Prevalent Musculoskeletal Condition Research Articles

Wirksamkeit neurodynamischer Behandlung bei lateraler Epikondylitis: eine systematische Übersichtsarbeit

Abstract Background Lateral epicondylitis, commonly known as “tennis elbow,” is a prevalent musculoskeletal condition affecting up to 3% of the population, primarily in individuals over 40 years old. It leads to pain and dysfunction at the lateral epicondyle, primarily involving the tendons of forearm extensor muscles, innervated by the radial nerve. Recent insights suggest a multifactorial etiology, questioning the traditional tendinopathy model. Neurodynamics, exploring nerve mechanics, emerges as a potential treatment approach. Methods A systematic review following PRISMA guidelines searched multiple databases for clinical trials investigating neurodynamic interventions for lateral epicondylitis. Inclusion criteria involved lateral epicondylitis patients receiving neurodynamic treatment, with pain, disability, and functional improvement as primary outcomes. Results Six studies met the inclusion criteria. Neurodynamic techniques, including radial nerve mobilization and home exercises, showed positive outcomes. Significant pain reduction, improved grip strength, and increased ulnar deviation angle were observed in several studies. However, heterogeneity in study design, follow-up durations, and small sample sizes limit conclusive evidence. Conclusion Neurodynamic treatment, particularly radial nerve mobilization, appears promising in alleviating pain and improving nerve mechanosensitivity in lateral epicondylitis. High-quality research is needed to establish its efficacy, considering the limitations in existing studies. A multidisciplinary approach and standardized patient inclusion criteria should be emphasized to advance the management of this condition.

Ultrasonographic measurement indicated patients with chronic neck pain had reduced diaphragm thickness and mobility along with declined respiratory functions

Chronic neck pain (CNP) is a prevalent musculoskeletal condition including notable impairments in respiratory function. The diaphragm, serving dual roles in respiration and spinal stability, is intricately linked to the cervical spine through fascial, neurophysiological, and biomechanical connections. However, to date, none has investigated the diaphragm function in patients with CNP. To investigate the diaphragm function, respiratory muscle strength, and pulmonary function in patients with CNP. In addition, their associations were also examined. A case-control study. A total of 54 participants were recruited including 25 patients with CNP (CNP group) and 29 healthy adults (CON group). Pulmonary function including forced vital capacity (FVC) and forced expiratory volume in 1s (FEV1), and respiratory muscle strength represented by maximal inspiratory (MIP) and maximal expiratory pressure (MEP), as well as diaphragm function including ultrasonographic measures of mobility and thickness changes during maximal inspiration and expiration were assessed in all participants. Additionally, the intensity of pain and disability were evaluated using a Visual Analog Scale and Neck Disability Index only in patients with CNP. Significant reductions of the FVC, FEV1, MIP, and MEP were found in the CNP group compared to the CON group (p<0.05). The diaphragm mobility and thickness changes were also significantly decreased in the CNP group than the CON group with medium effect sizes (p<0.05). Only diaphragm thickness change was positively correlated with FVC, FEV1, and MEP in patients with CNP. Furthermore, MEP showed the strongest contribution to diaphragm thickness change based on the regression analysis. Impaired diaphragm function, respiratory muscle strength, and pulmonary function were observed in patients with CNP. Patients with smaller diaphragm thickness change had poorer pulmonary function and reduced maximal expiratory muscle strength. Diaphragm assessment and intervention may be considered in CNP management.

The influence of fascial manipulation on shoulder range of motion, pain, and function in individuals with chronic shoulder pain

