Present Pain Intensity Research Articles

Dry needling for the treatment of acute myofascial pain syndrome in general practitioners’ clinics: a cohort study

BackgroundMusculoskeletal pain is one of the leading complaints in the ambulatory setting. There are many ways to treat it, including pharmacologic and non-pharmacologic approaches. Dry needling (DN) is an option that is easy to learn, cheap and has a good safety profile. The aim of this study was to assess the association between DN performed by GPs for acute myofascial pain syndrome (MPS) and pain relief and to evaluate factors associated with treatment success.MethodsIn this prospective cohort study, two GPs performed DN in their clinics. Patients were asked to rank their pain using the Short-Form McGill Pain Questionnaire (SF-MPQ) before, 10-min and 1-week after the procedure. The SF-MPQ index consists of 3 parts; visual analog scale (VAS), pain rating index (PRI) and present pain intensity (PPI).Logistic regressions were performed to assess the variables associated with short- and medium- term success.ResultsFifty two patients were recruited from September 2019 until August 2020. VAS was 6.0 ± 2.3 (before), 4.1 ± 2.5 (10-min after) and 2.6 ± 2.71 (1-week after), P < 0.05. PRI was 17 ± 9.1 (before), 10.8 ± 8.5 (10-min after) and 5.1 ± 6.5 (1-week after), P < 0.05. PPI was 2.6 ± 1.0 (before), 1.7 ± 1.0 (10-min after) and 1.1 ± 1.2 (1-week after), P < 0.05.Short-term success was associated with the physician who performed the procedure (OR 10.08, 95% CI 1.15,88.4) and with the use of a single needle (vs. multiple needles inserted) (OR 4.55, 95% CI 1.03,20.11). Medium-term success was associated with being a native born (non-immigrant), OR 8.59, 95% CI 1.11,66.28 and with high level of initial pain, OR 11.22, 95% CI 1.82,69.27.ConclusionOur study demonstrated improvement in acute pain 10-min and 1-week after DN performed by a GP, in all parts of the SF-MPQ. Therefore, we believe DN is a good therapeutic option for GPs to aid patients suffering from MPS.

Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis.

Low back pain (LBP) can significantly affect a person's quality of life. Cupping has been used to treat LBP. However, various cupping methods are typically included in evaluating the efficacy of cupping therapy. Therefore, the objectives of this study were to evaluate the evidence from the literature regarding the effects of dry and wet cupping therapy on LBP in adults. Dry and wet cupping therapy are analyzed categorically in this study. We searched for randomized clinical trials with cupping in LBP published between 2008 and 2022. In dry or wet cupping clinical studies, pain intensity was assessed using the Visual Analogue Scale and present pain intensity, and the quality of life intensity was measured using the Oswestry disability index. The 656 studies were identified, of which 10 studies for 690 patients with LBP were included in the meta-analysis. There was a significant reduction in the pain intensity score with present pain intensity using wet cupping therapy (P < .01). In addition, both cupping therapy groups displayed significant Oswestry disability index score reduction compared to the control group (both P < .01). The patients with LBP have a substantial reduction by using wet cupping but have not shown a considerable decrease by using dry cupping (P = .19). In addition, only wet cupping therapy groups displayed a significantly improved quality of life compared to the control group. The study had a very high heterogeneity (I2 > 50%). It means there is no standardization in the treatment protocol in randomized clinical trials. In the meta-regression, there was statistically significant evidence that the number of treatment times and intercepts were related (P < .01). The present meta-analysis shows that wet cupping therapy effectively reduces the pain intensity of LBP. Furthermore, both dry wet cupping therapy improved patients with LBP quality of life.

The Effect of Manipulation Under Anesthesia for Secondary Frozen Shoulder: A Randomized Controlled Trial.

