Pain-reducing Effect Research Articles

Comparing the effectiveness of pregabalin and gabapentin in patients with lumbar radiculopathy: A systematic review and meta-analysis.

Gabapentinoids are commonly prescribed to control neuropathic pain of lumbar radiculopathy. Few trials have compared the efficacy of gabapentin (GBP) and pregabalin (PGB). Therefore, the authors conducted a meta-analysis to compare the difference in effect between GBP and PGB in lumbar radiculopathy patients. Articles which were published between January 1, 1960 and May 31, 2023 were investigated via Cochrane Central Register of Controlled Trials, Embase, Google Scholar, and MEDLINE. This meta-analysis was conducted on patients with lumbar radiculopathy. Gabapentin was used as an intervention, and pregabalin as a comparison. As outcomes, pain rating scales including visual analog scale (VAS) and numeric pain rating scale (NRS), and number of adverse events (dizziness and sedation) were obtained. PGB showed statistically significant improvement in pain scale (VAS and NRS) in short-term follow-up (6 weeks or less) compared to GBP. (Total mean difference of -0.31) However, in the long-term follow-up (6 weeks to 12 weeks), there was no difference in pain reduction effect between two groups. The incidence of AEs showed no difference between two groups. Based on this article, the existing evidence suggests that PGB was more effective in reducing pain of lumbar radiculopathy compared to GBP at the short-term follow-up, but there was no difference in the long-term follow-up. Physicians should consider this finding in prescribing medications for patients with lumbar radiculopathy.

The Effectiveness and Safety of Rhomboid Intercostal Block for Postoperative Pain Management in Thoracic and Breast Surgical Procedures: A Meta-analysis

Background: The rhomboid intercostal block (RIB) is an emerging regional anesthesia (RA) technique used for pain control following thoracic and breast surgery. However, comprehensive documentation on its effectiveness and safety profile remains limited. This study aims to assess the effectiveness and safety of RIB in thoracic and breast surgical procedures. Methods: A study search was conducted following PRISMA 2020 guidelines in PubMed, Cochrane Library, Embase, Scopus, and ProQuest from 2016 to 2023 to identify randomized controlled trials (RCTs) evaluating the effectiveness and safety of RIB in thoracic and breast surgeries. The primary outcome was patient pain scores at rest, recorded at one, six, 12, and 24 hours post-surgery. Secondary outcomes included 24-hour opioid consumption and rates of postoperative nausea and vomiting (PONV). Results: This meta-analysis included five RCTs with a total of 368 patients. Rhomboid intercostal block led to a significant reduction in NRS scores one hour post-surgery (SMD = -1.33; 95% CI = -1.74 to -0.91; P < 0.00001, I² = 18%, P = 0.27), 12 hours post-surgery (SMD = -0.74; 95% CI = -0.99 to -0.48; P < 0.00001, I² = 36%, P = 0.21), and 24 hours post-surgery (SMD = -1.62; 95% CI = -2.56 to -0.69; P = 0.00006, I² = 91%, P < 0.00001). Regarding secondary outcomes, the RIB group showed a significant reduction in 24-hour opioid consumption (SMD = -4.49; 95% CI = -6.09 to -2.90; P < 0.00001, I² = 95%, P < 0.00001) and PONV rates (RR = -0.29; 95% CI = 0.18 to 0.47; P < 0.00001, I² = 0%, P = 0.88). Conclusions: Rhomboid intercostal block provides effective pain reduction and lowers opioid consumption within 24 hours post-surgery, while also minimizing PONV rates.