BackgroundA prevalent musculoskeletal condition that has a substantial socioeconomic impact and causes considerable morbidity is chronic shoulder pain (CSP). CSP may result from a dysfunction of the upper quarter region's (UQR) myofascial continuum (MC), which is connected by deep fascia. Fascial Manipulation® (FM), proposed by Luigi Stecco, involves deep kneading performed at specific points on the deep fascia. FM is considered to reinstate the gliding of the fascial layers, thus may aid in the reduction of pain and improvement of shoulder function. ObjectiveThis study aims to determine the influence of FM on shoulder pain, passive range of motion (PROM), and function in participants with CSP. DesignSingle group, pretest-posttest design. MethodEighteen individuals with CSP aged 18–45 years were recruited. FM was applied to the painful and densified centre of coordination (CC) points on the MC of the UQR based on Stecco's FM method. The therapist performed the baseline, post-treatment, and numerical pain rating scale (NPRS) at rest and during activity, PROM, and pressure pain threshold (PPT). The follow-up measurements were done after seven days following the FM intervention. Also, the baseline and follow-up measurements of disability of arm, shoulder, and hand (DASH) score were performed. ResultsA considerable improvement in all shoulder PROM (p < 0.01), DASH score (p = 0.01), and pain reduction (p = 0.01) following FM were observed. However, the PPT showed no differences following FM (p > 0.05). ConclusionFM may be an effective treatment strategy in reducing pain and improving shoulder range of motion and function in patients with CSP.

Fixation technique of biodegradable magnesium alloy suture anchor in the rotator cuff repair of the shoulder in a goat model: a technical note

BackgroundShoulder disorders, particularly rotator cuff tears, are prevalent musculoskeletal conditions related to aging. Although the widely used suture anchor technique provides strong mechanical support to the tendon, it is associated with a risk of postoperative tendon retearing. The conventionally used titanium alloys can affect the interpretation of magnetic resonance imaging. Degradable magnesium alloys possess excellent biocompatibility, similar mechanical property to the bone, and stimulating bone formation ability from Mg2+. The purpose of this experiment was to develop innovative magnesium-based suture anchors to enhance rotator cuff repair by improving fixation materials, and to evaluate their feasibility in a goat model.MethodsWe developed fluoridized ZK60 suture anchors as the implantation material for two goats, who underwent rotator cuff repair surgery on both shoulders. Computed tomography (CT) and histological analysis were performed at 12 weeks postoperatively, and the results were compared between the magnesium and titanium alloy groups. Additionally, a hematological examination was conducted, which included assessments of red blood cells, white blood cells, platelets, coagulation function, liver function, kidney function, and magnesium ion concentration.ResultsThe 12-week postoperative CT images showed intact MgF2 ZK60 suture anchors, effectively reconnecting the infraspinatus tendon to the humeral head. The anchors became less visible on CT scans, indicating absorption by surrounding tissues. New bone formation in the MgF2 group surpassed that in the Ti group, demonstrating superior osseointegration. The similarity between cortical bone and magnesium reduced stress-shielding and promoted bone regeneration. Histological analysis revealed successful tendon healing with MgF2 anchors, while the Ti group showed discontinuous interfaces and reduced collagen secretion. Hematological examination showed stable liver, renal function, and magnesium ion levels.ConclusionsThe findings indicate that MgF2-coated suture anchors are feasible for rotator cuff repair and potentially other orthopedic applications. We hope that magnesium alloy anchors can become the solution for rotator cuff tendon repair surgery.

Ultrasound-guided injection of corticosteroid versus placebo in management of plantar fasciitis

: Plantar Fasciitis (PF) is a prevalent musculoskeletal condition causing heel pain, with approximately 1 million annual U.S. physician visits. It is more common in women, aged 45-64, and obese individuals. Diagnosis relies on clinical history and examination, and various treatments target pain relief, though consensus on the most effective modality is lacking. Corticosteroid injections are commonly used but pose risks. This six-month prospective randomized controlled trial with 50 individuals assessed the efficacy of corticosteroid versus placebo injections for resistant PF. Ultrasound-guided injections were administered, and outcomes were measured at 3 weeks and 3 months.: Results indicated significant improvement in pain scores, Ankle and Hindfoot scores, and plantar fascia thickness with corticosteroid injections compared to placebo. No serious adverse events were observed. Corticosteroids aim to reduce inflammation, and studies link decreased plantar fascia thickness to pain relief. Ultrasound guidance enhances precision in delivery. While some protocol limitations exist, this trial contributes valuable insights into the pharmacological effects of corticosteroids in PF treatment, aiding in evidence-based recommendations.

