Treatment of chronic mechanical spinal pain with intravenous pamidronate: a review of medical records.
We explored the effect of intravenous infusions of a bisphosphonate, pamidronate, in the management of chronic mechanical spinal pain, a worldwide public health problem in terms of lost workdays, medical treatment costs, and suffering. Bisphosphonates have an anti-nociceptive effect in animals. In humans, intravenous pamidronate relieves numerous painful conditions, including metastatic bone pain, ankylosing spondylitis, rheumatoid arthritis, and complex regional pain syndrome. We reviewed the charts of 25 patients who had experienced disabling spinal pain for several years, and whom we treated with intravenous pamidronate. None had a history of osteoporotic vertebral fractures or metastatic disease. Pain rating scores decreased in 91% of patients: on a 0-10 numeric rating scale, the mean pain change was -3.6 points and mean percentage change was -41% (P<0.0001). There was no increase in opioid or nonopioid analgesic medications associated with pain relief. The apparent analgesic effect of pamidronate for chronic mechanical spinal pain needs to be confirmed with placebo-controlled trials.
Pappagallo
Marco
M
Comprehensive Pain Treatment Center, Hospital for Joint Diseases, Orthopaedic Institute, and Department of Neurology, New York University School of Medicine, New York, New York 10003, USA.
Breuer
Brenda
B
Schneider
Aaron
A
Sperber
Kevin
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001416:Back Pain / Q000188:drug therapy* / Q000209:etiology; D002908:Chronic Disease; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy* / Q000209:etiology; D010024:Osteoporosis / Q000150:complications; D000077268:Pamidronate; D017060:Patient Satisfaction; D016103:Spinal Fractures / Q000150:complications
D000893:Anti-Inflammatory Agents; D004164:Diphosphonates; D000077268:Pamidronate