Short-Form McGill Pain Questionnaire Research Articles

Effect of Cryotherapy on Pain Associated with Chest Tube Removal after Thoracotomy

Context: Chest tube removal (CTR) is described as one of the worst feelings for critically ill patients after thoracotomy. Unrelieved pain causes undesired consequences that have adverse effects on patient quality of care. Analgesics usually manages CTR pain, but patients respond differently to drugs and might not provide complete relaxation. Cryotherapy is commonly applied as a non-pharmacological intervention for relieving CTR pain.
 Aim: This study aimed to evaluate the effect of cryotherapy on pain associated with chest tube removal after thoracotomy.
 Methods: This study was conducted in the cardio-thoracic critical care units at Cardiovascular and Thoracic Academy, affiliated to Ain Sham University Hospital. A purposive sample of 140 patients undergoing thoracotomy was included in this study. They were divided into control and study group (70 patients in each group). Data were obtained using the Chamber-Price Modified Pain Rating Scale (CPPRS), Standardized Linear Scale for Pain Assessment, and Modified McGill Pain Questionnaire-Short Form (MPQ-SF).
 Results: The results reveal that 50%, 67.1% of the control and study group patients were in the age group 51-≥60 years. 62.9, 81.4% of the control and study group were males. Besides, there were highly statistically significant differences regarding peripheral pulse, apical pulse, and respiratory rate throughout CTR pain assessment times and a highly statistically significant difference regarding blood pressure immediately after CTR between the study and control groups. Also, statistically significant differences regarding physiological and behavioral parameters, pain intensity, and quality (sensory and affective descriptors) were found between the study and control groups immediately and 30 minutes after cryotherapy was applied after chest tube removal.
 Conclusion: Cryotherapy effectively improved hemodynamic, physiological, and behavioral parameters, relieving pain intensity and improving pain quality after chest tube removal for patients with thoracotomy. The current study recommends conducting periodic in-service educational programs for critical care nurses regarding the benefits, methods, contraindications, and side effects of cryotherapy for relieving pain associated with CTR after thoracotomy. Motivate nurses in critical care units to use cryotherapy as a non-pharmacological therapy for relieving pain associated with chest tube removal.

OPRM1 A118G polymorphism modulating motor pathway for pain adaptability in women with primary dysmenorrhea.

Primary dysmenorrhea (PDM) is a common condition among women of reproductive age, characterized by menstrual pain in the absence of any organic causes. Previous research has established a link between the A118G polymorphism in the mu-opioid receptor (OPRM1) gene and pain experience in PDM. Specifically, carriers of the G allele have been found to exhibit maladaptive functional connectivity between the descending pain modulatory system and the motor system in young women with PDM. This study aims to explore the potential relationship between the OPRM1 A118G polymorphism and changes in white matter in young women with PDM. The study enrolled 43 individuals with PDM, including 13 AA homozygotes and 30 G allele carriers. Diffusion tensor imaging (DTI) scans were performed during both the menstrual and peri-ovulatory phases, and tract-based spatial statistics (TBSS) and probabilistic tractography were used to explore variations in white matter microstructure related to the OPRM1 A118G polymorphism. The short-form McGill Pain Questionnaire (MPQ) was used to access participants' pain experience during the MEN phase. Two-way ANOVA on TBSS analysis revealed a significant main effect of genotype, with no phase effect or phase-gene interaction detected. Planned contrast analysis showed that during the menstrual phase, G allele carriers had higher fractional anisotropy (FA) and lower radial diffusivity in the corpus callosum and the left corona radiata compared to AA homozygotes. Tractographic analysis indicated the involvement of the left internal capsule, left corticospinal tract, and bilateral medial motor cortex. Additionally, the mean FA of the corpus callosum and the corona radiata was negatively correlated with MPQ scales in AA homozygotes, but this correlation was not observed in G allele carriers. No significant genotype difference was found during the pain-free peri-ovulary phase. OPRM1 A118G polymorphism may influence the connection between structural integrity and dysmenorrheic pain, where the G allele could impede the pain-regulating effects of the A allele. These novel findings shed light on the underlying mechanisms of both adaptive and maladaptive structural neuroplasticity in PDM, depending on the specific OPRM1 polymorphism.

