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Neck and back pain – spinal spondylitic syndromes

from Chief complaints and diagnoses

Published online by Cambridge University Press:  18 December 2009

Stephen H. Thomas
Affiliation:
Harvard Medical School
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Summary

This chapter groups neck and back pain from spinal stenosis, as well as intervertebral disk disease, or arthritis, into the category of spinal spondylitic syndromes (SSS). NSAIDs are frequently used to treat pain from these disorders despite the scant evidence support for their use in SSS. Few data address efficacy of opioids for SSS. A trial in patients with spinal osteoarthritis showed significant pain reduction compared with placebo from either regular formulation oxycodone plus acetaminophen, or sustained-release oxycodone. There is preliminary evidence supporting some role for gabapentin in cervical SSS pain. Endorsement of gabapentin use for SSS pain is based primarily upon its presumed benefit in related pain syndromes such as diabetic neuropathy. The omega-3 fatty acids eicosapentaenoic acid and decosahexaenoic acid, which have known anti-inflammatory properties, are used for SSS pain of discogenic nature.
Type
Chapter
Information
Emergency Department Analgesia
An Evidence-Based Guide
, pp. 273 - 276
Publisher: Cambridge University Press
Print publication year: 2008

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