Significant Decrease In Pain Scores Research Articles

Efficacy of Slow Reversal Hold and Isometrics in Improving Muscle Strength, Increasing Range of Motion, and Reducing Pain in Patients with Osteoarthritis of Knee

Osteoarthritis of knee is a common problem in the elderly population worldwide. Physical therapy has been shown to be useful in decreasing pain and increasing mobility in this population. The aim of this study was to study the effectiveness of slow reversal hold and isometric exercise techniques in reducing pain, increasing muscle strength, and increasing range of motion for knee flexion in patients with osteoarthritis of knee. The other aim of this study was to compare the relative effectiveness of these two interventions. 60 subjects participated in this study and were randomly assigned either to the slow reversal hold group (n = 30) or, to the isometrics exercise group (n = 30). All subjects performed their respective exercises for 3 weeks. Pain scores using the visual analog scale, muscle strength using manual muscle testing of quadriceps and hamstrings, and range of motion (ROM) for knee flexion using a goniometer were recorded both pre-treatment and post-treatment for both left and right knees. Both the interventions showed a significant decrease in pain scores, an increase in muscle strength, as well as an increase in the ROM. However, ROM was significantly increased in the slow reversal hold group as compared to the isometrics group in both knees. It was concluded that both exercise techniques could be useful in patients with osteoarthritis of knee for decreasing pain and increasing muscle strength. Slow reversal hold technique might be a better technique than isometrics for increasing ROM for knee flexion.

Postoperative Pain Among Patients After Day-Case Surgery.

Postoperative pain occurs at a high incidence after day-case surgery, with many patients reporting moderate to severe pain. A cross-sectional design was used in this study to estimate the prevalence of postoperative pain in the early postoperative period after day-case surgery and to determine whether there is a relationship between demographic and clinical variables. A convenient sample of 300 patients, aged between 18 and 80 years, was selected from all postoperative patients after day-case surgery over a period of 6 months. At the first 2 hr after surgery, about 70% of patients had either no pain or mild pain at rest and about 30% of patients had moderate to severe pain. About one third of these patients (103; 35.8%) reported mild pain, and about 43% of patients had moderate to severe pain on movement in the first 2 hr after surgery. Furthermore, 25.3% and 41.3% of the patients reported moderate to severe pain during the first 24 hr after hospital discharge at rest and on movement, respectively. Female patients had significantly higher pain scores than male patients (p < .001). Significant decrease in pain scores was reported in the first 2 hr after surgery (mean = 2.2, SD = 2) and within the first 24 hr after discharge (mean = 1.8, SD = 2.2, t(288) = 4.3, p =. 005) at rest. The prevalence of pain among postoperative patients after day-care surgery in Jordan is high. Young adult and female patients have higher pain scores after day-case surgery.

Patient characteristics affect the response to ketamine and opioids during the treatment of vaso-occlusive episode-related pain in sickle cell disease.

BackgroundN-methyl-D-aspartate receptor activation has been implicated in the pathobiology of inflammatory, nociceptive and neuropathic pain, opioid tolerance, opioid-induced hyperalgesia, and central sensitization. Some of those mechanisms underlie sickle cell disease(SCD)-associated pain.MethodsWe conducted an exploratory cohort study of SCD patients who during vaso-occlusive episodes (VOEs) received subanesthetic doses of the N-methyl-D-aspartate receptor antagonist, ketamine, as an adjunct to opioids. We sought to identify predictors of changes in pain scores and of the percentage of ketamine infusions associated with meaningful changes (≥20% reduction) in pain and opioid consumption.ResultsEight-five patients received 181 ketamine infusions for VOE-associated pain. Combined with opioids, ketamine yielded significant decrease in pain scores and opioid consumption. Ketamine administered to males and to younger patients yielded greater pain score decrease compared with females (P=0.013) and older patients (P=0.018). Fifty-four percent of infusions yielded meaningful reductions in pain scores, and in multivariate analysis, sex, age group, pain location, and infusion duration independently predicted pain score changes.ConclusionThis study suggests that in SCD patients admitted with VOE-associated pain, ketamine has age- and sex-dependent effects. These data can inform sample and effect size calculations for controlled trials to determine which SCD patients would benefit most from ketamine.

A Randomized, Controlled Trial of Mirror Therapy for Upper Extremity Phantom Limb Pain in Male Amputees.