Effects of Heat Treatment On Dysmenorrhea and Its Mental Health Outcomes: A Randomized Clinical Trial

This randomized controlled prospective experimental trial was conducted with 46 students with dysmenorrhea who were randomized in a 1:1 ratio to the heat treatment group (HTG) ( n = 23) and control group (CG) ( n = 23). To HTG, dry heat was applied for 20 minutes to the lower abdominal region of the subjects when their dysmenorrhea was most severe. Visual Analogue Scale (VAS), the Short Form McGill Pain Questionnaire (SF-MPQ), the Menstrual Attitude Questionnaire (MAQ), and the Depression Anxiety and Stress Scale (DASS) were used in this study. At the first menstrual cycle, both groups received the questionnaires, and no treatment was applied. At the second, third, and fourth menstrual cycles, VAS and SF-MPQ were applied before the treatment (T1), right after the treatment (T2), and 2 hours after the treatment (T3). MAQ and DASS were applied right after the treatment. Seven subjects from HTG and four subjects from CG were excluded from the study on account of their analgesic medicine usage, inability to menstruate, or by their own requests. When HTG and CG were compared, the decrease in the dysmenorrhea pain after the heat treatment in each of the three menstrual cycles was found to be statistically significant ( P < 0.05). In each of the four menstrual cycles, depression, anxiety, and stress were detected in each subject in both groups. However, the effectiveness of the treatment was not determined ( P > 0.05). In HTG, awareness of the changes during menstruation was diminished with time. [ Psychiatr Ann . 2023;53(6):270–281.]

ID: 222114 Effects of High Frequency Spinal Cord Stimulation as Measured by Autonomic Tone and fMRI

We investigated high frequency spinal cord stimulation (HF-SCS) efficacy in 1) reducing autonomic output as measured by galvanic skin response (GSR) levels during anticipation of and exposure to noxious thermal stimuli in while undergoing functional magnetic resonance imaging of the brain, and 2) altering subjective experience of pain as measured by the Short Form McGill Pain Questionnaire (SF-MPQ-2) and a modified Brief Pain Inventory Short Form (BPI-SF).

Association between Migraine and Quality of Life, Mental Health, Sleeping Disorders, and Health Care Utilization Among Older African American Adults

PurposeThis study examines the associations between migraine headaches, well-being, and health care use among a sample of underserved older African American adults. Controlling for relevant variables, the association between migraine headaches and (1) health care utilization, (2) health-related quality of life (HRQoL), and (3) physical and mental health outcomes was examined.MethodsOur sample included 760 older African American adults from South Los Angeles recruited through convenience and snowball sampling. In addition to demographic variables, our survey included validated instruments, such as the SF-12 QoL, Short-Form McGill Pain Questionnaire, and the Geriatric Depression Scale. Data analysis included 12 independent multivariate models using multiple linear regression, log transferred linear regression, binary and multinomial logistic regression, and generalized linear regression with Poisson distribution.ResultsHaving migraine was associated with three categories of outcomes: (1) higher level of health care utilization measured by (i) emergency department admissions and (ii) number of medication use; (2) lower level of HRQoL and health status measured by (i) lower self-rated health (ii) physical QoL, and (iii) mental QoL; and (3) worse physical and mental health outcomes measured by (i) higher number of depressive symptoms, (ii) higher level of pain, (iii) sleep disorder, and (iv) being disabled.ConclusionsMigraine headache significantly was associated with quality of life, health care utilization, and many health outcomes of underserved African American middle-aged and older adults. Diagnoses and treatments of migraine among underserved older African American adults require multi-faceted and culturally sensitive interventional studies.

Validity of the Modified Defense and Veterans Pain Rating Scale Supplemented With Items Germane to Total Joint Replacement: Secondary Analysis From a Randomized Trial.

