Pain In Area Research Articles

Evaluating Treatment Preferences and the Efficacy of Capsaicin 179 mg Patch vs. Pregabalin in a Randomized Trial for Postsurgical Neuropathic Pain in Breast Cancer: CAPTRANE.

Background/Objectives: CAPTRANE evaluated the efficacy and tolerability of high-concentration capsaicin patch (HCCP) vs. oral pregabalin for the treatment of postsurgical neuropathic pain (PSNP) following breast cancer surgery. The study was designed with the aim of demonstrating noninferiority of one HCCP against daily pregabalin. Methods: This was a multicenter, randomized, parallel-arm, open-label study conducted across nine centers in France. The primary endpoint was a change from baseline in the Numeric Pain Rating Scale (NPRS) score after 2 months. Results: Recruitment challenges resulted in the randomization of 140 patients (versus 644 planned); the per-protocol population comprised 107 patients (HCCP: n = 65; pregabalin: n = 42). Baseline characteristics were similar between the two groups. In the per-protocol analysis, the mean (standard deviation) change versus baseline in NPRS score was -1.926 (2.554) with HCCP and -1.634 (2.498) with pregabalin. The prespecified analysis showed that HCCP was not inferior to pregabalin: the lower bound of the 90% confidence interval for the between-arm difference was -0.889 and the upper bound was +0.260 (i.e., below the predefined clinical threshold of +0.4). Patient-reported outcomes showed no statistically significant differences between treatments. The painful area size decreased significantly more with HCCP. Tolerability profiles differed, with HCCP mostly causing application-site reactions. While >50% of patients switched from pregabalin to HCCP, none switched from HCCP to pregabalin. Conclusions: This comparative study in PSNP post breast cancer surgery, evaluating a single treatment of HCCP, shows a noninferior reduction in pain intensity, a superior reduction in painful area size, and a patient preference for HCCP compared with pregabalin. Despite limitations, it contributes valuable initial data for PSNP management in breast cancer care.

Effectiveness of non-invasive ultrasound-guided electrical stimulation of genicular nerves for chronic knee pain: A case report.

Chronic knee pain is a common health issue that requires effective and noninvasive treatment. We devised a novel noninvasive approach using ultrasound-guided electrical nerve reactivation (ENR) in which ultrasound is used to identify the genicular nerve (GN). Then, transcutaneous low-frequency stimulation is applied for 10 seconds. The aim of this study was to clarify the pain-relieving effects of ENR on the GN innervating the knee joint. Patients had visited our hospital with the complaint of knee joint pain. This study included 21 osteoarthritic knees from 16 patients with a mean age of 78.3 ± 8.5 years. Baseline measurements included the range of motion of the knee joint, Visual Analogue Scale (VAS) scores for pain, and maximum knee flexion angle during squatting. A therapist conducted an interview to locate the painful area of the knee and then performed ultrasound-guided ENR by targeting the GN. The preintervention VAS score was 49.3 (95% confidence interval: 41.0, 57.5). Postintervention VAS scores showed significant reductions: 27.0 (19.0, 35.1) immediately after the intervention (P < .0001), 27.7 (22.6, 32.8) at 1-day postintervention (P = .002), and 29.0 (22.9, 35.1) at 1-week postintervention (P = .001). The knee flexion angle during squatting significantly improved from 108.1° (101.6, 114.5) preintervention to 121.9° (115.1, 128.7) postintervention (P < .001). There was a significant increase in flexion angle preintervention and postintervention (P = .02); however, no significant change was observed in the extension angle. In addition, no adverse events were reported. This study is the first to demonstrate the effects of ultrasound-guided low-frequency stimulation of the GN for knee osteoarthritis. Although the exact mechanism of pain relief is unclear, we hypothesize that alterations in neurotransmission, with or without endorphin release, may play a role. Moreover, ENR may improve nerve entrapment by causing contraction of surrounding muscles.This study demonstrated that ultrasound-guided ENR targets the GN and effectively reduces pain without complications. This treatment addresses the limitations of invasive methods, such as hydrorelease and radiofrequency ablation. Furthermore, ultrasound-guided ENR has diverse applications in diagnostics, physical therapy, and pre-exercise pain management and will greatly benefit patients and healthcare professionals.

Spatial Distribution Dynamics of Sensory Disturbances in the Treatment of Obesity-Related Meralgia Paresthetica Using Transcutaneous Electrical Nerve Stimulation.

