Urine drug testing: current recommendations and best practices.

Background: The precise role of urine drug testing (UDT) in the practice of pain medicine is currently being defined. Confusion exists as to best practices, and even to what constitutes standard of care. A member survey by our state pain society revealed variability in practice and a lack of consensus.

Automatic adaptation of neurostimulation therapy in response to changes in patient position: results of the Posture Responsive Spinal Cord Stimulation (PRS) Research Study.

Background: Variation in the intensity of neurostimulation with body position is a practical problem for many patients implanted with a spinal cord stimulation system because positional changes may result in overstimulation or understimulation. These posture-related changes in patients' perception of paresthesia can affect therapeutic outcomes of spinal cord stimulation therapy. An accelerometer-based algorithm that automatically adjusts spinal cord stimulation based on sensed body position or activity represents a potential solution to the problem of position-mediated variations in paresthesia perception.

Assessment of patient preference for constant voltage and constant current spinal cord stimulation.

Objectives:   Spinal cord stimulation devices control energy by generating either constant voltage (CV) pulses or constant current (CC) pulses. This study aimed to investigate: 1) whether patients feel differences between CV and CC stimulation; 2) if patients prefer CV or CC stimulation.

Methods:   Fourteen patients blinded to the type of pulse generation received 20 randomized pairs of 15-sec pulse trains (CC-CV, CV-CC, CV-CV, or CC-CC).