Efficacy of Low-Dose Deflazacort with Tamsulosin in the Medical Expulsive Therapy of Distal Ureterolithiasis: A Randomized Controlled Trial

Introduction: Distal ureterolithiasis, characterized by stones in the lower ureter, poses significant challenges in clinical management. Medical expulsive therapy (MET) using Tamsulosin is a common non-invasive treatment, but its efficacy can be limited, especially for stones larger than 5 mm. Deflazacort, a corticosteroid with anti-inflammatory properties, may enhance the effectiveness of Tamsulosin by reducing ureteral inflammation and facilitating stone passage. Methods: This prospective, randomized controlled trial enrolled 80 patients with distal ureteral stones <8 mm. Participants were randomly assigned to receive either Tamsulosin alone or Tamsulosin with Deflazacort for 28 days. Primary outcomes included stone expulsion rate and time, while secondary outcomes were pain reduction, analgesic use, and adverse effects. Results: The combination therapy group showed a higher expulsion rate (85% vs. 70%) and significantly faster expulsion time (10.1 days vs. 13.9 days, p=0.006). Pain reduction was greater in the Deflazacort group, with fewer colic episodes and reduced analgesic requirements. Adverse effects were comparable between the groups, with no significant increase in major side effects in the combination therapy group. Conclusion: The addition of low-dose Deflazacort to Tamsulosin significantly improves stone expulsion rates, reduces expulsion time, and lowers pain levels in patients with distal ureterolithiasis, without increasing major adverse effects. This combination may represent a superior treatment option in MET for distal ureteral stones.

Can a Continuous Wound Infiltration System Replace Intravenous Patient-Controlled Analgesia for Postoperative Pain Management after a Single-Port Access Laparoscopy?

Background: The aim of this study was to determine whether continuous wound infiltration (CWI) can replace intravenous patient-controlled analgesia (IV PCA) and to investigate effective pain control strategies after a single-port access (SPA) laparoscopy for adnexal disease. Methods: A total of 470 patients (the CWI group [n = 109], the IV PCA group [n = 198], and the combined group [n = 163]) who underwent an SPA adnexal laparoscopy and who received CWI or IV PCA for postoperative pain management were retrospectively reviewed. The numeric rating scale (NRS) pain score at 6, 12, 24, and 48 h (h) after surgery and the total amount of fentanyl administered via IV PCA were collected. The incidence of postoperative nausea and vomiting (PONV) and the total amount of rescue antiemetic drugs administered were also evaluated. Results: The mean NRS pain scores at 6 h (combined vs. PCA vs. CWI, 3.08 vs. 3.44 vs. 3.96, p < 0.001), 12 h (2.10 vs. 2.65 vs. 2.82, p < 0.001), and 24 h (1.71 vs. 2.01 vs. 2.12, p < 0.001) after surgery were significantly lower in the combined group. CWI showed a similar pain-reduction effect after surgery compared to IV PCA, except for the acute phase (within 6 h after surgery). The incidence of PONV during the entire hospitalization period was significantly lower in the CWI group compared to the groups using IV PCA (p < 0.05). The combined group had a significantly lower incidence of PONV and use of rescue antiemetics than the IV PCA group (p < 0.05). The combined group required significantly less total PCA fentanyl compared to the IV PCA group (combined vs. PCA, 622.1 μg vs. 703.1 μg, p < 0.001). Conclusions: CWI is an effective alternative to IV PCA and has fewer side effects. Combined use of CWI and IV PCA may be an ideal pain management strategy, offering a strong pain-reduction effect and only moderate side effects.

Composite skin substitutes, 3D skin bioprinting and the “BioMask” concept in regenerating skin defects - review

The treatment of skin trauma, especially facial skin trauma, is a major challenge due to its complex structure, the presence of appendages, color, texture, and the large area to be reconstructed in extensive trauma. “The gold standard” for treating trauma is autologous intermediate thickness skin grafting. An alternative solution is the usage of bioengineered skin substitutes. Tissue engineering is intended to provide patients with better treatment options and more effective pain reduction. Unique skin lesions are those related to the face. To fulfill the need to improve the results of facial skin reconstruction, the “Biomask” concept was introduced for the treatment of facial wounds. The purpose of this review is to analyze composite dermal-epidermal substitutes already on the market for clinical use, as well as briefly discussing materials in the testing phase, focusing on 3D skin bioprinting and facial trauma regeneration using “BioMask”. PubMed and Google Scholar databases were searched for relevant sources. Search terms included “skin substitutes”, “synthetic skin substitutes”, “bioengineered skin”, “composite skin substitutes” and additionally each analyzed unit of composite skin substitutes was searched. Bioengineered skin substitutes effectively fulfill the role of dressings during the reconstruction of skin injuries. The development of 3D skin bioprinting is enabling the increasing and effective use of these materials. The high requirements in the treatment of facial skin injuries are the trigger for the development of new materials such as "BioMask". The synergy of new technologies makes it possible to create improved methods of wound dressing and reconstruction of skin defects.

