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Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
With careful attention to screening for safety of the integumentary system, physical agents may be beneficial for certain musculoskeletal and neuromuscular sources of pain for appropriate individuals with advanced diseases. Cancer survivors as a specific patient population have historically had limited and/or cautious access to modalities due to concerns for the potential spread of disease secondary to the ability of certain modalities to increase circulation. Wilson et al.49 performed an updated literature review which examined sources published between 2001 and 2016 on safety, efficacy, and use of physical agents for cancer survivors based on the original 2001 review (sources 1972–2001) completed by Pfalzer.50 With the exception of fairly recently introduced modalities such as low-level laser and scrambler therapy, Wilson et al.49 found no new evidence for thermal, mechanical, electromagnetic, or electrotherapeutic agents. This review is, however, a very valuable source for precautions and considerations for modality use specific to cancer survivors.
Successful treatment of acute worsening complex regional pain syndrome in affected dominant right-hand from secondary pathology of new onset third and fourth digit trigger finger
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Multimodal treatments included occupational therapy for improved range of motion, hand and finger bracing, desensitization techniques; two sessions of scrambler therapy about 1 year apart; and neuropathic and opioid pain medications. Over the subsequent years, patient’s symptoms improved to a tolerable level of right-hand pain and improved finger range of motion. However, he suffered from continued allodynia and discoloration of the right wrist and palm, sudden shooting pains in the hand, and frequent dropping objects from the hand. He continued to take nortriptyline 60 mg daily, oxycodone/acetaminophen 5/325 mg twice a day as needed, and duloxetine 60 mg daily. Sympathetic block or spinal cord stimulation interventions were not pursued due to life-long anticoagulation and previous extensive cervical to lumbar spine fusion surgeries.