McGill Questionnaire Research Articles

Current Trends in Modalities of Pain Assessment: A Narrative Review.

Pain is a common complaint among a spectrum of diseases. Although an ideal objective method of pain assessment is lacking, several validated tools are available for use in clinical research and practice. The tool considerations are based upon the parameters to be assessed and factors specific to patient, disease, and availability of instruments. This review classifies and brings the key aspects of currently available pain assessment tools on a single platform to ease the selection process for researchers/practitioners. The tools utilized for pain assessment were collected from articles available in PubMed and Google Scholar databases and classified into the following domains: unidimensional, multi-dimensional, investigation-based, and computerized algorithm-based tools. Their purpose of use and limitations are reviewed. The unidimensional scales are used to describe only the characteristics of pain, like intensity (e.g. numerical rating scale), type (e.g. neuropathic pain questionnaire), or pattern. In contrast, multi-dimensional tools, like Mc Gill Questionnaire, assess not only pain as an individual symptom but also its influence on physical functioning and general well-being. However, certain components like ethnicity, age, cognitive impairment, sedation, and emotion become a limiting factor in selecting the scale. In addition to these scales, a potential role of parameters such as biopotentials/markers has also been shown in pain assessment. Last, artificial intelligence is also being applied in evaluation of pain. Pain measurement is subjective in nature as assessed through questionnaires and observational tools. Currently, multi-dimensional approaches of pain assessment are available, which can lead to precision pain management.

What is the Effect of Lidocaine Compared to Lidocaine and Clove Oil on Episiotomy Site Anesthesia: Results from a Randomized Clinical Trial

Background: Episiotomy is a commonly performed obstetric procedure that often results in perineal pain for women. Objectives: This study aimed to compare the effects of lidocaine alone and lidocaine combined with clove oil on pain at the episiotomy site. Methods: This randomized clinical trial was conducted at Baharloo Hospital in Tehran, involving 65 nulliparous women who underwent episiotomy. Perineal pain was assessed using the Visual Pain Intensity Scale (VAS) and the McGill Questionnaire. The control group received a 2% lidocaine injection, while the intervention group received a combination of 0.8% clove oil and 2% lidocaine to alleviate pain before the episiotomy. The clove oil was applied topically to the episiotomy site 10 minutes prior to the lidocaine injection. During the episiotomy repair stage, both groups received a 2% lidocaine injection. Pain intensity was measured using the aforementioned tools at 1, 6, and 12 hours after episiotomy repair. Results: There was no statistically significant difference in average pain intensity between the two groups before and 12 hours after the intervention (P > 0.05). However, at 1 and 6 hours after the intervention, the combination of clove oil and lidocaine resulted in significantly lower pain compared to the lidocaine-only group (P < 0.05). Conclusions: Considering the greater effectiveness of lidocaine combined with clove oil in reducing episiotomy site pain intensity and the absence of side effects, this method can be recommended as an adjuvant therapy to reduce pain at the episiotomy site.

Clinical Depression and Anxiety Are Relieved by Microvascular Decompression in Patients with Trigeminal Neuralgia-A Prospective Patient-Reported Outcome Study.

