Reduction In Pain Intensity Research Articles

Complex physiotherapy in the treatment of cervical pain in military men

Aim: Study of the effectiveness of complex physiotherapeutic treatment of cervicalgia in the MM of the AFU. Materials and Methods: 45 male MM of the AFU aged 27-62 years, average age 42.3 ± 5.8 years, with pain in the cervical spine were examined. The effectiveness of drug and combined drug and complex physiotherapeutic treatment of cervical pain was evaluated according to the indicators of the NPAD scales, NDI and VAS. Results: Cervicocranial pain (37.8%) and cervicobrachial pain (33.3%) prevailed in the structure of the pain syndrome in the MM of the AFU. Against the background of the treatment, a significant decrease in the severity of the pain syndrome and complaints was observed in a significant majority of patients. There was a statistically significant decrease in the intensity of the pain syndrome according to the VAS (from 6.8±0.8 points to 5.2±0.5 points in group 1, and from 6.2±0.4 points to 4.8±0, 6 points in group 2. There was also a trend towards normalization of indicators on the NPAD scales (from 61.8 ± 3.6 points to 57.3 ± 4.1 points in group 1 and from 62.2 ± 4.1 points to 50, 2±3.8 points in group 2) and NDI (from 36.7±3.2 points to 29.1±4.3 points in group 1 and from 37.5±3.8 points to 25.3±3.2 points in the 2nd group). Conclusions: 1. Cervical pain syndrome of the spine in MM of the AFU most often manifests itself in the form of cervicocranialgia and cervicobrachialgia. 2. Drug treatment of cervicalgia demonstrates an effective reduction in pain intensity according to VAS, especially when combined with physiotherapeutic treatment. 3. Complex physiotherapeutic treatment in combination with drug therapy in MM of the AFU leads to regression of pain syndrome and improvement of quality of life and reduction of disability according to the diagnostic scales of NPAD and NDI.

Effects of acupuncture versus placebo on clinical status and potential specific effects in Fibromyalgia: an umbrella review of 11 meta-analyses.

The use of acupuncture is related to patients' expectations, and the therapeutic interaction effect remains a topic of debate in the literature. Accordingly, it is still unclear whether acupuncture can generate positive clinical effects in patients with fibromyalgia (FM). To determine the effectiveness of acupuncture versus placebo for clinical outcomes and determine the overall effect not attributed to specific effects in patients with FM. Umbrella review of systematic reviews (SRs) and meta-analyses. An electronic search was performed in MEDLINE (via PubMed), Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases from inception until December 2023. We selected studies with a clinical diagnosis of FM and that analyzed the effectiveness of acupuncture compared with a placebo. Pain intensity, functional status, fatigue, sleep quality, and depression symptoms were assessed. Effect sizes were calculated as the mean difference (MD) or standard mean difference (SMD). The quality of intervention reporting was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Eleven SRs with 8399 participants were included. Compared with placebo, acupuncture was associated with reductions in pain intensity (MD = -1.13 cm, 95% CI -2.09 to -0.17, p < 0.001), physical function (SMD = -0.63, 95% CI -1.67 to 0.41, p = 0.06), sleep quality (SMD = -0.25, 95% CI -1.39 to 0.88, p = 0.06), and fatigue (SMD = 0.20, 95% CI = 0.17 to 0.22, p < 0.001). The proportion not attributable to specific effects (PCE) of acupuncture was 58% for pain intensity (PCE = 0.58, 95% CI 0.45 to 0.71), 57% for physical function (PCE = 0.57, 95% CI -0.07 to 1.20), and 69% for fatigue (PCE = 0.69, 95% CI 0.18 to 1.21). Acupuncture showed a statistically significant difference in decreased pain intensity and fatigue in women with FM. However, the certainty of evidence was low to very low; its effects are not clinically important, and more than 50% of the overall treatment effects were not attributed to the specific effects of acupuncture. CRD42023487315.