Manipulation under anesthesia (MUA) is often used for frozen shoulder treatment, but controversy still exists regarding MUA compared with conservative treatment. This research was conducted to compare the outcome between MUA and celecoxib (CLX) in secondary frozen shoulder. Patients with secondary frozen shoulder were randomized into two groups, an MUA plus exercise (EX) group and a CLX plus EX group. Clinical outcomes were documented at baseline and at 1day, 2, 4, and 12weeks after intervention, including Constant-MurleyScore (CMS) for function, Pain Rating Index (PRI) and Present Pain Intensity (PPI) for pain, passive range of motion (ROM) measurements including external rotation, internal rotation, forward flexion, and abduction. Primary outcome was CMS. Secondary outcomes were PRI, PPI, and passive ROM. Sixty-seven patients out of 68 in the MUA group and 66 out of 68 in the CLX group finished the entire study period. There were no significant differences in basic properties of the two groups before intervention. As the primary outcome, CMS changes in the MUA group improved faster than the CLX group. Secondary outcomes, passive ROM, and pain PPI were faster and significant in the MUA group from 1day after intervention compared with CLX (P < 0.05). At 12weeks, a statistically significant difference was not observed in the PPI (P > 0.05). A statistically significant difference was not observed in the PRI between groups in 1day (P > 0.05). For the primary outcome, from 0 to 12weeks the mean changes in CMS were 44.00 for MUA plus EX (95%CI 43.07-44.93, P < 0.001) and 27.09 for CLX plus EX (26.20-27.98, P < 0.001). The significant difference in improvement appeared from 2weeks. To treat secondary frozen shoulder with MUA, this treatment could achieve better therapeutic effects on improvement of function, pain, and passive ROM than CLX did. The trial was registered at www.chictr.org.cn , identifier ChiCTR2200060269.

A Case-Control Study of the Effects of Implementing the Registered Nurses' Association of Ontario Guidelines for the Assessment and Management of Postoperative Pain and the Use of Relaxation Therapy in 312 Patients with Bone and Soft-Tissue Malignancy.

BACKGROUND The present study aimed to investigate the effects of implementing the Registered Nurses' Association of Ontario (RNAO) guidelines for the management of postoperative pain and the use of Jacobson's relaxation technique (JRT) in patients with bone and soft-tissue malignancy at a single center in China. MATERIAL AND METHODS A total of 312 patients were recruited and randomly divided into 2 groups. In the intervention group, the RNAO pain-management technique of JRT was adopted, while the control group received the standard institutional nursing management. Pain scores after the operation, according to the Numerical Rating Scale (NRS) combined with the Wong-Baker Faces Pain Rating Scale and Short-Form McGill Pain Questionnaire, were compared between the 2 groups. Nursing satisfaction was compared as well. RESULTS At 6, 24, and 72 h after the operation, the NRS scores combined with the Wong-Baker Faces Pain Rating Scale in the intervention group were significantly lower than those in the control group (P<0.001); 72 h after the operation, the Pain Rating Index, Visual Analogue Scale, present pain intensity, and total scores for the intervention group were significantly lower than those for the control group (P<0.001 for all 4 scores). The scores reported from the patients for nursing response and consequent care (P<0.001), nursing competence (P=0.029), and surgical pain-control satisfaction (P<0.001) in the intervention group were also significantly higher than those in the control group. CONCLUSIONS JRT can improve postoperative pain-control and nursing satisfaction in patients with malignant bone and soft-tissue tumors. These data suggest a benefit for application of JRT in clinical care.

Effects of Acupuncture on Neuropathic Pain Induced by Spinal Cord Injury: A Systematic Review and Meta-Analysis.

Introduction Neuropathic pain is a commonly seen symptom and one of the most intractable comorbidities following spinal cord injury (SCI). Acupuncture has been widely used for neuropathic pain after SCI in clinical settings. There is no systematic review or meta‐analysis evaluating the efficacy of acupuncture in the treatment of SCI-induced neuropathic pain. Thus, this study aimed to conduct a systematic review and meta-analysis to assess the efficacy of acupuncture on SCI-induced neuropathic pain. Methods Seven databases were comprehensively searched, including PubMed, the Cochrane Library, the Web of Science, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Service System (SinoMed), the Wanfang Database, and the Chinese Scientific Journals Database (VIP) from their inception to 30 September 2021. Two independent reviewers evaluated the eligibility of the data retrieved based on the pre-established eligibility criteria and assessed the methodological quality of the included studies using the Cochrane Risk of Bias Tool. The outcome indexes in this study included the visual analogue scale, the numeric rating scale, the present pain intensity, and the pain region index. Sensitivity and subgroup analyses were also performed to specifically evaluate the intervention effects. In addition, publication bias was analyzed. Results Six randomized controlled trials (145 participants in the experimental groups and 141 participants in the control groups) were identified that evaluated the application of acupuncture for neuropathic pain after SCI and were included in this study. The results of our study revealed that acupuncture had a positive effect on the pain severity (standardized mean difference (SMD): −1.40, 95% confidence interval (CI): −2.23; −0.57), the present pain intensity (MD = −0.61, 95% CIs = −0.98; −0.23), and the pain region index (MD = −3.04, 95% CI = −3.98; −2.11). In addition, sensitivity analyses showed that these results were robust and stable. Subgroup analyses indicated that electroacupuncture (EA) had better effects on SCI-induced neuropathic pain. However, a publication bias was observed. Conclusion Available evidence appears to suggest that acupuncture may have a role in SCI-induced neuropathic pain management, but this remains to be determined.