Objective: Patients with idiopathic trigeminal neuralgia (TN) live in constant fear of triggering shock-like pain episodes, which may cause symptoms of depression and a reduction in quality of life. Microvascular decompressive surgery has been demonstrated to achieve satisfactory and stable results. With this study, we wanted to investigate prevalence and risk factors for depression and perceived stress in correlation with symptom relief after surgical treatment. Methods: In this prospective study, patients undergoing microvascular decompression (MVD) for TN were included. The Barrow Neurological Institute Pain Score (BNI), Beck Depression Inventory (BDI), Chronic Pain Acceptance Questionnaire (CPAQ), Perceived Stress Questionnaire (PSQ) and McGill questionnaire were used to evaluate depression, stress and anxiety disorders before and 3 months after MVD. Results: A total of 35 patients (16 male (46%)) with a mean age of 55.4 (SD 15) years were included in this study. The BDI revealed that 24 (68.8%) patients harbored mild-to-extreme depression preoperatively (2.4 ± 1.4), which improved to 1.2 (±0.6, p < 0.0001). Pain acceptance also changed from 64 (±11.3) to 67.7 (±9.3, p = 0.006). Perceived stress decreased from 46.9 (±21.9) to 19.6 (±18.6) (p < 0.0001) postoperatively, and pain decreased from 31.0 (±11.7) to 9.4 (±12.9, p < 0.0001). Microvascular decompression reduced the mean BNI pain score significantly from 4.6 to 1.8 postoperatively (p < 0.00001). Conclusions: Depression and perceived stress are prevalent in patients with idiopathic TN. Adequate treatment not only provides a high rate of satisfaction through pain relief, but also leads to immediate and significant improvements in depression and stress. Thus, in patients with TN who do not reach an adequate and timely pain reduction through medical management and develop signs of depression, early treatment with microvascular decompression should be considered.

ХРОНИЧЕСКИЕ БОЛЕВЫЕ СИНДРОМЫ В СТАРЧЕСКОМ ВОЗРАСТЕ И РОЛЬ СУБСТАНЦИИ Р. ПРИ ДАННОЙ ПАТОЛОГИИ

ABSTRACT AIM. To investigate chronic pain syndromes in old age and evaluate the clinical significance of substance P in this pathology. MATERIAL AND METHODS. The study enrolled 68 patients over the age of 75 years with the presence of musculoskeletal pain of any origin for at least 3 months. The mean age of the patients reached 81.9 ± 5.8 years (from 75 to 100 years), most of them were women (85.3%). In this study, the severity of pain was assessed using a visual analogue scale (VAS), and the type of pain was analyzed using questionnaires and scales: DN4, PainDetect, Fibromyalgia Identification Questionnaire (FIRST), Central Sensitization Questionnaire, McGill Pain Questionnaire. The blood concentration of substance P was determined by enzyme immunoassay. RESULTS AND DISCUSSION. The severity of pain syndrome on the VAS scale reached 6.3 ± 2.2 points. The mean scores for DN4 were 3.9 ± 2.1 points, and for PainDetect — 14.7 ± 9.4 points. The mean value of the FIRST questionnaire for diagnosing fibromyalgia was 3.5 ± 1.6 points, and the McGill questionnaire was 69.8 ± 43.7 points. The mean value of the central sensitization scale reached 44.3 ± 16.7 points. Pain syndrome was more severe in women: the mean VAS value in women was 6.4 ± 2.3, in men — 5.1 ± 1.2 points (p = 0.02). The severity of the neuropathic component of the pain syndrome in women was also higher: DN4 scores in women were 4.0 ± 2.1, and in men — 2.9 ± 1.7 points (p = 0.08), and PainDetect — 15.7 ± 9.4 and 8.6 ± 6.4 points, respectively (p = 0.02). The mean values of the screening questionnaire for diagnosing fibromyalgia in women reached 3.7 ± 1.5 points, and in men — 2.7 ± 1.5 points (p = 0.07). In the group of women, the mean McGill questionnaire scores were 74.2 ± 45.2, in men — 45.3 ± 23.6 points (p = 0.006). The mean values of the central sensitization questionnaire for women were: 46.1 ± 16.3, and for men — 34.2 ± 15.5 points (p = 0.03). However, no significant differences in the severity of depression were recorded in women and men: 6.2 ± 2.8 and 5.0 ± 3.4 points, respectively (p = 0.3). The mean concentration of substance P in the study group was 222.6 ± 92.9 pg/ml, varying from 74 to 529 pg/ml. In men, the mean blood concentration of substance P reached 267.1 ± 85.2 pg/ml, in women — 214.2 ± 92.7 pg/ml (p = 0.02). An inverse correlation was registered between the blood concentration of substance P and the age of patients (r = −0.31; p = 0.02). No significant relationships were found between the blood concentration of substance P and the values of all pain questionnaires. Significant correlations were registered between VAS and DN4 (r = 0.29; p = 0.01), PainDetect (r = 0.41; p = 0.004), McGill questionnaire (r = 0.53; p &lt; 0.0001) and central sensitization questionnaire (r = 0.3; p = 0.01). There was no significant correlation between the severity of pain according to VAS and the severity of depression (r = 0.16; p = 0.21). The severity of depression correlated with indicators of DN4 (r = 0.31; p = 0.01), FIRST (r = 0.26; p = 0.03), McGill questionnaire (r = 0.29; p = 0.02) and central sensitization questionnaire (r = 0.5; p &lt; 0.0001). There was a direct correlation between the age of patients and indicators of DN 4 (r = 0.24; p = 0.05) and the central sensitization questionnaire (r = 0.25; p = 0.04). CONCLUSION. The study results suggest the presence of severe chronic pain syndrome of various types in old patients and longlivers. Significant relationships were found between pain indicators assessed using different scales and questionnaires. In this study, no significant correlations were established between the blood concentration of substance P and pain parameters. KEYWORDS: pain, old age, substance P, questionnaires, scales, neuropathic, depression