Small needle-knife versus extracorporeal shock wave therapy for the treatment of plantar fasciitis: A systematic review and meta-analysis

BackgroundPlantar fasciitis (PF) is the most common cause of chronic heel pain among adults. Extracorporeal shock wave therapy (ESWT) is the recommended in the current guidelines, and the small needle-knife yields acceptable clinical effects for musculoskeletal pain. ObjectiveTo systematically compare the efficacy of the small needle-knife versus ESWT for the treatment of PF. MethodsThe present review was registered in the International Prospective Register of Systematic Reviews (i.e., “PROSPERO”, CRD42023448813). Two of the authors searched electronic databases for randomized controlled trials (RCTs) comparing the small needle-knife versus ESWT for the treatment of PF, and collected outcomes including curative effect, pain intensity, and function. Risk of bias was assessed using the Cochrane Handbook Risk of Bias tool and the quality of the RCTs was evaluated according to the Jadad Scale. The same authors independently performed data extraction from the included studies, which were imported into Review Manager version 5.4.1(Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2020) for meta-analysis. ResultsThe initial literature search retrieved 886 studies, of which 6 were eventually included in this study. Meta-analysis revealed no significant difference in curative effect (OR = 1.87; 95 % CI [0.80, 4.37], p = .15) nor short-term pain improvement (MD = 2.20; 95 % CI [-2.77, 7.16], p = .39) between the small needle-knife and ESWT. However, the small needle-knife may be more effective than ESWT for pain improvement in mid-term (MD = 9.11; 95 % CI [5.08, 13.15], p＜ .00001) and long-term follow-ups (MD = 10.71; 95 % CI [2.18, 19.25], p＜ .00001). Subgroup analysis revealed that the small needle-knife combined with a corticosteroid injection yielded a statistically significant difference in reduction of pain intensity at all follow-ups (MD = 4.84; 95 % CI [1.33, 8.36], p = .007; MD = 10.99; 95 % CI [8.30, 13.69], p＜ .00001; MD = 17.87; 95 % CI [15.26, 20.48], p＜ .00001). Meta-analysis revealed no statistical differences in short-term (MD = 1.34; 95 % CI [-3.19, 5.86], p = .56) and mid-term (MD = 2.75; 95 % CI [-1.21, 6.72], p = . 17) functional improvement between the needle-knife and ESWT groups. In a subgroup analysis of moderate-quality studies, the small needle-knife demonstrated a favorable effect on mid-term functional improvement (MD = 1.58; 95 % CI [0.52, 2.65], p = .004), with low heterogeneity (χ2 = 0.77, p = .038, I2 = 0 %). Conclusion: Pain reduction and functional improvement are essential for the treatment of PF. Therefore, treatment using the small needle-knife may be superior to ESWT. Results of this systematic review and meta-analysis may provide alternative treatment options for patients with PF as well as more reliable, evidence-based recommendations supporting use of the small needle-knife.

Exercise prescription variables predict reductions in pain intensity in adults with chronic low back pain: secondary analysis of a randomised controlled trial

ObjectivesThe relationship between exercise training variables and clinical outcomes in low back pain (LBP) is unclear. The current study aimed to explore the relationship between exercise training parameters and pain...

Topical treatment of chemotherapy-induced peripheral neuropathy (CIPN) with high-concentration (179 mg) capsaicin patch in breast cancer patients - results of the QUCIP study.

