Pain Levels Research Articles

Quasi-Experimental Study: Evaluating the Effectiveness of Jacobson Relaxation Techniques on Pain Among Post-COVID Geriatrics with Co-morbid Illness

Introduction: Jacobson's progressive muscle has been widely recognized for its potential benefits in pain management, particularly in populations experiencing high levels of stress and anxiety, which are common in post-COVID patients. Objectives: This study aimed to evaluate the effectiveness of Jacobson Relaxation Techniques on pain among post-COVID geriatrics who had co-morbid illness. Methods: Quantitative study was selected for the study. A total of 82 participants were selected using purposive methods allocated to either the intervention group (n=41) or the control group (n=41). Pain levels were assessed using the Numeric Pain Rating Scale (NPRS) at baseline and after a week of intervention. Descriptive statistics and inferential analysis were employed to analyze the data. Results: The study finding revealed that the intervention group had a pre-intervention pain score of 7.2 ± 1.5, which reduced to 4.5 ± 1.2 post-intervention, indicating a noticeable reduction in pain levels following the intervention. In contrast, the control group had a pre-intervention pain score of 7.0 ± 1.4, which showed a minimal reduction to 6.8 ± 1.3 post-intervention, suggesting that the control condition had little to no impact on pain levels. The intervention group demonstrated a significant reduction in pain scores compared to the control group post-intervention (p < 0.05), indicating the efficacy of Jacobson Relaxation Techniques in pain management among post-COVID geriatrics with co-morbid illness. Conclusions: Jacobson Relaxation Techniques offer a valuable non-pharmacological approach for alleviating pain in post-COVID geriatrics with co-morbid illness. Further study recommended on the integration of these techniques into clinical practice can improve the quality of life for this vulnerable population, addressing a critical aspect of post-COVID care.

Probiotics’ supplementation alleviates disease severity and improves postural balance by repairing intestinal leak in patients suffering from osteoarthritis: A double-blinded clinical trial

Abstract Increased intestinal leakiness and associated systemic inflammation are potential contributors to osteoarthritis (OA) and postural imbalance in the geriatric population. To-date, no successful treatment to correct postural imbalance in OA is known. We aimed to explore the effects of a multistrain probiotic upon postural imbalance in OA-affected patients. In this randomized, double-blind trial with a placebo group, 147 patients suffering from knee OA (age-span = 64-75 years) were divided into placebo (n=75) and probiotics (n=72) study groups. Vivomix 112 billion, multistrain probiotic was given once a day for 12 weeks. The outcomes of study variables were determined first at baseline and later after 12 weeks of intervention. These were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee flexion range-of-movement (ROM), pain intensity by visual analogue scale (VAS), handgrip strength (HGS), gait speed, and balance control assessed in standing, semi-tandem, and tandem stances. We determined plasma zonulin, to determine intestinal leak along with c-reactive protein (CRP) and 8-isoprostanes levels. A total of 136 OA patients taking placebo (n=71) and probiotics (n=65) were analyzed. The probiotics group exhibited a reduction in pain intensity, disease severity, and WOMAC scores along with improvement in balance scores, HGS, and walking speed (p<0.05 for all), no change in ROM, resting pain, and 8-isoprostanes levels. The correlation analysis revealed a robust association of balance scores with plasma markers of intestinal leakiness and inflammation in probiotics but not in the placebo group. Probiotics reduce postural imbalance in OA patients partly due to a reduction in intestinal leakiness.