Valid measures of pain are helpful to adjust treatment plans in real time after total joint replacement (TJR). We enhanced the existing Defense and Veterans Pain Rating Scale (DVPRS) with items related to pain at rest and movement, in specific reference to operative and nonoperative joints, creating the TJR-DVPRS. This manuscript is presented to validate the modified survey instrument. The aims of this psychometric study were to evaluate (1) the latent structure of the TJR-DVPRS, (2) the relationships among the pain dimensions represented on the TJR-DVPRS and the reference-standard Short-Form McGill Pain Questionnaire (version 2, SF-MPQ-2), and (3) the responsiveness of these two measures before and after TJR. This report involves a secondary analysis of pain surveys from 135 veterans undergoing TJR at one center who participated in a randomized trial. The study was approved by the institutional review boards from participating institutions. The TJR-DVPRS and SF-MPQ-2 were completed preoperatively, during postoperative day 1, and 6 weeks post-surgery. Standard psychometric evaluations included correlations, principal component analysis, and internal consistency of survey items and subscales, using preoperative baseline data as a frame of reference. Responsiveness analysis included assessing both effect size and thresholds of clinically important change for survey subscales using data from all three time points. Two reliable subscales were identified for the TJR-DVPRS, one including items about pain intensity and interference related to the operative joint (Cronbach's α = .809) and the other including two pain items on the nonoperative joint. Combining the subscales indicated a two-factor solution: The first valid factor entailed the four subscales of the SF-MPQ-2 and the TJR-DVPRS operative joint subscales, indicating that these subscales validly represent the same pain dimension. The second valid factor entailed the TJR-DVPRS subscale addressing the nonoperative joint. Responsiveness analysis following accepted psychometric methods demonstrated significant decreases in pain from the preoperative period to 6 weeks postoperatively for all subscales. The TJR-DVPRS and SF-MPQ-2 subscales were similarly responsive, except for the SF-MPQ-2 neuropathic and TJR-DVPRS nonoperative joint subscales, which were minimally responsive during the preoperative to 6-week period. The TJR-DVPRS is valid for use among veterans undergoing TJR and poses significantly less respondent burden than does the SF-MPQ-2. The brevity and ease of use of the TJR-DVPRS make it a practical tool for use during surgical recovery to monitor pain intensity at rest and with movement in the operative joint, and to assess pain interference with activity, sleep, and mood. The TJR-DVPRS is at least as responsive as the SF-MPQ-2, but the SF-MPQ-2 neuropathic and TJR-DVPRS nonoperative joint subscales were minimally responsive. Limitations of this study include the small sample size, under-representation of women (which would be expected in the veteran population), and using only veterans. Future validations studies should include civilians and active military TJR patients.

Efficacy and Safety of SIKD1977 in Combination with Standard Treatment for Postherpetic Neuralgia: Study Protocol for a Double Blind, Placebo-Controlled, Randomized, Multicenter, Phase 2 Clinical Trial.

Postherpetic neuralgia (PHN) is the most common chronic complication of herpes zoster, associated with poor quality of life and increased patient and healthcare resource expenditure. This randomized controlled trial aims to evaluate the efficacy and safety of SIKD1977 (Sogeonjungtang) in combination with standard treatment and estimate an effective dose for treating PHN. This is a protocol for a randomized, placebo-controlled, double-blind, multicenter trial. A total of 90 eligible participants with PHN will be recruited from three hospitals and randomly allocated to high-dose group, low-dose group, or placebo group in a 1:1:1 ratio. The trial will involve a 6-week oral administration of SIKD1977/placebo, and a 1-week follow-up period. The primary outcome will be the weekly average change in average daily pain score (ADPS) from baseline to the end of treatment. The secondary outcomes will include the weekly average changes in ADPS from baseline to week 2, 4, and 7, differences in Short-Form McGill Pain Questionnaire, Visual analogue scale, 5-level EuroQol-5 dimensions, Patient Global Impression of Change, and consumption of rescue drugs. All adverse events will be assessed during the trial. This study will provide evidence for the efficacy and safety of SIKD1977, and an effective dose for PHN. This protocol has been registered in the Clinical Research Information Service with the identification codeKCT0007939.

Long-Term Safety and Efficacy of Mirogabalin for Central Neuropathic Pain: A Multinational, Phase 3, 52-Week, Open-Label Study in Asia.

Central neuropathic pain (CNeP) is difficult to treat and has diverse etiology, including spinal cord injury (CNePSCI), Parkinson's disease (CNePPD), and central post-stroke pain (CPSP). The safety and efficacy of mirogabalin have been demonstrated in short-term trials, including patients with CNePSCI. The objective of our study was to confirm the safety/efficacy of mirogabalin in patients with CNePPD and CPSP, and obtain long-term data for CNePSCI. This 52-week, open-label extension of a previous randomized controlled study was conducted across Japan, Korea, and Taiwan. Patients with CNePSCI, CNePPD, or CPSP received twice daily (BID) 5-10mg mirogabalin for a 4-week titration period, after which the dosage was maintained for 47weeks at a maximum of 15mg BID, followed by a 1-week taper period receiving the same dose but only administered once daily. The primary endpoint was safety, assessed primarily by incidence and severity of treatment-emergent adverse events (TEAEs). Efficacy was assessed in a post hoc analysis of data obtained by the short-form McGill Pain Questionnaire (SF-MPQ). Of the 210 patients enrolled, 106, 94, and 10 had CNePSCI, CPSP, and CNePPD, respectively. The mean overall age of patients was 62.9years, and most patients were male and of Japanese ethnicity. TEAEs occurred in 84.8% of patients, the most common being somnolence (16.7%), peripheral edema (12.4%), edema (11.4%), nasopharyngitis (11.0%), and dizziness (7.6%). Most TEAEs were mild. Severe and serious TEAEs occurred in 6.2% and 13.3% of patients, respectively. All patient groups experienced reductions in SF-MPQ visual analog scores for pain: mean ± standard deviation changes from baseline at week 52 were -2.3 ± 21.13mm (CNePSCI), -17.0 ± 24.99mm (CPSP), and -17.1 ± 35.32mm (CNePPD). Mirogabalin was generally safe, well tolerated, and effective for treatment of CNeP in this long-term study. ClinicalTrials.gov identifier, NCT03901352.