Background: To date, there have been no studies on the dynamics of areas of pain, paraesthesia and hypoesthesia after the use of various transcutaneous electrical nerve stimulation in the treatment of meralgia paresthetica. Methods: In this pilot study, we observed 68 patients with obesity-related bilateral meralgia paresthetica. Pain syndrome, paraesthesia symptoms, and hypoesthesia were evaluated using 10-point scores. In addition, pain drawing (PD) was used to determine the area of the spatial distribution of pain syndrome and paraesthesia symptoms, and body drawing was used to determine the area of hypoesthesia. Sham TENS was performed in the control group, and effective TENS was performed in the treatment group. The treatment group consisted of two subgroups. One subgroup underwent HF-LA TENS, and the second subgroup underwent LF-HA TENS. Results: Despite the greatest analgesic effect observed from HF-LA TENS, which was assessed using scoring methods, during and after treatment, the reduction in the area of pain and paraesthesia symptoms and the area of hypoesthesia was moderate, short-term, and reversible. In contrast, LF-HA TENS had a pronounced analgesic and sustained anti-paraesthesia effect, manifested by a noticeable decrease in pain and paraesthesia symptoms area in PD, gradually increasing during the first 2 months of follow-up and accompanied by an irreversible prolonged decrease in the area of hypoesthesia. Conclusion: The areas of paraesthesia and hypoesthesia correlate with affective reactions to long-term chronic pain, which noticeably regress under the influence of LF-HA TENS compared to HF-LA TENS.

Changes in spatial bodily pain distribution one year after benign hysterectomy with emphasis on prevalence and risk factors for de novo and persistent pelvic pain- a prospective longitudinal multicenter study

BackgroundThe objectives were to determine the prevalence of de novo and persistent pelvic pain after benign hysterectomy and to assess risk factors.MethodsA Swedish prospective multicenter study of 440 women undergoing benign hysterectomy was conducted between October 2011 and March 2017. Measures of pain, the spatial extent of bodily pain, and pain sensitivity were assessed using a self-reporting questionnaire, Margolis’s patient pain drawing, and quantitative sensory testing of pain thresholds for pressure, heat, and cold, respectively. Quality of life was evaluated by EQ-5D-3L and SF-36. Psychological distress was assessed by the Hospital Anxiety and Depression Scaleand the Stress-Coping Inventory. Logistic regression models were used to assess risk factors, and the outcome was presented as an adjusted odds ratio (aOR) and 95% confidence interval (CI).ResultsPreoperatively, 18.0% of the women reported no bodily pain, 41.5% had pelvic pain, either as the only location (7.0%) or along with pain in other locations (34.5%), and 40.5% had non-pelvic pain only. Postoperatively, 6.2% developed de novo pelvic pain and 16.4% had persistent pelvic pain. De novo pelvic pain developed exclusively in women who preoperatively had non-pelvic pain only. Risk factors for de novo pelvic pain were a long hospital stay (aOR 1.50 (95%CI) 1.02–2.21)), high preoperative pain intensity (aOR 1.25 (95%CI 1.01–1.62)) and a high number of pain areas (aOR 1.15 (95%CI 1.05–1.27)), along with anxiety (aOR 10.61 (95%CI 1.84–61.03)) and low EQ-5D-3L health index (aOR 0.02 (95%CI 0.00–0.31)). Risk factors for persistent pelvic pain were lower age (aOR 0.89 (95%CI 0.81–0.97)), higher number of pain areas (aOR 1.08 (95%CI 1.02–1.14)), and a higher frequency of preoperative pain (aOR 12.75 (95%CI 2.24–72.66)).ConclusionAlthough hysterectomy appeared to be reasonably effective in curing pelvic pain, a non-negligible proportion of women developed de novo pelvic pain or had persistent pelvic pain. De novo pelvic pain seemed to affect only those who preoperatively had widespread bodily pain. Women at risk for de novo and persistent pelvic pain after hysterectomy could be identified preoperatively.Trial registrationsThe study was retrospectively registered in ClinicalTrial.gov (NCT01526668) on 01/27//2012.

