anti-inflammatory property of steroids reduces inflammation around the sinuvertebral nerve and spinal nerve roots.…”

Section: Introductionmentioning

confidence: 99%

YouTube as a Source of Information on Epidural Steroid Injection

Lee

Park

2021

JPR

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Objective: With the advance of the internet, social media platforms have become a major source of medical information. We assessed the reliability, quality, and usefulness of the most-viewed YouTube videos of epidural steroid injection (ESI). Methods: A search was conducted on YouTube on February 13, 2020, using the keywords "epidural injection," "epidural steroid injection," "epidural transforaminal injection," and "epidural transforaminal steroid injection." The top 50 most-viewed videos were assessed with a modified DISCERN scale (mDISCERN) and a Global Quality Scale (GQS). Further, the usefulness of information in each video was evaluated. Results: Only 22% of videos contained information with high reliability, and these were produced by hospitals or physicians. None of the videos provided by media organizations and patients were reliable. As for information quality, only 34% were moderate to excellent quality. Even of the videos produced by hospitals or physicians, approximately half were of generally poor or poor quality. Regarding the usefulness of information, although 76% were assessed to contain useful information, 8% had misleading information. Particularly, four of these videos contained misleading information, and three were provided by patients who experienced ESI. Conclusion:YouTube is a platform where medical information is actively shared and widespread. Here, we found that the reliability and quality of videos were low even when these were produced by hospitals or physicians. Further, the quality tended to be much lower when it was provided by media organizations or patients. Future efforts by physicians and professional societies to improve the reliability and quality of medical content are necessary.

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Section: Introductionmentioning

confidence: 99%

YouTube as a Source of Information on Epidural Steroid Injection

Lee

Park

2021

JPR

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“…Most people experience pain due to pathologies of the nervous or musculoskeletal systems [ 1 , 2 ]. When the degree of pain is severe, patients’ quality of life decreases, and their function in daily activities and work deteriorates [ 1 , 2 ]. Therefore, pain control is important in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

Park

Chang

2022

J Yeungnam Med Sci

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Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

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“…Chronic pain is characterized by enhanced sensory neurotransmission that increases sensitivity to noxious stimuli and the perception of non-noxious stimuli as pain. 1 Neuropathic pain is one of the most common and debilitating chronic pain conditions that considerably deteriorates patients’ activities of daily living and quality of life. 2 Neuropathic pain is caused by several diseases, including metabolic (eg, diabetic neuropathy), autoimmune (eg, multiple sclerosis), and vascular (eg, stroke and spinal cord infarct) diseases and infection (eg, postherpetic neuralgia), trauma, and cancer.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding medications for reducing neuropathic pain, anticonvulsants (gabapentin or pregabalin), tricyclic antidepressants, and opioids are usually prescribed. 1 These drugs primarily target neurons including axons and dendrites. 6 Various adverse effects related to the restraint of neuronal activity, such as somnolence or dizziness, are unavoidable.…”

Section: Introductionmentioning

confidence: 99%

Minocycline for Controlling Neuropathic Pain: A Systematic Narrative Review of Studies in Humans

Shin¹,

Kim²,

Lee³

2021

JPR

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Objective Minocycline is known to reduce microglial activation, suggesting that it may reduce neuropathic pain. We reviewed studies in humans that evaluated the effectiveness of minocycline in alleviating neuropathic pain. Methods We searched the PubMed, Embase, Cochrane library, and SCOPUS databases for papers published before January 06, 2021, using the search words minocycline and pain. The inclusion criteria for the selection of articles were (1) minocycline administered to humans and (2) minocycline administered to control neuropathic pain. Results The primary literature search yielded 2299 relevant papers. Based on the assessment of the titles, abstracts, and full-text, nine publications were selected for this review. Only four of the nine studies showed a positive pain-reducing outcome after minocycline administration. Two of the three studies on chemotherapy-induced neuropathic pain showed a positive pain-reducing effect. Minocycline was effective in controlling pain from diabetic and leprotic neuropathies. However, minocycline was not effective in controlling lumbar radicular pain and pain resolution after carpal tunnel release. Conclusion Our review provides evidence that minocycline may have some potential for reducing neuropathic pain. Further high-quality studies need to be conducted to validate this potential.

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Conservative Treatments Frequently Used for Chronic Pain Patients in Clinical Practice: A Literature Review

Cited by 10 publications

References 23 publications

YouTube as a Source of Information on Epidural Steroid Injection

YouTube as a Source of Information on Epidural Steroid Injection

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

Minocycline for Controlling Neuropathic Pain: A Systematic Narrative Review of Studies in Humans

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