Hand Pain Research Articles

Cubital tunnel syndrome of the ulnar nerve caused by an epineural ganglion cyst: a case report and review of the literature

BackgroundThe ulnar nerve has a long and complex anatomical course, originating from the brachial neural plexus in the neck with nerve trunk formation at the posterior neck triangle, and on to the axilla. This intricate anatomical pathway renders the nerve susceptible to compression, direct injury, and traction throughout its course. Compression of the ulnar nerve is the second most common compression neuropathy of the median nerve adjacent to the wrist joint, after carpal tunnel syndrome.Case presentationA 45-year-old Sudanese housewife complained of progressive right forearm and hand muscle wasting, pain, and neuropathic symptoms. She was diagnosed with right-sided cubital tunnel syndrome. The diagnosis was derived intraoperatively from a nerve conduction study suggesting the level of conduction block and recommending decompression. Magnetic resonance imaging was not done preoperatively due to financial limitations. An epineural ganglion (15 × 20 mm2) compressing and flattening the ulnar nerve was diagnosed intraoperatively. Surgical decompression of the ulnar nerve and removal of the epineural ganglion achieved a remarkable postoperative result and pleasing outcome.ConclusionSurgical management is the cornerstone of treatment for compressive neuropathy and ranges from simple nerve decompression to complex neurolysis procedures and nerve transposition to adjust the anatomical course of the nerve.

Application of a Mathematical Method to Assess Associations Between Work Exposures and Severe Back and Hand Pain Using Job Exposure Matrices in the CONSTANCES Cohort.

DELTREIL, GUILLAUME PhD*; TARDIVEL, PATRICK PhD; GRACZYK, PIOTR PhD; ESCOBAR-BACH, MIKAEL PhD; FADEL, MARC MD; DESCATHA, ALEXIS MD* Author Information

Case Presentatoins of the Harvard Affiliated Emergency Medicine Residencies: An Unusual Case of Hand Pain

Case Presentatoins of the Harvard Affiliated Emergency Medicine Residencies: An Unusual Case of Hand Pain

Study on the effect, safety, prognosis quality and application value of extracorporeal shock wave based neural activity in carpal tunnel syndrome patients

BackgroundMild to moderate CTS is the most common median nerve compression disease in middle-aged and elderly women, mainly manifested by hand numbness and pain. This paper analyzes the extracorporeal shock wave of patients with mild to moderate CTS after nerve mobilization.MethodsThe clinical data of 92 patients with CTS from June 2020 to June 2022 are analyzed and randomly divided into extracorporeal shock wave group (n = 47) and routine group (n = 45). The routine group undergoes nerve mobilization, and the extracorporeal shock wave group receives extracorporeal shock wave therapy on the basis of the routine group. The clinical efficacy, symptom improvement, pain score, median nerve electrophysiological examination results, upper limb symptom and function scores, and ADL scores before and after treatment are observed. The Spearman correlation coefficient is used to analyze the correlation between upper limb function and ADL score, and the incidence of complications after treatment is analyzed.ResultsThe clinical efficacy, symptom improvement, pain score, median nerve electrophysiological examination results, upper limb symptom and function score, ADL score and the incidence of complications in the extracorporeal shock wave group are significantly better than those in the conventional group (P < 0.05). ADL scores are negatively correlated.ConclusionExtracorporeal shock wave combined with nerve mobilization has a significant effect in the treatment of CTS patients, which can significantly improve the symptoms and pain scores of patients, and enhance the function of patients’ upper limbs. At the same time, the incidence of complications in patients is less, and it has high safety.