Does Liquid/Injectable Platelet-Rich Fibrin Help in the Arthrocentesis Treatment of Temporomandibular Joint Disorder Compared to Other Infusion Options? A Systematic Review of Randomized Clinical Trials.

Temporomandibular joint disorders (TMDs) are prevalent musculoskeletal conditions involving pain and dysfunction of jaw mobility and function, which have proven difficult to treat satisfactorily. The present study aimed to assess the effectiveness of a liquid platelet-rich fibrin (i-PRF) infusion during arthrocentesis versus other options using coadjuvant materials to reduce TMD symptoms. A literature search was conducted using PubMed, EMBASE, Web of Science, Scopus, and ClinicalTrials.gov for RCTs published before January 2024, comparing i-PRF to any other TMD treatment. This systematic review was registered on PROSPERO (CRD42023495364). The searches generated several recent RCTs that compared i-PRF injection combined with arthrocentesis (AC) to AC-only or AC with platelet-rich plasma (PRP). The outcomes analyzed included measures of pain (visual analog scale, VAS), maximum mouth opening, joint sounds, and MRI-verified changes in joint structure. Across the RCTs, the addition of i-PRF injection to AC resulted in significant improvements in pain relief, joint function, mouth opening, and structural changes compared to AC-only or with PRP over follow-up periods ranging from 6 to 12 months. Current clinical evidence favors using i-PRF as an adjunct to AC rather than AC-only or AC with PRP for the treatment of TMDs. The improvements in subjective and objective outcome measures are clinically meaningful. Still, additional high-quality RCTs with larger sample sizes and longer follow-ups are required to strengthen the evidence base and better define the role of i-PRF in TMD management guidelines.

Effects of Lifestyle Interventions on the Improvement of Chronic Non-Specific Low Back Pain: A Systematic Review and Network Meta-Analysis.

Chronic non-specific low back pain (CNSLBP) is a highly prevalent musculoskeletal condition that has a great socioeconomic impact on health systems. Instead of focusing on mechanical causes and direct workload in the development of CNSLBP, genetics, psychosocial environment, lifestyle and quality of life are coming to the forefront in its approach. The main objective was to analyze whether interventions aimed at modifying lifestyle can be effective in improving pain intensity and functional disability in CNSLBP. A search in PubMed, Web of Science, Scopus and SportDiscus databases was performed. Both a univariate and a multivariate network meta-analysis were applied with the difference pre/post-treatment. A total of 20 studies were included for qualitative analysis, of which 16 were randomized clinical trials with a moderate-high methodological quality and were part of the quantitative analysis. The interventions that had the greatest effect in reducing pain intensity were cognitive therapy combined with functional exercise programs, lumbar stabilization exercise and resistance exercise; meanwhile, for functional disability, they were functional exercise programs, aerobic exercise and standard care. In conclusion, a multimodal intervention aimed at changing one's lifestyle that encompasses cognitive, behavioral, and physical aspects seems to be highly effective in improving pain intensity and functional disability caused by CNSLBP; however, it is not yet known if these improvements are maintained in the long term.

Prevalence of Knee OA and its Association with Low Back Pain

Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal condition known to impact quality of life and daily functioning significantly. Previous studies have identified a potential association between knee OA and low back pain, but this relationship requires further exploration to understand its implications fully. Objective: The objective of this study was to investigate the correlation between knee OA and low back pain, specifically examining the impact of knee pain on quality of life, daily functioning, and the severity of low back pain. Methods: A cross-sectional study was conducted with 377 OA patients aged between 45 to 75 years, selected via non-probability convenient sampling from various hospitals in Sialkot. Exclusion criteria included a history of knee surgery or recent trauma, mental retardation, or diabetes. Data were collected using the Oswestry Low Back Disability Index and the KOOS Urdu version. Statistical analysis was performed using SPSS version 26, focusing on descriptive statistics, mean and standard deviation for quantitative data, and the chi-square test for associations, with a significance threshold set at a p-value greater than 0.05. Results: The study found that the prevalence of knee OA varied by age group, with the highest prevalence (46.6%) in the 45-54 age group. Female participants predominated (75.9%). Severity levels of knee OA were classified as mild (32.6%), moderate (42.2%), and severe (21.8%). Significant correlations were observed between knee OA and low back pain, with correlation coefficients of 0.480 for pain effects on QOL, 0.441 for pain during SRF, 0.571 for pain during AODL, and 0.437 for the total score of pain. Conclusion: The study confirms a significant correlation between knee OA and low back pain, highlighting the need for integrated management approaches for patients suffering from these conditions. Addressing both knee and back pain concurrently could lead to better patient outcomes and improved quality of life.

