Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Neck and back pain – radicular syndromes
from Chief complaints and diagnoses
Published online by Cambridge University Press: 18 December 2009
Edited by
Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Summary
The etiologic differences between radiating spine pain (RSP) and other causes of neck and back pain translate into differences in therapeutic approach. This chapter focuses on pharmacologic treatment modalities for RSP. Patients with refractory RSP often require opioid therapy, but available evidence does not support specific recommendations. Studies suggest no incremental benefit, compared with NSAIDs, for PO low-potency opioids (e.g. codeine) or agonist-antagonist agents (e.g. meptazinol, ethoheptazine). The authors believe that the main role for low-potency opioids in RSP is for use in patients who fail, or do not tolerate, other therapies such as NSAIDs. Corticosteroids have been used for the treatment of acute RSP since 1960s. The injection of corticosteroids into the epidural space is a commonly used approach. A single dose of methylprednisolone significantly reduces pain scores in RSP, but the effect is small in magnitude and limited in duration.
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- Emergency Department AnalgesiaAn Evidence-Based Guide, pp. 268 - 272Publisher: Cambridge University PressPrint publication year: 2008