Influence of Joint Flexibility, Hand Grip Strength and Pain on Oral Hygiene in Musculoskeletal Disorders—A Non-Interventional Clinical Study

The study included 200 subjects, half suffering from back, neck, shoulder, elbow, and wrist problems, belonging to different age groups and professions; 100 had joint pain, and 100 were without joint pain. The study assessed individuals exposed to oral health issues by measuring the strength of hand grip, flexibility, and pain score of the back, neck, shoulder, elbow, and wrist. The strength of the hand grip and the angle of the elbow and shoulder were measured in addition to a questionnaire to assess the relationship between back pain and oral health. To evaluate dental health status and oral hygiene, the total number of decayed, missing, and filled teeth (DMF/T) and Oral Hygiene Index-Simplified (OHI-S) indices were used. The difference between all demographic parameters was statistically significant (p < 0.05). It was observed that there was a significant difference in calculus, debris, and dental caries scores in both groups, with significantly lower scores and better oral hygiene in patients without joint pain. Concerning pain score and joint movements, the group without joint pain showed a significantly better range of movements and less pain than patients suffering from joint pain, and statistically a significant difference (p < 0.05) was observed between both groups. The present study revealed that musculoskeletal disorders, pain in the neck and hand, and restricted movements were common among professionals. We observed that pain in joints, neck, and hands, with restricted movements, caused a serious impact on the maintenance of oral hygiene practices among subjects of different professions.

Abstract OT1-17-01: Protocol Description of Genetics and Inflammatory Markers to predict Chemotherapy-Induced Peripheral Neuropathy among Early Stage Breast Cancer Patients Receiving Taxane Therapy – GENIE Study

Abstract Background Chemotherapy induced peripheral neuropathy (CIPN) is one of the most common dose-limiting side effects seen among patients with early stage breast cancer and received taxane-containing regimens. The primary clinical manifestation of CIPN is sensory neuropathy such as numbness, tingling and pain in hands and feet, which negatively affect the patient’s quality of life (QoL). Although in most patients, CIPN improves over time, in a subset of patients, it remains a substantial debilitating problem, significantly affecting QoL. To date, there are no effective prevention strategies- or sufficient treatment due to the limited understanding of CIPN pre-disposing factors or pathophysiology. We hypothesize that a multimodal integration of biomarkers with CIPN progression analysis will be required to understand the pathophysiology and to consistently predict patient susceptibility. Further, we hypothesize that this multimodal approach may be leveraged to identify targets for CIPN treatment and/or prevention. This abstract describes the study protocol used to explore this hypothesis. Objective This study is designed to 1) identify genetic, transcriptional, epigenetic, metabolic, inflammatory biomarkers predictive of CIPN development among patients with early stage breast cancer receiving a taxane containing therapy; 2) With these biomarkers, develop an algorithm to identify patients who are at risk of developing CIPN before or during taxane therapy. Methods This is a longitudinal, multicenter, observational study. Patients with early-stage breast cancer who are receiving a taxane-containing (paclitaxel, docetaxel or nab-paclitaxel) treatment regimen, without preexisting peripheral neuropathy are eligible. Estimated enrollment is 400 patients. Demographic and clinical data are collected after patients consent to participate. Molecular data and patient reported outcomes (PRO) are collected prior to initiation of taxane therapy, the 4th, 8th, and 12th week of taxane therapy, and at 3, 6, and 9 months after completion of taxane therapy. Blood samples are collected for molecular data which include genetic, transcriptional, epigenetic (DNA-methylation), and metabolic data. PRO are assessed using (i) the European Organization for Research and Treatment of Cancer CIPN20 questionnaire, (ii) the Brief Pain Inventory, (iii) the Pain Catastrophizing Scale, and (iv) the PRO Measurement System for anxiety, depression and pain interference. Initial data analysis will characterize the association of biomarkers in each modality (e.g., genetic, epigenetic, etc.) with the presence or absence of CIPN, and machine learning will be used to build candidate biomarker signatures to predict CIPN before and during taxane treatment. Two distinct multi-modal prediction models will be constructed: 1) a pre-treatment model to predict risk of developing CIPN, and 2) an on-treatment model to predict the onset of CIPN. The goal is to develop a parsimonious, clinically translatable model for robust and accurate predictions of taxane-induced CIPN. Trial Status: Active, 135 subjects enrolled. Trial Centers: 1) Cleveland Clinic Foundation (8 regional sites in Ohio and 1 in Florida); 2) Huntsman Cancer Institute, University of Utah Research Funding: National Institute of Neurological Disorder and Stroke. Grant No.: 1R61NS113258-01A1 Citation Format: Mei Wei, Anukriti Sharma, Ken Johnson, Bihua Bie, courtney hershberger, Alper Sen, Emily E. Rhoades, Chi-Fan Hocking, George Budd, N. Lynn Henry, Charis Eng, Joseph Foss, daniel rotroff. Protocol Description of Genetics and Inflammatory Markers to predict Chemotherapy-Induced Peripheral Neuropathy among Early Stage Breast Cancer Patients Receiving Taxane Therapy – GENIE Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT1-17-01.