Chemotherapy-induced peripheral neuropathy (CIPN) following oral or intravenous chemotherapy often results in neuropathic pain, accompanied by symptoms such tingling, burning and hypersensitivity to stimuli, with a notable decline in quality of life (QoL). Effective therapies for CIPN are lacking, with a high demand for analgesics to address this issue. The QUCIP study aimed to assess the effectiveness of high concentration (179 mg) capsaicin patch (HCCP) in alleviating neuropathic pain and associated symptoms in breast cancer patients with confirmed CIPN. QUCIP is a prospective, multi-center observational study spanning 36 weeks with up to three HCCP treatments. Initial treatment (visit V0) was followed by two telephone contacts (T1, T2) and subsequent face-to-face visits every 12 weeks or upon retreatment (visits V1-V3). 73 female patients with painful CIPN post neoadjuvant/adjuvant breast cancer therapy were enrolled. Primary endpoint was the reduction of neuropathic pain symptom score (painDETECT®). Secondary endpoints included improvements in CIPN-specific QoL (QLQ-CIPN20), reductions in pain intensity (numeric pain rating scale, NPRS), and achievement of ≥ 30% and ≥ 50% pain reduction. Median age was 61 years, with 52.0% of patients experiencing peripheral neuropathic pain for > 1 year (> 2 years: 34.2%). The painDETECT® score significantly decreased from baseline (19.71 ± 4.69) to 15.80 ± 6.20 after initial treatment (p < 0.0001) and continued to decrease at follow-up visits. The NPRS indicated significant pain intensity reduction at each time point, particularly pronounced in patients receiving three HCCP treatments. Clinically significant pain relief of ≥ 30% increased from 25.0% at week 4 (T2) to 36.2%, 43.5%, and 40.0% at weeks 12 (V1), 24 (V2), and 36 (V3), respectively. The percentage of patients achieving pain relief of ≥ 50% increased from 14.7% at T2 to 15.5%, 21.7% and 32.5% at V1, V2 and V3, respectively. Patients further reported a significant improvement in their CIPN-related QoL throughout the study. Adverse drug reactions (ADRs) mainly included application site reactions. In this study, HCCP shows benefit in managing CIPN in real-world settings. The data demonstrate a sustained and progressive reduction in neuropathic pain and symptomatology, confirming the clinical benefit of repeated treatment observed in former clinical trials. HCCP treatment has also the potential to significantly improve the QoL associated with CIPN. The safety profile of HCCP was confirmed, supporting its use in clinical practice.

Neuromuscular taping reduced pain intensity after the eccentric activity in senior high school students

Neuromuscular taping is one method that can be used to reduce the impact of pain after eccentric activity. The purpose of this study was to determine the effect of neuromuscular taping on the pain intensity after eccentric activity. This was an experimental study with the design of a randomized post-test control group. The 14 samples obtained were then randomly divided into two groups. Neuromuscular taping treatment (NMT) was used before performing eccentric activities. The eccentric activity performed was shoulder flexion-elbow extension. After 24 hours of recovery, the pain intensity was measured using a visual analog scale. The results of the Mann Whitney u test showed that there was no significant difference in pain intensity (p ≥ 0.05). The conclusion of this study was that the neuromuscular taping after eccentric activity did not reduce the pain intensity after 24 hours of recovery. However, there was a tendency that the neuromuscular taping treatment group showed lower pain intensity so NMT decreased the pain intensity after eccentric activity.

Efficacy of Infrainguinal vs Suprainguinal Approach to Fascia Iliaca Compartment Block for Postoperative Analgesia in Patients with Proximal Femoral Fracture: A Randomised Clinical Study

Introduction: The Fascia Iliaca Compartment Block (FICB) has been useful in postoperative pain management for surgeries involving the hip joint and femur. Under ultrasound guidance, one can approach this compartment using either the conventional infrainguinal or suprainguinal methods. The suprainguinal approach was expected to be better due to the more proximal placement of the drug. Aim: To compare the suprainguinal and infrainguinal approaches to FICB for postoperative analgesia in proximal femur fractures. Materials and Methods: This unicentric prospective randomised double-blind clinical study was conducted over six months following approval from the ethics committee and in accordance with the Clinical Trial Registry of India (CTRI/2022/12/048121). A total of 60 patients were randomly divided into two groups of 30 using computer-generated random numbers. FICB was performed in the preoperative area with either approach under ultrasound guidance depending on the assigned group. Surgery was performed under a subarachnoid block after 30 minutes. Postoperative pain was assessed using the Visual Analogue Scale (VAS) score. If the VAS score was greater than 4, rescue analgesia was administered with intravenous paracetamol 1 gm infusion. The incidence of postoperative delirium was also recorded. Results: The duration of postoperative analgesia was significantly longer in the suprainguinal group (Group S) (481.7±136.7 minutes) compared to the infrainguinal group (Group I) (385.2±99.39 minutes) (p-value=0.001). The VAS score was similar between the groups at 2, 6, and 12 hours. However, the VAS score was significantly lower in Group S (2.333±0.479) compared to Group I (2.867±1.196) at 24 hours. The incidence of postoperative delirium was comparable in both groups (p-value=0.754). Conclusion: Regarding the duration of analgesia and reduced pain intensity at 24 hours, suprainguinal FICB was more effective than infrainguinal FICB in managing pain. There were no significant differences in overall paracetamol intake and the incidence of delirium between the two groups.