Ultrasonographic characteristics of the shoulder in patients with shoulder pain: A retrospective study comparing younger and older age groups

Background Shoulder pain can be caused by structures within the shoulder joint or external structure to shoulder and the prevalence of shoulder pain is high. Objective The purpose was to investigate the ultrasonographic characteristics of patients with shoulder pain and to study the association between age groups (less than 60 years vs. 60 years and above) and commonly found abnormal ultrasonographic findings. Methods A retrospective study was conducted on 253 patients experiencing shoulder pain over a month. Data included gender, age, side of pain, pain duration, painful area, previous treatments, clinical assessment of shoulder pain. The abnormal findings in shoulder ultrasound images were reported, and the association between age group with common ultrasound abnormalities were analyzed using the chi-square test. Results Common abnormal ultrasound findings included subdeltoid bursitis (82.7%), biceps tendon effusion (48.7%), and supraspinatus tendinosis (44.2%). Moreover, patients aged 60 years and above had a significantly higher prevalence of biceps tendon effusion (53.6% vs 36.0%), supraspinatus tendon tear (19.3% vs 8.6%) and subscapularis tendon tear (6.1% vs 1.4%) compared to those aged less than 60 years. Conclusion The common abnormal ultrasound findings in patients with shoulder pain were subdeltoid bursitis, biceps tendon effusion and supraspinatus tendinosis. Patients aged 60 years and above had a significantly higher prevalence of biceps tendon effusion and tears in the supraspinatus and subscapularis tendons.

Utilization of Polygala paniculata L. Plants as Traditional Medicine by the Community of Borani Langa Village, Ngada Regency

Medical plants are types of plants that have medical benefits for humans and are commonly found in the surrounding environment and in forests. The plant Polygala paniculata L., also known as the fragrant root plant, is widely found in the Ngada Regency area. Polygala paniculata L. typically grows in yards, gardens, and along roadsides. Considering the strong relationship of the community with cultural traditions and the basic need of the community to use medicinal plants to cure various diseases, the utilization of medicinal plants in the community will continue to increase. This research aims to determine the benefits of the Polygala paniculata L. plant as a traditional medicinal plant in the yards and gardens of the Borani Langa Village community in Ngada Regency, as not many people or the community are aware of the benefits or efficacy of this plant. The method used is a qualitative descriptive method. The research was conducted through observation in Borani Langa Village, Ngada Regency. The results of the study indicate that the people of Borani Langa Village, Ngada Regency, are aware of the medicinal properties of the Polygala paniculata L. plant as traditional medicine. The part of the Polygala paniculata L. plant that is effective in curing certain types of diseases is the root. The Polygala paniculata L. plant is processed by boiling it with coconut oil until it reaches a boil, then cooling it down and storing it in a clean bottle. The way to utilize the Polygala paniculata L. plant is by massaging the painful area and applying it to the nose. As a traditional medicine, Polygala paniculata L. can cure diseases such as flu, pain, and muscle aches.

Comparison of Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation, and Association of Both in Patients With Refractory Chronic Back and/or Lower Limb Neuropathic Pain: A Prospective, Randomized, Double-Blind, Cross-Over Trial (BOOST-DRG Study)

ObjectivesSpinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRGS) have individually shown efficacy in relieving pain in patients with persistent spinal pain syndrome after spinal surgery (PSPS-T2). Combining SCS and DRGS simultaneously, along with Burst stimulation programming, may enhance the responder rate of patients with PSPS-T2. Material and MethodsThis study aimed to compare the pain relief (≥50%) responder rates in SCS, DRGS, and SCS+DGRS (DUAL) through a three-month randomized cross-over trial in patients with PSPS-T2. After the cross-over period, stimulation programming was switched to Burst. Secondary objectives included evaluating the clinical efficacy at three-, four-, six-, and 12-month follow-ups, assessing pain intensity, area of pain, area of paresthesia coverage, quality of life, functional disability, psychologic distress, medication intake, and the Multidimensional Clinical Response Index (MCRI). ResultsThe responder rate of pain relief was similar in SCS, DRGS, and DUAL (60%, p = 0.84) at the end of the cross-over period, increasing to 80% with the ability to switch between stimulation possibilities. Burst programming did not provide additional pain relief at the four-month follow-up (p = 0.99). Clinical outcomes significantly improved until 12-month follow-up compared with baseline. Considering a clinically significant increase of 1.05 of the MCRI, all patients were responders at three-, four-, and six- month follow-up, and 80% were responders at 12 months compared with baseline. ConclusionsThe full option to stimulate different neural structures, separately or simultaneously, led to improved responder rates, allowing patients to personalize treatment. A multidimensional assessment is essential to reveal the full potential benefits of neuromodulation in patients with chronic pain.