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.

The Efficacy of Aroma and Music Therapy to Reduce Dental Anxiety and Pain Intensity

This study aimed to determine the effectiveness of aromatherapy and music therapy in managing dental anxiety and pain among restorative dental patients in Peshawar, Pakistan. Sixty dental patients were selected after strictly following the inclusion and exclusion criteria. Informed consent was taken from the patients and instructed on the study protocols. Two groups were formed. One group had aromatherapy during the dental procedure, and the other had music therapy. The dental anxiety scale revised, present pain intensity and pain severity were used as the measuring tools in the study. SPSS 23 was used for statistical analysis. Chi-square and Mann-Whitney U tests were used for the analysis of the results. The association between pain intensity of dental patients with aromatherapy and music therapy was not significant. The percentage of discomforting pain in patients after aromatherapy was higher than in music therapy, while a higher percentage of patients were completely pain-free after music therapy. The mean rank score of pain severity was higher in a patient who received aromatherapy than music therapy. The difference in the pain severity scores across the therapy groups was statistically significant. The mean rank score of dental anxiety was also statistically significantly different across the therapy groups. The mean rank score of dental anxiety was higher for the patients who received aromatherapy than music therapy. It was concluded that distraction therapy works better to reduce the dental anxiety and pain intensity of dental patients. Furthermore, studies should be conducted to closely evaluate the difference and association of non-pharmacological treatments in this area.

The Hemophilia Joint Health Score version 2.1 Validation in Adult Patients Study: A multicenter international study

BackgroundThe Hemophilia Joint Health Score (HJHS) was developed and validated to detect arthropathy in children. Additional evidence is required to show validity in adults. We studied the convergent and discriminant construct validity of the HJHS version 2.1(HJHSv2.1) in adults with hemophilia. A secondary aim was to define age‐related normative adult HJHSv2.1 reference values. MethodsWe studied 192 adults with hemophilia, and 120 healthy adults in four age‐matched groups—18 to 29, 30 to 40, 41 to 50, and >50 years—at nine centers. Trained physiotherapists scored the HJHS and World Federation of Hemophilia (WFH) joint score. Health history, the Functional Independence Scale of Hemophilia (FISH), Hemophilia Activities List (HAL), and Short‐Form McGill Pain Questionnaire (SF‐MPQ) were also collected. ResultsThe median age was 35.0 years. Of participants with hemophilia, 68% had severe, 14% moderate, and 18% mild disease. The HJHS correlated strongly with WFH score (Spearman’s rho [rs] = .95, P < .001). Moderate correlations were seen between the FISH (rs = .50, P < .001) and SF‐MPQ Present Pain Intensity (rs = .50, P < .001), while a modest correlation was found with the HAL (rs = −.37, P < .001). The HJHS significantly differentiated between age groups (Kruskal‐Wallis T = 35.02, P < .001) and disease severity in participants with hemophilia. The HJHS had high internal reliability (Cronbach’s α = .88). We identified duration of swelling as a redundant item in the HJHS. ConclusionsThe HJHS shows evidence of strong convergent and discriminant construct validity to detect arthropathy in adults with hemophilia and is well suited for use in this population.