Exploring the Impact of Spinal Mobilization in Adolescent Idiopathic Scoliosis

Background: Adolescent idiopathic scoliosis (AIS) is a prevalent musculoskeletal condition in adolescents, characterized by a complex etiology and significant impact on health. The condition is typically managed through various physical therapies, but the effectiveness of combining different therapeutic approaches, particularly the integration of spinal mobilization with conventional exercises, is not well established. Objective: This study aimed to evaluate the effectiveness of combining Schroth exercises with spinal mobilization in improving Cobb's angle in patients with AIS, compared to Schroth exercises alone. Methods: A randomized controlled trial was conducted at Mubarak Hospital, Sargodha, involving 12 patients aged 10-20 years with diagnosed AIS. Participants were divided into two groups: a Control Group (n=6) receiving Schroth exercises and an Experimental Group (n=6) receiving Schroth exercises plus spinal mobilization. The treatment duration was four weeks. Pre- and post-intervention Cobb's angles were measured using radiographs. Data analysis was performed using SPSS version 25. Results: Both groups demonstrated a significant reduction in Cobb's angle post-intervention. The Control Group showed a decrease from a mean ± SD of 20 ± 3.46 degrees to 17.5 ± 3.61 degrees (P &lt; 0.001). The Experimental Group exhibited a more pronounced reduction, from 20.3 ± 2.80 degrees to 15.5 ± 3.08 degrees (P &lt; 0.001). Conclusion: The study concluded that the integration of spinal mobilization with Schroth exercises is more effective in reducing Cobb's angle in patients with AIS compared to Schroth exercises alone. This combination therapy may represent a more potent approach for the management of AIS.

New Horizons in Treatment of Knee Osteoarthritis: A Brief Look-up at Emerging Approaches

Knee osteoarthritis (OA) is a chronic and prevalent musculoskeletal condition that is the underlying cause of disability in most patients worldwide. Even though the pathophysiology of KOA has not yet been fully understood and includes a wide range of risk factors, current therapeutic options are temporarily palliative rather than curative. In recent years, new strategies have focused on the curative agents. As part of this review, we highlight the latest treatment approaches for KOA.

Fully automated evaluation of paraspinal muscle morphology and composition in patients with low back pain

Chronic Low Back Pain (LBP) is one of the most prevalent musculoskeletal conditions and is the leading cause of disability worldwide. The morphology and composition of lumbar paraspinal muscles, in terms of infiltrated adipose tissue, constitute important guidelines for diagnosis and treatment choice but still require manual procedures to be assessed. We developed a fully automated artificial intelligence based algorithm both to segment paraspinal muscles from MRI scans through a U-Net architecture and to estimate the amount of fatty infiltrations by a home-made intensity- and region-based processing; we further validated our results by statistical assessment of the accuracy and agreement between our automated measures and the clinically reported values, achieving dice scores greater than 95 % on the preliminary segmentation task, as well as an excellent degree of agreement on the following area estimates (ICC2,1 = 0.89). Furthermore, we employed an external public dataset to validate our model generalization abilities, reaching dice scores greater than 94 % with an average processing time of 21.92s(±3.38s) per subject. Hence, a deterministic and reliable measuring tool is proposed, without any manual confounding effect, to efficiently support daily clinical practice in LBP management.

