A Survey of Spinal Cord Stimulator Use by Chronic Pain Patients While Driving.

Objective: The study aims to assess utilization of spinal cord stimulator (SCS) devices while driving a vehicle and potential association with motor vehicle accidents (MVAs).

Materials And Methods: A telephone survey study was conducted in two phases, from 2001 to 2008 and from 2009 to 2011. Patients selected for the survey were age 18 or older and at least one year post-SCS implantation, demonstrating stable analgesic use for at least six months, and reporting a minimum of 50% pain relief and enhancement of activities of daily living.

Low and therapeutic doses of antidepressants are associated with similar response in the context of multimodal treatment of pain.

Background: Antidepressants are prescribed in a wide range of doses to treat both depression and chronic pain, with optimal psychopharmacology individualized for each patient. In the past decade more antidepressants from different chemical classes have become available and are being used for the treatment of both chronic pain and depression.

Objective: To review the utilization pattern changes and compare response rates of different classes and doses of antidepressants for various pain conditions in the context of multimodal therapies.

Dealing with difficult patients in your pain practice.

Pain patients can be difficult. They can provoke negative feelings of frustration and anger among clinicians and damage the doctor-patient relationship. This article helps practitioners to identify those pain patients who would be prone to difficult behavior and sheds light on some of the reasons behind the behavior that give rise to difficult feelings.

Labetalol for prophylactic treatment of intractable migraine during pregnancy.

Headaches tend to improve in the majority of migraineurs during pregnancy, but some patients report a worsening of migraine and present a management challenge because of the restrictions of pharmacotherapy during pregnancy. Treatment options become even more limited for pregnant migraineurs who develop preeclampsia. Labetalol was tried successfully in reducing the frequency, duration, and intensity of migraine attacks in a pregnant woman with preeclampsia.