The effects of hamstring stretching exercises on pain intensity and function in low back pain patients: A systematic review with meta-analysis of randomized controlled trials.

This meta-analysis aims to synthesize the available data on the effectiveness of hamstring stretching exercises in relieving pain intensity and improving function for patients with low back pain. Google Scholars, PubMed, Embase, Cochrane, MEDLINE, CNKI, Wanfang, and VIP were searched from inception to August 2023. We included randomized controlled trials that investigated the effectiveness of hamstring stretching exercises in patients with low back pain. The primary outcomes assessed were pain intensity, hamstring muscle flexibility, and function. Study selection, data extraction, and assessment of risk of bias were performed independently by two reviewers. Our searches retrieved 344 trials, of which 14 met the inclusion criteria for this review (n = 735 participants). The combined meta-analysis showed hamstring stretching resulted in lower pain scores (standardized mean difference = -0.72, 95% confidence interval: -1.35 to -0.09; I 2 = 89%, p = 0.03) in different categories of low back pain. Subgroup analysis showed that hamstring stretching led to a larger range of motion for cases of back pain with radiating pain (standardized mean difference = 2.39, 95% confidence interval: 1.76 to 3.02; I 2 = 0%, p < 0.001). The combined meta-analysis revealed that hamstring stretching resulted in lower Oswestry Disability Index scores in comparison to regular treatment, particularly in individuals suffering from low back pain across all subtypes (mean difference = -6.97, 95% confidence interval: -13.34 to -0.60; I 2 = 95%, p = 0.03). This meta-analysis demonstrates the effectiveness of hamstring stretching exercises in reducing pain intensity in various categories of low back pain and improving the straight leg raise in patients experiencing back pain with radiating pain. Additionally, it highlights the improvement in function for patients with back pain across all subtypes.

The impact of ketorolac and paracetamol on post-operative pain and analgesic consumption post-dental extraction

Background: Despite being very popular, there is limited direct comparative research that has evaluated their efficacy in post-extraction pain control between ketorolac and paracetamol. Those undertaken have shown varied results; some show that ketorolac is superior in pain relief and duration of action and others show no significant difference in efficacy between the two. This discrepancy underlines the need for further research that is important in determining the relative efficacy of the two analgesics in those patients undergoing dental extractions, something that is very important in guiding the choice of analgesic for the clinician to use in the emergency room for dental patients. Aims and Objectives: This study aimed to compare the analgesic efficacy of paracetamol (500 mg) and ketorolac (10 mg) in managing acute pain following dental extractions. Materials and Methods: A prospective, randomized, and double-blind controlled trial was conducted on 80 patients undergoing single tooth extraction. Participants were allocated to receive either paracetamol 500 mg or ketorolac 10 mg orally post-extraction. Pain intensity was assessed using the visual analog scale at predetermined intervals post-extraction. Secondary outcomes included time to first analgesic request besides total analgesic consumption over 24 h. Results: Patients from Group II (ketorolac) demonstrated lower intensity pain scores at all-time points post-extraction compared to Group I (paracetamol). On the other hand, Group-I (ketorolac) demonstrated an extended time to the first analgesic request (P = 0.914) and lower total analgesic consumption (P = 0.0001) in the first 24-h post-extraction than Group-I (paracetamol). Conclusion: Ketorolac (10 mg) functioned better for pain than paracetamol (500 mg) in reducing pain intensity following dental extractions, with a longer duration of analgesic effect and reduced need for additional analgesia. These findings suggest that ketorolac may be preferred over paracetamol for immediate post-operative pain management within dental extractions, considering patient-specific contraindications and risk factors.