EFFECTS OF MLS-LASER ON NEUROPATHIC PAIN IN DIABETIC SENSОMOTOR NEUROPATHY

About 20-50 % of patients with diabetes and about 60 % of those with diabetic neuropathy develop neuropathic pain, which is characterized by tingling, burning, sharp, shooting, or stabbing sensations, and even electric shock-like sensations. Painful diabetic neuropathy can significantly affect the quality of life of patients with diabetes, the ability to perform daily activities and negatively affect mood. According to the 2021 consensus of an international panel of experts regarding the treatment of painful distal symmetric polyneuropathy, non-pharmacological forms of treatment should also be considered due to unsatisfactory pharmacotherapy. A number of studies have demonstrated the role of photobiomodulation as a non-pharmacological method of treating painful diabetic neuropathy. The purpose of this placebo-controlled, longitudinal study was to investigate the effect of high-energy MLS-laser therapy on neuropathic pain. Material and methods: A total of 69 cases of patients with type 2 diabetes and painful diabetic neuropathy of the lower extremities were followed, divided into two groups: an experimental - 41 patients received high-energy laser radiation and a control (placebo) group - 28 patients, with a "mock" laser treatment. For objectification of pain, the Bulgarian version of the short form of the McGill pain questionnaire, version SF-MPQ-2, which includes the visual analog scale (VAS), was used. Comparisons between groups were performed with parametric or non parametric tests depending on the distribution of the variables, the number of the compared groups and the study pre test – post test design. Results: The pain index, reported by the McGill questionnaire, in the experimental group, decreased by - 63.2 % at the end of the nine-day treatment and by - 56.1 % at the 90th day after the start of treatment compared to the value before therapy. In the control group, there was a minimal change at the end of treatment (day 21), which did not persist until the end of the observation period (day 90). Conclusions: MLS laser therapy significantly increases the pain threshold and should be considered a safe, non-pharmacological adjunct to standard therapy in patients with painful diabetic peripheral neuropathy.

The experience of pain and its ontological modelling from a philosophical point of view: Phenomenological description and ontological revision of theMcGill Pain Questionnaire.

The aim of the article is to identify, on the basis of the phenomenological and ontological analysis of the experience of pain and the ways in which this experience is expressed in natural language, an ontological modelling of the language of pain and, at the same time, a revision of the traditional version of the McGill questionnaire. The purpose is to provide a different characterisation and an adequate evaluation of the phenomenon of pain, and, consequently, an effective measure of the actual experience of the suffering subject.

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.

