neuropathic pain in a lower extremity immediately after spinal cordstimulator (SCS) lead insertion.Program Description: A retrospective chart review from May2005 to May 2010 was conducted and identified: 165 patientshaving undergone a total of 285 SCS procedures (trial, 160; implan-tation, 125). Four of these patients were noted to have experiencednew pain in their lower extremity immediately after lead insertions.Each of them underwent lumbar SCS lead insertion; 2 after trial, 1after implantation, and 1 after both trial and implantation. Theirsymptoms were pain localized to a small area of 1 lower extremity:3 at the dorsum of the first metatarsophalangeal joint, 1 at themedian knee, and 1 localized to the dorsal foot. A thorough clinicalexamination was notable for heightened sensitivity to light touchand pinprick (allodynia) at the painful area, but no sensory or motordeficits were noted. All 4 patients were treated with oral steroids for7 days (Medrol Dosepack taper) and followed closely until symptomresolution.Setting: Private practice outpatient clinic.Results: Within 5 to 10 days of oral steroid treatment, all thepatients experienced complete resolution of this pain symptomol-ogy without residual neurologic complications. None of the patientsrequired removal of their SCS leads secondary to this pain issue.Discussion: Transient neuropathic pain after SCS lead insertion isan uncommon complication. Based on data collected, the incidenceis 1.40% (4/285). The clinical presentation is focal pain and allo-dynia without other neurologic deficits. The etiology of these symp-toms is unclear, however, irritation to a single or small group ofnerve fibers caused by the spinal needle or SCS lead insertion mayprovide an explanation.Conclusions: Spinal cord stimulation therapy has been adoptedas a standard modality for neuropathic pain. Although the develop-ment of new neuropathic pain symptoms is an uncommon compli-cation of this procedure, it can be transient if well managed with oralsteroids, patient reassurance, and close follow-up.

Poster 319Retrospective Prevalence of Myofascial Tender andTrigger Points in Patients Presenting WithCervicothoracic and Lumbosacral Spine–relatedPain.Akshay Garg (The George Washington UniversitySchool of Medicine and Health Sciences, Washington,DC, United States); Mehul Desai, Puneet Sayal.

Disclosures: A. Garg, none.Objective: To retrospectively report the prevalence of tenderpoints and trigger points at The George Washington UniversitySpine and Pain Center in patients presenting with cervicothoracicand lumbosacral spine pain, differentiating each based on referralpatterns. To organize the data according to specific diagnoses andcorrelate the specific innervations of the associated tender point andtrigger point muscles.Design: Retrospective.Setting: Tertiary spine and pain center.Participants: 11 subjects with cervicothoracic spine–relatedpain, and 13 subjects with lumbosacral spine–related pain.Interventions: We tested for the presence or absence of cervicaland/or lumbar tender and/or trigger points and the minimum painpressure threshold reading of those points by using a digital algom-eter.

Main Outcome Measures: The presence or absence of tenderand trigger points, minimum pain pressure threshold.Results: Of patients with cervical spine–related pain, 82% werefound to have tender and/or trigger points in specific muscles.Patients with lesions in C3-C4 presented more commonly with bothtender and trigger points located in the middle trapezius; C5-C6lesions with tender points in biceps brachii, brachioradialis, pecto-ralis major; C5-C6 lesions with trigger points in pectoralis major;and C6-C7 lesions with tender points in latissimus dorsi and tricepsbrachii. Of patients with lumbar spine–related pain, 62% werefound to have tender and/or trigger points in specific muscles.Patients with lesions in L2-L3 and L3-L4 presented more commonlywith both tender and trigger points located in adductor longus; andL5-S1 lesions with both tender and trigger points in tibialis anterior,soleus, and biceps femoris. The majority of diagnoses made in thesepatients with cervical and lumbar spine pain included spondylosis,disk bulging, and spinal stenosis. No adverse effects were notedfrom pressure algometer usage.Conclusions: Tender and trigger points appear more likely tooccur in specific muscles in the presence of spinal pathology.

Poster 320Efficacy of an Interdisciplinary Pain ManagementProgram: Patient Perception.James Huang, MD (Northwestern, Chicago, IL, UnitedStates); Sara D. Barrett, PhD, Christine M. Gagnon, PhD,Steven P. Stanos, DO.

Disclosures: J. Huang, none.Objective: To assess patients’ perception of change beyond tra-ditional functional restoration program goals of improved functionand decreased pain by using a new questionnaire that consisted ofadditional patient-centered outcomes.Design: Retrospective chart review.Setting: Academic pain center.Participants: Sixty-six consecutive chronic pain patients partici-pating in a pain management program.Interventions: Patients with intractable chronic pain were as-sessed by a physician, psychologist, and a vocational counselor (ifworker’s compensation related). The patients participated in eitheran intensive (5 days per week, for up to 4 weeks) or a modified (1-2half days per week for up to 5 weeks) outpatient program, depend-ing upon identified needs during the initial assessment. Treatmentprograms included individual and group appointments with painpsychology, physical, and occupational therapy, biofeedbackand/or relaxation training, and medical management. The patientsalso participated in group nursing lectures, vocational lectures, andmovement-based classes, including Feldenkrais.Main Outcome Measures: Adaptation to the Patient’s GlobalImpression of Change. Domains assessed included the following:overall status, overall pain, overall sleep, overall mood, overallphysical functioning, overall ability to cope with pain, overall abilityto manage pain flare-ups, and the overall efficacy of medication.Each domain could be rated from 1 (very much improved) to 7 (verymuch worse).Results: Mean ratings showed that patients considered the pro-gram effective. Domains perceived to be most improved were “over-all status” and “overall ability to cope with pain” (M�1.91,SD�0.89; M�1.95, SD�0.94, respectively). Domains perceived as

S283PM&R Vol. 3, Iss. 10S1, 2011