POINT-OF-CARE ULTRASOUND FOR GUIDANCE OF CLOSED REDUCTION OF FIFTH METACARPAL NECK (BOXER'S) FRACTURE

BackgroundUltrasound has been used previously in fracture identification, analgesia delivery, and fracture reduction for patients in the emergency department. It has not been previously described as a tool for the guidance of closed fracture reduction in fifth metacarpal neck fractures (“boxer's fractures"). Case ReportA 28-year-old man presented with hand pain and swelling after punching a wall. Point-of-care ultrasound revealed a significantly angulated fifth metacarpal fracture, which was confirmed with a subsequent hand x-ray study. After an ultrasound-guided ulnar nerve block, closed reduction was performed. Ultrasound was used to assess reduction and ensure improvement in bony angulation during the closed reduction attempts. Post-reduction x-ray study confirmed improved angulation and adequate alignment. Why Should an Emergency Physician Be Aware of This? Point-of-care ultrasound has previously had efficacy in fracture diagnosis and anesthesia delivery for fifth metacarpal fractures. Ultrasound can also be used at the bedside to assist in the determination of adequate fracture reduction when performing closed reduction of a boxer's fracture.

Peripheral Artery Bypass Graft for the Treatment of Ischemic Ulcer or Severe Pain of Hand in Connective Tissue Diseases.

Chronic ischemia of the hands and feet is a rare medical condition that requires surgical revascularization. In particular, digital ischemia resulting from connective tissue diseases (CTDs) is among the most important manifestations that negatively affect patients' quality of life. Here, we describe a bypass graft technique for treating digital ischemia. This study aimed to share the considerable benefits of surgical intervention for CTD and present a treatment algorithm. From 2009 to 2020, bypass graft surgery was performed on 10 patients with CTD to relieve their ischemic symptoms or ulceration. Preoperative angiography was performed, and blood distribution patterns were analyzed in detail. Based on the angiographic 4-level analysis, bypass graft surgeries were performed accordingly. The postoperative follow-up was 15 to 72 months. Pain in the hands that underwent the bypass graft surgery improved immediately after surgery. All ulcerations healed and the mean time recorded for ulceration healing was 45.7 days. Here, we propose an appropriate surgical treatment algorithm for managing CTD using arterial bypass graft surgery, and its positive long-term results demonstrate that it is an appropriate option for treating digital ischemia. In conclusion, strict measures with precise preoperative planning can provide satisfactory long-term results in patients with CTD.

Revisiting Cryptocyanine Dye, NK-4, as an Old and New Drug: Review and Future Perspectives.

NK-4 plays a key role in the treatment of various diseases, such as in hay fever to expect anti-allergic effects, in bacterial infections and gum abscesses to expect anti-inflammatory effects, in scratches, cuts, and mouth sores from bites inside the mouth for enhanced wound healing, in herpes simplex virus (HSV)-1 infections for antiviral effects, and in peripheral nerve disease that causes tingling pain and numbness in hands and feet, while NK-4 is used also to expect antioxidative and neuroprotective effects. We review all therapeutic directions for the cyanine dye NK-4, as well as the pharmacological mechanism of NK-4 in animal models of related diseases. Currently, NK-4, which is sold as an over-the-counter drug in drugstores, is approved for treating allergic diseases, loss of appetite, sleepiness, anemia, peripheral neuropathy, acute suppurative diseases, wounds, heat injuries, frostbite, and tinea pedis in Japan. The therapeutic effects of NK-4's antioxidative and neuroprotective properties in animal models are now under development, and we hope to apply these pharmacological effects of NK-4 to the treatment of more diseases. All experimental data suggest that different kinds of utility of NK-4 in the treatment of diseases can be developed based on the various pharmacological properties of NK-4. It is expected that NK-4 could be developed in more therapeutic strategies to treat many types of diseases, such as neurodegenerative and retinal degenerative diseases.

