Review of Interventional Therapies for Refractory Pediatric Migraine.

This is a review of the latest and seminal evidence in pediatric migraine. It covers the etiology and pathophysiology known today, and then will review treatment options, efficacy and safety, quality of data and indications. Though migraine is usually regarded as an infliction in adults, it is not uncommon in the pediatric population and affects up to 8% of children.

Treatment and Management of Xiphoidalgia.

Unlabelled: Xiphodynia is a rare but debilitating condition that can be described as a form of pain on the xiphisternal joint or any related structures that are anchored to the xiphoid process. Although xiphodynia is a musculoskeletal pain in nature, the pain located in the anterior chest can commonly mislead physicians into pursuing other diagnoses such as cardiac diseases. This leads to a prolonged duration of pain before receiving treatment.

A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee.

Purpose Of Review: The purpose of this systematic review is to discuss emerging evidence in the field of viscosupplementation for chronic knee pain secondary to Osteoarthritis (OA). This review focuses on types of viscosupplementation that are clinically available currently, evidence to support their use, contraindications, and adverse events.

Recent Findings: OA, also known as degenerative joint disease, is the most common form of arthritis in the United States, affecting 54.

A Comprehensive Update of the Treatment and Management of Bertolotti's Syndrome: A Best Practices Review.

Bertolotti's Syndrome is defined as chronic back pain caused by transitional lumbosacral vertebra. The transitional vertebra may present with numerous clinical manifestations leading to a myriad of associated pain types. The most common is pain in the sacroiliac joint, groin, and hip region and may or may not be associated with radiculopathy.

Comprehensive Review and Update of Burning Eye Syndrome.

Keratoconjunctivitis sicca ("dry eye") is a common (14%-30% of adults over age 48) though difficult to treat condition that causes both discomfort and disability with associated dryness, pain, and visual disturbances. Etiology is not clearly understood but is likely varied, with a subset of patients suffering from chronic neuropathic pain referred to as "burning eye syndrome." This review of existing literature summarizes the clinical presentation, natural history, pathophysiology, and treatment modalities of burning eye syndrome.

Adverse Effects of Recreational and Medical Cannabis.

Purpose Of Review: This comprehensive review discusses the adverse effects known today about marijuana, for either medical or recreational use. It reviews the role of cannabis in the treatment of chronic pain, cognitive and neurological adverse effects, special cases and addiction.

Recent Findings: Cannabinoids work through the endocannabinoids system and inhibit the release of GABA and glutamate in the brain, impact neuromodulation, as well as dopamine, acetylcholine and norepinephrine release.

Canadian national hypoparathyroidism registry: an overview of hypoparathyroidism in Canada.

Purpose: To evaluate the epidemiology, presentation and management of hypoparathyroidism in Canada. Hypoparathyroidism is associated with significant morbidity and poor quality of life. We present baseline results from the Canadian National Hypoparathyroidism Registry, a prospective observational study evaluating hypoparathyroidism in Canada.

An Evidence-Based Review of Elagolix for the Treatment of Pain Secondary to Endometriosis.

Purpose Of Review: This is a review of elagolix use for pain related to endometriosis. It summarizes the background and recent data available about the pathogenesis of endometriosis and pain that is secondary to this syndrome. It then reviews the evidence to support the use of elagolix and the indications for use.

A Comprehensive Review of Slipping Rib Syndrome: Treatment and Management.

Purpose Of Review: This is a comprehensive review and update on advances in the understanding and treatment of slipping rib syndrome. It covers the physiology and pathophysiology at the basis of the syndrome, epidemiology and clinical presentation as well as diagnosis. It goes on to review the available literature to provide description and comparison of the available methods for alleviation.

Oral Muscle Relaxants for the Treatment of Chronic Pain Associated with Cerebral Palsy.

Purpose Of Review: This is a comprehensive literature review of the available for treatment of oral muscle relaxants for cerebral palsy (CP) and associated chronic pain. It briefly describes the background and etiology of pain in CP and proceeds to review and weigh the available evidence for treatment for muscle relaxants.

Recent Findings: CP is a permanent, chronic, non-progressive neuromuscular and neurocognitive disorder of motor dysfunction that is diagnosed in infancy and is frequently (62% of patients) accompanied by chronic or recurrent muscular pain.

A Comprehensive Review and Update of the Use of Dexmedetomidine for Regional Blocks.

Purpose Of Review: This evidence-based systematic review will focus on the use of dexmedetomidine and its role as adjuvant anesthetics in regional blocks to help better guide physicians in their practice. This review will cover background and mechanism of dexmedetomidine as well as the use in various regional blocks.

Recent Findings: Local anesthetics are preferred for nerve blocks over opioids; however, both due come with its own side effects.

Interventional Approaches to Pain and Spasticity Related to Cerebral Palsy.

