Publications by authors named "Nebojsa N Knezevic"

Neuropathic pain is a complex and debilitating condition resulting from nerve damage, characterized by sensations such as burning, tingling, and shooting pain. It is often associated with conditions such as multiple sclerosis (MS), Guillain-Barré syndrome (GBS), and diabetic polyneuropathy. Conventional pain therapies frequently provide limited relief and are accompanied by significant side effects, emphasizing the need to explore alternative treatment options.

View Article and Find Full Text PDF

Background: Chronic pain is defined as any persistent or recurring pain lasting longer than 3 months that significantly affects a person's quality of life. Millions worldwide are impacted by chronic pain, but its subjective nature makes it difficult to quantify and compare between individuals.

Methods: This retrospective analysis aimed to examine the differences in pain perception and reporting between male and female patients, as well as how their pain was managed.

View Article and Find Full Text PDF
Article Synopsis
  • Recent research highlights the potential of biologic treatments like mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) for relieving low back pain by promoting healing in intervertebral discs.
  • A systematic review and meta-analysis evaluated the effectiveness of MSC and PRP injections for chronic low back and leg pain, analyzing data from various credible sources.
  • The findings included 8 randomized controlled trials and 8 observational studies, revealing fair evidence quality but noting a lack of high-quality studies, suggesting a moderate recommendation for these treatments.
View Article and Find Full Text PDF

Background: The analysis of epidural procedure utilization has revealed several notable trends over recent years. Utilization increased significantly until 2004, then rose minimally until 2011, followed by gradual declines up to 2019 in the Medicare population. The COVID-19 pandemic led to a marked 19% decline in usage from 2019 to 2020.

View Article and Find Full Text PDF

Background: The use of facet joint interventions for spinal pain management experienced rapid growth between 2000 and 2010, with an annual increase of 14.2%. However, this trend slowed significantly from 2010 to 2019, with a reduced growth rate of just 2.

View Article and Find Full Text PDF

Background: Numerous studies have highlighted the escalating costs associated with managing low back and neck pain, as well as other musculoskeletal disorders. In the past, there was a notable increase in the use of interventional techniques to address these disorders. However, the COVID-19 pandemic disrupted various chronic pain treatment approaches, including interventional procedures and opioid use, following a broader trend of reduced healthcare services.

View Article and Find Full Text PDF

Background: Peripheral nerve stimulation (PNS) has been used for over 50 years to treat chronic pain by delivering electrical pulses through small electrodes placed near targeted peripheral nerves those outside the brain and spinal cord. Early PNS systems often required invasive neurosurgical procedures. However, since 2015, the Food and Drug Administration (FDA) approved percutaneously implanted PNS leads and neurostimulators  offering a much less invasive, non-opioid option for managing recalcitrant chronic pain.

View Article and Find Full Text PDF
Article Synopsis
  • - Chronic stress significantly impacts physical and mental health, primarily through the hormone cortisol produced by the adrenal glands, which can have harmful effects when elevated over long periods.
  • - The stress response is regulated by the hypothalamic-pituitary-adrenal (HPA) axis, and prolonged high cortisol levels can lead to metabolic disorders, especially inflammatory bowel diseases (IBDs), as well as cognitive and psychiatric problems.
  • - This review discusses the complex interactions between cortisol and its receptors, aiming to better understand how chronic stress affects metabolism and brain function, which could inform potential therapeutic approaches.
View Article and Find Full Text PDF

Introduction: The International Neuromodulation Society convened a multispecialty group of physicians based on expertise with international representation to establish evidence-based guidance on using intrathecal drug delivery in chronic pain treatment. This Polyanalgesic Consensus Conference (PACC)® project's scope is to provide evidence-based guidance for clinical pharmacology and best practices for intrathecal drug delivery for cancer pain.

Materials And Methods: Authors were chosen on the basis of their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature.

View Article and Find Full Text PDF
Article Synopsis
  • The increasing use of interventional techniques in chronic pain patients on anticoagulant and antiplatelet therapy poses challenges in balancing the bleeding risk from these medications and the thrombosis risk from discontinuation.
  • Guidelines have been developed through a literature review and expert consensus to help assess and manage the risks of bleeding and thrombosis during interventional procedures for these patients.
  • These guidelines provide a framework for healthcare professionals to make informed decisions regarding the continuation or temporary suspension of anticoagulant and antiplatelet therapy in the context of interventional pain management.
View Article and Find Full Text PDF

Substance P (SP) plays a crucial role in pain modulation, with significant implications for major depressive disorder (MDD), anxiety disorders, and post-traumatic stress disorder (PTSD). Elevated SP levels are linked to heightened pain sensitivity and various psychiatric conditions, spurring interest in potential therapeutic interventions. In chronic pain, commonly associated with MDD and anxiety disorders, SP emerges as a key mediator in pain and emotional regulation.