PREVALENCE OF MUSCULOSKELETAL DISCOMFORTS AMONG RURAL FARMERS IN NORTH-WESTERN NIGERIA

Agricultural tasks can be considered some of the most demanding and hazardous, especially in developing countries where crop production relies heavily on manual implements. Weeding, one of the common agricultural activities performed by farmers, requires a significant amount of physical effort and often involves awkward wrist and trunk postures, subjecting farmers to multiple risk factors that can result in musculoskeletal discomfort. In this study, a combination of qualitative and quantitative approaches is used to examine the prevalence of musculoskeletal conditions among rural peasant farmers in Jigawa, a state in northwestern Nigeria. The results of this study indicate that lower back pain, upper back pain, and wrist/hand pain are the most prevalent musculoskeletal conditions experienced by peasant farmers who are exposed to intensive manual farming operations.

Epidemiology of low back pain: frequency, risk factors, and patterns in South-South Nigeria.

Low back pain (LBP) is a prevalent musculoskeletal condition that poses significant public health challenges. However, its epidemiology in Sub-Saharan Africa, especially in rural settings, remains largely unexplored. This study aimed to determine the epidemiology of LBP in a Nigerian Teaching Hospital. This was a retrospective review of the records of all LBP cases seen at the rheumatology clinic from 2018 to 2022 in a Teaching Hospital in South-South Nigeria. The sociodemographic and clinical data, including disability scores, was extracted from the patients' medical records. The data was analyzed using IBM SPSS version 25, and the level of significance was set at p < 0.05. Among 1,580 patients, 319 (20.2%) reported LBP. The mean age was 59.51 ±10.21, and the peak age incidence was 51-60 years. Low back pain was more prevalent in females (61.4%). Work-related factors (47.3%) such as heavy lifting (26.3%), prolonged sitting (19.4%), and poor posture (27.9%) were the prominent risk factors. Sedentary behavior (11.5%) and obesity (16.9%) contributed. Common clinical manifestations included difficulty standing or bending (73%), walking difficulties (67.7%), sleep disturbances (51.4%), and radicular pain (45.8%). Common etiologies were spondylosis (66.5%), spondylolisthesis (22.3%), disc prolapse (19.4%), spinal canal stenosis (15.4%), muscle spasm (12.2%), and tuberculous spondylitis (9.7%). Acute and chronic LBP constituted 12.2% and 79.9% of cases, respectively. In terms of disability, 33.5% had minimal, 44.5% had moderate, 15.4% had severe, and 6.6% had crippling disabilities. Mechanical causes were the most implicated in LBP. Work-related factors and lifestyle choices contribute to the occurrence of LBP. Adjusting posture and lifestyle modification reduces LBP risk. Understanding its epidemiology is crucial for optimizing care and implementing preventive strategies.

Prevalence of neck pain and its associated factors in Africa: a systematic review and meta-analysis protocol

IntroductionNeck pain is one of the most prevalent musculoskeletal pain conditions with multifactorial impact including pain, disability and reduced quality of life. To the best of our knowledge, no systematic...

Effect of blood flow restriction training on pressure pain threshold and hand function among adults with persistent neck pain: A study protocol for a randomized controlled trial

Background: Persistent neck pain is a prevalent musculoskeletal condition that affects the quality of life and functional abilities of individuals. Blood Flow Restriction Training (BFRT) is a novel therapeutic approach that involves restricting blood flow to exercising muscles to enhance strength and function. However, limited research has been conducted on the effects of BFRT on pressure pain threshold and hand function in adults with persistent neck pain. This randomized controlled trial aims to investigate the potential benefits of BFRT as a treatment intervention for this population. Methods: This study will be a prospective parallel group active controlled trail done at Physiotherapy Department, Galgotias University. Ethical clearance has been obtained from Departmental Ethics Committee on 19/05/2023 with reference number DEC/PT/GU/2023 and the Trial has been registered with Clinical Trial Registry India CTRI/2023/06/053439. Informed consent will be obtained from all the participants who are eligible to be included in the study. 110 patients with persistent neck pain will be randomly allocated into two groups. The BFRT group will receive supervised training sessions three times a week for eight weeks, performing low-load resistance exercises with blood flow restriction applied using personalized cuff pressure. The control group will receive standard care for neck pain, which may include general advice, manual therapy, and/or home exercises without BFRT. The primary outcome measures will be the pressure pain threshold, assessed using a pressure Algometer, and hand function, evaluated using standardized tests such as Hand Grip Strength and Purdue Peg board Test. Results: The data obtained will be analyzed using appropriate statistical methods, and the significance level will be set at p&lt;0.05. Conclusion: This trial will contribute valuable contribution highlighting the potential benefits of BFR training in improving pressure pain threshold and hand function in adults with persistent neck pain.