Haemodialysis nurses' occupational health and work-related musculoskeletal hand pain after work: A cluster analysis.

To identify clusters based on haemodialysis nurses' self-rated work ability, work engagement and self-reported work hours and to compare the identified clusters regarding hand pain after work. Cross-sectional survey. Data based on the Work Ability Index, Utrecht Work Engagement Scale and hand pain severity after work were collected through a web-based survey among 503 haemodialysis nurses working in SwedenandDenmark. A two-step cluster analysis was used to identify homogenous groups of cases within the dataset, followed by comparative analyses of the clusters. Four distinct clusters were identified, illustrating differing profiles of haemodialysis nurses' work ability, work engagement and working hours. Nurses who worked part-time and reported moderate work ability and average work engagement had significantly higher ratings of hand pain after work. Haemodialysis nurses are a heterogeneous group as regards work ability, work engagement and self-reported work hours. The four distinct clusters of nurses indicate a need for customized interventions for retaining each subgroup at work.

An Epidemiological Study of Cell Phone-Related Injuries of the Hand and Wrist Reported in United States Emergency Departments From 2011 to 2020

Increasing ownership and use of mobile phones has been recently linked to reports of hand and wrist pain from overuse, as well as more serious injuries related to distracted behaviors, such as falls and texting while driving. We describe the epidemiology of hand and wrist injuries presenting to US emergency departments from 2011 to 2020, which were associated with cell phone use using the Consumer Product Safety Commission's National Electronic Injury Surveillance System. The National Electronic Injury Surveillance System database was queried for treatment records from 2011 through to 2020 for all cell phone-related injuries of the lower arm, wrist, hand, and fingers. Using parameters provided by the National Electronic Injury Surveillance System database, there were 1,213 unique cases, yielding a total weighted estimate of 50,487 national cases presenting to emergency departments in the United States. Between 2011 and 2020, the weighted estimate of annual cell phone-related injuries ranged from 3,389 to 7,320 cases. Falls were the most common cause of injury, accounting for 29.8% of estimated cases. The most common types of injuries were lacerations (22.3%). The national estimate of cell phone-related injury was the highest in the age range of 11-20 years (26.4%), followed by 21-30 years (22.2%). Women were affected more frequently than men (59.6% vs 40.4%). Upper extremity injuries related to cell phone use represent an increasing burden of disease to the US healthcare system. Raising awareness regarding cell phone-related injuries and in-home fall-prevention strategies, especially among elderly individuals, should be considered as means of decreasing the number of such injuries. Strategies for decreasing the burden of cell phone-related injuries occurring as a result of falls among teenagers and young adults should focus on minimizing distractions while using a cell phone. Limitations of the study include inaccuracies related to probability-weighted case estimation and limitations in reporting injuries. Knowledge of the burden of upper extremities injuries associated with this common handheld device can help to both raise awareness of this issue, as well as to potentially inform injury-prevention strategies.

Awareness of Nurse’s Knowledge Regarding Hemodialysis Procedure and Complications in Dialysis Center of Sulaimani city