Dolor pélvico en mujeres con episiotomía versus mujeres con desgarro perineal de segundo grado

IntroductionPelvic pain is one of the most common pelvic floor dysfunctions in the postpartum period, depending on the degree of injury and the time at which it is assessed. The degree of involvement of a mediolateral episiotomy is similar to that of a second degree perineal tear, therefore it was decided to conduct a study to collect the degree of pain reported using the McGill Pain Questionnaire. Material and methodsAn observational, prospective longitudinal epidemiological study of dynamic cohorts was conducted among 384 women, of whom 255 had a second-degree tear and 129 had undergone an episiotomy. An assessment of the pelvic floor was carried out, together with data collection (performance or not of perineal massage, pelvic floor muscle exercises, presence of Kristeller, type of suture) as well as the degree and type of pain using the McGill Questionnaire, in the immediate puerperium, at six weeks, and six months of postpartum. ResultsIn the immediate puerperium more than 50% of women reported some type of painful sensation, without finding significant differences between both cohorts. However, as the study evolved, there was a progressive decrease in pain in both cohorts. By six weeks postpartum, less than 33% of women reported a painful sensation, considered as absence of pain according to the criteria of the McGill questionnaire. ConclusionThe presence of episiotomy or second degree perineal tear was not related to perineal pain.

Application of photobiomodulation for chronic pain-related TMD on pain points versus pre-established points: Randomized clinical trial.

Photobiomodulation therapy (PTB) is a therapeutic possibility for temporomandibular disorders (TMD), but its effectiveness and protocols for use remain controversial. This study is a RCT that compared the effectiveness of PTB on pain points of the masticatory muscles and TMJs, located through palpation versus application of pre-established points in women with painful TMD, diagnosis by DC/TMD (Diagnostic Criteria for Temporomandibular Disorders - Brazilian Portuguese version). Therefore, a total sample of 54 women, aged between 18 and 60years, was investigated. Volunteers were randomly randomized and PTB was applied in four different groups with a dose of 4J and 6J divided into pre-established application points (PE - G1) and pain points (PD - G2) - Groups 4PE, 4PD, 6PE and 6PD. Four laser applications were performed with a wavelength of 780nm, one session per week, totaling one month of therapy. The following assessments were performed: DC/TMD, Brief Pain Inventory (BPI), McGill Questionnaire - Short Version (SF-MPQ) and Pain Intensity, Visual Analogue Scale (VAS). Friedman's test was used for within-group comparisons, while the Mann-Whitney test was used for between-group comparisons (p<0.05). According to the results, laser application on pain points (G2) was more effective. McGill's results showed that regardless of dose, the pain point application group had better outcomes (p=0.004). Pain intensity evaluation (last days) also showed that application at the pain points was more effective regardless of dose (p=0.0002). Medians and interquartile deviations showed overall that PTB was more effective at pain points, with a trend towards better outcomes at the 6J dose. Therefore, it can be concluded that in women with chronic painful TMD, the application of PTB at pain points is more effective than the application at pre-established points. Therefore, individualized PTB protocols are proposed, based on examination palpation of the masticatory structures.

Non-invasive brain stimulation for fatigue in post-acute sequelae of SARS-CoV-2 (PASC)

Backgroundand purpose: Fatigue is among the most common persistent symptoms following post-acute sequelae of Sars-COV-2 infection (PASC). The current study investigated the potential therapeutic effects of High-Definition transcranial Direct Current Stimulation (HD-tDCS) associated with rehabilitation program for the management of PASC-related fatigue. MethodsSeventy patients with PASC-related fatigue were randomized to receive 3 mA or sham HD-tDCS targeting the left primary motor cortex (M1) for 30 min paired with a rehabilitation program. Each patient underwent 10 sessions (2 sessions/week) over five weeks. Fatigue was measured as the primary outcome before and after the intervention using the Modified Fatigue Impact Scale (MFIS). Pain level, anxiety severity and quality of life were secondary outcomes assessed, respectively, through the McGill Questionnaire, Hamilton Anxiety Rating Scale (HAM-A) and WHOQOL. ResultsActive HD-tDCS resulted in significantly greater reduction in fatigue compared to sham HD-tDCS (mean group MFIS reduction of 22.11 points vs 10.34 points). Distinct effects of HD-tDCS were observed in fatigue domains with greater effect on cognitive (mean group difference 8.29 points; effect size 1.1; 95% CI 3.56–13.01; P < .0001) and psychosocial domains (mean group difference 2.37 points; effect size 1.2; 95% CI 1.34–3.40; P < .0001), with no significant difference between the groups in the physical subscale (mean group difference 0.71 points; effect size 0.1; 95% CI 4.47–5.90; P = .09). Compared to sham, the active HD-tDCS group also had a significant reduction in anxiety (mean group difference 4.88; effect size 0.9; 95% CI 1.93–7.84; P < .0001) and improvement in quality of life (mean group difference 14.80; effect size 0.7; 95% CI 7.87–21.73; P < .0001). There was no significant difference in pain (mean group difference −0.74; no effect size; 95% CI 3.66–5.14; P = .09). ConclusionAn intervention with M1 targeted HD-tDCS paired with a rehabilitation program was effective in reducing fatigue and anxiety, while improving quality of life in people with PASC.