Using Extracorporeal Shockwave Therapy in Patients with Orthopedic Conditions

Background: Among other non-invasive procedures, Extracorporeal Shockwave Treatment (ESWT) has been used to resolve many musculoskeletal ailments. The authors completed a systematic review to study articles that reported the effectiveness of focused shockwave therapy in patients with orthopedic conditions. Methods: A comprehensive search was conducted across reputable databases including Pub Med, The Cochrane Library, Science Direct, PEDro, Clinicaltrials.gov, and Google Scholar, ensuring a thorough review of the literature until October 10, 2022. Original articles of any design reporting on the use of ESWT in orthopedic patients were meticulously selected. Information related to study design, sample size, participants, intervention, and key findings of the study were extracted. The PEDro classification scale, a recognized tool, was used to evaluate the quality of the studies, further enhancing the credibility of findings. Results: Nineteen research articles (including 1157 participants) were retrieved and included for qualitative analysis. The sample size ranged from twenty-one to one hundred fifteen subjects, and the articles were published between 2001 and 2022. Out of 19 studies published, five were conducted in China, three in Germany, two in Iran and Turkey, and one in the United States, Canada, Italy, Denmark, Spain, Taiwan, and Saudi Arabia. The risk of bias was either moderate or low among the included studies. In patients with various orthopedic conditions, considerable moderate evidence of ESWT’s effectiveness and success in lowering pain levels, increasing treatment success rates, promoting patient-reported functional recovery, and raising performance-based functional outcomes was seen in the results. Conclusion: The systematic literature review provided compelling evidence of the successful application of ESWT in treating a wide range of musculoskeletal problems. These positive outcomes were achieved without severe complications and morbidities, offering a promising outlook for the future of orthopedic treatment.

Investigating the Correlations between Patient Demographics and Complications Following Total Knee Arthroplasty: A Cross-Sectional Study

Introduction: This study investigates the relationship between patient age, gender, and various complications, such as pain, restricted range of motion (ROM), and hemorrhage following total knee arthroplasty. Materials and Methods: This cross-sectional study included 62 patients (Mean±SD age= 65.9±7.38 years; female participants=74.2%) who underwent total knee arthroplasty at Atieh Hospital in Tehran, Iran, between 2020 and 2021. Pain levels were assessed using the numerical pain rating score. Meanwhile, knee joint ROM was evaluated using a reliable mobile application. Hemorrhage was measured through knee joint drainage. Statistical analyses were performed to analyze the data. Results: Women reported higher pain levels and more restricted ROM in passive knee extension and active/passive knee flexion compared to men (P<0.05). However, no significant differences were observed between genders in active knee extension and hemorrhage. A significant inverse correlation was found between pain and ROM in passive knee extension (rho=-0.41, P≤0.001), as well as in active (rho=-0.5, P≤0.001) and passive knee flexion (rho= -0.59, P≤0.001). However, no significant relationship was observed between pain and active knee extension or hemorrhage. Age showed no statistically significant correlation with the other variables. Conclusion: This study highlights the association between higher pain levels and greater ROM restrictions in passive knee extension and active/passive knee flexion following total knee arthroplasty; however, patient age and gender were not found to be associated with postoperative hemorrhage. These findings underscore the importance of closely monitoring pain and ROM, particularly in women undergoing total knee arthroplasty.

Postobturation Pain of three Novel Calcium Silicate-based sealers with asymptomatic irreversible pulpitis or necrotic pulp with chronic apical periodontitis: prospective clinical trial

BackgroundBioceramic-based root canal sealers are increasingly important in root canal treatment because of their biocompatible properties. This study aimed to evaluate postobturation pain incidence and intensity after root canal obturation with NeoSealer Flo, MTA-Bioseal, and GuttaFlow bioseal calcium silicate-based sealers and AH Plus epoxy resin-based sealer in patients with asymptomatic irreversible pulpitis or necrotic pulp with chronic apical periodontitis.MethodsA total of 120 participants with single-rooted teeth were included and randomly divided into four groups according to the root canal sealer used (n = 30). The patients were subsequently categorised based on the pulp vitality (vital or nonvital) in each group (n = 15) and all teeth were obturated in a single-visit. The postobturation pain scores were recorded on a visual analogue scale (VAS) at 6 h, 24 h, 48 h, 72 h, 7 d and 30 d. Moreover, analgesic intake was also noted at 24 h and 48 h. The Mann–Whitney U test, Kruskal‒Wallis H test, Friedman test, and Spearman’s correlation test were used, and a p value < 0.05 was considered significant.ResultsVAS scores were highest for the 6 h > 24 h > 48 h ≈ 72 h ≈ 7 d ≈ 30 d time intervals for both pulp status in each root canal sealer. A significant decrease in the VAS score was observed for all sealers from 6 h to 48 h (p 0.05). Nonvital cases had lower VAS scores at all time intervals. Analgesic intake was greater in the first 24 h (p < 0.05) in vital cases (p < 0.05) and also in females than males.ConclusionThe level of pain experienced after obturation was similar in patients with different pulp status for all the root canal sealers. Analgesic intake was greater in vital cases and females within 24 h.Trial registrationClinicalTrial.gov, NCT06515756, record date: 2024-07-17, retrospectively registered.

