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Background: Neurostimulation is a highly effective therapy for the treatment of chronic Intractable pain, however, due to the complexity of pain, measuring a subject's long-term response to the therapy remains difficult. Frequent measurement of patient-reported outcomes (PROs) to reflect multiple aspects of subjects' pain is a crucial step in determining therapy outcomes. However, collecting full-length PROs is burdensome for both patients and clinicians. The objective of this work is to identify the reduced set of questions from multiple validated PROs that can accurately characterize chronic pain patients' responses to neurostimulation therapies. Methods: Validated PROs were used to capture pain, physical function and disability, as well as psychometric, satisfaction, and global health metrics. PROs were collected from 509 patients implanted with Spinal Cord Stimulation (SCS) or Dorsal Root Ganglia (DRG) neurostimulators enrolled in the prospective, international, post-market REALITY study (NCT03876054, Registration Date: March 15, 2019). A combination of linear regression, Pearson's correlation, and factor analysis were used to eliminate highly correlated questions and find the minimal meaningful set of questions within the predefined domains of each scale. Results: The shortened versions of the questionnaires presented almost identical accuracy for classifying the therapy outcomes as compared to the validated full-length versions. In addition, principal component analysis was performed on all the PROs and showed a robust clustering of pain intensity, psychological factors, physical function, and sleep across multiple PROs. A selected set of questions captured from multiple PROs can provide adequate information for measuring neurostimulation therapy outcomes. Conclusions: PROs are important subjective measures to evaluate the physiological and psychological aspects of pain. However, these measures are cumbersome to collect. These shorter and more targeted PROs could result in better patient engagement, and enhanced and more frequent data collection processes for digital health platforms that minimize patient burden while increasing therapeutic benefits for chronic pain patients. [ABSTRACT FROM AUTHOR]

The prevalence of chronic pain is between 33% to 64% and is due to cancer pain, but it has also been observed in non-cancer patients. Chronic pain is associated with lower quality of life and higher psychological distress and depressive/anxiety disorders in patients without a history of disorder. In this study we evaluated in clinical practice the effectiveness of the intrathecal pump in 140 patients who underwent pain therapy at our Center. These patients were consecutively enrolled from January 2010 to July 2018. Follow-up was carried out over these eight years regarding the infusion modalities. Pain relief was obtained in 71 (50,7%) patients out of the 140 that experienced satisfactory pain control globally. Intrathecal therapy is one of the best options for chronic severe refractory pain. The greatest advantage of this therapy is due to the possibility of treating the pain with minimal dosages of the drug, avoiding the appearance of troublesome side effects. [ABSTRACT FROM AUTHOR]

Background: chronic low back pain is one of the most common causes of chronic pain. Low back pain can have many causes but most cases have nonspecific etiology. There are many approaches in the management of chronic low back pain. Methodology: we carried out a systematic review on observational (nonrandomized) of 43 studies using PUBMED. Aim: to evaluate the use of analgesics, mainly Non-Steroidal Anti-inflammatory Drugs and opiates, compare their efficacies for symptomatic treatment of low back pain, and study the side effects briefly for both category of drug. Conclusion: management of chronic low back pain aims mainly to improve function, and quality of life, and to decrease level of disability, and therefore, it remains as a big challenge for the general practitioner. More studies must be done to compare efficacies of various lines of management for both short and long term. [ABSTRACT FROM AUTHOR]

The aim of the high standard rehabilitation programme was to verify and also to find out to what extent it is possible to influence chronic pain of observed patients and to monitor the specific factors that contribute to the chronic pain relief. 233 patients with chronic pain lasting more than three months (despite intensive therapy) went through the one office of our rehabilitation facility (R.R.R. Center - Center for the treatment of pain and movement disorders in Olomouc). 89 patients refused to participate in the rehabilitation programme. Three patients who agreed to participate in this programme had resigned after the apology during the treatment, rest of the patients resigned without apology. In cooperation with general practitioners and specialists the diagnostic and treatment efforts were focused maximally on 42 remaining patients. Complete regression of the chronic pain was recorded in cases of all of the 42 patients (16 men and 26 women). The treatment clarified that in etiological summary also functional musculoskeletal disorders participated besides the organic causes of chronic pain. These functional musculoskeletal disorders were the main etiological cause of the chronic pain. Promptly after removal of these disorders there came a pain relief up to 0 on a Visual Analogue Scale. The essential finding is that the organic changes proven on input with expectancy of long lasting course of chronic pain are not the main etiological cause of the chronic pain. On the contrary the main cause are the functional musculoskeletal disturbances with expectancy of effective treatment and possibility of complete regression of the chronic pain. Pathological reflex changes (Trigger and Tender points) participated dominantly in the pain symptomatics. [ABSTRACT FROM AUTHOR]