Алгофобия пункции верхнечелюстной пазухи, все ли мы знаем о ней?

Introduction. Performing a puncture of the maxillary sinus at the stages of diagnosis and treatment of rhinosinusitis remains relevant. The emerging algophobia, according to other patients, or their own previously experienced pain forces patients to abandon this manipulation. In this context, properly performed, with good anesthesia, maxillary sinus puncture is painless and easily tolerated by patients. Objective. To increase the effectiveness of the treatment of maxillary sinusitis by improving the anesthetic support during the puncture of the maxillary sinus based on the study of various types of analgesia near the located anatomical zones. Patients and methods. A total of 152 patients took part in the prospective study, of which: according to absolute indications, 50 patients with acute exacerbation of chronic sinusitis underwent maxillary sinus puncture under application anesthesia, 50 patients with chronic periodontitis underwent extraction of the tooth of the upper jaw under infiltration anesthesia, and 52 patients with chronic diseases of the upper gastrointestinal tract underwent esophagogastrodoudenoscopy (EGD) under topical anesthesia. To objectify and determine the intensity of pain, a visual analogue scale, the McGill questionnaire, Wong–Baker and Brief Pain scales were used. Results. Pain sensations of patients from the puncture of the maxillary sinus averaged 1.27 points, in the first control group, 0.18 points; in the second control group, 1.79 points. The subjective assessment of pain during tooth extraction was significantly lower and significantly different from those during puncture and EGD. Subjective assessments during puncture and EGD did not significantly differ from each other. Values for all groups ranged between «no pain» and «almost no pain.» Conclusion. Subject to the technique and time of anesthesia, puncture of the maxillary sinus is well tolerated by patients of different age groups, and pain, according to the questionnaires, does not go beyond “almost does not hurt.”

Sleep quality in people with chronic pain undergoing hemodialysis

Objective: to evaluate sleep quality in people with chronic pain undergoing hemodialysis. Methods: observational, prospective, and cross-sectional study carried out in two hemodialysis clinics. The sample was formed by 76 people with chronic kidney disease and chronic pain who were undergoing hemodialysis. We used a sociodemopgrahic and clinical form, the visual analogue scale for pain, the McGill questionnaire, and the Pittsburgh Sleep Quality Index. Results were analyzed using descriptive and inferential statistics and correlation tests. Results: most participants had very poor sleep quality. There was a correlation between sleep quality and the visual analogue scale for pain (p=0.027). There was a negative correlation between McGill pain scale descriptors and sleep quality (p=0.033). Conclusion: the sleep quality levels of most participants suffered alterations and were classified as poor or very poor. Contributions to practice: this study provides data on correlations associated with the sleep quality of patients with chronic pain undergoing hemodialysis. It also gives support for nursing teams to develop interventions to improve the sleep quality of these patients.

Discomfort to Comfort, Coconut oil can Reduce Menstrual Pain!

