Methadone in the intrathecal treatment of chronic nonmalignant pain resistant to other neuroaxial agents: the first experience.

Intrathecal drug delivery is a widely used and effective method of treatment for chronic intractable pain. Unfortunately all currently used agents can not provide adequate pain relief in all patients. A prospective study of neuroaxial methadone was performed in 24 patients, all of whom had failed treatment with multiple previous intrathecal drugs.

Compensation status as a predictor of outcome in nonsurgically treated low back injury.

Whether the compensation status of patients injured in occupational accidents influences treatment outcome remains a controversial issue. This article describes the treatment outcome status of compensated versus noncompensated patients who received comprehensive functional restoration treatment of low back pain in a hospital-based, interdisciplinary, occupational rehabilitation and pain management program. Results of this investigation revealed treatment outcome differences between the two groups in two of three measures at discharge (subjective pain intensity and return-to-work), and outcome differences in one of five measures at 6-month follow-up (subjective pain intensity).

The comprehensive diagnosis of spinal pain. A new psychodiagnostic instrument.

The psychological assessment of patients suffering back pain has become a standard part of comprehensive diagnostic protocol and an accepted responsibility of the clinical practitioner. This is for good reason, since research confirms the value of psychological evaluation to clinical diagnosis, treatment planning, and the outcomes of both medical and surgical treatment. However, the traditional psychological tests developed for use with psychiatric patients and in mental health settings are not appropriate for nonpsychiatric orthopaedic patients with back pain.

Comprehensive treatment approach for lower back workers' compensation injuries.

A clinical outcome follow-up comparison of treatment and non-treatment groups was conducted to investigate the clinical effectiveness of a hospital-based occupational rehabilitation program. Twelve-month follow-up data were collected on 44 patients participating in a comprehensive treatment program and 20 patients referred for treatment but denied participation by their workers' compensation insurance company. Outcome data indicate that the population of workers' compensation low back injured patients who participated in occupational rehabilitation treatment subsequently were more likely to return to employment, consumed fewer analgesics, required fewer hospitalizations for additional diagnostics and/or treatment, and required fewer additional surgeries than a comparison group of patients denied comparable treatment.