Cold therapy devices (CTDs) have been shown to provide analgesia, reduce swelling, and improve outcomes following orthopedic procedures. However, comparative data on postoperative narcotic use and pain control between CTDs and traditional ice packs remain limited. This study evaluates patient satisfaction and opioid use among those using CTDs after carpometacarpal (CMC) arthroplasty or distal radius open reduction internal fixation (ORIF). A prospective analysis was conducted on 124 patients who underwent hand surgery by a single fellowship-trained surgeon between June 2023 and February 2025. A total of 92 patients who underwent CMC arthroplasty or distal radius ORIF were included. Patient-reported outcomes on pain relief, cryotherapy use adherence, and opioid usage were compared between CTD users and those using traditional ice packs. In CMC arthroplasty patients, CTD users reported significantly higher pain relief scores (9.56/10 vs 3.42/10, P < .001) and greater adherence (>3 sessions/day: 94.4% vs 36.8%, P < .001) than ice pack users. Similar patterns were observed in distal radius ORIF patients, with higher CTD usage at both 3 and 7 days postoperatively (96% vs 11% and 88% vs 11%, respectively; P < .001). In distal radius ORIF patients, CTD users demonstrated a significant increase in 6-week Single Assessment Numeric Evaluation (SANE) score. No significant difference in oxycodone consumption was observed between groups for either procedure. CTD use following CMC arthroplasty and distal radius ORIF is associated with improved pain relief and adherence with cryotherapy. Although opioid use did not differ significantly, CTDs show promise as an adjunct for postoperative pain management in hand and wrist surgery.

We present a rare, previously unreported case of total hip arthroplasty (THA) implantation in a patient with an ankylosed hip and pelvic-femoral synostosis who sustained a subtrochanteric fracture. A 70-year-old woman had previously undergone right-sided infectious coxitis treatment, leading to hip ankylosis and pelvic-femoral synostosis. The patient had experienced no hip joint movement from her 20s for over 50 years due to bone fusion at 2 levels. Walking was feasible with compensation, given the ankylosis at an "ideal position" of 15° of flexion, 10° of abduction, and neutral rotation. The patient sustained a subtrochanteric fracture at the age of 70. Given the ankylosis and pelvic-femoral synostosis in the proximal femur fragment, an ideal solution was sought for the surgical management of this case. Synostosis was resected, total hip replacement was performed using revision arthroplasty components, solving both the problem of the ankylosed hip and that of the subtrochanteric fracture. The subtrochanteric fracture united, and sufficient motion was achieved after THA. THA led to adequate fracture healing, relief of chronic lumbosacral pain and significant improvements in function, proving to be a promising solution for challenging complex hip cases, offering significant improvements in quality of life when combined with careful surgical technique, thorough planning, and attentive postoperative care.

BackgroundDespite the widespread adoption of uniportal video-assisted thoracoscopic surgery (VATS), postoperative pain associated with this procedure remains a significant concern. Effective postoperative analgesia is essential for facilitating the recovery of patients undergoing thoracic surgery. Thoracic paravertebral block (TPVB) is widely recognized as an extremely effective method of analgesia in such surgeries. Our previous study has demonstrated that the diffusion of local anesthetic during nerve blocks is related to body position. Therefore, this study aimed to evaluate the impact of thoracic paravertebral nerve block in various body positions on the analgesic outcomes for patients undergoing single-port thoracoscopic lung resection.MethodsA randomized controlled trial was conducted to assess the impact of different body positions during thoracic paravertebral nerve blocks on the analgesic effect in patients undergoing single-port thoracoscopic partial lung resection. Patients scheduled for thoracoscopic lung resection will be included in this study. Participants (n = 200) will undergo thoracic paravertebral nerve block under ultrasound guidance. After the injection of the drug, they will be placed in either a supine position or a lateral position with the puncture side up. The NRS scores will be assessed at 1 h, 2 h, 8 h, 12 h, 24 h, and 48 h postoperatively. Postoperative opioid consumption, rescue analgesia time and frequency, patient satisfaction, incidence of adverse reactions, and length of hospital stay will also be recorded.DiscussionThis research project mainly aimed to investigate the impact of different perioperative positions for thoracic paravertebral nerve block on the analgesic effects in patients undergoing single-port thoracoscopic lung resection. The results may provide important implications for the development of effective analgesic strategies and robust clinical evidence to support the recovery of patients undergoing thoracic surgery.Trial registrationClinicalTrials.gov NCT06789276. Registered on 10 January 2025.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-025-09198-7.