Background: Menstrual pain usually begins several hours before or just after the onset of menstruation. Women commonly experience pain in the lower abdomen and in some, it radiates to lumbar region, it affects their performance of their daily activities. Coconut oil has many benefits like it is anti-inflammatory and anti-toxin and fights pain directly and also it is cheap as well as it is easily available in home. Aims: The aim of the study was to find the effectiveness of applying coconut oil over lower abdomen in reducing menstrual pain among young women residing in a selected hostel. Materials and Methods: A pre-experimental one group pre-test and post-test study design, using a quantitative approach and non-probability purposive sampling technique on 30 hostlers, participated on the basis of their severity of menstrual pain. The tools deployed include sociodemographic variables, universal pain assessment scale, and modified McGill questionnaire. On the day of the menstrual pain, a selfprepared pre-test questionnaire was administered and after 1 h of intervention the post-test was administered. Both descriptive and inferential statistics were used for the analysis of data. Results: Pre- and post-test and paired-t test were analyzed. The mean ± standard deviations of pre-test were 2.03 ± 1.03 and the post-test was 0.76 ± 0.97. The pain reduced with 1.27 mean differences. The obtained t-value was13.32 and P-value significantly improved at P &lt; 0.00. Conclusion: The study revealed that applying coconut oil over lower abdomen of menstruating women showed improvement in bringing down the level of menstrual pain. This indicates that application of coconut oil effectively reduced the menstrual pain.

Comparison of Post-Cesarean Pain Perception of General Versus Regional Anesthesia, a Single-Center Study.

Background and Objectives: Pain during and after the procedure remains the leading concern among women undergoing cesarean section. Numerous studies have concluded that the type of anesthesia used during a cesarean section undoubtedly affects the intensity and experience of pain after the operation. Materials and Methods: This prospective cohort study was conducted at the Clinic for Gynecology and Obstetrics, Clinical Center "Dragisa Misovic-Dedinje", Belgrade, Serbia. Patients at term pregnancy (37-42 weeks of gestation) with an ASA I score who delivered under general (GEA) or regional anesthesia (RA) by cesarean section were included in the study. Following the procedure, we assessed pain using the Serbian McGill questionnaire (SF-MPQ), Visual Analogue Scale (VAS) and the pain attributes questionnaire at pre-established time intervals of 2, 12, and 24 h after the procedure. Additionally, time to patient's functional recovery was noted. We also recorded the time to the first independent mobilization, first oral intake, and lactation establishment. Results: GEA was performed for 284 deliveries while RA was performed for 249. GEA had significantly higher postoperative sensory and affective pain levels within intervals of 2, 12, and 24 h after cesarean section. GEA had significantly higher postoperative VAS pain levels. On pain attribute scale intensity, GEA had significantly higher postoperative pain levels within all intervals. Patients who received RA had a shorter time to first oral food intake, first independent mobilization, and faster lactation onset in contrast to GEA. Conclusions: The application of RA presented superior postoperative pain relief, resulting in earlier mobilization, shorter time to first oral food intake, and faster lactation onset in contrast to GEA.

Chronic Pain And Levodopa Therapy in Parkinson’s Disease Patients

Background: Pain is a frequent non-motor symptom in patients with Parkinson’s disease (PD) and appears to be related to low levels of dopamine. This study describes the characteristics of chronic pain in a group of PD patients undergoing levodopa therapy. Methods: This was a cross-sectional study. The pain was assessed in 21 selected PD patients with chronic pain using several scales and instruments. Changes in pain response from levodopa use (wearing-off phenomenon) were monitored. Results: The most prevalent type of pain was nociceptive (71.4%), musculoskeletal and dystonic, but neuropathic pain accounted for the highest pain score according to the Parkinson’s Disease Pain Classification System (45.5±30.08). Patients with neuropathic, nociplastic, or nociceptive pain upon wearing-off were those who responded to levodopa (p=0.999). According to the McGill questionnaire, patients with pain upon wearing-off had higher scores in the affective/motivational dimension (p=0.022). Conclusion: Using a new pain classification and scoring tool, this study corroborates a good response to levodopa in PD-related pain.

Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study.

There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p &lt; 0.01) between the groups, for the Physical Health domain and the total score of the SF-12 questionnaire, and for all the domains of the McGill questionnaire; but no significant differences were found in the data from the WPAI-GH questionnaire. Statistically significant data (p &lt; 0.01) were found for mechanosensitivity in the abdominal area and limbs, but not for the lumbar assessment, within the group, with very few significant intergroup differences. The frequency of active MTrPs is higher in the groups of women with primary dysmenorrhea and during the menstrual phase, with the prevalence of myofascial trigger points of the iliococcygeus muscle being especially high in all examination groups (&gt;50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea.

