Health Professionals Musings April 2014


Neuropathic Pain in the General Population: A Systematic Review of Epidemiological Studies, Van Hecke et al, Pain, 2014, Vol 155, pp 654 - 62

This paper from Dundee in the United Kingdom looked at 21 studies in the literature that established prevalence rates for neuropathic pain in the general population and did not derive it from Specialist or Pain Clinics. The prevalence was examined by eight studies and ranged from 1-18%. The authors’ best estimate was that neuropathic pain in general practice represented somewhere between 7-10% of patients.

Comment: This figure would seem reasonable to me, thus the prevalence of approximately five times less than what is typically found in Pain Clinics (40-50% prevalence).

Effects of Testosterone Treatment on Bone Mineral Density in Hypogonadal Men Receiving Intrathecal Opioids, Finch et al, Pain Practice 2014 1st April

This paper from the Australian Pain Specialist, Dr Phillip Finch, looked at 27 patients with intrathecal opioid therapy for chronic pain. 11 received Testosterone supplementation and 16 did not. Testosterone supplementation increased Testosterone levels. 87% of those not treated with Testosterone had low Testosterone levels and 69% had osteoporosis on bone mineral densitometry.

Comment: This confirms that implementing recommended practice actually leads to correction of Testosterone and correction of osteoporosis in patients with intrathecal opioid therapy. This should be regarded as a mandatory part of clinical practice.

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