Pain Burden in Post-COVID-19 Syndrome following Mild COVID-19 Infection

The global pandemic of SARS-CoV-2 has affected several hundred million people, and many infected people have suffered from a milder initial infection but have never fully recovered. This observational study investigates the pain burden in sufferers of post-COVID-19 syndrome after a milder initial infection. One hundred post-COVID-19 patients filled out questionnaires regarding sociodemographic data, previous comorbidities, present pharmacological treatment, pain intensity and pain localisation. Health-related quality of life, fatigue, emotional status, and insomnia were measured by validated questionnaires. Multiple post-COVID-19 symptoms, including post-exertional malaise, were evaluated by a symptom questionnaire. Among the 100 participants (mean age 44.5 years), 82% were women, 61% had higher education, and 56% were working full or part time. Nine participants reported previous pain or inflammatory conditions. Among the most painful sites were the head/face, chest, lower extremities, and migrating sites. Generalised pain was self-reported by 75 participants and was estimated in 50 participants. Diagnosis of fibromyalgia according to the 2016 criteria was suspected in 40 participants. Subgroup analyses indicated that comorbidities might play a role in the development of pain. In conclusion, a major part of sufferers from post-COVID-19 syndrome develop pain, and in addition to its many disabling symptoms, there is an urgent need for pain management in post-COVID-19 syndrome.

Oxycodone is superior to morphine for pain relief following peroral oesophageal myotomy: a prospective, randomized, controlled trial.

Patients underwent peroral endoscopic myotomy (POEM) for treating achalasia suffered with mild to moderate, sometimes even severe postoperative pain. To evaluate the efficacy of oxycodone on postoperative analgesia of patients undergoing PEOM. In this prospective, double-blinded, randomized, controlled trial, patients with achalasia were recruited and received 0.08 mg/kg oxycodone or morphine 15 min before the end of the POEM procedure. The short-form McGill questionnaire (SF-MPQ) was used to measure the postoperative pain at 0, 2, 6, 24, and 48 h after surgery, which included the visual analogue scale (VAS), the present pain intensity (PPI) scale, and the pain rating index (PRI). A total of 73 patients were included, of whom 36 received oxycodone, and 37 received morphine. Compared with morphine, patients received oxycodone were associated with lower VAS in the first 24 h postoperatively (1.64 ±0.76 vs. 2.14 ±1.23, p = 0.042) as well as PPI at 2 h (1.11 ±0.40 vs. 2.22 ±0.89, p < 0.001), 6 h (1.42 ±0.55 vs. 2.08 ±0.92, p < 0.001) and 24 h (1.06 ±0.23 vs. 1.30 ±0.46, p = 0.006). Patients who received oxycodone experienced lower sensory McGill pain score than those who received morphine at 2, 6, 24, and 48 h after surgery (p < 0.05). Significantly lowered affective McGill pain score was observed in the oxycodone group at 0, 2, and 24 h postoperatively. Regarding the PRI, the sum of both sensory and affective McGill pain scores, patients with oxycodone therapy were associated with better scores postoperatively. Oxycodone appears to be superior to morphine in dealing with post-POEM pain, which has distinct visceral pain characteristics.

A comparative study into the effects of topical hot salt and hot sand on patients' perception of low back pain.

BACGROUND:Low back pain (LBP) has been regarded as one of the musculoskeletal problems which is affecting more than three-quarters of individuals in their lifetime. Nowadays, various pharmacological and nonpharmacological therapies are employed for relieving and treating LBP. This study was conducted to compare the effects of topical hot salt and hot sand on patients' perception of LBP.MATERIALS AND METHODS:In this, quasi-experimental study patients with LBP referring to the orthopedic clinic of Shahrekord educational hospital were divided randomly into two interventions and one control group in 2020. All three groups were received naproxen cream and daily physiotherapy in the same manner, the interventional groups in addition either topical hot salt or topical hot sand. Data gathering tool for measuring patients' perception of LBP was the McGill Pain Short Form Questionnaire to be completed at the beginning, immediately at the end, and 2 months after the intervention. The data were analyzed using SPSS statistical software (version 21.0).RESULTS:Totally, 90 patients were randomized based on the table of random numbers (mean age 51.1 + 11.1), and finally, 87 patients completed the study. Patients' perception of LBP before the intervention was homogenous in hot salt, hot sand, and the control group The mean score of total pain experience before the intervention was 14.1 ± 11.3 for hot sand, 13.9 ± 10.7 for hot salt and 13.7 ± 10.1 for control group The mean scores of these three groups were not significant before the intervention (P > 0.05). The mean score of total pain experience immediately after the intervention was 6.7 ± 4.2 for hot sand, 5.2 ± 3.1 for hot salt and 13.9 ± 9.8 for control group. The mean scores of the hot sand group and the hot salt group were significantly decreased compared with control group (P > 0.05). The mean score of total pain experience two months after the intervention was 5.6 ± 3.27 for hot sand, 4.21 ± 2.14 for hot salt and 13.8 ± 10.4 for control group. Mean score of total pain experience in both intervention groups had significantly reduced two months after the intervention compared to control group (P ≤ 0.001); so that the effect of hot salt treatment on reducing total pain experience was larger than hot sand (P ≤ 0.001). The same trend was observed for VAS and Present pain intensity variables.CONCLUSIONS:The findings have revealed that the topical treatments with hot salt and hot sand could have a significant effect on the perception of LBP compared to those in the control group; whereas hot salt might be stronger effects than hot sand on reducing LBP.

