Organ and tissue loss through disease and injury motivate the development of therapies that can regenerate tissues and decrease reliance on transplantations. Regenerative medicine, an interdisciplinary field that applies engineering and life science principles to promote regeneration, can potentially restore diseased and injured tissues and whole organs. Since the inception of the field several decades ago, a number of regenerative medicine therapies, including those designed for wound healing and orthopedics applications, have received Food and Drug Administration (FDA) approval and are now commercially available. These therapies and other regenerative medicine approaches currently being studied in preclinical and clinical settings will be covered in this review.
2018 data shows that every day, 128 people in the United States die after overdosing on opioids.1 The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.2
Interrelations between pain, nicotine, and tobacco smoking are of increasing interest due to their prevalence, public health impacts, and significant comorbidity (Fig. 1). Approximately one-third of American adults suffer from chronic pain,46,91 and over two-thirds endorse lifetime nicotine use.14 Although the prevalence of cigarette smoking in the general population has declined to approximately 14%,67 this trend has not been observed among pain patients.68
Spinal cord stimulation has become a widely used and efficient alternative for the management of refractory chronic pain that is unresponsive to conservative therapies. Technological improvements have been considerable and the current neuromodulation devices are both extremely sophisticated and reliable in obtaining good results for various clinical situations of chronic pain, such as failed back surgery syndrome, complex regional pain syndrome, ischemic and coronary artery disease. This technique is likely to possess a savings in costs compared with alternative therapy strategies despite its high initial cost. Spinal cord stimulation continues to be a valuable tool in the treatment of chronic disabling pain.
Treatment of back pain due to facet joint syndrome has been a challenge for physicians since its recognition ∼80 years ago. Intra-articular injections of steroids, local anesthetics, and phenol have been widely adopted despite their known shortcomings. Recently, intra-articular injection of amniotic membrane-umbilical cord (AMUC) has been utilized in various orthopedic indications, including those involving synovial joints, due to its reported anti-inflammatory properties. Herein, use of AMUC for facet joint syndrome was evaluated.
An epidural steroid injection delivers steroids directly into the epidural space in the spine. Sometimes additional fluid (local anesthetic and/or a normal saline solution) is used to help 'flush out' inflammatory mediators from around the area that may be a source of pain.
The epidural space encircles the dural sac and is filled with fat and small blood vessels. The dural sac surrounds the spinal cord, nerve roots, and cerebrospinal fluid (the fluid that the nerve roots are bathed in).
Misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high). The term nonmedical use of prescription drugs also refers to these categories of misuse. The three classes of medication most commonly misused are:
According to the American Academy of Pain Medicine, chronic pain affects approximately 100 million U.S. adults and costs $560 to $635 billion per year in direct medical treatment costs and lost productivity. Talk about a painful pill to swallow.
Exercise is a common treatment for chronic pain. Depending on your current state of health, it may help decrease inflammation, increase mobility, and decrease overall pain levels, no additional medication required.
Chronic Pain Doesn't Have to be a Life Sentence Suffering from chronic pain can be incredibly isolating and frustrating. Visiting doctor after doctor can leave you feeling as if there is no treatment for your pain. If you or a loved one is suffering from chronic pain, this book can be a first step to understanding treatments that can help manage pain. Though doctors have tried to treat patients in pain throughout history, more recently, focused training and certification in pain medicine has resulted in the emergence of a new specialty designed to help people suffering from chronic pain. Pain-Wise also includes expert advice on: - Identifying what parts of your body are in pain, using a simple anatomy guide - How to choose a pain specialist that is right for you - Getting the most out of your doctor's visits - Basic explanations of common interventional pain management techniques - How to follow-up on treatment Written by three doctors with years of experience in pain management, Pain-Wise is a patient's guide to simplifying the confusing and often overwhelming process of finding treatment for chronic pain. It will teach you the basics of how pain works, explain different interventional pain therapies in layman's terms, and help you find a doctor that can manage, and potentially relieve, your chronic suffering.
This empowering book provides a comprehensive resource to help readers of all ages understand pain, seek the right diagnosis and treatment, and allow them to take control of their pain.
Unfortunately, pain is a universal human experience. For many, their experience of pain transcends an occasional or nagging discomfort and disrupts their lives. Understanding Pain: What You Need to Know to Take Control presents insights that will be useful to anyone who wants to be more knowledgeable about recognizing pain conditions through symptoms and telltale signs, and needs to be fully informed about the various treatment options available.
Providing information that is at once cutting-edge, comprehensive, and easy-to-understand, the chapters also provide the resources needed to obtain further information about the topic. The book covers all major pain syndromes in a manner accessible to those without backgrounds in science or pain treatment, explicitly explaining symptoms, tests that may be needed, and treatments and rehabilitation techniques that are possible. The last section of the text discusses pain issues of specific populations, such as children, the elderly, and women during childbirth.
In the tradition of William Styron’s tour de force Darkness Visible, The Body Broken is a gorgeously told and intensely moving account of one woman’s extraordinary odyssey into a life of chronic pain–and of the unyielding resilience of the human spirit.
At age nineteen, Lynne Greenberg narrowly survived a devastating car crash. When her broken neck healed–or so everyone thought–her recovery was hailed as a medical miracle and she returned to normal life. Years later, she seemed to have it all: a loving husband, two wonderful children, a peaceful home, and a richly satisfying job as a tenured poetry professor. Then, one morning, this blissful façade shattered–the pain in her neck returned in the most vicious way. A life with physical agony ensued.
Greenberg realized that she had been living for years on borrowed time. As she and her family navigated an increasingly complicated web of doctors and specialists, Greenberg taught herself to fight her own battles–against a medical system ill-equipped to handle patients with chronic pain, and against the emotional pitfalls of a newly restricted life. Drawing on her family’s support, her own indomitable spirit, and an intense connection to the poetry she taught, Greenberg found the strength to return to a productive and satisfying–if irrevocably changed–life. This deeply personal saga takes us to the heart of a family’s struggle to survive a crisis, and shows us how, at the most profound levels, such an odyssey affects a patient’s marriage, the ability to parent, family, work, and friendships.
The Body Broken is a powerful, lyrical story of one woman’s remarkable determination and breathtaking courage, as she puts mind over matter in the struggle to reclaim her life.