Background: Hemodialysis is required to the specific nurses’ knowledges and the virtuous nursing care with the high standard practice for the management of end stage kidney disease patient. Nurse’s knowledge about hemodialysis takes a key role in the success of this practice. This study aimed to assessing the nurse’s knowledge about hemodialysis procedure and complication in Sulaimani City. Methods: A descriptive cross-sectional study was conducted in Shar Teaching Hospital from June 1, 2022 to February 2, 2022. A total 102 nurses were recruited to this study by using a convenience sample size. Data were collected by using the structured questionnaire that was about sociodemographic variables and nursing awareness about hemodialysis. Results: The study found the participant nurses were mostly female (52%), married (62.7%), in the age group (28<38 years) (78.4%), the professional diploma level of education (69.6%), and 5 -10 years of experiences (79.4%). Age group (28<38 years) and Bachler education level had a significant relationship with knowledge about hemodialysis procedure (p. value= 0.04) and its complications (p. value= 0.02. Knowledge about washing hand (33.3%), putting gloves (41.2), and chest pain and shortness of breath complication (50%) were less considerably among the nurses. Conclusions: This study has found level of knowledge about hemodialysis were considered low among nurses. Age and level of education were significantly but inconsistently associated with the knowledge about hemodialysis. Nurses did not have proficient knowledge about infection control and the complications of hemodialysis. This study recommends the continuous training to low educated nurse.

LITERATURE REVIEW: PENGARUH PEMBERIAN VITAMIN B TERHADAP PERBAIKAN KLINIS PASIEN DENGAN CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome (CTS) is an entrapment neuropathy with symptoms such as hand pain, paresthesias in the fingers innervated by the median nerve, weakness, and thenar muscle atrophy. The purpose of this literature review is to analyze the effectiveness of vitamin B administration on clinical improvement in CTS patients. Data were obtained by searching using Google Scholar, PubMed, and Science Direct published from 2011 to 2021. After the article selection process, 7 articles were included in this literature review, of which there were two articles showing that vitamin B6 can improve clinical symptoms of patients with CTS, one article showed that methylcobalamin had an effect on clinical improvement of CTS with and without DM, and 4 articles showed that the combination of vitamins B1, B6, and B12 was effective in reducing the VAS and TSS of subjects with CTS. Vitamin B6, methylcobalamin, and a combination of vitamins B1, B6, and B12 are effective as conservative therapy in improving clinical symptoms in patients with mild to moderate CTS

Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system

BackgroundProximal humerus fractures are often treated with a fixed-angle titanium plate osteosynthesis. Recently, plates made of alternative materials such as carbon fibre-reinforced polyetheretherketone (CFR-PEEK) have been introduced. This study presents the postoperative results of patients treated with a CFR-PEEK plate.MethodsPatients with proximal humerus fractures treated with a CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) were included. In follow-up examination, age and gender adjusted Constant-Murley Score (ACS), Subjective Shoulder Value (SSV), Quick Disabilities of the Arm, Shoulder and Hand Score (QDASH) and pain score (Visual Analog Scale (VAS)) were analyzed. General condition at follow-up was measured by European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L). Range of motion was recorded. In addition, radiographs at follow-up, unfavorable events and revision rate were analyzed.ResultsIn total, 98 patients (66.0 ± 13.2 years, 74 females, 24 males) were reexamined. Mean follow-up was 27.6 ± 13.2 months. There were 15 2-part, 28 3-part and 55 4-part fractures. The functional scores showed good results: SSV 83.3 ± 15.6%, QDASH 13.1 ± 17.0 and ACS 80.4 ± 16.0. A 4-part-fracture, head split component, nonanatomic head shaft reposition and preoperative radiological signs of osteoarthritis were significant negative predictors for poorer clinical scores. Unfavourable events were observed in 27 patients (27.6%). Revision surgery was performed in 8 (8.2%) patients. Risk factors for an unfavourable event were female gender, age of 50 years and older, diabetes, affected dominant hand, 4-part fracture, head split and preoperative radiological signs of osteoarthritis.ConclusionThere are several advantages of the CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) such as the polyaxial screw placement and higher stability of locking screws. In summary, the CFR-PEEK plate osteosynthesis is a good alternative with comparable clinical results and some biomechanical advantages. Proximal humerus fractures show good clinical results after treatment with a CFR-PEEK plate. The revision rate and the risk of unfavorable events are not increased compared to conventional titanium plate osteosynthesis.Level of evidenceIV