In-depth clinical characterization of intravenous iron infusion-induced hypophosphatemic osteomalacia and its resolution

Abstract Iron deficiency anemia is treated by iron supplementation. Increasing evidence has shown that the carbohydrate components in iron infusions can cause hypophosphatemia and subsequent osteomalacia due to excess iFGF23 (intact Fibroblast Growth Factor 23). We here undertook an in-depth characterization of 13 patients with iron infusion-induced osteomalacia (IIIO). Patients were characterized (monocentric institutional practice) by means of laboratory, bone density, HR-pQCT and virtual osteoid volume estimation. We additionally report a patient who was treated with burosumab because iron infusions had to be continued despite osteomalacia. All 13 patients received ferric carboxymaltose (FCM) infusions and presented with low phosphate levels in the laboratory. Stopping the FCM infusions and supportive treatment by substitution of phosphate, calcium, native and/or active vitamin D was the chosen therapeutic approach. Pain, mobility, biochemical data, such as serum phosphate levels, bone mineral density, bone microstructure and virtual osteoid volume were the main outcome measures. Our results indicate biochemical normalization (e. g. phosphate levels pre: 0.50 mmol/l ± 0.23 mmol/l, post: 0.93 mmol/l ± 0.32 mmol/l, P&amp;lt;.001) after stopping the FCM infusion and establishing supportive treatment. Additionally, pain levels on the visual analogue scale (VAS) decreased (VASpre 7.31 ± 1.22, VASpost 2.73 ± 1.27, P&amp;lt;.0001) and areal bone mineral density (expressed as T-score) improved significantly (T-scorepre: -1.85 ± 1.84, T-scorepost: -0.91 ± 2.13, P&amp;lt;.05). One patient requiring ongoing FCM infusions experienced significant additional benefits from burosumab treatment. In conclusion, our results highlight the importance of monitoring phosphate in patients treated with FCM infusions. Stopping FCM infusions is effective in addressing the excess of iFGF23 and thereby phosphate wasting. Supportive therapy enables quick recovery of the musculoskeletal system and improves pain levels in these patients.

“Do You Yourself Have Any Idea What is Going On?”: Invitations for Lay Diagnosis in Dutch Primary Care Physiotherapy

ABSTRACT Lay perspectives are important in the recovery of patients with nonspecific pain as they influence levels of pain and patients’ pain experiences. Although previous interactional research has focused on patients’ unsolicited attempts to share their perspectives, health professions also employ specific techniques to solicit them. Physiotherapists are recommended to assess lay perspectives and include them in treatment. One way to do so is through invitations for lay diagnosis (this paper). However, little is known about how lay perspectives are constructed through these invitations and how physiotherapists follow up on them. In this study, physiotherapy intakes were analyzed using conversation analysis. We found that invitations for lay diagnosis are frequently embedded in previous health care visits or patients’ knowledge gathering activities. Patients often express low epistemic status when they construct their lay perspectives and engage in lay diagnostic activity in response to these invitations. Additionally, physiotherapists’ responses in the third position, such as follow-up questions, may influence the further development of patients’ lay perspectives. These invitations provide patients an opportunity to share their views on their health issues, but also create an interactional challenge due to the reversal of usual epistemic dynamics. The study highlights the complexity of doing lay diagnosis, which can include diagnoses or explanations of varying specificity. The specificity and elaboration of these perspectives are influenced by the physiotherapists’ subsequent responses. We provide recommendations for healthcare professionals to facilitate lay diagnosis, and our findings contribute to the discussion around patient empowerment, shared decision making, and patient centered care.