Epidural steroid injections (ESI) are frequently used to treat lumbosacral radicular pain, but the solute spread in the epidural space needs further investigation. This semi-blind, randomized study assessed clinical outcomes and contrast spread patterns between the parasagittal interlaminar (PIL) and transforaminal (TF) approaches in 79 adults with low back pain. Participants were randomly assigned to receive either TF-ESI (3ml) or high-volume PIL-ESI (10ml). All procedures were performed under fluoroscopic guidance. Contrast spread was evaluated by a blinded pain specialist, and clinical outcomes, including analgesia, patient satisfaction, and quality of life, were measured at two weeks, one month, two months, and six months post-treatment. Results showed no differences in baseline characteristics between groups. There were no statistically significant differences between the two groups in mean pain intensity at baseline and six months after treatment (p = 0.590 and 0.484, respectively). Pain relief, satisfaction, quality of life, and contrast spread to the anterior epidural space did not differ over six months. However, the TF group required significantly more fluoroscopic images (p < 0.001). High-volume PIL-ESI provides clinical efficacy and anterior contrast distribution equivalent to TF-ESI, with fewer fluoroscopic images needed.

Comparative effects of Baduanjin training versus bedside cycle ergometer training on pulmonary function in lung cancer patients after thoracoscopic surgery. A total of 520 patients who had undergone video-assisted thoracoscopic surgery (VATS) for lung cancer at Huaihe Hospital of Henan University between January 2022 and January 2025 were selected for this study. These patients were randomly assigned to either a Baduanjin training group (Experimental group, n = 260) or a bedside cycle ergometer training group (Control group, n = 260). The study compared baseline and post-rehabilitation measurements between the two groups, including pulmonary function, pain levels, immune markers, cancer-related fatigue, and quality of life to evaluate the short-term efficacy of these two rehabilitation approaches for post-VATS recovery. No statistically significant differences were found in baseline characteristics between the two groups (P > 0.05). The experimental group showed significantly higher forced expiratory volume in one second (FEV1) (2.53 ± 0.29, 2.00 ± 0.24, P < 0.001) [0.484,0.576], forced vital capacity (FVC) (3.59 ± 0.39, 2.92 ± 0.33, P < 0.001) [0.608,0.732], and FEV1/FVC ratio (69.9 ± 3.5, 67.3 ± 3.3, P < 0.001) [2.015,3.185]. Pain intensity scores were significantly lower in the experimental group (1.3 ± 0.4, 2.0 ± 0.5, P < 0.001) [-0.778,-0.622]. The experimental group also demonstrated significantly higher CD4+/CD8+ ratio(1.70 ± 0.31, 1.53 ± 0.28, P < 0.001) [0.119,0.221], lower TNF-α levels (8.2 ± 1.8, 9.3 ± 2.1, P < 0.001) [-1.436,-0.764], and lower IL-6 levels (8.4 ± 2.1, 10.0 ± 2.7, P < 0.001) [-2.016,-1.184]. The experimental group exhibited significantly lower cancer-related fatigue scores (3.0 ± 0.7, 3.7 ± 0.7, P < 0.001) [-0.820,-0.580] and significantly higher quality of life scores (91.23 ± 6.78, 87.89 ± 7.01, P < 0.001) [2.155,4.525]. No statistically significant difference was found in the incidence of complications between the two groups (P = 0.631). Baduanjin yields superior comprehensive benefits compared to bedside cycle ergometer training in post-VATS lung cancer patients, demonstrating enhanced efficacy in pulmonary function recovery, pain relief, inflammation reduction, immune enhancement, fatigue alleviation, and quality of life improvement. As a device-free, cost-effective, and readily applicable intervention, it presents significant clinical value as a scientific and economical alternative for postoperative pulmonary rehabilitation. ChiCTR2500109262.