Assessment of symptoms of the post-COVID-19 syndrome in patients with different rheumatic diseases

BackgroundPatients with rheumatic diseases significantly suffer during and after infection with coronavirus disease (COVID-19). Post-COVID-19 syndrome (PCS) refers to signs and symptoms occurring during or following a COVID-19 infection that continue beyond 12 weeks. The study aimed to assess PCS symptoms in rheumatic disease patients compared to a control group not suffering from a rheumatic disease or any other chronic illness.ResultsThe prevalence of PCS symptoms was significantly higher in rheumatic disease patients compared to the control group: fatigue (69.1% vs. 41.25%), myalgia (73.5% vs. 37.5%), attention deficits (57.4% vs. 40%), and muscle weakness (33.8% vs. 13.8%). Objectively, the study group had significantly higher scores for the Fatigue Severity Scale (FSS) (35.46 ± 13.146 vs. 25.1 ± 7.587), Short-form McGill Pain Questionnaire (SF-MPQ-2) (21.66 ± 10.3 vs. 11.6 ± 3.433), and higher grades of functional disability in the Post-COVID-19 Functional Status scale (PCFS). Rheumatic disease patients had significantly higher frequencies of anxiety and depression, as assessed by the Hospital Anxiety and Depression Scale (HADS), and cognitive impairment, as assessed by the Mini-Mental State Examination (MMSE), than the controls (P = 0.023, P = 0.003, P = 0.0001, respectively). Moreover, SLE patients had the most symptoms and the highest FSS, SF-MPQ-2, PCFS, and HADS scores, as well as the lowest MMSE scores (P = 0.0001 for all except cough (P = 0.043), weakness (P = 0.015), paresthesia (P = 0.027), and anosmia (P = 0.039)). Lower disease duration, hospitalization during acute COVID-19, steroid use, smoking, and biologics non-use were significantly associated with higher PCS symptoms. Smoking was a significant risk factor (P = 0.048), and biologics use was protective (P = 0.03). Rheumatic disease patients who received two doses of the COVID-19 vaccinations had better scores on the FSS, HADS for anxiety and depression, and MMSE than those who received a single dose (P = 0.005, P = 0.001, P = 0.009, P = 0.01).ConclusionRheumatic disease patients have a higher prevalence and risk of PCS, so strict follow-up, avoiding smoking, controlling disease activity, and COVID-19 vaccinations are essential for decreasing the morbidity of PCS.

P099 Attention-based Virtual Reality - A Safe, Acceptable and Potentially Highly Effective Treatment for Fibromyalgia Syndrome: Findings from The VIPA Study