Improving Pain Assessment After Inpatient Orthopedic Surgery: A Comparison of Two Scales

ABSTRACT Purpose: In pain assessment, the commonly used Numeric Rating Scale (NRS) offers an incremental 0-to-10 range of response options. But this broad range often leads to discordant evaluations between nurses and their patients. This study aimed to compare the NRS to the three-category Interventional Pain Assessment (IPA) scale, validate the IPA scale in an inpatient setting, and determine RN and patient scale preferences. Methods: This prospective study enrolled 122 postoperative orthopedic patients and their designated 104 RNs at a level 1 trauma center in the midwestern United States. Patients were asked to verbally rate their pain from 0 to 10 using the NRS and from 0 to 2 on the IPA scale. Patients were also asked which scale best conveyed their pain. The RNs were asked which scale best informed them of their patient's pain situation and which scale they preferred. To establish a correlation between the two scales, we considered NRS values of 0 to 7 (signifying no pain to moderate pain) to correspond to IPA scale values of 0 to 1 (signifying no pain to tolerable pain). NRS values of 8 to 10 (signifying severe pain) were considered to correspond to IPA scale values of 2 (signifying intolerable pain). Responses in which patients reported IPA scores indicating no pain to tolerable pain but NRS scores above 7 or IPA scale scores indicating intolerable pain but NRS scores of 7 or below were defined as discordant answers. Results: Data analysis revealed a strong significant correlation between the NRS and IPA scale (τ = 0.597), with an 82.7% concordance rate. Once an NRS score rose above 7, more discordance between the two scales became increasingly prevalent, as evidenced by the 45% of patients who also reported tolerable pain on the IPA scale. Significantly more patients (89.3%) preferred the IPA scale to communicate their pain level than the NRS (10.7%). Significantly more RNs (76%) felt the IPA scale best informed them of their patient's pain and was a better guide for treatment than felt the NRS did so (24%). Conclusions: The IPA scale asks about pain tolerability and thus has a direct role in the management of pain medications. Both patients and nurses felt they were better able to convey and understand pain when using the IPA scale than when using the NRS. There was consensus regarding pain scale preference among patients and their RNs, with both groups preferring the IPA scale due to its simplicity and, among the RNs, its usefulness in guiding treatment. The IPA scale may be a much better tool for accurately assessing a patient's pain experience and needs, with the potential to change practice and improve pain management.

Beneficial effects of non‐pharmacological interventions for post‐stroke pain: A meta‐analysis

AbstractPurposePain is a frequent post‐stroke health concern, and several non‐pharmacological interventions are commonly employed to manage it. However, few reviews have examined the effectiveness of such interventions, making it difficult to draw conclusions about their usefulness. Furthermore, subgroup analysis based on post‐stroke pain level or intervention characteristics is rarely performed. This study aimed to investigate the effectiveness of non‐pharmacological interventions and evaluate the significant factors associated with post‐stroke pain through subgroup analysis.DesignSystematic review and meta‐analysis.MethodsRelevant studies were obtained from seven databases, from their commencement up to March 2024, as well as from the gray literature. The PICOS approach was used to evaluate the eligibility criteria of the studies. The RoB‐2 tool was used to determine the risk of bias in each randomized trial. Pooled estimations of standardized mean difference and heterogeneity (quantified with I2) were obtained using a random‐effects model. The stability of the pooled result was then assessed using the leave‐one‐out approach. STATA 17.0 was used to run the meta‐analysis.FindingsNon‐pharmacological interventions were effective in reducing pain immediately after intervention (pooled SMDs: −0.79; 95% confidence interval [CI]: −1.06 to −0.53; p &lt; 0.001). The approach involving acupuncture, aquatic therapy, or laser therapy and rehabilitation training was effective for post‐stroke hemiplegic shoulder pain. A pooled analysis of non‐pharmacological interventions showed that both less than 4 weeks and more than 4 weeks of interventions were effective in alleviating pain in stroke patients.ConclusionNon‐pharmacological approaches appear to be beneficial for reducing post‐stroke pain. The outcomes based on the modalities merit further research.Clinical relevanceFurther studies are needed to determine the effects of different modalities on pain intensity following a stroke. Furthermore, to avoid overestimation of intervention efficacy, future randomized trials should consider blinding approaches to the interventions delivered.