MyKOA-Cope: the development of a culturally relevant integrative group psychological intervention for people with chronic knee osteoarthritis pain

Introduction: Knee osteoarthritis is a highly prevalent musculoskeletal condition that causes chronic pain and psychological distress. The biological aspects of arthritis pain can be effectively managed with medication, physiotherapy and surgical procedures. However, no known psychological interventions to manage the psychological aspects of chronic pain have been developed in Sri Lanka.Objective: The study aimed to develop a culturally relevant integrative group psychological intervention for patients with chronic knee osteoarthritis pain.Methods: The first phase involved a literature review of existing psychological interventions on chronic pain management, which was used to develop a culturally relevant group psychological intervention named as “MyKOA-Cope: Psychological intervention for chronic knee osteoarthritis”. In the second phase, a Delphi study and a focus group discussion were conducted to evaluate the feasibility of the newly developed intervention.Results: The MyKOA-Cope is a six-session, in-person group intervention that lasts 45-50 minutes per session. These sessions include: 1) orientation to the intervention; 2) relaxation training; 3) exercise and pacing; pleasant activity scheduling; 4) identify negative automatic thoughts; 5) cognitive restructuring and calming selfstatements and 6) termination and maintenance strategies.Conclusion: The present study developed a culturally appropriate psychological intervention to enhance paincoping skills among patients with chronic knee osteoarthritis. This intervention has the potential to address the psychological aspects of chronic pain and contribute to the biomedical model. Future research can validate and tailor the MyKOA-Cope to suit the needs of patients with different illness conditions, literacy levels, and those who speak in Tamil in Sri Lanka.

The burden of musculoskeletal disorders in the Middle East and North Africa (MENA) region: a longitudinal analysis from the global burden of disease dataset 1990—2019

BackgroundMusculoskeletal (MSK) disorders are one of the main causes of disability among adults globally. The burden of MSK disorders varies greatly between different regions and is the highest in low- and middle income- countries. This study sought to investigate trends in the burden of MSK disorders across the MENA region, utilizing the GBD 2019 dataset.MethodsThis ecological study utilized data from the Global Burden of Disease (GBD) to report on the burden of musculoskeletal (MSK) disorders in The Middle East and North Africa (MENA) region between 1990 and 2019. Our analysis involved descriptive statistics and sociodemographic trends and did not employ any specific statistical analyses. Using age-standardized rates of prevalence and disability-adjusted life-years (DALYs), we reported trends in the burden of MSK disorders, as well as national variation between different countries. Furthermore, we analyzed trends in risk factors contributing to MSK disorders by age and gender.ResultsThe longitudinal analysis from 1990 to 2019 showed an increase in the age-standardized rate for prevalence and DALYs of MSK disorders by 5% and 4.80%, respectively. Low back pain continued to be the most prevalent MSK condition, while RA and other MSK disorders had the largest percentage increase for DALYs between 1990 and 2019. The study found that Afghanistan had the lowest age standardized DALYs rate attributed to MSK disorders, while Iran, Turkey, and Jordan had the highest. Further, Syria showed the most dramatic decrease while Saudi Arabia had the most notable increase in age standardized DALY rates from 1990 to 2019. In 2019, occupational risks, high body mass index, and tobacco smoking were the main risk factors for MSK disorders, with occupational risks being the largest contributor, and between 1990 and 2019, there was a decrease in the contribution of occupational risks but an increase in the contribution of high body mass index as a risk factor.ConclusionThis study highlights the significant burden of MSK disorders in the MENA region, with various risk factors contributing to its increasing prevalence in recent decades. Further research is needed to better understand the underlying factors and potential interventions that could improve health outcomes. Addressing MSK disorders should be a public health priority in the region, and efforts should be made to develop effective strategies to prevent and manage this debilitating condition.