Biomechanical evaluation of an experimental internal ring fixator (RingFix) for stabilization of pelvic ring injuries on an osteoporotic bone model

During the last decades, effective pain reduction and early mobilization were identified as the central priorities in therapy of insufficiency fractures of the pelvis. For operative treatment minimally-invasive stabilization techniques are favored. While there is consensus on the significance of sufficient dorsal stabilization the role of additional fixation of the anterior fracture component stays under discussion. Within the present study we developed an internal ring fixator system (RingFix) with the question whether an in-itself-closed construct can improve stability of the entire ring structure. RingFix was evaluated on an osteoporotic bone model with a standardized FFP IIIc fracture within an established biomechanical setup regarding its primary stabilization potential. Further, it was compared to transiliac–transsacral screw fixation with and without stabilization of the anterior fracture component. The transiliac–transsacral fixation with separate screw fixation of the anterior fracture showed significantly higher stability than the RingFix and the transiliac–transsacral screw fixation without anterior stabilization. Our results show that stabilization of the anterior fracture component relevantly improves the stability of the entire ring construct. As a bridging stabilizer, RingFix shows biomechanical advantages over an isolated dorsal fracture fixation, but inferior results than direct stabilization of the single fracture components.

Platelet rich plasma injection in knee osteoarthritis: results after four years.

Background Knee osteoarthritis (KOA) is a progressive degenerative disease and a leading cause of disability worldwide. Intra-articular injection of platelet-rich plasma (PRP) is still a debatable symptomatic treatment and has provided multiple publications in literature with mixed results. Aim of the work To evaluate the short and long term effects of intra-articular injection of PRP on pain and functional status of the knee joint as measured by the Lysholm questionnaire and visual analogic pain scale (VAS). Patients and methods Twenty-one patients with primary Kellgren-Lawrence grade 3 KOA were assessed using the Lysholm questionnaire and the visual analogue scale for pain (VAS). A single PRP injection was administered, followed by reassessment of VAS at the first, fourth and eighth weeks after the injection. After eight weeks, patients were assessed with VAS and Lysholm questionnaire. In order to evaluate the long term effect of this single injection, we reassessed the patients four years after the injection using the same method. Results Fifteen females (71%) and six males (29%) with mean age 60 years (ranging from 44 to 76 years) were enrolled. After a single PRP injection, there was significant improvement in Lysholm and VAS. Before the injection, VAS medium score was 7 (ranging from 5 to 9) and we observed improvements in all assessments at the first (medium VAS 2), fourth (medium VAS 2) and eighth week (medium VAS 2) post injection and was still better than the pre injection score after 4 years (medium VAS 4). This was also observed in Lysholm score. The pre injection score was 41; at 8 weeks, 84; at 4 years, 66. Conclusion PRP injection achieves good results in the symptomatic treatment of Kellgren-Lawrence grade 3 KOA. This study confirmed that a single PRP injection can provide a long-term effect in pain reduction and functional status improvement in KOA, despite the progression of the disease. Further studies with more patients and randomized double blinded controlled studies are recommended to confirm these results.