Fast pain relief in exercise-induced acute musculoskeletal pain by turmeric-boswellia formulation: A randomized placebo-controlled double-blinded multicentre study.

Background:Plant extracts with analgesic properties are seldom considered for treatment of acute musculoskeletal pain due to delay in onset of analgesia. Turmeric (Curcuma longa) and boswellia (Boswellia serrata) extracts are well-studied anti-inflammatory compounds gaining in popularity and used as an alternative to conventional treatments for musculoskeletal pain. This study analyzed the analgesic effect of a formulation of turmeric and boswellia extracts in sesame oil (Rhuleave-K, TBF) in reducing exercise-induced acute musculoskeletal pain in healthy participants.Methods:In this randomized double-blinded placebo-controlled, single-dose, single-day, multicentre study, a total of 232 participants (TBF n = 116; placebo n = 116) having moderate-to-severe exercise-induced acute musculoskeletal pain were randomized in an allocation concealed 1:1 ratio to receive a single dose of 1000 mg of TBF or placebo. The outcome measures were numerical rating scale (NRS), categorical pain relief scale (PRS), onset of analgesia, and short form of McGill questionnaire (SF-MPQ). NRS and PRS were measured from predose to every 30 minutes interval of postdose up to 6 hours at rest, with movement and applying pressure on the affected part. The onset of analgesia was measured from the time of dosage and censored at 6 hours of postdose. The sum of pain intensity difference (SPID6) and total pain relief (TOTPAR6) at 6 hours was, respectively, analyzed from NRS and PRS scores.Results:TBF showed a significant reduction in pain intensity (SPID6rest) with 97.85% improvement in cumulative responder analysis compared with 2.46% in placebo. The onset of pain relief was fast and highly significant in the TBF group with 99% of participants having a mean perceptible pain relief at 68.5 minutes (95% confidence interval, 59.5–77.4) and 96% of participants having a mean meaningful pain relief at 191.6 minutes (95% confidence interval, 176.7–206.4) compared to the placebo group. Highly significant and continuous improvement in pain relief was observed in the TBF group with 93% of participants having ≥ 50% of maximum TOTPAR6 with a number needed to treat of 1.1 at rest.Conclusion:Exercise-induced acute musculoskeletal pain can be effectively relieved by TBF (Rhuleave-K) in about 3 hours signifying its strong analgesic activity.

The effect of Virtual Reality (VR) on anxiety and pain in patients undergoing port implantation

Abstract A growing body of evidence supports Virtual Reality (VR) as an effective and safe strategy for management of pain and stress associated with medical procedures in both adults and children. We therefore initiated a feasibility study to investigate the effect of VR on pain, stress, and anxiety during elective surgery, e.g. implantation of a central-venous port catheter, hypothesizing that VR can reduce intraoperative pain, stress and anxiety of the patient. In this manuscript, the preliminary results of the first 20 (out of 6o planned) patients are presented. Baseline pain characteristics did not differ between the two study groups (VR group (n=10) and standard (no VR device) group (n=10)). System usability (“easy to use”, “easy to learn” and “safe”) was rated “good - very good” by the study participants. Selfassessment of anxiety components (Y-6 item questionnaire) revealed a calming (3.3 ± 0.5 vs. 2.4 ± 0.5, P= 0.009) and relaxing (2.7 ± 1.2 vs. 1.8 ± 0.4; P=0.09) effect of the VR device. Evaluation of pain level (Short form McGill questionnaire) during the procedure revealed a lower pain intensity (VAS) level (17.5 ± 12.1 vs. 19.5 ± 10.6; P= 0.834) and present pain intensity (PPI) score (0.9 ± 0.6 vs. 1.0 ± 0.5; P= 0.841) in the VR group Preliminary data of our feasibility study indicates a positive effect of VR towards reduction of pain and stress in patients undergoing minor surgery in local anaesthesia. However, further data is needed to substantiate these results.