Phantom limb pain (PLP) is prevalent in patients post-amputation and is difficult to treat. We assessed the efficacy of mirror therapy in relieving PLP in unilateral, upper extremity male amputees. Fifteen participants from Walter Reed and Brooke Army Medical Centers were randomly assigned to one of two groups: mirror therapy (n = 9) or control (n = 6, covered mirror or mental visualization therapy). Participants were asked to perform 15 min of their assigned therapy daily for 5 days/week for 4 weeks. The primary outcome was pain as measured using a 100-mm Visual Analog Scale. Subjects in the mirror therapy group had a significant decrease in pain scores, from a mean of 44.1 (SD = 17.0) to 27.5 (SD = 17.2) mm (p = 0.002). In addition, there was a significant decrease in daily time experiencing pain, from a mean of 1,022 (SD = 673) to 448 (SD = 565) minutes (p = 0.003). By contrast, the control group had neither diminished pain (p = 0.65) nor decreased overall time experiencing pain (p = 0.49). A pain decrement response seen by the 10th treatment session was predictive of final efficacy. These results confirm that mirror therapy is an effective therapy for PLP in unilateral, upper extremity male amputees, reducing both severity and duration of daily episodes. NCT0030144 ClinicalTrials.gov.

Enhanced release and drug delivery of celecoxib into physiological environment by the different types of nanoscale vehicles

Celecoxib (CEL) as the very low water soluble drug was loaded 16 and 50% (w/w) through an impregnation method on varieties of alumina nanostructures such as synthetic sol-gel γ-alumina (Gam-Al), functionalized sol-gel γ-alumina (Gam-Al-NH2), organized nano porous alumina (Onp-Al) and then the results compared with commercial alumina (Com-Al) and SBA-15 (SBA). Analyses of the samples were carried out by FT-IR, X-ray diffraction (XRD) and N2-sorption. in vitro studies were accomplished in simulated body fluid (SBF), simulated gastric fluid (SGF) and simulated intestinal fluid (SIF). In vivo study was carried out on male wistar rats under standard conditions.The N2-sorption revealed the initial pore characteristics of the nanocarriers. XRD patterns showed that the 50% loaded samples contain bulk celecoxib and its solubility in body fluids is lower than that of 16% loaded samples. In the case of 16% loaded samples, the drug solubility in three simulated body fluids drug was found to decrease in the following order: Gam-Al-CEL>Onp-Al-CEL>Com-Al-CEL>SBA-CEL. Gam-Al-CEL showed the highest release (96%) in SBF after 60min in vivo study showed significant decrease in pain score in rats for Gam-Al-NH2-CEL-16% and Gam-Al-CEL-50%. It could be concluded that the synthetic aluminas have a developing future potential compared to the formal SBA and commercial alumina.

Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients.

The objective of this study is to determine the use and efficacy of spa therapy in patients with a wide spectrum of rheumatic and musculoskeletal diseases under real-life clinical practice circumstances. In this retrospective observational study at the Medical Ecology and Hydroclimatology Department of Istanbul Faculty of Medicine, the records of all adult patients with rheumatic and musculoskeletal diseases who were prescribed a spa therapy in various health resorts in Turkey between 2002 and 2012 were analyzed. Patients sojourned to and stayed at a health resort and followed a usual 2-week course of spa therapy. The patients were examined within a week before and after the spa therapy at the department by the physicians and outcome measures were pain intensity (visual analog scale, VAS), patient's general evaluation (VAS), physician's general evaluation (VAS), Health Assessment Questionnaire (HAQ), Lequesne's Functional Index (LFI), Western Ontario and McMaster Universities Index (WOMAC), Waddell Index (WI), Neck Pain and Disability Scale (NPDS), Shoulder Disability Questionnaire (SDQ), Fibromyalgia Impact Questionnaire (FIQ), and Beck's Depression Inventory (BDI). In total, 819 patients were included in the analysis. The diagnoses were 536 osteoarthritis; 115 fibromyalgia; 50 lumbar disc herniation; 34 cervical disc herniation; 23 nonspecific low back pain; 22 ankylosing spondylitis; 16 rheumatoid arthritis; 9 rotator cuff tendinitis; and 14 other conditions/diseases including scoliosis, stenosing flexor tenosynovitis, congenital hip dislocation in adult, Behçet's disease, de Quervain tendinopathy, psoriatic arthritis, osteoporosis, fracture rehabilitation, and diffuse idiopathic skeletal hyperostosis. Statistically significant decrease in pain scores was found in all patients except hip osteoarthritis (p=0.063) and rheumatoid arthritis (p=0.134) subgroups; and statistically significant improvement in function in all patients except hip osteoarthritis (p=0.068), rheumatoid arthritis (p=0.111), and rotator cuff tendinitis (p=0.078) subgroups. In daily clinical practice, spa therapy is prescribed and practiced mainly for osteoarthritis, then fibromyalgia, lumbar/cervical disc herniation, and nonspecific low back pain; and less for ankylosing spondylitis, rheumatoid arthritis, and rotator cuff tendinitis. The study results suggest that real-life spa therapy may be effective in a variety of rheumatic and musculoskeletal diseases by improving pain and function.