Comparison of Splanchnic Nerve Block with Ropivacaine/ Depo Medrol and Ropivacaine/Depo Medrol/Fentanyl in Patients Suffering from Abdominal Pain Due to Pancreatic Cancer

Background: This double-blind clinical trial aimed to investigate the effectiveness of splanchnic nerve blocks using different medication combinations on pain severity and duration of pain relief in patients with pancreatic cancer-related abdominal pain. Methods: Thirty eligible patients were randomly assigned to either a control group receiving splanchnic blocks with Ropivacaine/Depo Medrol/Saline or an intervention group receiving splanchnic blocks with Ropivacaine/Depo Medrol/Fentanyl. Pain severity was assessed using the Numeric Rating Scale (NRS) at 2, 6, and 24 hours and one week post-intervention. Statistical analysis included independent t-tests, Friedman tests, and False Discovery Rate (FDR) correction. Results: Prior to intervention, no significant difference in NRS scores was observed between groups (p = 0.0642). However, at the 6-hour and one-week intervals, the case group exhibited significantly lower NRS scores than the control group, indicating the efficacy of the intervention in reducing pain levels. The case group showed a substantial decrease in NRS scores from a pre-intervention mean of 7.8 to 0.5 at 2 hours, while the control group experienced a reduction from 9.083 to 2.583. The mean duration of pain relief was longer in the case group (5.429 days) compared to the control group (3.25 days). Friedman tests revealed significant differences in pain scores across time intervals within both groups (p &lt; 0.001). Conclusion: Splanchnic nerve blocks using Ropivacaine/Depo Medrol/Fentanyl combination demonstrated significant pain reduction effects, particularly at 6 hours and one-week post-intervention, compared to the control group. These findings showed that the addition of fentanyl in pharmaceutical combination as a opioid to the splanchnic block has reduced the pain score and increase the duration of pain relief in patients being involved in pancreatic cancer with abdominal pain.

Varus Thrust Assessment Identified Responders to Quadriceps Exercise in Individuals at Risk of or with Knee Osteoarthritis.

Identification of responders/non-responders to unsupervised therapeutic exercise represents a critical challenge towards establishment of tailored self-management at home. Focusing on visualized varus thrust during gait as a possible effect moderator, this study determined whether and how varus thrust influences the therapeutic effects of home-based quadriceps exercise in individuals at increased risk of, or with, established knee osteoarthritis. This study is a secondary subgroup analysis of a randomized controlled trial (n = 50). Varus thrust at baseline was assessed via recorded gait movie. Analysis of covariance and subsequent mediation analysis were used to determine whether and how varus thrust influences the therapeutic effect of home-based quadriceps exercise after adjustment for covariates. To address the possible distinct impact of varus thrust on unsupervised and supervised exercise, the results were cross-checked with previous supervised exercise cohort using a meta-analysis. Individuals without varus thrust displayed greater and clinically meaningful pain-relief after exercise after adjustment for covariates. The greater pain-relief in individuals without varus thrust was attributed, at least partly, to an improvement in knee flexion range of motion. Notably, the meta-analysis revealed that unsupervised and supervised exercise programs induce consistent and clinically meaningful pain reduction in individuals without varus thrust. Varus thrust is a robust effect moderator of the pain reducing effect of quadriceps exercise. Further, greater pain reduction may be a function of improvement of knee flexion range of motion. These studies provide evidence that varus thrust assessment represents valuable approach to identify responders/non-responders to quadriceps exercise even for unsupervised protocol at their home environment.

Does botulinum neurotoxin A make walking easier in children with cerebral palsy? A randomized clinical trial.

To assess the effect of single botulinum neurotoxin A (BoNT-A) injectionsinto the calf muscles on the gross energy cost of walking in children with cerebral palsy (CP) and to evaluate the effect of BoNT-A on walking capacity, physical activity, perceived changes in mobility, and pain. This was an industry-independent, randomized, quadruple-blind, placebo-controlled, multicentre trial (ClinicalTrials.gov registration: NCT02546999). Sixty-one children (33 male, median age [range] = 8 years [4-16 years]) with spastic CP and classified in Gross Motor Function Classification System (GMFCS) levels I and II allocated to single injections of either BoNT-A or 0.9% saline into the calf muscles. The main outcome was gross energy cost (J/kg/m); secondary outcomes were walking capacity, habitual physical activity, perceived change in mobility tasks, and calf pain at baseline, 4 weeks (P1), 12 weeks (P2), and 24 weeks (P3) after the injection. The mean change in energy cost did not differ significantly between groups at the primary time point P2 (-0.27 J/kg/m, 95% confidence interval - 0.91 to 0.36, p = 0.404), nor at P1 or P3. Regarding the secondary outcomes, there was some evidence of a larger reduction in pain intensity in the group given BoNT-A (p = 0.043). One treatment with BoNT-A was not superior to placebo in making walking easier in children with CP classified in GMFCS levels I and II, at least in the short term. BoNT-A may have a pain-reducing effect.