Correlates of Psychological Distress in Patients With Cancer at a Psycho-oncology Clinic.

Patients with cancer experience significant psychological distress. Most studies investigated individual risk factors for distress in their respective treatment setting, which limit generalizability of results or comparison of relative importance. To investigate the relation between psychological distress in patients referred to a psycho-oncology clinic and its correlates in a comprehensive manner. Medical charts of patients who visited the psycho-oncology clinic at a tertiary hospital from May 2019 to May 2020 were reviewed. Demographic, cancer-related, and psychiatric factors; health-related quality of life; and somatic pain were investigated. The Hospital Anxiety and Depression Scale, item 9 on the Patient Health Questionnaire-9, Functional Assessment of Cancer Therapy-General, Present Pain Intensity, and Distress Thermometer were measured at the index visit. Simple and multiple linear regression analyses were performed with the Distress Thermometer score as a dependent variable. A total of 454 patients were included. The univariate analyses showed age and physical, emotional, and functional well-being scores on the Functional Assessment of Cancer Therapy-General were negatively associated with the Distress Thermometer scores, while female genital cancer, advanced disease, recent radiotherapy, the Hospital Anxiety and Depression Scale score, and the Present Pain Intensity score showed a positive relation. After adjusting for all other variables, female genital cancer (P=0.027), anxiety subscale of the Hospital Anxiety and Depression Scale (P<0.001), the Present Pain Intensity (P=0.002), and physical (P<0.001) and functional (P=0.019) well-being subscales of the Functional Assessment of Cancer Therapy-General remained significant. Patients with cancer who visited a psycho-oncology clinic experienced more distress if they had female genital cancer, low health-related quality of life score, severe anxiety, or somatic pain.

Pain measurement in the older people: evaluation of the psychometric properties of the Geriatric Pain Measure (GPM-24) \u2013 Polish version

BackgroundChronic pain in older people is of particular importance not only with regard to negative subjective experience but also as an indicator of the quality of medical care. Brief scales to assess pain may help health professionals with early recognition and treatment to avoid patient suffering. However, these scales should be adapted to the cultural context to provide valid assessments. The aim of this study was to evaluate the psychometric properties of the Polish translation of the Geriatric Pain Measure – 24 (GPM-24) in older people.MethodsThe study was conducted among 181 people aged 65 and over with chronic (noncancer) pain of varying intensity lasting more than 6 months. Construct validity was assessed using the principal component analysis (PCA) method with oblimin rotation. Criterion validity was evaluated by correlating the scores of the GPM-24 with the scores of the McGill-Melzack questionnaire (MPQ). The reliability of the GPM-24 was estimated in terms of internal consistency using Cronbach’s alpha coefficients.ResultsThe PCA revealed a 6- component structure of the set of items that constituted the GPM-24. Most of these components were defined by items included in the same subscale, similar to the result obtained by the original scale’s authors. There were significant correlations between the GPM-24 and some dimensions of MPQ: affective (rho = 0.25, p = 0.001), present pain intensity (rho = 0.44, p < 0.001), pain rating index total (rho = 0.31, p < 0.001), and number of words chosen (rho = 0.26, p < 0.001). The value of the standardized Cronbach’s alpha equalled 0.89 and thus confirmed the high reliability of the GPM-24.ConclusionsThe Geriatric Pain Measure − 24 is a reliable and valid tool that is recommended for the monitoring and multidimensional assessment of chronic pain in older people in daily practice as well as in clinical trials.Trial registrationStatutory research “Chronic pain in people over 65 years of age” K/ZDS/005733, conducted in 2015–2018.

