Multicenter, Randomized, Placebo-controlled Crossover Trial Evaluating Topical Lidocaine for Mechanical Cervical Pain.

Background: There are few efficacious treatments for mechanical neck pain, with controlled trials suggesting efficacy for muscle relaxants and topical nonsteroidal anti-inflammatory drugs. Although studies evaluating topical lidocaine for back pain have been disappointing, the more superficial location of the cervical musculature suggests a possible role for topical local anesthetics.

Methods: This study was a randomized, double-blind, placebo-controlled crossover trial performed at four U.

Antimicrobial therapies for chronic pain (part 2): the prevention and treatment of chronic pain.

The discovery and development of antimicrobial therapies represents one of the most significant advancements in modern medicine. Although the primary therapeutic intent of antimicrobials is to eliminate their target pathogens, several antimicrobials have been shown to provide analgesia as a secondary benefit. Antimicrobials have demonstrated analgesic effects in conditions that involve dysbiosis or potential subclinical infection (, chronic low back pain with Modic type 1 changes; chronic prostatitis/chronic pelvic pain; irritable bowel syndrome; inflammatory bowel disease; functional gastrointestinal disorders/dyspepsia; myalgic encephalomyelitis/chronic fatigue syndrome), and might even prevent the chronification of pain after acute infections that are associated with excessive systemic inflammation (, post COVID-19 condition/long Covid, rheumatic fever).

Nonorganic (Behavioral) Signs and Their Association With Epidural Corticosteroid Injection Treatment Outcomes and Psychiatric Comorbidity in Cervical Radiculopathy: A Multicenter Study.

Objective: To determine the association between cervical nonorganic pain signs and epidural corticosteroid injection outcomes and coexisting pain and psychiatric conditions.

Patients And Methods: Seventy-eight patients with cervical radiculopathy who received epidural corticosteroid injection were observed to determine the effects that nonorganic signs have on treatment outcome. A positive outcome was a decrease of 2 or more points in average arm pain, coupled with a score of 5 on a 7-point Patient Global Impression of Change scale 4 weeks after treatment.

Isolated Mononeuropathy From Rucksack Palsy: A Case Series.

Although there is increasing awareness of brachial plexopathy secondary to rucksack use, isolated mononeuropathies have been less well described. Three cases of mononeuropathy secondary to rucksack use in military personnel are presented, including injuries to the long thoracic and spinal accessory nerves. We also review several different factors in the proper construction, components, and fitting of the rucksack that should be considered in order to prevent rucksack palsy and provide a concise suggestion for rucksack use and education.

Waddell (Nonorganic) Signs and Their Association With Interventional Treatment Outcomes for Low Back Pain.

Background: The rising use of injections to treat low back pain (LBP) has led to efforts to improve selection. Nonorganic (Waddell) signs have been shown to portend treatment failure for surgery and other therapies but have not been studied for minimally invasive interventions.

Methods: We prospectively evaluated the association between Waddell signs and treatment outcome in 3 cohorts: epidural steroid injections (ESI) for leg pain and sacroiliac joint (SIJ) injections and facet interventions for LBP.

Fulminant heterotopic ossification after combat-related amputation: a report of 2 cases.

Heterotopic ossification (HO) is the process of abnormal formation of lamellar bone in nonosseous tissues. In this case presentation, we describe patients with aggressive HO, which becomes symptomatic shortly after injury for which we have suggested the term "fulminant heterotopic ossification." These atypical presentations of fulminant HO highlight the necessity for continued research directed at improved understanding of HO and may suggest a role for early partial surgical excision as a definitive management strategy.