Nefopam as a multimodal analgesia in thoracoscopic surgery: a randomized controlled trial.

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure. However, some patients still experience severe pain after VATS. Pain after VATS can disturb deep breathing and coughing, and can increase postoperative pulmonary complications. Therefore, multidisciplinary pain management is emphasized for enhanced recovery after VATS. Nefopam is a centrally-acting, non-opioid, non-steroidal analgesic drug, and its pain reduction effect in many surgeries has been reported. We sought to determine whether administration of nefopam is effective as multimodal analgesia in VATS. This study enrolled patients aged 19 years or older, and scheduled for elective VATS lobectomy with American Society of Anesthesiologists (ASA) physical class I-III. Forty-six participants were randomly divided into a group receiving nefopam (group N), and a control group (group O) in a 1:1 ratio. The study participants, and the researcher collecting the data were blinded to the group allocation. For the group N, nefopam 20 mg was administered before surgical incision and also at the end of surgery while chest tube was inserted. For the group O, normal saline 100 mL was administered. The primary outcome of this study was the pain score, by verbal numerical rating scale, at rest and upon coughing. Forty-five participants (group N =22, group O =23) were involved in the statistical analysis. Nefopam reduced pain at rest at 0 h [8 (IQR, 5-10) vs. 4 (IQR, 2-7), P=0.01], and at 0-1 h [5 (IQR, 5-8) vs. 3 (IQR, 2-5), P=0.001]. Pain upon coughing decreased with nefopam at 0 h [9 (IQR, 6-10) vs. 6 (IQR, 2-8), P=0.009], 0-1 h [6 (IQR, 5-8) vs. 5 (IQR, 2-6), P=0.001], and at 12-24 h [4 (IQR, 3-7) vs. 3 (IQR, 1-4), P=0.03]. Injection of 20 mg of nefopam before incision and at the end of surgery relieved postoperative pain at 0 h, 1 h at rest and at 0 h, 1 h, 12-24 h with coughing after VATS. Therefore, nefopam can serve as a useful component of multimodal analgesia for pain management after VATS. ClinicalTrials.gov (NCT05173337).

Development and Validation of an Ultrasonography-Based Machine Learning Model for Predicting Outcomes of Bruxism Treatments.

We aimed to develop a predictive model for the outcome of bruxism treatments using ultrasonography (USG)-based machine learning (ML) techniques. This study is a quantitative research study (predictive modeling study) in which different treatment methods applied to bruxism patients are evaluated through artificial intelligence. The study population comprised 102 participants with bruxism in three treatment groups: Manual therapy, Manual therapy and Kinesio Tape or Botulinum Toxin-A injection. USG imaging was performed on the masseter muscle to calculate muscle thickness, and pain thresholds were evaluated using an algometer. A radiomics platform was utilized to handle imaging and clinical data, as well as to perform a subsequent radiomics statistical analysis. The area under the curve (AUC) values of all machine learning methods ranged from 0.772 to 0.986 for the training data and from 0.394 to 0.848 for the test data. The Support Vector Machine (SVM) led to excellent discrimination between bruxism and normal patients from USG images. Radiomics characteristics in pre-treatment ultrasound scans of patients, showing coarse and nonuniform muscles, were associated with a greater chance of less effective pain reduction outcomes. This study has introduced a machine learning model using SVM analysis on ultrasound (USG) images for bruxism patients, which can detect masseter muscle changes on USG. Support Vector Machine regression analysis showed the combined ML models can also predict the outcome of the pain reduction.