Circulating Inflammatory Biomarkers Predict Pain Change Following Exercise-Induced Shoulder Injury: Findings From the Biopsychosocial Influence on Shoulder Pain Preclinical Trial

Shoulder pain is a highly prevalent musculoskeletal condition that frequently leads to suboptimal clinical outcomes. This study tested the extent to which circulating inflammatory biomarkers are associated with reports of shoulder pain and upper-extremity disability for a high-risk genetic by psychological subgroup (catechol-O-methyltransferase [COMT] variation by pain catastrophizing [PCS]). Pain-free adults meeting high-risk COMT × PCS subgroup criteria completed an exercise-induced muscle injury protocol. Thirteen biomarkers were collected and analyzed from plasma 48 hours after muscle injury. Shoulder pain intensity and disability (Quick-DASH) were reported at 48 and 96 hours to calculate change scores. Using an extreme sampling technique, 88 participants were included in this analysis. After controlling for age, sex, and BMI, there were moderate positive associations between higher c-reactive protein (CRP; βˆ = .62; 95% confidence interval [CI] = −.03, 1.26), interleukin-6 (IL-6; βˆ = 3.13; CI = −.11, 6.38), and interleukin-10 (IL-10; βˆ = 2.51; CI = −.30, 5.32); and greater pain reduction from 48 to 96 hours post exercise muscle injury. Using an exploratory multivariable model to predict pain changes from 48 to 96 hours, we found participants with higher IL-10 were less likely to experience a high increase in pain (βˆ = −10.77; CI = −21.25, −2.69). Study findings suggest CRP, IL-6, and IL-10 are related to shoulder pain change for a preclinical high-risk COMT × PCS subgroup. Future studies will translate to clinical shoulder pain and decipher the complex and seemingly pleiotropic interplay between inflammatory biomarkers and shoulder pain change. PerspectiveIn a preclinical high-risk COMT × PCS subgroup, 3 circulating inflammatory biomarkers (CRP, IL-6, and IL-10) were moderately associated with pain improvement following exercise-induced muscle injury.

Activity-related pain predicts pain and functional outcomes in people with knee osteoarthritis: A longitudinal study.

Knee Osteoarthritis (OA) is a prevalent musculoskeletal condition, commonly resulting in pain and disability. However, pain and disability in this population are poorly related with the degree of structural joint damage. Underlying pain mechanisms, including activity-related pain and sensitization assessed via Quantitative Sensory Testing (QST), may better predict pain and functional outcomes of those with knee OA. Therefore, the aim of this study was to explore whether activity-related pain and sensitization assessed via QST predict future pain, function, fatigue, physical performance and quality of life outcomes in those living in the community with knee OA. Eighty-six participants with knee OA were recruited in Dunedin, New Zealand. Those eligible to participate underwent baseline testing including QST as well as measures of activity-related pain including Movement-evoked Pain (MEP) and Sensitivity to Physical Activity (SPA). Outcome measures exploring pain, function, fatigue and quality of life outcomes were collected at baseline, and two follow-up periods (two and nine weeks). Univariable linear regression models were developed followed by multivariable linear regression models for each prognostic marker adjusting for age, gender, BMI, OA duration, baseline pain intensity and socioeconomic status. Activity-related measures of pain, including MEP and SPA, demonstrated predictive associations with pain and functional outcomes prospectively in those with knee OA. Therefore, those demonstrating activity-related pain are at future risk of greater pain, disability and reduced quality of life. Larger, externally validated longitudinal studies are required which include individuals with more severe knee OA.

Multidimensional evaluation of the pain profile as prognostic factor in individuals with hip or knee osteoarthritis receiving total joint replacement: protocol of a 2-year longitudinal prognostic cohort study

IntroductionKnee and hip osteoarthritis are two highly prevalent musculoskeletal pain conditions. Unsuccessful rates after hip/knee replacement range from 10% to 20%. Subjects with sensitisation manifestations are vulnerable to worse clinical...