Comparison of 2 Types of Local Anesthetic Techniques in the Reduction of Distal Radius Fracture: A Prospective Cohort Study.

The treatment of distal radius fractures may require manipulation of the fracture assisted by finger traction, causing pain both at the fracture site and at the fingers. The usual type of anesthesia used does not anesthetize the fingers. We conducted a prospective cohort study with two groups, hematoma block (HB) and hematoma with associated median nerve block (MHB). Characteristic variables of the patients were collected. The main variable for the analysis was pain, measured using the Visual Analogical Scale (VAS). It was measured prior to the injection (VAS1), during fracture reduction (VAS2), and 30 minutes after the injection (VAS3) in both groups. The study included a total of 140 fractures (70 anesthetized with HB), 78% were women. There were no significant differences in the variables age, sex, Elixhauser index. and need for surgery between the groups. In the HB group, the VAS means were VAS1 5.23 cm (SD 2.31), VAS2 5.80 cm (SD 2.52), and VAS3 1.89 cm (SD 1.94); while in the MHB group, VAS1 5.13 cm (SD 2.36), VAS2 3.15 cm (SD 1.70), and VAS3 1.09 cm (SD 1.38). Area of greatest pain during fracture reduction in the HB group was finger traction in 78% cases (p < .05), while in the MHB group it was the manipulation of the fracture site in 71% cases (p < .05). The study demonstrates that the use of hematoma with associated median nerve block decreases pain perception in patients with distal radius fracture that needs closed reduction, when compared to HB alone.

The associations between adverse childhood experiences and body pain among middle-aged and older adults: findings from China

BackgroundAdverse Childhood Experiences (ACEs) have been implicated in the development of body pain, yet research on their impact on body pain and its progression remains scarce. This study aimed to examine the associations between ACEs and the presence and areas of body pain, as well as their developmental trajectories among middle-aged and older Chinese adults.MethodsWe included participants aged 45 years and above from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2018. Retrospective data on ACEs and pain sites were collected with questionnaires. The presence of pain at different body sites was categorized into three areas: head & neck, trunk, and limbs. ACEs consisted of ten types of adverse experiences and were cumulatively scored. For the cross-sectional analysis (2011), logistic regressions were performed to estimate the associations between ACEs and pain presence in specific areas. In the longitudinal analysis (2011–2018), we further applied group-based trajectory modelling (GBTM) to determine the developmental trajectories of body pain. Multinomial logistic regressions were then conducted to estimate the associations between ACEs and pain trajectories.ResultsIn the cross-sectional analysis (n = 8157), ACEs were positively associated with the presence of pain in the head & neck (odds ratio [OR] = 3.55, 95% confidence intervals [CI] = 2.37–4.74), trunk (OR = 3.28, 95% CI = 2.47–4.34), and limbs areas (OR = 2.30, 95% CI = 1.77-3.00) compared to no ACEs. These associations varied by sex and residence. In the longitudinal analysis (n = 5188), GBTM identified three developmental trajectories of body pain (n = 9521): high-increasing (7.44%), low-moderate (33.67%) and maintained-low trajectories (58.89%) trajectories. Compared to participants without ACEs, individuals had three ACEs and 4 or more ACEs were consistently associated with low-moderate (three ACEs: OR = 2.26, 95% CI = 1.81–2.83, four or more ACEs: OR = 3.11, 95% CI = 2.51–3.87) and high-increasing (three ACEs: OR = 3.28, 95% CI = 2.03–5.30, four or more ACEs: OR = 6.78, 95% CI = 4.30-10.68) body pain trajectories across sexes and residence.ConclusionThis study highlighted the significant association between ACEs and body pain among middle-aged and older Chinese, emphasizing the importance of preventing or mitigating ACEs as a strategy for the prevention and management of body pain.

Effect of Lingual Nerve Block and Localised Somatosensory Abnormalities in Patients With Burning Mouth Syndrome-A Randomised Crossover Double-Blind Trial.