The SpineJack system is a minimally invasive device designed to restore vertebral height and stability in vertebral compression fractures (VCFs). This systematic review and meta-analysis evaluates its clinical efficacy, safety, and potential advantages over conventional treatments. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, Embase, and Scopus were searched on July 20, 2024, for original clinical studies involving adult patients with VCFs treated using the SpineJack system. Studies reporting quantitative outcomes such as pain (Visual Analog Scale, VAS), disability (Oswestry Disability Index, ODI), and vertebral body height (VBH) restoration were included. Data were pooled using random-effects models, and publication bias was assessed through funnel plots and regression analysis. 18 studies comprising 1482 patients (930 treated with SpineJack) met the inclusion criteria. Fracture etiologies included osteoporotic, traumatic, and pathologic. Meta-analysis demonstrated significant reductions in pain (VAS standardized mean difference (SMD) 2.26, 95% CI 1.68 to 2.84, P<0.001) and disability (ODI SMD 3.64, 95% CI 2.91 to 4.38, P<0.001). Restoration of anterior VBH (SMD 1.45, 95% CI 1.12 to 1.78, P<0.001, I²=0%), and middle VBH (SMD 3.93, 95% CI 1.51 to 6.34, P=0.001) were both significant. Reported complications were infrequent and primarily minor. The SpineJack system provides a safe and effective minimally invasive option for VCF management, yielding considerable improvements in pain relief, functional recovery, and vertebral height restoration. Additional high-quality studies are warranted to further define its comparative advantages and long-term outcomes.

Chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS), classified as National Institutes of Health (NIH) category III prostatitis, is a common urological disorder, accounting for 90%-95% of prostatitis cases. Its pathogenesis involves inflammatory cascades along the bladder-prostate axis, neurogenic inflammation, and impairment of the mucosal barrier. Sodium hyaluronate (Cystistat), a glycosaminoglycan (GAG) layer replenishment agent, has demonstrated efficacy in treating bladder pain syndrome. However, its therapeutic role in CP/CPPS remains underexplored. This study aimed to evaluate the clinical efficacy of intravesical hyaluronic acid (Cystistat) instillation in patients with CP/CPPS, identify potential predictive factors, and develop a predictive model to support personalized treatment strategies. A retrospective analysis was conducted on 41 patients with CP/CPPS who received intravesical Cystistat between January 2023 and April 2024. NIH Chronic Prostatitis Symptom Index (NIH-CPSI) scores-including total score and subdomains (pain, urinary symptoms, and quality of life)-and visual analog scale (VAS) scores were compared before and after treatment using paired t-tests. Cohen's d was calculated to assess effect size. A treatment response was defined as a Global Response Assessment (GRA) score ≥2. Multivariate logistic regression was used to explore predictors of treatment response. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), with fivefold cross-validation and sensitivity analyses. NIH-CPSI total scores significantly improved following treatment (25.71 ± 2.91 to 19.56 ± 4.28; mean change: -6.15 [95% CI: -7.27 to -5.02]; p < 0.001; Cohen's d = 1.68). VAS scores also showed significant reduction (7.07 ± 1.07 to 4.16 ± 1.67; mean change: -2.91 [95% CI: -3.36 to -2.46]; p < 0.001; Cohen's d = 2.07). Improvements were observed across all NIH-CPSI subdomains, with the greatest effect noted in the pain domain (Cohen's d = 1.32). Overall, 70.7% of patients achieved a GRA score ≥2. Logistic regression identified that elevated C-reactive protein (CRP) levels (OR = 1.28, 95% CI: 0.90-1.82) were positively associated with response, while longer disease duration (OR = 0.98, 95% CI: 0.94-1.02) and lower maximum urinary flow rate (Qmax) (OR = 0.88, 95% CI: 0.67-1.15) were negatively associated. However, none of these associations reached statistical significance. A model incorporating CRP, disease duration, and Qmax yielded an AUC of 0.76 (cross-validated AUC: 0.73 ± 0.12). Sensitivity analyses confirmed the model's robustness across alternative definitions of treatment success. Intravesical hyaluronic acid (Cystistat) therapy appears to be clinically effective for CP/CPPS, particularly in pain relief and quality-of-life improvement. Patients with elevated CRP levels and shorter disease duration may benefit more from this treatment. The derived predictive model offers a tool for individualized clinical decision-making. These findings lend indirect support to the "bladder-prostate axis" hypothesis, suggesting that Cystistat may alleviate pelvic pain by restoring bladder mucosal integrity and reducing inflammatory mediator activity. Future prospective randomized controlled trials are needed to validate these findings and further elucidate the underlying mechanisms. Further prospective, large-scale studies are needed to confirm efficacy, especially in OAB-associated subtypes, and refine predictive modeling approaches.