Transoral Atlantoaxial Reduction Plate (TARP) Technique for the Treatment of Irreducible Atlantoaxial Dislocation (IAAD) Caused by Old Odontoid Fracture

Study Design Retrospective case series study. Objectives This study aimed to evaluate the clinical efficacy of TARP technique for treating IAAD caused by old odontoid fracture and assess the outcomes of patients who underwent TARP technique over 2 years of follow-up. Methods Between January 2005 and September 2017, 56 patients with IAAD caused by old odontoid fractures were treated with TARP technique. Patients’ clinical, radiological, and surgical data were retrospectively analyzed. Radiological parameters included the atlantodental interval (ADI) and the space available for the spinal cord (SAC) were measured. Occipitocervical pain levels and neurologic status were evaluated with Visual Analog Scale (VAS) and Japanese Orthopaedic Association (JOA) score respectively. Degree of cervical dysfunction was assessed by Neck Disability Index (NDI). Fusion status was evaluated by images during the follow-ups. Results Surgeries for 56 cases were performed successfully with no injury to the spinal cord, nerve, or blood vessels. All patients achieved satisfactory reduction and fixation. Clinical symptomatic relief was obtained in all cases (100%). Patients were followed up for an average of 33.9 ± 9.6 months (ranged 24-60 months). Improvements in the postoperative ADI, SAC, VAS, JOA score and NDI were significant ( P &lt; .05). Besides, Bone fusion was observed in all patients. No hardware failure or re-dislocation occurred during the follow-up period. Conclusions TARP technique is an effective procedure for the treatment of IAAD caused by old odontoid fracture, which can achieve complete release, satisfactory decompression, reduction and fixation, and reliable bone fusion through a single transoral approach.

“Investigating the combined effects of scapular-focused training and Mulligan mobilization on shoulder impingement syndrome” a three-arm pilot randomized controlled trial

ObjectivesTo assess whether the combination of scapular-focused training and mulligan mobilization (SFTMM) improves pain and proprioception compared to scapular-focused training (SFT) and a control group in female rock climbers with shoulder impingement syndrome (SIS).DesignThree-arm randomized controlled trial (RCT).SettingOutpatient setting.SubjectsIndividuals were randomly assigned to SFTMM, SFT alone, and control group.Interventions8 weeks of SFTMM and SFT.Main measuresOutcome measures were pain and proprioception.ResultsThe results revealed significant differences in pain scores and proprioception among female rock climbers with SIS who participated in SFTMM, SFT, and a control group (F(2, 32) = 81.01, p = 0.001, η2 = 0.83 for pain scores; F(2, 32) = 178.2, p = 0.001, η2 = 0.91 for proprioception scores). Post-hoc tests via the Bonferroni test indicated that both SFTMM and SFT significantly reduced pain levels (p = 0.001) and improved proprioception levels (p = 0.001) compared with the control group. There was no significant difference in pain scores and proprioception between the SFTMM group and the SFT group (p > 0.05).ConclusionsIn conclusion, the study indicates that SFTMM significantly reduces pain and improves proprioception in female rock climbers with SIS, as shown by notable changes compared to the control group. However, no statistically significant difference was found between the SFTMM (combined intervention) and SFT alone. Therefore, while the incorporation of SFT and MM shows promise; further research is needed to fully understand its long-term benefits and clinical implications.Ethical Code RegistrationThe study was approved at Ethics.research.ac.ir, code: IR.SSRC.REC.1402.170 on 2023-10-22.

Potential of diacerein in combination with aerobic exercise in comprehensive treatment of knee osteoarthritis

BACKGROUND: Knee osteoarthritis is a common degenerative disease characterized by cartilage destruction and inflammatory changes in the synovial membrane. Obesity and metabolic syndrome are significant risk factors that exacerbate inflammatory processes and contribute to the progression of osteoarthritis. Modern treatment methods include both pharmacological agents and non-pharmacological approaches such as aerobic exercise. AIM: To evaluate and compare the effectiveness of diacerein combined with aerobic physical activity (Nordic walking) in the comprehensive treatment of knee osteoarthritis. MATERIALS AND METHODS: The study involved 65 patients aged 45 to 70 years with knee osteoarthritis and metabolic syndrome. The participants were divided into three groups. The first group received diacerein (Artrocare); the second group was engaged in Nordic walking; the third group – a combination of these methods. The visual analog scale of pain, Western Ontario and McMaster University Osteoarthritis (WOMAC) index, quality of life (Short Form-36), glycated hemoglobin levels, and other biochemical parameters were assessed over 16 weeks of observation. RESULTS: The study demonstrated statistically significant reductions in pain levels and improvements in functional parameters in all the groups. The greatest improvements were observed in the group receiving combined therapy. The method showed a significantly positive impact on quality of life and reduced the need for analgesics in comorbid patients. Additionally, the patients with metabolic syndrome showed improved biochemical parameters with the combination of diacerein and Nordic walking. CONCLUSIONS: The combined use of diacerein and Nordic walking is an effective and safe method for treating knee osteoarthritis, particularly in patients with metabolic syndrome. This approach significantly reduces pain, improves joint function, and enhances overall quality patient’s life.