To investigate the effect of a lingual nerve block on spontaneous pain in patients with burning mouth syndrome (BMS) and to estimate associated somatosensory abnormalities by quantitative sensory testing (QST). A standardised QST battery including cold detection threshold (CDT), warmth detection threshold (WDT), thermal sensory limen (TSL), paradoxical heat sensation (PHS), cold pain threshold (CPT), heat pain threshold (HPT), mechanical pain threshold (MPT), wind-up ratio (WUR) and pressure pain threshold (PPT) was performed at the oral mucosa of the most painful site and intraoral control site in 20 BMS patients, and at the tongue and cheek mucosa in 22 age- and gender-matched healthy controls. The effect of a lingual nerve block on spontaneous burning pain reported by the BMS patients on a 0-10 cm visual analogue scale (VAS) was investigated in a randomised double-blind crossover design using (1 mL) lidocaine (lido) or saline (sal) with an interval of 1 week. The BMS patients were grouped into 'central' and 'peripheral' mechanisms based on the effect of the lingual nerve injections. For each BMS patient, Z-scores and Loss/Gain scores were computed. Differences among groups and sites were analysed using a two-way ANOVA. Differences within group were assessed by paired t-test. The 20 BMS patients were characterised on the basis of VAS changes (ΔLido-ΔSal) as a peripheral BMS subgroup (n = 9) with pain relief more than 1 cm on the VAS and a central BMS subgroup (n = 11) with pain relief less than 1 cm. BMS patients (n = 20) had lower sensitivity to thermal stimuli (i.e., CDT, WDT, TSL, CPT, HPT and PPT) and higher sensitivity to mechanical stimuli (i.e., PPT) compared with controls (p ≤ 0.007). Based on Loss/Gain coding, L1G0 (loss of thermal somatosensory function with no somatosensory gain, 55.0%) was the most frequent coding in the BMS group, which was higher than 11.4% in the control group (p < 0.001). Surprisingly, there was no significant difference between the peripheral and central BMS subgroups with regard to the Z-scores of any of the nine QST parameters (p > 0.097). The results of the lingual nerve blocks demonstrated two distinct phenotypes with either peripheral or central mechanisms but no direct impact on somatosensory function. Overall, somatosensory function in BMS patients seems abnormal in the painful areas compared to matched controls with a conspicuous loss of thermosensory function.

ВИЗНАЧЕННЯ СИЛОВОГО НАВАНТАЖЕННЯ НА ВЕРХНЮ ЧАСТИНУ ОРТОПЕДИЧНОГО ТА ПІСЛЯОПЕРАЦІЙНОГО ВЗУТТЯ

The results of determining the force load on the upper part of orthopedic and postoperative shoes, taking into account the bending of the sole, are presented. To determine the force of the load on the top of the postoperative orthopedic shoes, the friction forces between the side surfaces of the shoes and the outer sides of the foot were neglected in the work. Thus, the task was reduced to the compilation of equilibrium equations of a plane system of forces. To determine the unknown forces, it was necessary to compile a system of two equilibrium equations, which will represent the algebraic sums of the projections of all forces on the horizontal and vertical axes, which will be equal to zero. The most common type of deformation acting on shoe parts during manufacturing and operation is stretching and bending. It is the last factor that affects the force load on the upper part of orthopedic and postoperative shoes. Deviation of the human musculoskeletal system from the normal anatomical structure and functioning is one of the serious and widespread ailments of the population. An important factor in reducing the inconvenience caused by this disease is the rational choice of orthopedic shoes. Compliance of orthopedic footwear with the functions that rely on it (supporting the arch of the foot, relieving painful areas, making the limb supportive, increasing the area of ​​foot support) is achieved by a reasoned approach to choosing the design of the product, including in the structure of special, special shape and size details, etc.. Degree compliance of this type of footwear with the real needs of the consumer depends on a complex of factors, and the ability to satisfy them is largely determined by the optimal ratio of indicators of reliability and comfort in the use of upper materials. Textile materials are widely used in the footwear industry for uppers, insoles, insoles, linings, and other parts of various types of footwear. This is caused by their valuable consumer properties, such as low hardness and surface density, pleasant texture, high heat-insulating properties, and a variety of artistic and colorful decoration.