Background Dysmenorrhea is a prevalent gynecological disorder with multifactorial pathophysiology, including prostaglandin overproduction, inflammation, and pain sensitization. Emerging evidence suggests that gut microbiota may contribute to pain modulation, although causal relationships remain unclear. Methods Bidirectional two-sample Mendelian randomization (MR) was performed to investigate causal associations between dysmenorrhea and gut microbiota. Complementary in vivo validation was conducted in a primary dysmenorrhea (PDM) rat model treated with ibuprofen or the traditional Chinese medicine Wenjing Zhitong Decoction (WJZTD). The gut microbiota composition was analyzed using 16S rRNA sequencing, and correlations with pain-related parameters were assessed. Results Forward MR analyses revealed that genetic liability to dysmenorrhea influenced the abundance of specific gut taxa, notably reducing Lachnospiraceae genera and increasing Erysipelotrichaceae, which was consistent with observed alterations in PDM rats. Reverse MR provided no robust evidence that gut microbiota causally affect dysmenorrhea. In the PDM model, both ibuprofen and WJZTD produced analgesic effects, but induced distinct microbial signatures: ibuprofen increased the presence of Staphylococcus , while WJZTD enriched the population of Bifidobacterium . Correlation analyses highlighted Blautia as a microbiota feature associated with reduced pain, suggesting that modulation of this genus may represent a potential therapeutic strategy. Conclusion This study demonstrates that dysmenorrhea causally alters gut microbiota composition. The restoration of Blautia and Bifidobacterium by WJZTD is associated with pain alleviation, highlighting gut microbiota modulation as a potential strategy for dysmenorrhea management.

ABSTRACT Objectives To describe the profile of sports-related musculoskeletal complaints treated by physiotherapy during a multi-sport university competition, identify associated factors (training load, strengthening frequency, and previous complaint history), and evaluate the immediate effect of physiotherapy interventions on pain. Methods This cross-sectional descriptive epidemiological study analyzed physiotherapy records from a University Games (2022–2025), involving 5100 student-athletes. All athletes who sought physiotherapy for a musculoskeletal complaint during the events were included. A standardized assessment form recorded demographics, sport modality, training characteristics, strengthening frequency, previous complaints in the same region, anatomical location, mechanism, physiotherapy interventions, and pain intensity (Numeric Pain Rating Scale, NPRS) before and after treatment. Incidence rates were calculated as physiotherapy-treated complaints per 1000 athlete exposure hours. Results A total of 1803 physiotherapy treatment encounters were registered. Most complaints involved the lower limbs (64.7%) and were classified as traumatic (50.3%) or atraumatic/overuse (25.0%). Five team sports – futsal, 7-a-side soccer, volleyball, handball, and basketball – accounted for 93.6% of sport-specific cases. The overall incidence of physiotherapy-treated complaints was 29.62 per 1000 athlete exposure hours. Baseline pain showed no significant difference between encounters with and without a previous complaint in the same region (p = 0.060), was weakly correlated with weekly sport-training hours (ρ = 0.101, p = 0.014), and was not associated with strengthening frequency (ρ = 0.038, p = 0.192). In 1020 encounters with pre- and post-treatment data, a mean reduction of −2.69 NPRS points was observed (p < 0.001; Cohen’s d = 1.58). Conclusion Musculoskeletal complaints during multi-sport university competitions predominantly affect the lower limbs and are mainly traumatic in nature, particularly in high-intensity team sports. Immediate, on-site physiotherapy provides substantial pain relief, underscoring its role in acute athlete care and as a foundation for targeted injury prevention strategies.

Proteins as indicators of stress and pain in lambs after castration by a rubber ring with and without pain relief.

Placebo Response in Acute and Prophylactic Treatment of Migraine: A Systematic Review and Meta-Analysis Covering 36 Years of Research.

Low-Intensity Pulsed Ultrasound Regulates Th17/Treg Balance With Potential Association With the IL-1β/IL1R1/MyD88 Signaling Pathway to Alleviate Pelvic Pain in a Rat Prostatitis Model.

Full-endoscopic versus microscopic spinal decompression for lumbar disc herniation: a meta-analysis of 20 cohort studies.

The aim of the study was to evaluate the efficacy of laser therapy (high-intensity vs. low-level) in treating tennis elbow. PubMed, Scopus, Embase, and Web of Science were systematically searched for randomized controlled trials up to February 2025. Cochrane risk-of-bias tool was used for quality assessment. Data were analyzed via RevMan 5.4. Twelve randomized controlled trials were included. Laser therapy demonstrates significant improvements in pain, grip strength, and functional outcomes for tennis elbow patients. Subgroup analysis reveals that both high-intensity laser therapy ( P = 0.01) and low-level laser therapy ( P < 0.00001) effectively reduce pain versus baseline with comparable efficacy, although high-intensity laser therapy shows nonsignificant improvement versus placebo ( P = 0.07). Regarding functional improvement, high-intensity laser therapy is similar to low-level laser therapy (both significant, P < 0.05). For grip strength, both modalities show significant improvement ( P < 0.05), with high-intensity laser therapy exhibiting superior effects. Further analysis of combination therapies showed that laser combined with bandage demonstrates more significant pain relief and functional improvement. High-intensity laser therapy and low-level laser therapy are both effective modalities for improving symptoms of tennis elbow (pain, function, and grip strength). Low-level laser therapy demonstrates more consistent significance in pain relief, while high-intensity laser therapy shows greater advantages in enhancing grip strength. More importantly, laser therapy combined with bandage produces synergistic effects, highlighting its value as a key complementary component within multimodal rehabilitation programs.