View Article and Find Full Text PDF

The perception of pain is strongly influenced by various social, emotional, and cognitive factors. A psychological variable which has consistently been shown to exert its influence on pain is a cognitive process referred to as pain catastrophizing. Numerous studies have found it to be a strong predictor of pain intensity and disability across different clinical populations.

View Article and Find Full Text PDF
Article Synopsis
  • This article talks about how a molecule called nitric oxide is linked to pain and how hormones in our body also play a part in this.
  • It explains that both nerve signals and hormone signals can work together to create pain, especially in cases of nerve damage or inflammation.
  • More research is needed to understand this connection better, which could help find new ways to treat pain.
View Article and Find Full Text PDF
Article Synopsis
  • This paper talks about how nitric oxide (NO) and hormones affect mental health problems like stress, anxiety, depression, and PTSD.
  • These issues are common around the world and involve tricky chemical interactions in our bodies.
  • The paper emphasizes that even though a lot of research has been done, we still don't fully understand how these problems work, so more studies are needed to help improve mental health treatment.
View Article and Find Full Text PDF

While total knee arthroplasties (TKAs) are performed with the intent to reduce pain, chronic postsurgical pain (CPSP) is one of the most well-documented complications that can occur following surgery. This study aimed to assess whether perioperative factors, focusing on acute postsurgical pain and perioperative opioid consumption, were associated with the development of chronic postsurgical pain. Under general anesthesia, 108 patients underwent TKA and were treated postoperatively with a multimodal analgesia approach.

View Article and Find Full Text PDF
Article Synopsis
  • The review assesses the effectiveness of radiofrequency neurotomy for treating sacroiliac joint pain, which affects approximately 25% of low back pain cases and lacks a standardized diagnostic method.
  • Despite various treatment options like exercise and injections, their effectiveness is inconsistent, and recent changes in Medicare’s coverage reflect ongoing uncertainty in intervention efficacy.
  • The findings suggest that while radiofrequency neurotomy could be a viable treatment based on fair evidence, significant limitations and variations in study quality highlight the necessity for more robust research.
View Article and Find Full Text PDF

Background: Chronic axial spinal pain is one of the major causes of disability. Literature shows that spending on low back and neck pain and musculoskeletal disorders continues to escalate, not only with disability, but also with increasing costs, accounting for the highest amount of various disease categories. Based on the current literature utilizing controlled diagnostic blocks, facet joints, nerve root dura, and sacroiliac joints have been shown as potential sources of spinal pain.

View Article and Find Full Text PDF
Article Synopsis
  • * The 2016 CDC guidelines for opioid prescribing have had adverse effects, leading to increased hospitalizations and mental health issues due to improper prescribing practices and rapid tapering of opioids.
  • * A panel of experts is creating new guidelines for prescribing opioids for chronic non-cancer pain, based on a thorough review of clinical and epidemiological evidence to improve patient outcomes.
View Article and Find Full Text PDF

Cortisol, a critical glucocorticoid hormone produced by the adrenal glands, plays a pivotal role in various physiological processes. Its release is finely orchestrated by the suprachiasmatic nucleus, governing the circadian rhythm and activating the intricate hypothalamic-pituitary-adrenal (HPA) axis, a vital neuroendocrine system responsible for stress response and maintaining homeostasis. Disruptions in cortisol regulation due to chronic stress, disease, and aging have profound implications for multiple bodily systems.

View Article and Find Full Text PDF
Article Synopsis
  • The sacroiliac joint can significantly contribute to low back and leg pain, affecting 10-25% of patients with ongoing axial low back pain without specific disc-related issues.
  • A systematic review and meta-analysis were conducted to evaluate how effective intraarticular injections are in treating pain from this joint, using the PRISMA guidelines.
  • The study collected data from various trials published between 1966 and 2022, focusing on pain relief and functional improvement after three months, emphasizing studies with fluoroscopic guidance.
View Article and Find Full Text PDF

Background: Extensive research into potential sources of thoracic pain with or without referred pain into the chest wall has demonstrated that thoracic facet joints can be a potential source of pain confirmed by precise, diagnostic blocks.The objective of this systematic review and meta-analysis is to evaluate the effectiveness of medial branch blocks and radiofrequency neurotomy as a therapeutic thoracic facet joint intervention.

Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies of medial branch blocks and the radiofrequency neurotomy in managing thoracic pain utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was performed.

View Article and Find Full Text PDF