Effects of Toe-Strengthening Exercises on Medial Longitudinal Arch Height, Muscle Stiffness, and Functional Movement

Background: Prolonged training in combat boots can place significant stress on the medial longitudinal arch, potentially leading to lower-extremity muscle stiffness and an increased risk of injury. This study assessed the impact of toe-strengthening exercises on improving the lower-extremity function and functional movement in cadets undergoing training. Methods: Forty junior cadets (mean age: 22.6 years) participated in this study. The measurements included the medial longitudinal arch height, lower-extremity muscle stiffness, functional movement, and leg length. Results: Cadets who performed the toe exercises demonstrated improved lower-extremity muscle stiffness and functional movement performance (hurdle step, p = 0.010; rotary stability, p = 0.001). A significant correlation was observed between the exercise group and time (tibialis right, p = 0.008; tibialis left, p = 0.028). Conclusions: This study highlighted the potential of toe-strengthening exercises to enhance the lower-extremity function and reduce the risk of injury among cadets. However, challenges in identifying the medical history, past injuries, and specific areas of pain for each cadet were noted. These findings support the implementation of targeted toe exercises in military training programs to prevent injuries.

Unlocking the Potential of the Superficial Cervical Plexus Block in Chronic Pain Management: A Narrative Review and Single-Center, Retrospective Case Series.

Background/Objectives: The anesthetic block of the sensory branches of the superficial cervical plexus renders a specific area of the face, head, and anterior neck insensible and painless. Chronic pain in these areas can be difficult to diagnose and treat. In this report, we briefly review the existing evidence on the topic of the superficial cervical plexus block (SCPB) to set the context for our research. We then share our own clinical experience with the SCPB for managing chronic pain syndromes from both cancerous and non-cancerous etiologies. Methods: We first performed a comprehensive literature search and narrative review of clinical cases and studies that utilized the SCPB as an analgesic technique. We then conducted a retrospective case series of all patients who had received an SCPB at our pain clinic since 2020. Results: Our literature review found only a few cases reported, with most of them focusing on acute painful emergencies and perioperative pain syndromes and only very few addressing chronic pain. In our pain clinic, 14 patients received one or more SCPBs for chronic pain management. In 43% of these cases, the pain was related to cancer. The most common areas of pain corresponded to the regions supplied by the transverse cervical and great auricular nerves. The procedures were uneventful in all cases, and patients rated them as effective and worthwhile 71% of the time. Conclusions: Despite the lack of high-quality studies on SCPBs in pain management, the authors' experience suggests that it is a valid minimally invasive alternative for managing chronic face, head, and neck pain.

Prevalence of Work-Related Musculoskeletal Disorders among Hairdressers and Beauticians in Peshawar: A Descriptive Cross-Sectional Study

Background: This study examined the prevalence of Work-Related Musculoskeletal Disorders (WRMSDs) among hairdressers and beauticians in Peshawar, specifically targeting the areas of Hayatabad, University Town, and Peshawar Saddar. Objective: The objective of this study is to determine the prevalence of work-related musculoskeletal disorders (WRMSDs) among hairdressers and beauticians in Peshawar, focusing on associated risk factors and impacts on occupational health. Methods: A descriptive cross-sectional design was employed, surveying a total of 340 participants, including 179 males and 161 females. Results: The findings revealed a high prevalence of WRMSDs, with 73.8% of respondents reporting various musculoskeletal conditions. The most reported areas of pain were the ankles (62.1%), followed by the lower back (56.5%), hands/wrists (35.0%), and shoulders (34.4%). Other frequently affected areas included the neck, upper back, hips/thighs, knees, and elbows. Musculoskeletal symptoms had varying impacts on work performance, with 8.5% of respondents reporting no impact, 40.0% reporting a slight impact, 31.8% reporting a moderate impact, 13.2% reporting a high impact, and 6.5% reporting a severe impact. Conclusion: The study found a significant association between repetitive tasks involving awkward postures and work-related stress contributing to musculoskeletal symptoms. Among the 340 participants, 283 reported both work-related stress and repetitive awkward postures as contributors to musculoskeletal symptoms, while only 7 participants reported neither. These findings suggest that repetitive tasks involving awkward postures are significantly associated with stress-related musculoskeletal symptoms among hairdressers and beauticians.

Effect of Treatment of Neuropathic and Ischemic Diabetic Foot Ulcers with the Use of Local Ozone Therapy Procedures-An Observational Single Center Study.