The Impact of Changes in Paraspinal Muscle Tissue on Lumbar Percutaneous Intradiscal Radiofrequency Therapy

Background/Objectives: This study aimed to assess whether fatty changes in paraspinal muscle tissue negatively affect pain relief and functional outcomes, measured by the Oswestry Disability Index (ODI), in patients undergoing intradiscal bipolar radiofrequency thermocoagulation for lumbar degenerative disc (LDD) disease. Fatty changes in paraspinal muscles, often associated with sarcopenia, are known to negatively influence treatment outcomes. However, there is limited research on how these changes affect pain and functional capacity following intradiscal procedures. Methods: In this study, data from 59 patients treated for LDD were analyzed. Pain severity was measured using the Numerical Rating Scale (NRS), and the ODI was recorded before the procedure and at 1, 3, and 6 months post-procedure. Fatty changes in the paraspinal muscle tissue were evaluated using the Goutallier classification based on pre-procedure T2-weighted MRI scans, while disc degeneration was assessed using the Pfirrmann classification. Results: The results showed significant positive correlations between the Goutallier and Pfirrmann classifications and pain levels at all time points post-procedure (p &lt; 0.05). Notably, the relationship between NRS scores and Goutallier classification was stronger than that with Pfirrmann classification (p &lt; 0.05). ODI scores were also significantly correlated with both Goutallier and Pfirrmann classifications at each time point, with a stronger association observed between ODI and Goutallier classification than with NRS (p &lt; 0.05). Conclusions: These findings suggest that fatty changes in the paraspinal muscle tissue may significantly influence treatment outcomes and should be considered during pre-treatment evaluations. Further research is needed to explore this relationship more comprehensively.

INFLUENCE OF POPLITEUS MUSCLE MANIPULATION AND QUADRICEPS STRENGTHENING ON ANTERIOR KNEE PAIN IN RUNNERS

Background: Anterior knee pain is prevalent among young athletes, with sports-related injuries accounting for 25–30% of cases. Patellofemoral pain syndrome (PFPS) contributes to up to 40% of knee disorders, with annual prevalence rates reported at 22.7% in the general population and 28.9% in adolescents. Among runners, the incidence of PFPS ranges from 37% to 56%. Objective: The popliteus muscle is primarily associated with anterior knee pain but may also influence posterior knee discomfort. This study aims to investigate the effects of soft tissue manipulation of the popliteus muscle combined with quadriceps strengthening exercises on anterior knee pain in athletic runners, addressing a gap in the literature regarding the interaction between these muscle groups. Methods: In this experimental study, 30 subjects with non-traumatic anterior knee pain were recruited. Baseline assessments included quadriceps strength and pain levels. Participants then underwent six sessions of popliteus manipulation alongside quadriceps strengthening exercises. Post-intervention, all parameters were reassessed. Results: A significant reduction in knee pain (P &lt; 0.005) was observed after the six-week intervention, with more pronounced improvements in Group A compared to Group B. Conclusion: The results suggest that incorporating popliteus soft tissue manipulation can effectively reduce anterior knee pain while strengthening the quadriceps enhances muscle function. These findings support the integration of popliteus manipulation into treatment protocols for athletes experiencing anterior knee pain.