Diagnostic methods of the impact on the life’s quality of lumbar pain syndromes in workers of harmful industries

Occupational diseases associated with pain syndrome in the lower part are one of the most common causes of physical and psychological health disorders. Lower back pain (LBP) also affects labor productivity and the social sphere of life and is becoming an increasingly important factor in the growth of medical care costs. The study aims to research a comprehensive study of the impact of chronic LBP on the quality of life of workers in unfavorable conditions of metallurgical production. Experts have carried out a hygienic assessment of working conditions according to the data of the special assessment of working conditions cards, a questionnaire (a questionnaire of disorders of vital activity in Oswestrovsky's lower back pain, a questionnaire of McGill's pain) and a clinical examination of 132 employees (men) of various industries of the metallurgical enterprise. We analyzed the results of additional instrumental examination methods: radiography of the lumbar spine and electroneuromyography of the nerves of the lower extremities. Under the working conditions of workers of the leading professions of metallurgical production, combined and combined effects of harmful production factors are characteristic, the integral assessment of which corresponds to class 3.2. The severity of the labor process among employees of the studied professions was within classes 2.0.-3.1. According to the McGill questionnaire experts have found statistically significant differences in the main occupational groups: the highest pain indicators were in the group of wire-drawing workers (index - 7.5±4.9; rank - 14.6±10.2) and drivers of intra-factory vehicles (index - 6.9±4.4; rank - 15.1±11.3). After the treatment there were positive dynamics in the values of rank indicators on the affective and evaluative scales (p&lt;0.05). Researchers have identified statistically significant differences between all the studied groups (F=2.55, p=0.041), when using the Oswestrovsky questionnaire. There were degenerative-dystrophic changes of the spine on radiographs of the lumbar spine. According to the results of an electroneuromyographic study, the authors revealed signs of dysfunction at the level of segments L5-S1-2 of the lumbosacral spine. As a result of the study, we have revealed the relationship between the early detection of disorders of the musculoskeletal system with the peculiarities of the labor process and the deterioration of the quality of worker’s life in the production of hardware. To assess the intensity of LBP in workers engaged in harmful working conditions, it is possible to use the McGill and Oswestrovsky pain questionnaires. The detection of pain syndrome and early rehabilitation in people with occupational diseases of the musculoskeletal system contributes to prolonging the working age and improving the quality of life in people with physical overload in the workplace.

Pain Characteristics in Patients with Inflammatory Bowel Disease: A Monocentric Cross-Sectional Study.

The abdominal pain common in inflammatory bowel disease [IBD] patients is traditionally associated with inflammation but may persist during clinical remission. Central sensitization [CS] has not previously been explored in these patients. This study aimed to determine the epidemiology of pain in IBD patients and to specify pain characteristics with particular attention to CS. This cross-sectional study included 200 patients; 67% had Crohn's disease [CD]. Pain was assessed using the McGill questionnaire, using the Douleur Neuropathique 4 [DN4] questionnaire and by clinical examination. Its impacts on quality of life, depression and anxiety were also assessed. Three-quarters of IBD patients complained of pain, including intermittent pain attacks, 62% reported abdominal pain and 17.5% had CS. The prevalence of pain [83.6% vs 59.1%; p < 0.001] and abdominal pain [68.7% vs 48.5%; p = 0.006] was higher in CD patients than in ulcerative colitis [UC] patients. Multivariate analysis confirmed that age [p = 0.02], sex [female] [p = 0.004] and CD [p = 0.005] were independent risk factors for pain. Pain intensity was greater in the case of CS (6 [5-3] vs 3 [1.5-5], p < 0.003) which significantly impaired quality of life [p < 0.003] compared with pain without CS. The prevalence of pain was high in IBD patients [≈75%] and higher in CD patients. Significant impacts on quality of life were confirmed. More than 25% of patients with abdominal pain described CS as responsible for more severe pain and worsened quality of life. NCT04488146.