Background: Diabetes ranks high among worldwide global health problems, and diabetic foot ulcer syndrome (DFU) is considered as one of its most serious complications. The purpose of this study was to evaluate the impact of local ozone therapy procedures on the wound healing process in patients with two DFU types: neuropathic and ischemic. Material and Methods: In the retrospective study reported here, the treatment outcomes of 90 patients were analyzed: 44 males (48.8%) and 46 females (51.2%), in the age range between 38 and 87 years of age, with neuropathic (group 1) and ischemic (group 2) diabetic foot ulcers treated by means of local ozone therapy. The assessment of therapeutic effects in both groups of patients included an analysis of the rate of ulcer healing using planimetry and an analysis of the intensity of pain associated with ulcers performed using the VAS scale. Results: After the application of ozone therapy procedures, a statistically significant decrease in the surface area of the ulcers was obtained in both groups of patients, respectively: in group 1 from 7 (6-7.5) cm2 to 3 (2-3.5) cm2 and in group 2 from 7.5 (6.5-8) cm2 to 5 (4.5-5.5) cm2 (p < 0.001), with a complete healing of ulcers not observed in any patients from groups 1 and 2. After treatment, the surface area of the assessed ulcers was smaller in the neuropathic group. The intensity of pain experienced after treatment also decreased with statistical significance in both groups (p < 0.001). Conclusions: Short-term local ozone therapy was effective in promoting wound healing and alleviating pain in patients with DFUs of both neuropathic and ischemic etiology. The effectiveness of therapy in the neuropathic type of DFUs was significantly higher than in the ischemic type, in which patients had a higher incidence of risk factors and more advanced lesions, characterized by a larger initial ulcer area and greater intensity of pain.

Ergonomic awareness and practices to prevent musculoskeletal disorder among healthcare workers in UAE: A cross-sectional study

BackgroundHealth professionals are at a higher risk of developing WMSD due to the nature of their work. Ergonomic awareness and practice promote workers' general well-being and safety in the workplace. AimAssess the ergonomic awareness and practice among healthcare workers in the UAE, its relationship with demographic variables and determine the prevalence of musculoskeletal disorders (MSDs) in this population. MethodThis was a cross-sectional study among 307 healthcare workers from hospitals in Dubai, Ajman, and Sharjah in the UAE. A self-administered online questionnaire was used for data collection. Chi-square tests were used to assess associations between variables. ResultsIn the present study, the majority were female (77.4%). Concerning the nationalities, non-EMR (71.4%) and EMR (28.6%). The majority fell within the age group of 30–39 (39%). Regarding work experience, 58% had over ten years of experience. Results showed that 89.3% had good ergonomic awareness, while 63.5% demonstrated good ergonomic practices. Musculoskeletal Disorders (MSDs) were reported by 89.6% of participants, with the most common areas of pain being the lower back, neck, and shoulders. Education level was significantly associated with ergonomic awareness (p < 0.05). Age (P < 0.05) and years of experience (P < 0.01) were significantly associated with ergonomic practice. A significant association was observed between MSD and ergonomic awareness (P < 0.01), with good awareness associated with reported pain. ConclusionA significant occurrence of musculoskeletal disorders (MSDs), particularly in the neck, low back, and shoulders. The association was observed with education and ergonomic awareness, age and years of experience with practice and MSD and awareness.

Effectiveness of the scapula mobilization technique on the neural mechanosensitivity of the upper limb neural test 1 in individuals with mechanical cervicalgia. A randomized controlled trial

Objectiveto observe whether the mobilization of the scapula improves the mechanosensitivity of the median nerve in patients with cervicalgia. Localized cervical pain caused by compression of a nerve root without presenting irradiated features along the nerve path is diagnosed as cervicalgia. Muscles around the scapula can be directly responsible of this compression. Methods60 adults diagnosed with cervicalgia and with a positive upper limb neural test 1(ULNT1) were recruited. Participants in the experimental group received a scapula mobilization technique. Participants in the control group, with electrodes on both sides of the neck and connected to turned off analgesic current device, received an abduction-adduction mobilization of the calcaneus in the lower limb contralateral to the painful area. The variables measured were pain, goniometry of elbow extension in movement for the median neurodynamic test (ULNT1) and hand grip strength. ResultsResults showed that the increase in strength (p = 0.01) and elbow extension movement (p = 0.01) and the decrease in pain (p < 0.01) from the intervention group showed significant changes compared to the changes from control group. ConclusionScapula mobilization technique in subjects presenting with cervicalgia and a positive ULNT1 significantly appears to help improve the neural mechanosensitivity of the median nerve and pain.

Predicting chronic post-traumatic head and neck pain: the role of bedside parameters.

