Search

Coccygodynia or pain in the coccygeal region is often somatic and in a great percentage associated with a traumatic injury. It has multiple origins and may be multifactorial. We present a case of pelvic pain. A 55-year-old with a diagnosis of coccygodynia, who underwent abdominoperineal resection due to a rectal adenocarcinoma. The patient was treated by blockade and radiofrequency of the impar ganglion. We emphasize the anatomical alterations that can occur after this kind of surgery and the importance of a treatment tailored to each patient and their characteristics. [ABSTRACT FROM AUTHOR]

Radiofrequency is based on an electric field to generate a nerve injury or modulate the nociceptive signal, and it can be monopolar or bipolar, continuous or pulsed. Pulsed modality is used on the dorsal root ganglion for treatment of radicular pain resistant to other treatments, with good results after 3 months. Otherwise, continuous radiofrequency is used for low back pain from facet joint with variable results. In recent years, intracanal pulsed radiofrequency through a catheter has been developed for the treatment of several dorsal root ganglia, especially in canal stenosis and failed back syndrome. The results in these applications are promising. The scientific evidence in all the mentioned areas is weak and more solid and long-term studies are needed. [ABSTRACT FROM AUTHOR]

As the population ages, lumbar pain is more prevalent and grows the interest for low cost and low risk diagnostic methods and therapeutic procedures. Ultrasound improves interventional pain procedures and reduces x-ray exposure. There is insufficient evidence for the clinical value of ultrasound as a diagnostic tool in the management of low back pain and more research is needed to define the role of rehabilitative ultrasound imaging. [ABSTRACT FROM AUTHOR]

Post-amputation pain of the lower limb may occur due to a neuroma of the sciatic nerve, among other causes. We present the case of a 48 year old woman with stump pain, 15 years after the transfemoral amputation of the lower right limb, which prevents her from using the prosthesis. The presence of a sciatic neuroma of 2.2 × 2.2 × 1.5 cm at 8 cm proximal to the stump is diagnosed. An ultrasoundguided, diagnostic-therapeutic test was performed, infiltrating 0.2% ropivacaine and 0.4% triamcinolone in two sessions. Since the patient shows a good response, Pulsed Radiofrequency (PRF) is applied to the neuroma but there is no satisfactory response to the treatment. Therefore, surgical exeresis is considered as a last option as it has shown good results over pain, despite having a high injury recurrence. More studies on the adequate management of stump-neuroma pain are needed since the existent scientific evidence in this regard is scarce. [ABSTRACT FROM AUTHOR]