Determinants of depression in non-cardiac chest pain patients: a cross sectional study.

BackgroundNon-cardiac chest pain (NCCP) is a common patient complaint imposing great costs on the healthcare system. It is associated with psychological factors such as depression. The aim of the present study is determining depression predictors in NCCP patients.MethodsThe participants of this cross-sectional study were 361 NCCP patients. Patients filled out questionnaires concerning their sociodemographic, lifestyle, and clinical factors (severity of pain, type D personality, somatization, cardiac anxiety, fear of body sensations, and depression).ResultsBased on multiple ordinal logistic regression, lack of physical activity (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.09-2.87), sleep quality (OR, 2.98; 95% CI, 1.15-7.69), being a smoker (OR, 1.33; 95% CI, 2.41-4.03), present pain intensity (OR, 1.08; 95% CI, 1.05-1.11), type D personality (OR, 2.43; 95% CI, 1.47-4.03), and somatization (OR, 1.22; 95% CI, 1.15-1.3) were significant predictors of depression in NCCP patients. Additionally, multiple linear regression showed that being unmarried (β = 1.51, P = 0.008), lack of physical activity (β = 1.22, P = 0.015), sleep quality (β = 2.26, P = 0.022), present pain intensity (β = 0.07, P = 0.045), type D personality (β = 1.87, P < 0.001), somatization (β = 0.45, P < 0.001), and fear of bodily sensation (β = 0.04, P = 0.032) increased significantly depression scores in NCCP patients.ConclusionsPhysicians should consider the predictors of depression in NCCP patients which can lead to receiving effective psychological consultations and reducing the costs and ineffectual referrals to medical centers.

Convolutional Neural Network Optimization Algorithm-Based Magnetic Resonance Imaging in Analysis of Chronic Pain Caused by the Myofascial Trigger Point

This study was to explore the value of magnetic resonance imaging (MRI) technology processed by convolutional neural network (CNN) optimization algorithms in the clinical research of patients with chronic pain caused by myofascial trigger points (MTrPs). Firstly, referring to the traditional iterative algorithm, this study iterated the convolution network and data consistency layer as a whole for several times, which increased the fitting ability of the data consistency layer and network. When it was applied to magnetic resonance examination, it could be concluded that the effect of its reconstruction method was better than the traditional convolution neural network without the data consistency layer. The image edge was clear, and the restoration effect of details was better. 100 patients with chronic neck pain caused by MTrP were collected and divided into an ultrasound treatment group and a local anesthetic drug injection group, with 50 cases in each group. In addition, 50 healthy volunteers were selected. After clinical treatment, the results showed that, after 3 weeks of treatment, the visual analog score (VAS) and the pain rating index (PRI) of the injection group were 3.16 ± 1.14 points and 4.92 ± 1.26 points, respectively; the present pain intensity (PPI) score was 2.06 ± 0.85 points, and the number of pain days per month was 7.73 ± 1.15. After 1 month of treatment, the VSA and PRI of the injection group were 1.24 ± 0.89 and 1.31 ± 0.97, respectively; the PPI score was 1.34 ± 0.65, and the number of pain days per month was 5.34 ± 0.98. In addition, there were 38 cases reaching the level of clinical cure, accounting for 76%. Therefore, all indicators in the injection group were better than those in the ultrasound treatment group, and the differences were statistically significant ( P &lt; 0.05 ). The results of MRI examination showed that compared with the healthy control group, patients with chronic pain caused by the myofascial trigger point had reduced axial kurtosis (AK), mean kurtosis (MK), and radial kurtosis (RK) in multiple brain areas such as the right parahippocampal gyrus and the right medial prefrontal cortex. In short, chronic pain caused by the trigger point of the myofascial membrane would affect the microstructure of the gray matter of the patient’s brain. In clinical treatment, the efficacy of local anesthetic injection was better than ultrasound therapy.