Safety and efficacy of carbamazepine in the treatment of trigeminal neuralgia: A metanalysis in biomedicine.

Trigeminal neuralgia is a debilitating condition characterized by severe facial pain. Carbamazepine has been widely used as a first-line treatment option for trigeminal neuralgia, but there is a need to evaluate its safety and efficacy based on existing evidence. This meta-analysis aims to systematically assess the available literature and provide a comprehensive evaluation of the safety and efficacy of carbamazepine in the treatment of trigeminal neuralgia. A thorough search of electronic databases yielded a total of 15 relevant studies that met the inclusion criteria. The pooled analysis of these studies revealed that carbamazepine demonstrated significant efficacy in reducing pain intensity and frequency in patients with trigeminal neuralgia. Moreover, the drug was generally well-tolerated, with the most common adverse events being mild and transient. Subgroup analyses based on different dosages and treatment durations further supported the overall findings. However, caution should be exercised in patients with certain comorbidities or specific populations, as some rare but severe adverse events were reported. In conclusion, this meta-analysis provides strong evidence supporting the safety and efficacy of carbamazepine as a valuable therapeutic option for the management of trigeminal neuralgia. These results can guide clinicians in making informed decisions regarding the use of carbamazepine and contribute to optimizing treatment strategies for patients with trigeminal neuralgia. Further research is warranted to explore long-term safety and efficacy outcomes, as well as to compare carbamazepine with alternative treatment modalities.

A new method of distracting attention: Is it effective for pain and fear during phlebotomy in children?

This study examined the impact of a novel distraction approach on the mitigation of fear and pain experienced by children between the ages of 7 and 12 during phlebotomy procedures. A total of 246 children who underwent phlebotomy between January and March 2019 in the pediatric blood collection unit were included in this randomized controlled trial. The participants (n = 246) were randomized to the intervention (n = 123) and control groups (n = 123). A musical blood collection tube was used in the intervention group. The Personal Information form, the Children's Fear Scale (CFS), and the Faces Pain Scale-Revised (FPS-R) were used for the collection of the data. Fear and pain were primary and secondary outcomes, respectively. A formal approval from the ethics committee was sought in order to proceed with the study. In this study, the CONSORT checklist was used as a guide and ethical principles were followed. The pain intensity and fear level of the children in the intervention group (CFS=1.73±1.07; FPS-R= 1.65±1.33) were lower than those in the control (CFS=2.86 ± 1.07; FPS-R= 3.09±1.57). The reduction in the intervention group's pain intensity and fear level differed significantly (p=0.000 and p=0.000, respectively). The results showed that using the musical blood collection tube as a new distraction technique reduces fear and pain intensity during phlebotomy in children. The musical blood collection tube can be used by health professionals as a non-pharmacological method to reduce the pain and fear of children during blood collection.

Нейропатическая боль у пациенток с эндометриозомɸ — диагностика и лечение: сравнительное проспективное исследование

INTRODUCTION. Chronic pelvic pain is the most common symptom of endometriosis. The neuropathic component of chronic pain has a significant impact on all areas of patients’ lives. AIM. To increase the effectiveness of treatment of patients with chronic pelvic pain with a neuropathic component due to endometriosis. MATERIAL AND METHODS. A comparative analysis of the results of examination and treatment of 65 women (18–45 years old) with a histologically verified diagnosis of endometriosis, suffering from chronic pelvic pain and neuropathy was carried out. RESULTS AND DISCUSSION. The use of complex therapy reduced pain intensity by 89% in patients with neuropathy due to indometriosis. Progestogen-only hormonal therapy is less effective for patients suffering from chronic pelvic pain with a neuropathic component due to endometriosis. CONCLUSION. The use of a muscle relaxant is effective for chronic pelvic pain with a neuropathic component in endometriosis. KEYWORDS: endometriosis, chronic pelvic pain, neuropathic pain, depression