Traumatic brain injury (TBI) annually impacts 69 million individuals worldwide. Mild TBI constitutes approximately 90% of all TBIs. Chronic pain post-mTBI occurs in 29% to 58% of patients. This study aims to introduce a predictive model for chronic pain development in individuals diagnosed with mild traumatic brain injury (mTBI) immediately postinjury. We included individuals who had sustained mTBI in motor vehicle accident (MVA). All patients had initial assessments within the first 72 hours (representing the subacute period) after the injury and performed follow-ups for 1 year. Machine learning model was applied to the integrated measures of clinical pain, pain-related psychological parameters, mTBI clinical signs, and sociodemographic information. This study included 203 patients experiencing acute head or neck pain attributable to mTBI post-MVA. We categorized these patients into 2 groups: patients who progressed to develop chronic head or neck pain (n = 89, 43.8%) and patients who recovered (low/mild pain) (n = 114, 56.2%). Severity of the subacute neck pain, number of painful body areas, and education years were identified as the most significant factors predicting chronic pain. The optimized predictive model demonstrated high efficacy, with an accuracy of 83%, a sensitivity of 92%, and an area under the receiver operating characteristic curve of 0.8. Our findings indicate feasibility in predicting chronic post-MVA pain within the critical 72-hour window postinjury using simple bedside metrics. This approach offers a promising avenue for the early detection of individuals at increased risk for chronic pain, enabling the implementation of targeted early interventions.

Examining the relationship between smartphone characteristics and the prevalence of hand discomfort among university students

BackgroundStudents are among the groups that use smartphones for long periods throughout the day and night. Therefore, this study aimed to examine the relationship between smartphone characteristics and the prevalence of hand discomfort among university students.MethodsThis study included 204 university students, selected based on their willingness to participate and inclusion criteria. Participants reported hand pain and discomfort by completing the Cornell Hand Discomfort Questionnaire (CHDQ). Personal information was collected through a demographic questionnaire. Smartphone characteristics were obtained from the Internet based on the smartphone model self-reported by students.ResultsAccording to the Cornell questionnaire, 59.3% of students reported experiencing discomfort in their right hand, while 38.2% reported discomfort in their left hand due to smartphone use. Furthermore, 36.3% of students reported experiencing pain in two or more regions on their right hand, while 20.1% reported pain in two or more areas on their left hand. More than half of the students in the right hand (53.5%) and more than one-third (33.3%) in the left hand obtained pain scores of more than 1.5. The chi-square test indicated a statistically significant relationship between the weight of the smartphone and the prevalence of discomfort in the right hand (χ2 = 4.80, p = 0.03). Furthermore, a statistically significant relationship was found between the discomfort or pain scores experienced in both hands and the number of painful areas in those hands (right hand: χ2 = 219.04, p = 0.00; left hand: χ2 = 213.13, p = 0.00).ConclusionsSmartphone use can cause discomfort and pain in the hands of university students. The physical characteristics of the smartphone, such as its weight, play a significant role in contributing to right-hand-related pain among students. It is important to consider ergonomic factors in smartphone design and usage to reduce musculoskeletal problems among users, especially students.

The association between insomnia and musculoskeletal problems in employees of an automotive company in Tehran, Iran

ObjectivesThe purpose of this study was to examine the association between insomnia and the number of pain areas among employees of an automotive company. Secondary aim was to examine the association between depression, anxiety, and stress, and musculoskeletal pain independent of insomnia. Material and methodsWe performed a cross-sectional study conducted in an automobile manufacturing factory. To collect data, we used the Nordic Musculoskeletal Questionnaire, ISI (Insomnia Severity Index), and DASS-21 (Depression, Anxiety, and Stress Scale). The univariate and multiple association analyses were performed using ordinal logistic regression adjusted for gender, age, industrial/non-industrial, sport activity, pack year, educational level, years of employment, anxiety, stress, and depression. ResultIn individuals with insomnia, the lower back was the most common area where pain was reported (59.5%). In all areas, pain symptoms were significantly more prevalent in individuals with insomnia compared to those without insomnia. Insomnia was associated with having pain with an increased odds of number of pain sites (odds ratio [OR] 2.81,95%CI 2.34–3.39). In ordinal logistic regression, there was an association between insomnia and pain, independent of the effects of depression, anxiety, and stress (OR 2.21,95%CI 1.52–3.23). DiscussionInsomnia was associated with pain in all regions of the body and a higher prevalence of pain in multiple areas. The insomnia-pain association was independent of depression, anxiety, and stress.