Atypical influence of biomechanical knowledge in Complex Regional Pain Syndrome-towards a different perspective on body representation

Part of the multifaceted pathophysiology of Complex Regional Pain Syndrome (CRPS) is ascribed to lateralized maladaptive neuroplasticity in sensorimotor cortices, corroborated by behavioral studies indicating that patients present difficulties in mentally representing their painful limb. Such difficulties are widely measured with hand laterality judgment tasks (HLT), which are also used in the rehabilitation of CRPS to activate motor imagery and restore the cortical representation of the painful limb. The potential of these tasks to elicit motor imagery is critical to their use in therapy, yet, the influence of the body’s biomechanical constraints (BMC) on HLT reaction time, supposed to index motor imagery activation, is rarely verified. Here we investigated the influence of BMC on the perception of hand postures and movements in upper-limb CRPS. Patients were slower than controls in judging hand laterality, whether or not stimuli corresponded to their painful hand. Reaction time patterns reflecting BMC were mostly absent in CRPS and controls. A second experiment therefore directly investigated the influence of implicit knowledge of BMC on hand movement judgments. Participants judged the perceived path of movement between two depicted hand positions, with only one of two proposed paths that was biomechanically plausible. While the controls mostly chose the biomechanically plausible path, patients did not. These findings show non-lateralized body representation impairments in CRPS, possibly related to difficulties in using correct knowledge of the body’s biomechanics. Importantly, they demonstrate the challenge of reliably measuring motor imagery with the HLT, which has important implications for the rehabilitation with these tasks.

Association of the anti-thyroid peroxidase antibody with chronic hand pain in older adults in the Third National Health and Nutrition Examination Survey: a cross-sectional study.

Autoimmune thyroid disease (AITD) is the commonest autoimmune disease. Although viewed as a classic form of single-organ autoimmunity, AITD is increasingly associated with non-thyroid sequelae including musculoskeletal manifestations and chronic pain syndromes. However, large population-based studies are needed. To examine the relationships between chronic hand pain and the AITD autoantibodies, anti-thyroid peroxidase antibody (TPOAb), and anti-thyroglobulin antibody (TgAb), in the Third National Health and Nutrition Examination Survey (NHANES III). This is a cross-sectional study. We examined data from NHANES III on 4820 persons aged 60 years or older with respect to hand pain and its association with TPOAb and TgAb. Log-binomial regressions were fit to examine the associations between the anti-thyroid autoantibodies and hand pain. Positive TPOAb was associated with a higher prevalence of hand pain than negative TPOAb [prevalence ratio (PR) = 1.158, p = 0.048] in the unadjusted model. This association was no longer significant after controlling for age, body mass index, gender, and diabetes (p = 0.313). When positive TPOAb was considered as a categorical variable with four levels, the highest quartile was associated with hand pain in the unadjusted (PR = 1.489, p = 0.005) and adjusted models (PR = 1.325, p = 0.042). There was no significant association between TgAb and hand pain when covariates were controlled for. TPOAb may be associated with the presence of chronic hand pain in persons aged over 60 years, especially at higher serum levels.

Impact of Different Types of Bikes on Post-ride Pain and Insights into Strategies Adopted by Recreational Cyclists from Gurugram to Alleviate Pain: A Cross-sectional Survey