Breast-Pren (Pain Relief) as a Natural Compress Innovation to Reduce Milk Damage in Breastfeeding Mothers

Based on research (Apriani, et al 2018), the most common breastfeeding problem is breast swelling due to breast milk dams that cause breast milk not to come out smoothly. Cold compresses are one solution to the problem. Indonesia is a region rich in natural resources. These natural resources are not only used for food, but can also be an alternative medicine. Red betel is a plant that has a pain-reducing effect. The content of cabbage leaves helps in increasing blood perfusion to the swelling area, dilates capillaries and acts as a counter barrier so as to reduce swelling and inflammation of the breast so that milk flows Based on the description above, the author makes a product innovation, namely "Breast-Pren" which is a compress containing aloe vera, red betel and cabbage ingredients which are good for reducing breast swelling due to breast milk dams in nursing mothers

Assessing the Acceptability and Effectiveness of a Novel Therapeutic Footwear in Reducing Foot Pain and Improving Function among Older Adults: A Crossover Randomized Controlled Trial

Introduction: Nearly, a quarter of older adults suffer from frequent foot pain, impacting their quality of life. While proper footwear can alleviate this, design issues often hinder regular use. This study evaluated novel therapeutic footwear, designed for aesthetics and custom fit, to reduce foot pain. We hypothesized that older adults would experience less foot pain and favor the new footwear over their own. Methods: This 12-week crossover randomized controlled trial evaluated the effectiveness of OrthoFeet therapeutic footwear on reducing foot pain in older adults (n = 50, age = 65 ± 5, 18% male) with moderate to severe pain. Participants were assigned to either the AB or BA sequence. In AB, they wore OrthoFeet shoes for 6 weeks and then their own shoes for another 6 weeks; BA followed the reverse order. Pain and function were measured using the Foot Function Index. Acceptability was assessed through a technology acceptance model (TAM) questionnaire. Data collected at baseline, six, and 12 weeks were analyzed using t tests, χ2 tests, and generalized linear model. Results: Compared to participants’ own shoes, OrthoFeet shoes significantly reduced foot pain and disability. Notable improvements were observed in “foot pain at its worst,” “foot pain at the end of the day,” “overall pain score,” and “overall Foot Function Index score,” all showing statistically significant reductions (p < 0.050). Participants reported high adherence to wearing the OrthoFeet shoes, averaging 8 h per day and 5.8 days per week. TAM scores favored OrthoFeet shoes over participants’ own shoes in terms of ease of use, perceived benefit, and intention to recommend. Significant differences were noted in components representing perceived joint pain relief (p < 0.001, χ2 = 21.228) and the intention of use as determined by the likelihood of recommending the shoes to a friend with a similar condition (p < 0.001, χ2 = 29.465). Additionally, a majority of participants valued the appearance of the shoes, with 66% prioritizing shoe appearance and 96% finding the study shoes more stylish than their previous ones. Conclusion: This study underscores the significance of design and custom fit in promoting continuous wear for effective foot pain reduction in older adults. More research is needed on the intervention’s long-term impacts.

The two‐stage presale pricing for online products considering anchoring effect and payment pain reduction

AbstractOnline product pricing is an important research field in the platform economy, and a two‐stage mixed presale is a mainstream mode of online sales. In the process of online consumption, the payment method and presale mode have an important impact on consumer behaviour and product pricing. Based on the two‐stage mixed presale mode, this study considers the impact of anchoring and the payment pain reduction effect on consumer behaviour, establishes the corresponding product pricing model and obtains the optimal presale price, sales and profit. It sheds light on the influence mechanism of anchoring and the payment pain reduction effect on consumer behaviour and online product pricing. Theoretical and numerical analyses reveal that the payment pain reduction effect can help to raise the product price, stimulate market vitality and bring higher profits for online retailers, and the anchoring effect and consumers' loss aversion psychology can enhance the profits and sales of online retailers, but they will discourage setting high prices for products. The research results will further enrich the relevant research on customer behaviour and product pricing in the platform economy and will provide decision bases for platform enterprises and online retailers to participate in presale activities and formulate product pricing strategies.

The effectiveness of non-pharmacological interventions on reducing pain in patients undergoing bone marrow aspiration and biopsy: A systematic review and meta-analysis of randomized controlled trials.