Effects of Procedural Information, Buzzy, and Multiple Interventions on Pain in Children Undergoing Venipuncture: A Randomized Controlled Trial

ABSTRACT Background Needle-related procedures are commonly performed in childhood and lead to considerable pain. Purpose This randomized controlled study was conducted to compare the effects on venipuncture pain of the Buzzy, an informational animated video, multiple interventions, and standard care in children aged 6–12 years. Methods One hundred eighty children were assigned to the groups using a computerized randomization program. Pain level was evaluated by the children, parents, and their nurses using the Wong–Baker Faces Pain Scale. The level of agreement among the nurse, parents, and children's pain reports was evaluated. Multivariable regression analysis was performed to identify the factors significantly associated with pain score. Results The participants in the Buzzy, video watching, and multiple intervention groups reported lower mean pain scores (child: KW = 28.24, p &lt; .001; parent: KW = 18.51, p &lt; .001; nurse: KW = 44.4, p &lt; .001) than their peers in the control group. Moreover, age was identified as a risk factor affecting pain level (OR = 1.375, 95% CI [1.086, 1.740]; p = .008). Conclusions Buzzy and informational videos are potentially effective methods to facilitate venipuncture-related pain management in children. The use of pain management methods during venipuncture is recommended, especially in children younger than 10 years old.

Efficacy of Static Magnetic Field Therapy on Pain Intensity, Functional Disability, Sleep Quality and Depressive Symptoms in Patients with Mechanical Neck and Low Back Pain

Introduction: Mechanical neck pain (MNP) and mechanical low back pain (MLBP) can have a negative impact on the quality of life of patients and may be associated with high levels of disability. Magnetic field therapy has been using in the treatment of various diseases. This study was conducted to assess the effects of Static Magnetic Field (SMF) therapy generated by neodymium magnets in patients with MNP and MLBP. Methods: In this randomized, double-blind, sham-controlled, crossover study, patients with MNP and MLBP were randomly assigned to either the magnetic band or sham band treatment groups. After the initial 2-week phase (with participants randomly assigned to either treatment or sham-control), both groups underwent a 1-week washout period. Subsequently, the groups were swapped and proceeded with a second 2-week phase. Visual Analogue Scale (VAS), Oswestry Low Back Pain Disability Questionnaire (ODI), Neck Disability Index (NDI), Insomnia Severity Index (ISI), and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the patients' pain severity, functional disability, sleep quality, and levels of depressive symptoms, respectively. Results: Of the 30 subjects, 17 (56.7%) had MLBP, whereas 13 (43.3%) had MNP. Magnetic band treatment (MBT) resulted in a significant decrease in the VAS score (p &lt; 0.001) in all patients. MBT led to a significant decrease in the ODI score (p = 0.009) in patients with MLBP. A significant decrease in the NDI score was found in MBT (p &lt; 0.001) in patients with MNP. The improvement in ISI and PHQ-9 scores was also significantly higher in MBT (p &lt; 0.001). Conclusion: For patients with MNP and MLBP who have not experienced sufficient benefits from conventional treatments, neodymium magnets can be considered as an alternative treatment option due to their significant properties.

A Meta-analysis of the Effect of Aerobic Exercise during Pregnancy on Maternal Labor Pains

Objective: Systematically evaluate the effect of prenatal aerobic exercise on maternal labor pain.Methods: Systematic search: Cochrane Library, Embase, Web of science, PubMed, China Biomedical Database, China Knowledge Network (CNKI), Wanfang Data Knowledge Service Platform, Wipu.com, etc., and the time limit of the search was from the establishment of the library to June 2024, and randomized controlled trials (RCTs) related to the purpose of the study were collected and included by the after 2 researchers independently screened the literature, extracted information and evaluated the risk of bias of the included studies, RevMan5.3 software was applied to analyze the data. Results: A total of 10 RCTs were included, including 1144 cases of labor. Meta-analysis showed that prenatal aerobic exercise was effective in relieving labor pain level throughout the entire laboring process, with an MD [95% CI] of -1.80 [-2.75,-0.84], (P&lt;0.05), when compared with the control group. However, the effect was not significant in relieving 3-4 cm of uterine opening and when the uterine opening was more than 4 cm. Conclusion: Current evidence suggests that prenatal aerobic exercise relieves labor pain levels throughout labor, but is not significantly effective in relieving uterine opening of 3-4 cm and 4 cm or more. Due to the limitations of the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.