Abstract Background/Aims Chronic pain is highly prevalent and a leading cause of disability worldwide with a crippling socioeconomic cost. Current non-pharmacological management of conditions including Fibromyalgia Syndrome (FMS) are labour intensive to implement and not widely available. There is an urgent need to develop accessible, innovative treatments for pain cohorts. Virtual reality (VR) is a modern technology that immerses users within a three-dimensional, interactive virtual environment delivered through a head-mounted display. VR is widely used for acute pain, following multiple randomised controlled trials showing efficacy. Despite growing numbers of feasibility studies and a handful of larger clinical trials, robust evidence within chronic pain cohorts including FMS is still limited. Through the VIPA Study, we investigated the impact of different VR characteristics on acceptability and pain using multiple feasibility studies in patients with FMS. Methods Patients with FMS were recruited through outpatient clinics at the Norfolk and Norwich University Hospital. We investigated four VR systems representing the spectrum of commercially available technologies. Participants used each system in a random order for five minutes. The interactive VR program experienced with each headset was co-developed alongside industry partners specifically for patients with chronic pain. Baseline questionnaires included the McGill pain questionnaire short form (MPQ-SF; total score: 0-45), pain visual analogue scale (VAS; 0-10) and Revised Fibromyalgia Impact Questionnaire (FIQR; total score: 0-100). MPQ-SF and VAS data were also collected approximately 15 minutes after use of the fourth headset (post-intervention). Questionnaires collected acceptability data using 7-point Likert scale rating questions (1=strongly disagree to 7=strongly agree). The VR sickness questionnaire (VRSQ) gained side-effect data (total severity score: 0-100). Results 26 participants with FMS were included (mean (SD) age 48 ±14yrs, 88% female). Disease severity ranged from moderate to extreme (mean FIQR 65 ±16). Following use of all headsets, a 40% reduction in mean MPQ-SF total scores from baseline were reported (baseline 24 ±9, post-intervention 15 ±9, p = <0.001). A 24% reduction in mean pain VAS was observed (baseline 5.5 ±1.9, post-intervention 4.0 ±1.9, p = <0.001) with one participant reporting an 80% reduction (change in VAS: 5.9). Participants indicated high levels of acceptability across VR systems when asked about comfort, quality, usability and immersion (mean total headset score ranged from 77-97 out of 105). Side effects were infrequent and mild (mean total VRSQ score across devices: 17 ±12). 100% agreed they would be open to using VR regularly at home for pain management (mean rating 6.5 ±0.6). Conclusion Patients with FMS can experience large reductions in pain following VR, find the technology acceptable with limited side effects, and are open to home use for pain management. VR has enormous potential as an accessible, home-based treatment for chronic pain. VIPA provides strong justification for future RCTs investigating efficacy and dose-response. Disclosure J. Tsigarides: Grants/research support; J.T. has received a small amount of funding from Orbital Global Ltd to support research equipment purchase for The VIPA Study. V. Grove: None. N. Shenker: None. J. Dainty: None. J. Chipping: None. S. Miles: None. S. Sami: None. A. MacGregor: None.

Mirror Therapy for the Management of Phantom Limb Pain: A Single- Center Experience

Phantom limb pain (PLP) can have devastating consequences, affecting up to 90% of amputees. PLP is associated with analgesia dependence and impaired quality of life. Mirror therapy (MT) is a novel treatment that has been applied in other pain syndromes. We prospectively evaluated MT in the management of PLP. Prospective study of patients recruited between 2008 - 2020 who underwent unilateral major limb amputation, with a healthy contralateral limb. Participants were invited to attend weekly MT sessions. Pain in the seven days prior to each MT session was scored on a visual analogue scale (VAS -0-10mm) and the short form McGill pain questionnaire (SFMPQ). 98 patients (68M: 30F) ages 17-89 years were recruited over 12 years. 44% of patients had amputations due to peripheral vascular disease. Over an average of 2.5 sessions, the final treatment score on the VAS scale was 2.6 (SD ±3.0) with a reduction of 4.5 points on VAS score. As a comparison using the SFMQ scoring system, the average final treatment score was 3.2 (±5.0) with 91% overall improvement. Mirror therapy is a very powerful and effective intervention for PLP. It is an exciting addition to the armoury of vascular surgeons in the management of this condition.

Quantitative and Qualitative Pain Evaluation in Response to OnabotulinumtoxinA for Chronic Migraine: An Observational Real-Life Study.

(1) Background: Randomized controlled trials and real-life studies demonstrated the efficacy of OnabotulinumtoxinA (OBT-A) for CM prevention. However, no studies specifically addressed its effect on pain's quantitative intensity and qualitative characteristics. (2) Methods: This is an ambispective study: a post-hoc retrospective analysis of real-life prospectively collected data from two Italian headache centers on CM patients treated with OBT-A over one year (i.e., Cy1-4). The primary endpoint was the changes in pain intensity (Numeric Rating Scale, NRS; the Present Pain Intensity (PPI) scale, the 6-point Behavioral Rating Scale (BRS-6)) and quality scale (the short-form McGill Pain Questionnaire (SF-MPQ)) scores. We also assessed the relationship between changes in intensity and quality of pain and disability scale (MIDAS; HIT-6) scores, monthly headache days (MHDs), and monthly acute medication intake (MAMI) (3) Results: We retrieved 152 cases (51.5 years SD 11.3, 80.3% females). From baseline to Cy-4, MHDs, MAMI, NRS, PPI, and BRS-6 scores decreased (consistently p < 0.001). Only the throbbing (p = 0.004), splitting (p = 0.018), and sickening (p = 0.017) qualities of pain collected in the SF-MPQ were reduced. Score variations in MIDAS related to those in PPI scales (p = 0.035), in the BRS-6 (p = 0.001), and in the NRS (p = 0.003). Similarly, HIT-6 score changes related to PPI score modifications (p = 0.027), in BRS-6 (p = 0.001) and NRS (p = 0.006). Conversely, MAMI variation was not associated with qualitative or quantitative pain score modifications except BRS-6 (p = 0.018). (4) Conclusions: Our study shows that OBT-A alleviates migraine by reducing its impact on multiple aspects, such as frequency, disability, and pain intensity. The beneficial effect on pain intensity seems specific to pain characteristics related to C-fiber transmission and is associated with a reduction in migraine-related disability.

