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Related Concept Videos

Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...

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Related Experiment Video

Updated: Jul 28, 2026

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Reflex sympathetic dystrophy: alternative modalities for pain management.

H Gellman1

  • 1UAMS Department of Orthopaedic Surgery, University of Arkansas, Little Rock, USA.

Instructional Course Lectures
|June 1, 2000
PubMed
Summary

This study outlines treatment protocols for patients with early and chronic pain symptoms, emphasizing a multimodal approach including medication, therapy, and stellate ganglion blocks for improved outcomes.

Area of Science:

  • Pain Management
  • Neurology
  • Rehabilitation Medicine

Background:

  • Early and chronic pain conditions require tailored treatment strategies.
  • Stellate ganglion blocks (SGBs) are increasingly explored for various pain conditions.
  • Multimodal therapy offers potential for improved patient outcomes.

Purpose of the Study:

  • To describe a comprehensive treatment algorithm for patients with early and chronic pain symptoms.
  • To evaluate the efficacy of a stepwise treatment approach incorporating pharmacotherapy, physical therapy, and SGBs.
  • To identify patient subgroups who may benefit from specific interventions like SGBs or surgical sympathectomy.

Main Methods:

  • Treatment initiation based on symptom duration (early vs. chronic).

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  • Pharmacological interventions: methylprednisolone, NSAIDs, amitriptyline, calcium channel blockers.
  • Interventional procedures: stellate ganglion blocks (SGBs), acupuncture.
  • Rehabilitative therapies: occupational and physical therapy.
  • Surgical sympathectomy considered for non-responders to SGBs.

    • Main Results:

    • Early symptoms (< 6 months) treated with methylprednisolone, analgesics, and therapy; SGBs and acupuncture added if no initial response.
    • Chronic pain patients initiated with methylprednisolone, NSAIDs, amitriptyline, and calcium channel blockers.
    • Stellate ganglion blocks (SGBs) often require multiple sessions (at least 2) for efficacy.
    • Optimal benefit from SGBs achieved when combined with immediate post-procedure occupational or physical therapy.
    • Surgical sympathectomy is reserved for patients who respond to SGBs.

    Conclusions:

    • A structured, multimodal treatment approach is effective for managing early and chronic pain.
    • Stellate ganglion blocks (SGBs) are a valuable tool, particularly when combined with physical and occupational therapy.
    • Individualized treatment plans, including pharmacotherapy and interventional procedures, are crucial for optimizing pain management and function.