Magnetic resonance guided focused ultrasound for treatment of bone tumors.

Magnetic resonance guided focused ultrasound (MRgFUS) is a new modality in the management of primary and secondary bone tumors. We aimed to investigate the safety, efficacy, and feasibility of using MRgFUS for the treatment of (1) benign bone tumors with the intent of complete tumor ablation, (2) primary malignant bone tumors with the intent to assess its effectiveness in causing tumor necrosis, and (3) metastatic bone disease with the intent of pain relief. Twenty-four patients with benign bone tumors, primary malignant bone tumors, and metastatic bone disease were treated with one session of MRgFUS. Contrast-enhanced (CE) magnetic resonance imaging (MRI) was carried out post-procedure to assess and quantify the area of ablation. Those with malignant primary tumors had the tumors resected 2 weeks after the treatment and the ablated areas were examined histopathologically (HPE). The other patients were followed up for 3 months to assess for the side effects and pain scores. Significant volume of ablation was noted on CE MRI after the treatment. Benign bone tumors were ablated with minimal adverse effects. Metastatic bone disease was successfully treated with significant decrease in pain scores. Ablated primary malignant tumors showed significant coagulative necrosis on MRI and the HPE showed 100% necrosis. Pain scores significantly decreased 3 months after the procedure. Only two patients had superficial skin blistering and three patients had increase in pain scores immediately after treatment. MRgFUS is effective, safe, and noninvasive procedure that can be an adjunct in the management of primary and metastatic bone tumors.

Is reiki or prayer effective in relieving pain during hospitalization for cesarean? A systematic review and meta-analysis of randomized controlled trials.

This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL. Randomized controlled trials published in English or Portuguese were included in the review. Two reviewers independently screened eligible articles, extracted data and assessed the risk of bias. A GRADE table was produced to evaluate the risk of bias. There was evidence with a high risk of bias showing a statistically significant decrease in pain score through use of reiki and prayer, in relation to the protocol group: mean difference = -1.68; 95% confidence interval: -1.92 to -1.43; P < 0.00001; I2 = 92%. Furthermore, there was no statistically significant difference in heart rate or systolic or diastolic blood pressure. Evidence with a high risk of bias suggested that reiki and prayer meditation might be associated with pain reduction.

Strawberries improve pain symptoms in obese participants with radiographic evidence of knee osteoarthritis

Osteoarthritis (OA), a common form of arthritis is mainly characterized by inflammation, joint pain and cartilage degeneration but without any effective pharmacological cure. Obese are at risk of OA. We have previously reported the effects of dietary berries in improving cardio‐metabolic outcomes in obese adults. To our knowledge no previous reports have examined the effects of berries on OA. Thus, in the present study we examined the hypothesis that strawberries will improve metabolic profiles and symptoms of pain in obese participants with radiographic evidence of knee OA. In a randomized placebo‐controlled crossover trial obese participants [n=17 (Females 13, Males: 4); age: 56±7y; BMI: 39±6 (mean±SD)] were randomized to one of the two groups: strawberry (50g freeze‐dried) or placebo, each for 12 weeks. Blood draws, anthropometric measurements and surveys for pain scores [visual analog scale of pain (VAS) and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)] and quality of life indices [Health assessment questionnaire disability index (HAQ‐DI)] were administered at screen, 12, 14 (washout) and 26 weeks of the study. We found significant decreases in pain scores (VAS) in the strawberry vs. placebo group at 12 weeks (0.71±0.31 and 0.90±0.47, respectively, p&lt;0.05). While no differences were noted in biochemical profiles, especially, glucose, HbA1c, total‐ and LDL cholesterol and C‐reactive protein, HDL‐cholesterol was significantly lower in the strawberry vs. placebo group at 12 weeks (50±16 and 55±6.5mg/dL, respectively, p&lt;0.05). Thus, strawberry bioactive compounds may help alleviate pain symptoms in knee OA. These findings deserve further investigation in larger trials.Support or Funding InformationCalifornia Strawberry Commission, NIH grant U54GM104938 (OSCTR)

Color Doppler ultrasound characteristics after subinguinal microscopic varicocelectomy.