Purpose Of Review: This review will cover seminal and emerging evidence on interventional therapy chronic pain in cerebral palsy (CP). It will cover the background and burden of disease, present the current options, and then weigh the evidence that is available to support interventional therapy and the current indications.

Recent Findings: CP is a permanent posture and movement disorder from in-utero brain development defects with a 3-4/1,000 incidence in the US.

A Comprehensive Review and Update of Post-surgical Cutaneous Nerve Entrapment.

Purpose Of Review: This is a comprehensive review of the literature regarding post-surgical cutaneous nerve entrapment, epidemiology, pathophysiology, and clinical presentation. It focuses mainly on nerve entrapment leading to chronic pain and the available therapies.

Recent Findings: Cutaneous nerve entrapment is not an uncommon result (up to 30% of patients) of surgery and could lead to significant, difficult to treat chronic pain.

Baricitinib for the treatment of rheumatoid arthritis.

Rheumatoid arthritis (RA) is a common inflammatory disease with several implications on health, disability and economy. Conventional treatment for RA centers on anti-inflammatory drugs and specific targeting of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6). Baricitinib is a novel, Food and Drug Administration (FDA) approved, once daily oral drug that is effective in combination with current treatment and results in significantly reduced symptoms with good safety profile.

Use of Dexmedetomidine With Dexamethasone for Extended Pain Relief in Adductor Canal/Popliteal Nerve Block During Achilles Tendon Repair.

The use of regional anesthetic techniques in the peri-operative period has increased as a means to improve analgesia and patient outcomes. Traditionally, various local anesthetics are used and addition of adjuncts such as epinephrine, clonidine, and dexamethasone has shown to prolong the block effect. There has been ongoing research to support the prolongation of a regional block with the addition of dexamethasone and dexmedetomidine (Dex-Dex), providing analgesia for multiple days.

A comprehensive review of the treatment and management of Charcot spine.

Charcot spine arthropathy (CSA), a result of reduced afferent innervation, is an occurrence of Charcot joint, a progressive, degenerative disorder in vertebral joints, related mostly to spinal cord injury. The repeated microtrauma is a result of a lack of muscle protection and destroys cartilage, ligaments, and disc spaces, leading to vertebrae destruction, joint instability, subluxation, and dislocation. Joint destruction compresses nerve roots, resulting in pain, paresthesia, sensory loss, dysautonomia, and spasticity.

Treatment and Management of Twelfth Rib Syndrome: A Best Practices Comprehensive Review.

Background: Twelfth rib syndrome, or slipping of the 12th rib, is an often overlooked cause for chronic chest, back, flank, and abdominal pain from irritation of the 12th intercostal nerve. Diagnosis is clinical and follows the exclusion of other causes of pain. This syndrome is usually accompanied by long-suffering, consequent psychiatric comorbidities, and increased health care costs, which are secondary to the delayed diagnosis.

A Comprehensive Review of Over the Counter Treatment for Chronic Low Back Pain.

Purpose Of The Review: Chronic low back pain (CLBP) is a major contributor to societal disease burden and years lived with disability. Nonspecific low back pain (LBP) is attributed to physical and psychosocial factors, including lifestyle factors, obesity, and depression. Mechanical low back pain occurs related to repeated trauma to or overuse of the spine, intervertebral disks, and surrounding tissues.

An Evidence-Based Review of Galcanezumab for the Treatment of Migraine.

Purpose Of Review: This is a comprehensive review of the current literature on the usage of galcanezumab for migraine treatment. It reviews the biology, pathophysiology, epidemiology, diagnosis, and conventional treatment of migraines, then compares the literature available for galcanezumab with historical treatment options.

Recent Findings: Migraine is a common headache disorder and constitutes a significant source of distress from both a personal and societal perspective.

An evidence-based review of neuromodulation for the treatment and management of refractory angina.

Angina pectoris is defined as substernal chest pain that is typically exacerbated by exertion, stress, or other exposures. There are various methods of treatment for angina. Lifestyle modification and pharmacological management are considered as conservative treatments.

Use of cannabidiol (CBD) for the treatment of chronic pain.

Chronic pain can be recurrent or constant pain that lasts for longer than 3 months and can result in disability, suffering, and a physical disturbance. Related to the complex nature of chronic pain, treatments have a pharmacological and non-pharmacological approach. Due to the opioid epidemic, alternative therapies have been introduced, and components of the plant Cannabis Sativa, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have gained recent interest as a choice of treatment.

The Utility of Percutaneous Balloon Kyphoplasty for Treatment of Traumatic Vertebral Compression Fracture to Prevent Opioid Dependence in a Young Opioid-Dependent Patient.

Vertebral compression fractures are often found in the elderly population with known risk factors. Less commonly, they may occur in otherwise healthy patients following traumatic falls and can cause significant pain requiring opioid therapy. This case emphasizes the use of percutaneous balloon kyphoplasty as an effective treatment strategy in a young opioid-dependent patient as a means to support the return to baseline functionality.