COMPARISON OF THE EFFECTIVENESS OF MYOFASCIAL PAIN REDUCTION USING LOW-INTENSITY LASER AND RED LED LIGHT THERAPY IN PATIENTS WITH TEMPORO¬MANDIBULAR JOINT DYSFUNCTION

Introduction: Today, there is a significant prevalence of temporomandibular joint (TMJ) dysfunction, which currently ranges from 21.5 % to 50.5 %. This disease can worsen the patient's quality of life due to the presence of pain, which is the main symptom of this pathology. To reduce the intensity of pain in patients with TMJ dysfunction, low-level laser and red LED light therapy is used. There are a significant number of studies proving clinical efficacy in alleviating the symptoms of TMJ dysfunction using various methods of light therapy, but the number of studies comparing the effectiveness of different light therapy options among themselves is quite limited. The aim of the study was to compare the effectiveness of pain relief and the number of trigger points in patients with TMJ dysfunction using a low-level laser and red LED light. Materials and methods: 60 patients were randomised into 2 groups. Randomisation for patient allocation was performed using Microsoft Excel 2016. Patients of group I received red LED light therapy, radiation sources were applied to the trigger points of the masticatory muscles extracorporeally for 5 minutes. Patients in group II received low-intensity laser therapy for 30 seconds on the trigger points of the masseter muscles extracorporeally. Patients in both study groups received therapy weekly for 4 weeks. The effectiveness of the treatment was assessed by filling out a visual analogue scale (VAS), the number of trigger points of the masticatory muscles and the force of contraction of the masticatory muscles at rest and during tooth contact in patients with temporomandibular joint dysfunction. Results: the VAS scores in group I decreased by 47.02 % from the start of treatment, in group II – by 53.7 %. The number of trigger points in the projection of the masticatory, temporal muscles and parotid region in group I decreased by 62.34 %, in group II – by 72.21 %. According to electromyography, in group I, the amplitude of bioelectrical impulses of the masticatory muscles at rest decreased by 20.58 % on average, and in the state of voluntary teeth clenching – by 22.89 %. In group II, the amplitude of bioelectrical impulses of the masticatory muscles at rest decreased by 25.58 % on average, and in the state of voluntary teeth clenching – by 28.37 %. Conclusions: red LED light therapy and low-level laser therapy reduces pain intensity and the number of trigger points in patients with myofascial pain. Comparison of the effectiveness of red LED light therapy and laser therapy in reducing pain syndrome showed a higher ability of laser therapy to reduce myofascial pain and the number of trigger points in patients with temporomandibular joint dysfunction (p&lt;0.01).

Effects of White Noise Sound on the Severity of Muscle Vaccination Pain in Children Under Two Years.

Pain and its control is a significant health problem worldwide. The present study aimed to determine the effects of white noise (bird sound) on the severity of muscle vaccination pain in children under two years old. This study was a case-control study conducted in 2021. The samples included seventy children under two years old referred to the health centers in Ramsar City, Iran. The samples were selected using the convenient sampling method and divided into experimental and control groups. The data were collected using the demographic characteristics questionnaire, facial expression, and pain assessment in pediatric patients (FLACC). They were then analyzed by SPSS16 using an independent t-test and analysis of covariance (P<0.05). A significant difference was observed between the severity of muscle vaccination pain in children in the two groups (p=0.042); the pain intensity mean in the experimental group (6.45±2.01) was lower than the control group (8.94±1.28). This method can be a harmless and inexpensive intervention to reduce pain intensity and behavioral pain responses in infants during painful procedures, especially vaccination.

