Interdisciplinary Pain Team Flashcards
1
Q
Indications for epidural injections
A
- radicular pain
2
Q
efficacy of epidural injections
A
- less than 3 mo: response rate 90%
- less than 6 mo: response rate 70%
- over a year: response 50%
- FDA: effectiveness isnt established, can have severe side effects
3
Q
facet joint injections indications
A
- focal tenderness
- post-laminectomy syndrome
- post-spinal fusion pain
- low back pain with normal radiograph findings
4
Q
SI joint injection indications
A
- focal tenderness
- positive provocative SI joint tests
5
Q
efficacy of facet joint injections in chronic pain
A
aint effective
dont do it
6
Q
Facet radiofrequency ablation
A
- medial branch of spinal ramus
- Heat from RFA creates a small lesion in the nerve
7
Q
Efficacy of chronic pain in RFA
A
- discogenic pain: good
- chronic LBP: little benefit
- cervical pain: may provide effective management
8
Q
risks of RFA
A
- medial branch innervates stabilizers of spine
- loss of sensation
- long term nerve repair can take 6-12 mo and can be painful
9
Q
sympathetic block indications
A
- CRPS
- phantom limb
- vasomotor dysfunciton, swelling, allodynia, hyperalgesia, skin trophic changes
10
Q
what is a sympathetic block
A
local anesthetic drug injected at lower third L2 or upper third L3
* PT usually referred same day
11
Q
efficacy of sympathetic blocks in chronic pain
A
probs not great and evidence is “not encouraging” lol
12
Q
spinal cord stimulator indications
A
- failed back surgery
- CRPS
- peripheral neuropathy
- phantom limb pain
13
Q
efficacy of SCS in chronic pain
A
- mod evidence supporting use in persistent radicular pain
- pain relief with SCS decreases over time
- poor efficacy in non-radicular pain
- high risk
14
Q
informed consent for long term opioids
A
> 3 mo
15
Q
A