Patients often consider bone marrow aspiration and biopsy to be one of the most painful medical procedures. The effectiveness of non-pharmacological interventions to reduce pain during bone marrow aspiration and biopsy remains unclear. To synthesize existing evidence regarding the effectiveness of non-pharmacological interventions in mitigating procedural pain among patients undergoing bone marrow aspiration and biopsy. A systematic review and meta-analysis of randomized controlled trials. Six electronic databases, including PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library and Web of Science were searched from inception to July 15, 2023. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 2.0. Meta-analysis was conducted using STATA 16. The certainty of the evidence was assessed by the GRADE approach. This meta-analysis included 18 studies derived from 17 articles involving a total of 1017 participants. The pooled results revealed statistically significant pain reduction effects using distraction (SMD: -.845, 95% CI: -1.344 to -.346, p < .001), powered bone marrow biopsy system (SMD: -.266, 95% CI: -.529 to -.003, p = .048), and acupoint stimulation (SMD: -1.016, 95% CI: -1.995 to -.037, p = .042) among patients undergoing bone marrow aspiration and biopsy. However, the pooled results on hypnosis (SMD: -1.228, 95% CI: -4.091 to 1.515, p = .368) showed no significant impact on pain reduction. Additionally, the pooled results for distraction did not demonstrate a significant effect on operative anxiety (MD: -2.942, 95% CI: -7.650 to 1.767, p = .221). Distraction, powered bone marrow biopsy system and acupoint stimulation are effective in reducing pain among patients undergoing bone marrow aspiration and biopsy. Not applicable. This meta-analysis highlights the effectiveness of distraction, powered bone marrow biopsy system and acupoint stimulation for reducing pain in patients undergoing bone marrow biopsy. Healthcare professionals should consider integrating these interventions into pain management practices for these patients. (PROSPERO): CRD42023422854.

The short- and long-term effect of osteopathic manipulative treatment on pain, and psychosocial factors in adults with chronic low back pain.

Chronic low back pain (CLBP) has long plagued mankind, but little progress has been made in finding a rational and effective treatment, letalone a common cause. This study is an attempt to fill that void by measuring short- and long-term effects of osteopathic manipulative treatment (OMT), including psychosocial and pain reduction in CLBP patients. The objectives of this study were to investigate the effectiveness of neuromusculoskeletal medicine/osteopathic manipulative medicine (OMM) in treating CLBP, with a focus on biopsychosocial (pain sensitivity questionnaire [PSQ]) and pain control in chronic conditions. The study involved a large, single cohort observational design of 101 patients. The inclusion criteria for selecting patients targeted those with "nonspecific" CLBP. The National Institutes of Health (NIH) Minimum Dataset for Chronic Low Back Pain (NMD) was the measurement tool and was administered at consent (baseline), 2, 4, and 8weeks and at 6 and 12months. Time trends were analyzed as overall mean. Pairwise differences were compared between time points. Mixed-effects models were utilized to test the association of time with pain and biopsychosocial scores. Pain and PSQ scores decreased over the study timeline. The most significant change for both pain and biopsychosocial scores occurred at 6months compared to baseline, with a further reduction at 12months. OMT has been demonstrated to significantly reduce pain and psychosocial factors related to CLBP in both the short and long term.

Efficacy of chronic neck pain self-treatment using press needles: a randomized controlled clinical trial.