Effect of photobiomodulation on pain and clinical outcomes after total knee arthroplasty in individuals with knee osteoarthritis: A scoping review.

Comparison of pericapsular nerve group block and supra-inguinal fascia iliaca compartment block for preoperative analgesia in elderly patients with hip fracture: A prospective, randomized controlled study.

Introduction: Intrathecal adjuvants to local anaesthetics have been introduced to enhance clinical efficacy and prolong the duration of analgesia following infraumbilical surgical procedures, as spinal anaesthesia alone often provides inadequate postoperative pain relief. The addition of intrathecal opioids has been shown to effectively extend postoperative analgesia. Aim: To compare the efficacy of intrathecal nalbuphine (0.4 mg) vs fentanyl (25 μg) as adjuvants to hyperbaric bupivacaine in infraumbilical surgeries. Materials and Methods: The present triple-blinded randomised, clinical study was conducted at Dhiraj General Hospital, Vadodara, Gujarat, India, from February 2025 to June 2025. Sixty American Society of Anaesthesiologists (ASA) I-II patients undergoing elective infraumbilical surgeries were randomly allocated into two groups (n=30 each). Group A received bupivacaine (15 mg) with fentanyl (25 μg) and group B received bupivacaine (15 mg) with nalbuphine (0.4 mg) intrathecally. Primary outcomes included onset and duration of sensory/ motor blockade and duration of analgesia. Secondary outcomes included haemodynamic parameters, sedation scores, and side-effects. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Independent Student’s t-test was used for continuous variables and Chi-square test for categorical variables. The p&lt;0.05 was considered significant. Results: Both groups had comparable demographic characteristics with no significant differences in age, weight, gender distribution, ASA grading, or surgery duration (p&gt;0.05). Onset of sensory (4.07±1.12 vs 6.67±1.01 min, p&lt;0.001) and motor blockade (6.73±1.00 vs 7.87±1.20 min, p=0.009) was faster in group A. Duration of analgesia was significantly longer in group B (404.76±25.23 vs 291.91±31.87 min, p&lt;0.001). Group B required fewer rescue analgesics (2.03±0.95 vs 3.57±0.88, p&lt;0.001). Pruritus occurred only in group A (13.3%), while bradycardia (23.3%) and hypotension (26.7%) were higher in group B. Conclusion: Nalbuphine (0.4 mg) provides superior postoperative analgesia compared to fentanyl (25 μg) as an intrathecal adjuvant, making it an effective alternative for infraumbilical surgeries requiring prolonged pain relief.

ObjectiveThis review synthesizes current evidence on the efficacy of acupuncture in managing chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients, focusing on its mechanisms, clinical applications, and future research directions.MethodsThis narrative review synthesizes and critically appraises findings from randomized controlled trials (RCTs), meta-analyses, and preclinical studies, evaluating acupuncture's impact on pain relief, neurological function, and quality of life. Key databases were searched for studies published up to 2024.ResultsNineteen RCTs (n = 1174) demonstrated significant improvements in CIPN symptoms with acupuncture, particularly in reducing neuropathic pain (eg, via endogenous opioid modulation) and enhancing sensory function (eg, BDNF-mediated neuroplasticity). Optimal protocols involved 2-3 sessions/week for 4-12 weeks, targeting acupoints such as ST36 and LI4. Acupuncture outperformed pharmacotherapy (eg, duloxetine) in safety and patient-reported outcomes.ConclusionAcupuncture is a promising adjunctive therapy for CIPN, offering multimodal mechanisms and clinical benefits. Standardization of protocols and further high-quality RCTs are needed to strengthen evidence and guide integration into oncology care.

Women's experiences of pain relief and easing intensity through vocalisations during childbirth: A qualitative study.

Outcomes of en bloc surgery versus separation surgery for spinal solitary bone plasmacytomas: a multicenter cohort study with long-term follow-up durations.