Substantiating the Therapeutic Effects of Simultaneous Heat Massage Combined with Conventional Physical Therapy for Treatment of Lower Back Pain: A Randomized Controlled Feasibility Trial

There are various therapeutic options for the conservative management of lower back pain (LBP). A combination of two or more treatment options may be more effective in the clinical management of non-specific LBP. In this study, we compared the effects of simultaneous heat massage with conventional physical therapy in patients with subacute LBP. A single-center randomized controlled trial in which 40 participants with LBP were allocated to one of two groups: a heat massage group (HMG) and physical therapy group (PTG). The HMG received simultaneous heat massage therapy using a mechanical device (CGM MB-1401, Ceragem, Republic of Korea). The PTG received conventional physical therapy. Both groups received 40 min of therapy once daily, five times a week, for a total of four weeks. Changes in serum cortisol, epinephrine (EP), and norepinephrine (NE) were assessed. The outcomes were measured using the pain numeric rating scale (PNRS), the Oswestry disability index (ODI), the Roland-Morris disability questionnaire (RMDQ), the short-form McGill pain questionnaire (SF-MPQ), the multidimensional fatigue inventory (MFI-20), the Beck depression inventory (BDI), surface EMG (sEMG), and sympathetic skin response (SSR) at baseline (PRE), at 2 (2 W) and 4 weeks (4 W) following the intervention. The serum EP and NE levels in the HMG decreased after treatment. The PNRS, ODI, RMDQ, and SF-MPQ scores improved without significance in both groups. The BDI score showed improvement in the HMG before the PTG. The MFI-20 score improved in both groups, but the results were better in the HMG than in the PTG at 4 W. All the activities of sEMG were significantly decreased in both groups. However, the improvement of the %MVIC in the HMG was better than that in the PTG at 4 W. The SSR latency on sEMG decreased while the amplitude increased in the HMG at 2 W and 4 W, respectively. Following 4 weeks of combined therapies, heat massage was not superior to conventional physical therapy alone. Both treatments were shown to be effective in improving LBP and pain-related disability. However, heat massage was shown to have a better effect on the control of autonomic nerve function and underlying moods.

Evaluation of Work-Related Musculoskeletal Pain and Work Posture in Ultrasonologists Working in Mumbai

Background: Work-related musculoskeletal disorders (WRMDs) are common occupational problem observed in jobs which involves repetitive motion and assuming awkward positions for prolonged period of time. Ultrasonologists job activities involve holding the transducer head in a proper plane of scanning, one-sided static working position, prolonged pinch gripping of the ultrasound transducer, abduction at the shoulder during transducer placement and insufficient recovery time. Maintaining these awkward postures for a prolonged period of time increases their risk of having work related musculoskeletal disorders. Objective: To assess musculoskeletal pain, work posture and level of risk of injury during the work. Method: A sample of 60 ultrasonologists working in urban area fulfilling the selection criteria were screened for work related musculoskeletal pain using The Short form McGill Pain Questionnaire (SFMPQ) and for work posture and level of risk of injury using Rapid Entire Body Assessment (REBA). Results: Majority of the ultrasonologists complained of upper back pain (27%) followed by low back pain (19%), shoulders (16%), neck (16%), wrist (11%) and knees (11%). 93.3% of the study population fall under medium risk, 3.30% fall under low risk, and 3.30 % fall under high risk of injury related to work.. Conclusion: This study concludes that most of the ultrasonologists had upper back pain and moderate risk of musculoskeletal injuries related to work. Keywords: Rapid Entire Body Assessment, Work Related Musculoskeletal Disorders, Short form McGill Questionnaire, ultrasonologist.