Chronic neck pain is common among Japanese individuals, but few receive treatment. This randomized controlled trial aimed to evaluate the efficacy of acupuncture using press needles in the self-treatment of chronic neck pain and preliminarily identify the characteristics of patients likely to benefit from this treatment. Fifty participants with chronic neck pain were allocated to receive either press needle or placebo treatment for 3 weeks. The visual analogue scale (VAS) and motion-related VAS (M-VAS) scores for neck pain, Neck Disability Index score, and pressure pain threshold were measured at baseline, after the first session, at the end of the last session, and 1 week after the last session. Changes in the outcomes were analyzed using analysis of variance, and the relationships between the variables were evaluated using structural equation modeling. Intervention results as assessed by VAS score revealed no significant differences in the ANOVA. A between-groups comparison of M-VAS scores at the end of the last session and baseline showed a significant difference (press needle: -21.64 ± 4.47, placebo: -8.09 ± 3.81, p = 0.025, d = -0.65). Structural equation modeling revealed a significant pain-reducing effect of press needle treatment (β = -0.228, p = 0.049). Severity directly affected efficacy (β = -0.881, p < 0.001). Pain duration, baseline VAS and Neck Disability Index scores were variables explaining severity, while age and occupational computer use were factors affecting severity. Self-treatment with press needles for chronic neck pain did not significantly reduce the VAS score compared to placebo but reduced the motion-related pain as assessed by M-VAS score. A direct association was observed between pain severity and the effectiveness of press needles, and the impact of age and computer were indirectly linked by pain severity. Identifier UMIN-CTR, UMIN000044078.

Effectiveness of pineapple and papaya leaf combination for dysmenorrhea pain relief in mice (&lt;i&gt;Mus musculus&lt;/i&gt;)

Dysmenorrhea is a common gynecological condition in women, often attributed to excessive prostaglandin production, significantly impacting daily activities. Papaya leaves, known for their medicinal properties, are a chosen herbal remedy, albeit with a bitter taste, necessitating combination with pineapple fruit. This study aimed to assess the effectiveness of a combination of papaya leaf extract and pineapple fruit as an alternative treatment for primary dysmenorrhea. In an experimental research design employing the posttest-only control group, 32 male mice were divided into seven groups, injected with acetic acid as a pain inducer, and their writhing responses were recorded for 45 minutes at 15-minute intervals. Data analysis using the ANOVA test revealed significant differences in the number of writhing responses in mice (p &lt;0.05) compared to the positive control group, followed by the Duncan test. The percentage of analgesic protection was as follows: mefenamic acid (61.01%), pineapple fruit extract (62.78%), papaya leaf extract (63.39%), a combination of pineapple and papaya leaf extracts with a dose ratio of 3:1 (73.21%), 2:2 (47.32%), and 1:3 (37.78%). In conclusion, the combination of pineapple extract and papaya leaves in a dose ratio of 3:1 demonstrated the most effective pain reduction.

Assessment of spasticity-related pain in cerebral palsy and the efficacy of its treatment with incobotulinumtoxin A (literature review)

Pain in cerebral palsy (CP) occurs in 30–60% of cases. Pain associated with spasticity (PAS) is one of the most common causes of pain syndrome in cerebral palsy, which is often associated with impairment of the child’s daily life. Recently, more studies have been published on the use of botulinum toxin type A preparations to control PAS. The review article presents the results of a special pooled analysis of data on the analgesic effect of the drug Xeomin (incobotulinumtoxin A) in the treatment of PAS based on data from three phase III multicentre prospective comparative studies in children and adolescents with spastic forms of cerebral palsy. To evaluate PAS and the effect of incobotulinumtoxin A on it, a special questionnaire (Questionnaire on Pain caused by Spasticity, QPS) was used in these studies. The QPS reflects the child's pain associated with spasticity, which can be observed at rest and during various activities of the child.It was found that the children included in these studies reported the presence of PAS in more than 80% of cases with lower limb spasticity and in almost 70% of cases with upper limb spasticity. Parents or caregivers of these children observed an even higher prevalence of PAS. The use of incobotulinumtoxin A showed not only a pronounced antispastic effect, but also a significant reduction in the frequency and intensity of PAS in children and adolescents with cerebral palsy during normal daily activities, and during strenuous activities such as physical exercise and rehabilitation treatment. With repeated injection cycles of incobotulinumtoxin A, PAS continued to decrease, ensuring a reduction in pain even when physical activity became more difficult. Nowadays, injections with incobotulinumtoxin A can be considered as a routine therapeutic approach for the treatment of spasticity and increased muscle tone, but it is certainly an innovative method for effective pain reduction in cerebral palsy patients with lower and upper limb spasticity accompanied by PAS.