Water-Based Exercise in Patients With Nonspecific Chronic Low-Back Pain: A Systematic Review With Meta-Analysis

Abstract Babiloni-Lopez, C, Fritz, N, Ramirez-Campillo, R, and Colado, JC. Water-based exercise in patients with nonspecific chronic low-back pain: a systematic review with meta-analysis. J Strength Cond Res 38(1): 206–219, 2024—This study aimed to systematically review and synthesize evidence (i.e., active [land-based training] and nonactive controls [e.g., receiving usual care]) regarding the effects of water-based training on patients with nonspecific chronic low-back pain (NSCLBP). Web of Science (WOS), PubMed (MEDLINE), EMBASE, EBSCO (SPORTDiscus; CINAHL), and PEDro were searched, with no date restrictions, until October 2021. The included studies satisfied the following criteria: (a) NSCLBP (≥12 weeks) patients, (b) water-based intervention, (c) control group (land-based trained; nonactive group), and (d) outcomes related to pain, disability, quality of life, or flexibility. The main outcome analyzed in the meta-analysis was pain intensity. Secondary outcomes included disability, body mass index, and flexibility. The random-effects model was used, and effect size (ES) values are presented with 95% confidence intervals (CIs). The impact of heterogeneity was assessed (I 2 statistic), with values of &lt;25%, 25–75%, and &gt;75% representing low, moderate, and high levels, respectively. Alpha was set at p &lt; 0.05. In conclusion, 15 studies (n = 524) were meta-analyzed. After intervention, pain intensity was reduced compared with nonactive controls (ES = −3.61; p &lt; 0.001) and a similar reduction was noted when compared with land-based trained group (ES = −0.14; p = 0.359). Greater decrease in disability (ES = 2.15; p &lt; 0.001) and greater increase in sit-and-reach (i.e., flexibility; ES = −2.44; p &lt; 0.001) were noted after intervention compared with the nonactive group. In conclusion, water-based exercise therapy reduces pain intensity, disability, and increases flexibility in NSCLBP compared with nonactive subjects and was equally effective compared with land-based exercise to reduce pain. Favorable effects may be expected at ≤8 weeks. However, due to several methodological issues (e.g., high heterogeneity), for the improvement of most outcomes, we are unable to provide other than a weak recommendation in favor of intervention compared with control treatment.

The additional value of home exercises to self-management for the treatment of masticatory muscle pain. A clinical trial.

Initial management of temporomandibular disorders (TMD) based on self-management (SM) is strongly recommended by literature, nevertheless, research is needed to investigate the efficacy of different types of interventions under each component of SM against each other for the management of particular subtypes of TMD. The present study aimed to compare the clinical effectiveness of SM and SM with additional mandibular home exercises for the management of myalgia of masticatory muscles. A clinical trial was conducted with 54 subjects with a diagnosis of myalgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which were randomised into two groups: treated with SM (SM group) and treated with SM and mandibular home exercises (SM+EX group). Follow-ups were carried out at 2, 6, and 10 weeks, where it was evaluated: pain in the masticatory muscles, jaw opening range of motion, and mandibular functional limitation. Data were analysed using Wilcoxon signed-rank test for comparisons between periods (baseline, and weeks 2, 6, and 10) and Wilcoxon rank-sum test for comparison between groups (p=0.05). All the variables showed significant improvement (p<0.05) from baseline to the first follow-up and were maintained later, i.e. both groups were able to reduce pain, increase the jaw opening range of motion, and improve the mandibular functional limitation, although no significant differences were found between groups (p>0.05). The self-management program was able to reduce pain intensity, increase the jaw opening range of motion and improve functional limitation, but the addition of mandibular home exercises do not have a significant impact on myalgia of the masticatory muscles in the short-term. Key words:Myalgia, Self-care, Self-management, Temporomandibular joint disorders.

The effects of standardized cannabis products in healthy volunteers and patients: a systematic literature review.

There is growing recognition of the potential of cannabis to treat various medical conditions and symptoms, such as chronic pain, spasticity, and epilepsy. However, one of the biggest challenges is the assurance of a standardized cannabis product that contains a consistent amount of its main psychoactive substances delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), and which is compliant with predetermined specifications for these compounds. This is crucial not only to ensure consistent cannabis quality and dosage for patients but also to effectively translate research findings into clinical practice. This systematic literature review provides an overview of the effects of standardized cannabis products from Bedrocan, a leading Dutch producer of pharmaceutical-quality standardized medicinal cannabis. Cannabis administration to healthy volunteers induces dose-dependent acute effects, such as rapidly rising THC and CBD blood concentrations, the subjective experience of high and anxiety, slower reaction time and impaired attention, learning and working memory. Patient studies suggest that treatment with medicinal cannabis reduces pain intensity across a broad range of chronic pain-related medical conditions. Medicinal cannabis showed a mild safety profile, with minor and transient side effects, such as feeling high, coughing and mental confusion. The strength of acute effects, the experience of side effects and the drop-out rate in patient studies may depend on cannabis dose, cannabis composition (CBD:THC ratio), and cannabis use history of participants. Safety and efficacy of standardized medicinal cannabis products should be further investigated in randomized clinical trials with sufficient sample size, with particular focus on cannabis dose and composition, age and differences between males and females.