Comparing the Effects of Medical Cannabis for Chronic Pain Patients With and Without Co-Morbid Anxiety: A Cohort Study

Introduction There is growing evidence on the efficacy of cannabis-based medicinal products (CBMPs) for chronic pain(CP). Due to the complex interaction between chronic pain and anxiety, and the potential impact of CBMPs on both anxiety and chronic pain, this article aimed to compare the outcomes of CP patients with and without co-morbid anxiety following CBMP treatment. Methods Participants were prospectively enrolled in this cohort study and categorized by baseline General Anxiety Disorder-7(GAD-7) scores, into ‘no anxiety’(GAD-7<5) and ‘anxiety’(GAD-7≥5) cohorts. Primary outcomes were changes in Brief Pain Inventory Short-Form, Short-form McGill Pain Questionnaire-2, Pain Visual Analogue Scale, Sleep Quality Scale (SQS), GAD-7 and EQ-5D-5L index values at 1, 3 and 6 months compared to baseline. Results 1254 patients (anxiety=711; no anxiety=543) met inclusion criteria. Significant improvements in all primary outcomes were observed in both cohorts at all timepoints (p<0.050), except GAD-7 in the no anxiety group(p>0.050). The anxiety cohort reported greater improvements in EQ-5D-5L index values, SQS and GAD-7(p<0.050), but there were no consistent differences in pain outcomes. Conclusion A potential association between CBMPs and improvements in pain and health-related quality of life (HRQoL) in CP patients was identified. CP patients with co-morbid anxiety achieved greater improvements in general HRQoL, but not pain-specific outcomes.

Pain descriptors and adaptation of Short Form McGill Pain Questionnaire 2 (SF-MPQ-2) for older people in Brunei Darussalam

Background: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is common in older people, and tends to be under-reported and under-treated. In addition to quantifying pain severity using the visual analogue scale (VAS), use of the translated Short-Form McGill Pain Questionnaire (SF-MPQ-2) to identify pain descriptors may assist with pain assessment in older people. Aims: identify pain descriptors for different pain aetiology in older people using the adapted SF-MPQ-2 Brunei Malay version and compare pain severity assessments using the VAS and SF-MPQ-2. Patients and methods: A prospective study using the translated SF-MPQ-2 in older people admitted or seen in clinic under Orthopaedics and Geriatrics specialties between November 2018 and February 2019. Results: There were 75 participants, with 21 pain descriptors used. The main descriptors for fractures, osteoarthritis or muscle/tendon problems were identified. Despite pain medication, more than a third still experienced moderate to severe pain. However, almost all were satisfied with the pain management. There was a statistically significant difference between pain severity between the VAS and SF-MPQ-2, with the VAS possibly underestimating pain. Conclusions: The adapted SF-MPQ-2 appears feasible for use with older people in Brunei. Further studies are required to formally validate the SF-MPQ-2 in older patients and with specific medical conditions, such as diabetes or surgery.

Pain and Clinical Presentation: A Cross-Sectional Study of Patients with New-Onset Chronic Pain in Long-COVID-19 Syndrome.

The aim of this study was to evaluate the characteristics of pain (i.e., pain intensity, pain interference, clinical presentation) in Long-COVID-19 patients and compare the location of pain between successfully recovered COVID-19 patients and healthy matched controls. A cross-sectional case-control study was carried out. Long-COVID-19 patients, age- and sex-matched patients with a history of COVID-19 who had successfully recovered, and healthy controls were included. Outcomes included were pain characteristics (Brief Pain Inventory and Short-Form McGill Pain Questionnaire) and clinical presentation (Widespread Pain Index and Euroqol-5 Dimensions 5 Levels Visual Analogue Scale). Sixty-nine patients with Long-COVID-19 syndrome, sixty-six successfully recovered COVID-19 patients, and sixty-seven healthy controls were evaluated. Patients with Long-COVID-19 syndrome showed greater pain intensity and interference. In addition, they showed worse quality of life and greater widespread pain, with the most frequent locations of pain being the neck, legs, and head. In conclusion, patients with Long-COVID-19 syndrome show a high prevalence of pain, characterized by widespread pain of moderate intensity and interference, with the most frequent locations being the neck, legs, and head, significantly affecting the quality of life of these patients.

Internet-based basic body awareness therapy in fibromyalgia syndrome: A report of three cases.