Introduction: Non-traumatic injuries are prevalent among longdistance cyclists. However, there is a lack of studies analysing the impact of different types of bikes on the pain experienced by cyclists or the physiotherapy measures commonly adopted by cyclists post-ride. Aim: To understand the impact of different types of bikes on the pain experienced by cyclists and to identify the physiotherapeutic measures commonly adopted by Indian cyclists. Materials and Methods: A cross-sectional survey was conducted on 120 cyclists (94 males and 26 females) from three different cycling groups in Gurugram, Haryana, India. Data was collected from August 2022 to September 2022. A selfstructured questionnaire was used to collect information on sociodemographic profile, type of bike used, duration of cycling, average distance and speed covered, areas and types of pain experienced, and measures taken to address pain. The data was analysed using Statistical Package for Social Sciences (SPSS) version 24.0. The level of significance was set at p≤0.05. Data was presented as frequencies and percentages, and comparisons were made using Kruskal-Wallis and Chi-square tests. Results: The mean age of the study participants was 39.36±11.88 years. The average speed and distance covered in one ride were 22.52±4.73 km/hour and 43.50±15.32 km, respectively. A statistically significant association between the type of bike used and pain status (p&lt;0.05) was observed. 65% of riders reported experiencing pain in some part of their body in the last six months. Pain was more prevalent among hybrid bike users compared to mountain and road bike users. Male cyclists had a faster average speed compared to female cyclists by 5 km/hour. The average distance covered by male and female cyclists was similar, with just a 1 km difference. Cyclists commonly experienced pain in the wrists, legs, back, and neck. 19.1% of riders did nothing or only rested to address pain, while 21.66% opted for muscle stretching, 9.16% engaged in exercises, and 3.33% used cycling gloves for wrist and hand pain. Other measures included transcutaneous electrical nerve stimulation (TENS), dry needling, icing, refitting or changing the bike, and taking supplements. Conclusion: Among different types of bikes, hybrid bike users showed a higher incidence of pain. Cyclists in Gurugram tend to utilise limited physiotherapy measures to alleviate pain and enhance performance.

Association between Pain, Catastrophic Thinking, and Health-related Quality of Life in Patients with Hand Fractures

: Few reports have investigated the relationship between pain, catastrophic thinking, and health-related quality of life (QOL) in patients with hand fractures. We investigated the correlation between scores of the pain Numeric Rating Scale (NRS) and the Pain Catastrophizing Scale (PCS; rumination, helplessness, and magnification), and between the scores of PCS and health-related QOL based on the Short Form 8 questionnaire (SF-8).: Thirty-seven patients with hand and finger fractures were treated in a public hospital (16 men, 21 women; mean age, 56.5 years) and were treated by an occupational therapist. The relations between NRS, PCS, and SF-8 scores were examined at 4 to 6 months post-treatment. The effects of hand pain on catastrophic thinking and on mental, psychological, and daily role-based factors were analyzed by correlation and partial correlation analyses.The mean NRS score was 2.13. The mean PCS subitem scores were: rumination, 6.00; helplessness, 1.97; and magnification, 2.18. There were significant positive correlations between the NRS and all PCS scores. Relations between the PCS scores and SF-8 subitem scores, excluding items that were not correlated with NRS in partial correlation analysis, indicated significant negative correlations between multiple PCS subitems and SF-8 subitem scores for role physical, bodily pain, vitality, mental health, and physical component summary.Pain and catastrophic thinking were correlated with health-related QOL in patients with hand fractures. In addition to assessing hand pain, therapists should monitor the effects of mental and psychological factors and daily activities in this group of patients.

Management of stenosing flexor tenosynovitis in primary care.

Management of stenosing flexor tenosynovitis in primary care.

Thalidomide-induced sensory axonal polyneuropathy: A case report

Introduction: Several chemotherapeutic agents are currently available for the management of various malignancies; however, many are associated with adverse effects. A case of thalidomide- induced polyneuropathy is described below. Case Description: A 65year old man, with a history of secondary myelofibrosis in management with thalidomide, consulted for 5months of neuropathic pain and paresthesia in both hands. On physical examination, he presented hypoesthesia and hyperalgesia in both hands. In the electrodiagnostic studies (EDX) a sensory polyneuropathy of axonal type was concluded. Discussion: Chemotherapy-induced peripheral neuropathy (CIPN) is a side effect that occurs in up to 70% of patients. Symptomatology includes motor and sensitive deficit. EDX studies confirm diagnoses and characteristics. For the particular case of thalidomide involvement is mainly axonal. There is no standard treatment for CIPN, but several drugs can improve symptoms. Conclusions: CIPN is a frequent complication in patients managed with chemotherapy. The physiatrist is the ideal professional to provide a comprehensive approach to this entity, in order to improve the patient’s functionality.