Kinesio Taping for Labor Pain Control : A Randomized Controlled Trial

Aim: This study aimed to assess the efficacy of Kinesio tape on relief of pain associated with labor.Materials and Methods: We included 100 women (50 in each group). Each participant was subjected to assessment of Visual analogue scale, Present Pain Intensity (PPI) and Cardiotocography (CTG).Results: Our study showed that there was no significant difference between women of both groups regarding VAS pain scores which were documented hourly. .Also there was no significant difference between both groups in PPI except in hour3 in which PPI was significantly lower in Kinesio Taping than in control group (2.8±0.8 and 2. 5±0.9 respectively).The overall need for analgesic was comparable in kinesio and control group (54.0% versus 52.0%, respectively). 58.0% of cases group required uterotonic versus 64.0% in control group without significant difference between both groups. Patient satisfaction was significantly higher in Kinesio Taping than control group. The majority in cases group (46.0%) was satisfied, while 34.0%, 16.0% and 4.0%was either Quite satisfied, Neutral or Dissatisfied. On the other hands, the majority of control group (44.0%) was neutral and 42.0%, 8.0%and 6.0% were satisfied, dissatisfied and quite satisfied, respectively.Conclusion: Kinesiology taping was not shown to be effective for labor pain control. The remaining outcomes assessed (i.e., labor duration, uterotonic and anesthetic requirements, type of delivery, pathological CTG rates) showed no differences between the two groups. Maternal satisfaction with the childbirth experience and tape use was more with Kinesio tape group.

Patient satisfaction with root canal treatment and outcomes in the Swedish public dental health service. A prospective cohort study.

To document satisfaction with root canal treatment procedures and outcomes among patients treated at Swedish public dental clinics. The original material comprised 243 patients who began root canal treatment (RCT) at 20 public dental clinics in the county of Västra Götaland, Sweden. One to three years later, 236 (97.1%) were posted a questionnaire of eight items, rating patient perceptions of RCT-completion, present pain intensity and satisfaction with the RCT. To evaluate the reliability of the original responses, the first 50 respondents were mailed a follow-up questionnaire. Both descriptive and analytical statistics were used to compare respondents and non-respondents and tooth groups. One hundred and fifty-nine patients (67.4%) responded: 86 (54.1%) women and 73 (45.9%) men. The mean age 52.5 years, was higher than for non-respondents (P<0.001). A completed root filling was registered for the majority of the teeth (n = 112, 70.9%), but significantly fewer molars had been completed (n = 46, 59.7%, P = 0.02). Fifty percent (n = 59) of the patients reported current pain, mostly mild in intensity (n = 45, 38.1%). One hundred and twenty-three patients (80.9%) recalled experiencing pain during RCT. The highest satisfaction was registered for the item 'chewing ability' (mean = 1.6, SD = 1.9). The majority of patients (n = 114, 75.0%) stated that in retrospect they would still have chosen RCT. However, these patients belonged to the group which either registered the tooth as still present, or had not experienced much discomfort during or after RCT. Forty-four patients (88.0%) responded to the second questionnaire. The reliability of the responses was good. In summary, one to 3 years after beginning RCT at a public dental clinic, patient satisfaction was high, even though every fourth molar had been extracted or treatment had not been completed and half the patients reported persistent pain. The reliability of the patients' responses was considered to be good. The results indicate a need for further clinical observational studies of RCTs undertaken in general dental practice, with special reference to patient-centred outcomes.

Effects of Mindfulness-Based Cognitive Therapy for Chronic Pain: A Multicenter Study.

The prevalence of chronic pain in Spain is 15%. The objective of this study was to evaluate the efficacy of mindfulness-based cognitive therapy on patients with chronic pain. A quasi-experimental design of repeated measures pre- and post-test (N = 57) was carried out at three hospitals from the province of Alicante. Self-reported assessment measurements of pain intensity, anxiety-depression symptoms, perception of health status, interference of pain on sleep, self-efficacy in pain, acceptance, and mindfulness attitude were included. The T-test indicates significant differences in intensity of present pain, mental quality of life, and depression (medium effect sizes), as well as in self-efficacy: total score, symptom management and pain control (medium effect sizes), sleep disturbances and quantity of sleep (large effect sizes). MBCT is effective in reducing many symptoms in patients with chronic pain, although its maintenance needs to be further investigated.