Sleep duration and pain during the COVID-19 pandemic with depression and chronic diseases as mediators

The bidirectional relationship between sleep duration and pain during the COVID-19 pandemic remains poorly understood. This study explores these interactions and the mediating roles of depression and chronic diseases using data from the China Health and Retirement Longitudinal Study (CHARLS) cohort. A cross-sectional analysis was conducted on 15,979 participants aged 45 and older. Sleep duration was self-reported, and pain was assessed using validated anatomical charts. Depression symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), and chronic diseases were self-reported. Personal activity during the pandemic was measured using the Personal Activity Score during COVID-19 (PAS-COVID-19). The results showed a significant association between deviations from optimal sleep duration and increased pain frequency. Participants with both shorter and longer sleep durations reported higher pain levels, with depression and chronic diseases acting as significant mediators. However, personal activity did not significantly mediate the association between sleep duration and pain. These findings underscore the complex interplay among sleep duration, pain, depression, and chronic diseases during the COVID-19 pandemic, emphasizing the importance of integrated interventions to manage these interconnected health issues.

Postoperative analgesic effect of lumbar erector spinae plane block for developmental hip dysplasia surgery: a randomized controlled double-blind study.

Open surgery for developmental dysplasia of the hip (DDH) may cause severe pain due to tenotomies and pelvic-femoral osteotomies. This study aims to evaluate the analgesic effect of ultrasound-guided Lumbar Erector Spina Plane (L-ESP) Block in pediatric patients undergoing DDH surgery. Sixty children scheduled for DDH surgery were randomly assigned into two groups. Group I (n = 30) received L-ESP with 0.5 mL/kg of 0.25% bupivacaine before surgery. In contrast, Group II (n = 30), as the control group, received the same volume of saline injection. Identical postoperative analgesia protocol was adjusted for both groups. Parental satisfaction, pain levels, ibuprofen, and opioid consumption were recorded. Pain levels were evaluated with the FLACC (Face, Legs, Activity, Crying, Consolability) scale. FLACC scores at the first 24th hours were lower in the L-ESP group than the control group (p < 0.001). Rescue opioid utilization was higher in the control group (15/26) than in the L-ESP group (2/29) (p < 0.001). The consumption of ibuprofen was higher in the control group than in the L-ESP group in the ward (24/26 vs. 3/29, p < 0.001, respectively). Parental satisfaction was superior in the L-ESP group (p = 0.024). To provide postoperative analgesia for DDH surgery, ultrasound-guided L-ESP may be an effective and alternative regional anesthetic technique.

Chronic pain among primary fentanyl users: The concept of self-medication.

Chronic pain is among the leading causes of disability worldwide, of which only a small percentage of patients receive adequate treatment for. Non-prescribed opioid analgesics are commonly sought out in effort to alleviate unrelieved pain. This study assesses the prevalence and correlates of chronic pain among primary fentanyl users. A cross-sectional and structured survey was conducted with 200 adults who reported fentanyl as their drug of choice from a Vancouver acute care hospital. Presence and levels of chronic pain were determined through self-report. The majority of participants (n = 130, 72.6%) reported having chronic pain in the past 6 months, with the mean level of pain on a typical day to be 7.6 out of a scale of 10 (SD = 1.9). Majority (n = 85, 65.4%) reported using street opioids to self-medicate, while only 9 (6.9%) reported that their chronic pain was unrelated. Regression analysis indicated that increasing age and co-use of cannabis and opioids were independent associated factors of chronic pain. Higher levels of reported pain on a typical day were further associated with age and self-medication. The findings of this study demonstrate a significant association between self-medication and chronic pain among primary fentanyl users in British Columbia. For these individuals, inadequate pain relief may drive continued opioid use, which in turn may increase risks of treatment discontinuation and overdose. Appropriate pain management strategies are crucial to avoid opioid misuse and decrease the large societal burden caused by chronic pain. Our work points to the high prevalence of self-reported chronic pain among individuals who primarily use fentanyl. Among those with self-reported fentanyl use and chronic pain, self-medication with street opioids was found to be common and associated with higher reported pain levels on a typical day. This highlights the need for pain management strategies to be integrated into opioid dependence treatment and more research in the overlap of pain and fentanyl use.