Sickle cell disease (SCD) is a condition very common in the United States of America and its most common presenting symptom is pain related to vaso-occlusive events (VOE). The cost associated with healthcare for the sickle cell population exceeds 1 billion $USD yearly, and the majority of this cost is associated with admission related to vaso-occlusive events. With the increase longevity of patients with SCD, due to new therapies and vaccination against common infection related to SCD, the prevalence of older individuals experiencing VOE will likely increase. The psychological impact inflicted on patients with SCD can further complicate adequate care of patients experiencing acute or chronic pain and the latter must be taken into consideration when planning an optimal treatment regimen. This chapter reviews the short- and long-term management options of pain related to VOE, their limitations as well proposed regimen that could pave the way for the future of pain management of SCD.
Part of the book: Pain Management in Special Circumstances
Chronic pain is a debilitating condition that affects millions of people world-wide, leading to physical incapacitation and financial strain. Common methods for treatment include physical therapy, oral medications, injections, surgery, and neuromodulation. Injectates with steroids and local anesthetics can be a temporizing measure with intolerable side effects. The use of autologous biologic injectates (e.g., platelet rich plasma, bone marrow aspirate concentrate, tissue grafts, and stem cells) is growing in therapeutic potential and enthusiasm, giving hope to a subset of patients that have either failed conventional therapy or are not candidates for traditional steroid injections. In this chapter, we will describe different cases in which regenerative medicine can help in painful conditions as well as neuro-degenerative conditions. Regenerative medicine can be the new frontier in providing long lasting relief through changes in cell-signaling cascades, however further trials are needed to validate their use.
Part of the book: Pain Management