Comparison of the Analgesic Effect of Nepafenac 0.1%, Ketorolac 0.5%, and Diclofenac 0.1% Ophthalmic Solution during Intravitreal Injection

Background: Pain during intravitreal injection (IVT) is inevitable and might reduce the patient’s compliance. Topical anesthetic eye drop usually is administered to reduce pain during IVT. However, severe ocular pain has been reported in some patients. The most effective anesthesia for IVT is still controversy. Objective: To evaluate the analgesic effect of three topical non-steroidal anti-inflammatory drugs (NSAIDs) eye drop, nepafenac 0.1%, ketorolac 0.5%, and diclofenac 0.1%, during IVT. Materials and Methods: The present study was a prospective randomized, double-blinded, placebo-controlled study. Patients undergoing intravitreal bevacizumab injections were randomly divided into four groups. Group 1, group 2, group 3, and group 4 received topical nepafenac 0.1%, topical ketorolac 0.5%, diclofenac 0.1%, and artificial tear (placebo), respectively. One hour after receiving the eye drops, all patients underwent IVT with topical anesthetic eye drop. Pain assessment was performed immediately after IVT using the Thai version of Short-Form McGill Pain Questionnaire (SF-MPQ). The SF-MPQ consists of the main component of the SF-MPQ, the visual analogue scale (VAS), and the present pain intensity (PPI). Results: Eighty patients voluntarily enrolled in the present study. Median of VAS scores were 1.5 (0.8 to 4.6), 2.3 (1.5 to 4.6), 1.5 (1 to 3.2), and 2.4 (1.4 to 3.6) in nepafenac group, ketorolac group, diclofenac group, and placebo group, respectively (p=0.159). Median of the main component of the SF-MPQ scores were 4 (1.25 to 5.75), 5 (2.25 to 11.5), 5 (1.25 to 9.5), and 5 (3 to 13), in nepafenac group, ketorolac group, diclofenac group and placebo group, respectively (p=0.409). Median of the PPI scores were 1 (1 to 1.75), 1 (1 to 2), 1 (1 to 1), and 1 (1 to 2), in nepafenac group, ketorolac group, diclofenac group, and placebo group, respectively (p=0.529). Conclusion: There were no significant differences in analgesic effect during IVT between topical NSAIDs, nepafenac 0.1%, ketorolac 0.5%, diclofenac 0.1%, and placebo. Keywords: Intravitreal injection; Analgesic effect; Topical NSAIDs eye drop; SF-MPQ

Evaluation of Lumber Spine Stenosis on Magnetic Resonance Imaging Correlating with Its Clinical Manifestation

Lumber spine stenosis (LSS) is one of the major reasons of spinal surgery all over the globe. Despite using standard Diagnostic tools for LSS, the clinical and imaging findings often do not correlate. Over past years, the central spinal canal stenosis is assumed to be the diagnoses of lower back pain, while other anatomical stenosis (i.e lateral recess stenosis) not gaining as much attention. This fact assumed to be the reason for failed back surgery. In this context numerous studies in past have done. The aim of this study is to verify the clinical manifestation of LSS correlation to its Diagnostic find. To evaluate the lumbar spine stenosis on magnetic resonance imaging &amp; correlating with its clinical manifestations. The duration of study was three months. Study was done at Lahore General Hospital, Pakistan. A cross-sectional analytical study included 120 patients. According our study the patients comes with lumber spine stenosis at different levels. At L4L5 presents 39 (32.5%) patients, 47(39.2%) patients reveal at the level of L5S1, 14 (11.7%) patients at L2L3, and only 3 (2.5%) patients appear at the level of L1L2, 19 (15.8%) patients show stenosis at L3L4 Then we correlate the pain intensity with all lumber spine levels and the results are 35 (29.2%) patients are absent and 85 (70.8%) presents at the level of L4L5. On the level of L5S1 pain intensity is absent in 81 (67.5%) patients, &amp; present in 39 (32.5) patients. On the level of L2L3 106 (83.5%) absent and 14 (11.7%) patients are present pain intensity. On the level of L1L2 117 (97.5%) absent of pain intensity and only 3 (2.5%) patients are present with pain intensity. The study concluded that the clinical manifestation of lumber spine stenosis to devise the management plan for the patient for better diagnoses in magnetic resonance imaging in LSS. Keywords: Lumber spine stenosis, manifestation, MRI DOI: 10.7176/JHMN/90-10 Publication date: June 30 th 2021