Pain neuroscience education : a practice in motion

Chronic pain is poorly explained by the pathological biomechanical model. Pain neuroscience education (PNE) aims to help patients reconceptualize their pain by understanding its physiology and dissociating it from the notion of threat. It must be combined with functional re-education. Catastrophism and kinesiophobia exacerbate the perception of pain and are an obstacle to movement. Gradual exposure to movement, whether virtual or real, is a tool for managing pain more effectively and regaining optimum functionality. According to the literature, PNE reduces pain intensity, catastrophizing, kinesiophobia, disability and improves functionality.

Celiac plexus radiosurgery - an introduction to the method and a practical manual.

Celiac plexus radioablation (CPR) is an emerging non-invasive interventional treatment for severe pain associated with cancer-related damage to the celiac plexus. Due to its complex aetiology, such pain often responds poorly to conventional analgesics, and high doses of these medications can cause toxicity. Celiac plexus radiosurgery employs advanced radiotherapy techniques to administer a high single dose of 25 Gy to the anatomically defined celiac plexus, aiming to reduce pain intensity and enhance patients' quality of life. The safety and efficacy of CPR have been validated in a prospective single-arm clinical trial that included 125 patients. The positive outcomes of this trial led to the integration of CPR into pain management guidelines; however, the novel approach to radiotherapy planning might be initially challenging to grasp. In this article, we provide a brief overview of the method along with a comprehensive, Polish and English-language guide on how to perform CPR and manage patients, based on our clinical experience.

Treatment of Willis-Ekbom Disease (Restless Leg Syndrome); The Efficacy of Mulligan's Traction Straight Leg Raise among Paramedical Professionals.

Background: Restless Leg Syndrome (RLS) is a generalized neurological sensory-motor disorder characterized by intense restlessness and discomfort in the lower extremities, leading to an urge to move the legs at sleep time. Treatment protocols for RLS may include thermotherapy, stretching exercises, and Mulligan’s traction straight leg raise (SLR). Mulligan’s traction SLR is an effective method that influences peripheral and central neural pathways through mobilization, thereby alleviating RLS symptoms. Objective: The study aimed to compare the efficacy of stretching exercises and Mulligan traction straight leg raise in reducing RLS severity among paramedical staff. Methods: This randomized clinical trial included a sample size of 38 paramedical staff members diagnosed with RLS using standard criteria. Participants were allocated using the Convenient Sampling Technique and randomly assigned into Group 1 (Stretching Exercises) and Group 2 (Mulligan Traction SLR) through coin tossing. Each group consisted of 19 participants. The interventions were conducted three times per week for one month. Assessments were made using the RLS Severity Scale, Numeric Pain Rating Scale, Groningen Sleep Quality Scale, and Goniometer at baseline, and after the 2nd and 4th weeks of treatment. Results: The study indicated that both treatments were effective in treating RLS, showing a significant difference with p&lt;0.05. However, Mulligan's TSLR exhibited remarkable results in improving sleep quality, increasing SLR range of both legs, reducing pain intensity, and improving RLS symptoms, with p-values of 0.001, 0.000, 0.012, and 0.001, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 26. Conclusion: The study concluded that both Stretching Exercises and Mulligan's TSLR are effective treatments for RLS. However, Mulligan's TSLR showed superior effectiveness in reducing pain levels, RLS symptoms, and in improving sleep quality and SLR range among paramedical staff members.