Previous literature has shown that basic body awareness therapy (BBAT) may be an effective treatment for fibromyalgia syndrome (FMS). This study constitutes the first case study evaluating internet-based BBAT for FMS. The purpose of this case study was to describe the feasibility and preliminary outcomes of an internet-based BBAT training for a total of 8 weeks in three patients with FMS. The patients underwent a synchronous individual internet-based BBAT training. Outcomes were assessed using Fibromyalgia Impact Questionnaire Revised, Awareness-Body-Chart, Short-Form McGill Pain Questionnaire (SF-MPQ), and plasma fibrinogen level. These measures were administered at baseline and after the treatment. Patient satisfaction with the treatment was evaluated using a structured questionnaire. At the post-treatment evaluation, each patient showed improvements in all outcome measures. All patients had clinically significant changes in Fibromyalgia Impact Questionnaire Revised. The SF-MPQ total score in Patients 1 and 3 exceeded the minimal clinically important difference. All patients' pain severity exceeded the minimal clinically important difference for Visual Analogue Scale (SF-MPQ). Besides, we found some benefits in body awareness and the level of dysautonomia. At the end of the treatment, patient satisfaction with the programme was very high. Based on this case study, the application of internet-based BBAT seems feasible and promising for clinical benefits.

Can chronic spontaneous urticaria produce symptoms of neuropathic pain?

BackgroundChronic spontaneous urticaria (CSU) is a condition that is associated with recurrent pruritic hives and/or angioedema lasting for more than 6 weeks and is known to affect 1% of the population. Neuropathic pain can be defined as abnormal pain in the peripheral or central nervous system following injury and results from dysfunctions in the peripheral or central nervous system without peripheral nociceptor stimulation. Histamine appears in the pathogenesis of both the CSU and diseases of the neuropathic pain spectrum. ObjectiveTo evaluate the symptoms of neuropathic pain in patients with CSU using scales. MethodFifty-one patients with CSU and 47 sex- and age-matched healthy controls were included in the study. ResultsThe results of the short-form McGill Pain Questionnaire revealed the scores in the sensory and affective domains, Visual Analogue Scale (VAS) scores and pain indices to be significantly higher in the patient group (p < 0.05 for all cases), while the overall pain assessment and sensory assessment based on the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale were also significantly higher in the patient group. Based on the assumption that scores of > 12 indicated neuropathy, 27 (53%) of the patients in the patient group and 8 (17%) in the control group were found to have neuropathy (p < 0.05). Study limitationsCross-sectional study, small patient sample and use of self-reported scales. ConclusionIn addition to itching, patients with CSU should be aware of the potential for the association of neuropathic pain. In this chronic disease that is known to affect the quality of life, using an integrated approach with the patients and identifying accompanying problems are as important as treating the dermatological disorder.

Efficacy of combined application of traditional Chinese medicine foot bath and mild moxibustion in the treatment o f limb pain in diabetic peripheral neuropathy patients

Purpose: To determine the efficacy of the combination of traditional Chinese medicine (TCM) foot bath and mild moxibustion in the treatment of limb pain in patients with diabetic peripheral neuropathy (DPN).&#x0D; Methods: A total of 120 patients with symptoms of DPN-induced pain who were hospitalized at the Department of Endocrinology in the 903rd Hospital of PLA, from January 2020 to June 2021, were included in this study. They were randomly assigned to a study group and a control group, with 60 patients in each group. Patients in both groups received conventional treatments and nursing care, while those in study group were additionally treated with a combination of TCM foot bath and mild moxibustion. Treatment efficacy in the patients was evaluated using Short-Form McGill Pain Questionnaire (SF-MPQ), pain rating index (PRI), visual analogue scale (VAS), TCM symptom score (TCMSS), and Toronto Clinical Scoring System (TCSS).&#x0D; Results: Compared with control group, there were significant improvements in pain-related scores, namely, SF-MPQ, (p ˂ 0.05); PRI, (p &lt; 0.01); VAS, (p &lt; 0.05); as well as overall efficacy (p &lt; 0.05). Similar improvements were also observed with regard to TCMSS (p &lt; 0.001) and TCSS (p &lt; 0.001) in the study group. However, there were no significant changes in Adjusted Diabetes Quality of Life (A-DQOL) score and blood glucose control in both groups.&#x0D; Conclusion: Relative to the conventional treatment for DPN, limb pain and disease score of patients are significantly reduced by the combination of TCM foot bath and mild moxibustion treatments. Further clinical trials would be required prior to application in clinical practice.