The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) inthe testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy(MSV) on postoperative pain and semen parameters. Scrotal color Doppler ultrasound (CDUS) measurementswere made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using avisual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regardingsurgical outcome. A significant decrease in pain scores was observed in most patients at both follow-ups. The firstpostoperative CDUS revealed a significant increase in the TA-PSV (p<0.001) and a decrease in the TA-RI (p=0.002) and CARI(p=0.006). The second postoperative CDUS also revealed a significant increase in the TA-PSV and a decrease in the TA-RI,and the PSV in the ITA and CA and RI in the ITA and CA were significantly different from the values obtained pre-operativelyand at the first follow-up. A negative correlation was found between the pain level and TA-PSV (r=-0.433, p=0.012), whereassperm concentration positively correlated with both the TA-PSV and CA-PSV (r=0.534, p=0.001 and r=0.455, p=0.008, respectively). The PSV and RI are useful parameters for detecting changes in testicular microhemodynamics afterMSV. In addition, the TA-PSV and CA-PSV can be used to predict improvements in pain and sperm concentration.

Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial

Background:The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS.Materials and Methods:Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward.Results:The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours.Conclusion:Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.

Fluoroscopically guided retrocalcaneal bursa steroid injection: description of the technique and pilot study of short-term patient outcomes.

To describe a lateral fluoroscopically guided retrocalcaneal bursa injection technique, report patient outcomes at 1-4 weeks after steroid/anesthetic retrocalcaneal bursal therapeutic injection, and correlate pre-injection diagnostic heel ultrasound variables with improvement in patient pain scores. After IRB approval, fluoroscopically guided therapeutic retrocalcaneal bursa injections performed using a lateral approach were retrospectively reviewed. Pre-injection heel ultrasound results and pre- and post-injection patient VAS pain scores (scale 0-10) were recorded. The Wilcox matched-pair test compared pain scores, and Spearman's rho assessed for correlation between pain score changes and heel ultrasound results. Thirty-two injections were performed in 30 patients (25 females, 5 males; mean 56.5 ± 9.3years, range 39-75 years; 21 left heel, 11 right heel) with technical success in 32 of 32 cases (100%). Insertional Achilles tendon pathology and retrocalcaneal bursitis were present in 31 of 32 cases (97%) and 16 of 32 cases (50%), respectively. Median pre- and post-procedure pain scores were 8 (IQR 7, 10) and 1.75 (IQR 0, 6). A statistically significant decrease in pain score was observed following injection, with a median change of 4.75 (IQR 3, 8; p < 0.001). Clinically significant response (>50% reduction in pain score) was present in 69% (95% CI, 0.52-0.86; p < 0.001). No significant correlation was identified between a decrease in pain score and a sonographically abnormal Achilles tendon or retrocalcaneal bursa. Fluoroscopically guided retrocalcaneal bursal steroid/anesthetic using a lateral approach is an effective technique. This technique yielded 100% technical success and a clinically significant decrease in patient pain scores (p < 0.001).

Efficacy of ultrasound-guided mandibular block in predicting safer anesthetic induction.

Background:Mandibular nerve block reverses the trismus caused by pain and muscle spasm, thereby allowing for selection of a safer intubation technique.Aims:As ultrasonographic imaging has added newer dimensions to clinical anesthesia practice, we utilized this tool in performing mandibular nerve block and evaluated its efficacy in segregating trismus patients on etiological basis, to predict safer anesthetic induction.Settings and Design:Prospective, randomized controlled, outcome assessor blinded trial.Materials and Methods:Sixty-eight patients with unilateral mandibular fracture, acute pain, and trismus were randomized to receive mandibular nerve block by Vazirani-Akinosi approach (Group V) or the ultrasound-guided (USG) technique (Group U) before the general anesthetic induction for corrective surgery. Visual Analog Scale (VAS) score and inter-incisor distance was measured at intervals. Primary outcome measure was blocked failure (continued pain [VAS > 30] after the block procedure).Statistical Analysis Used:Mann–Whitney U-test and Wilcoxon signed rank test.Results:There was a significant decrease in pain score following the block procedure, except for six patients (block failure) in Group V. Inter-incisor distance increased to near-maximal levels after the nerve blockade, except for nine patients in Group V (including all block failures) and four in Group U having continued limited mouth opening. General anesthetic induction increased the inter-incisor gap in block failures (Group V) only.Conclusion:USG mandibular block appears to relieve reversible trismus more reliably, thereby allowing for a precise decision on a safer intubation technique.

A comparative study of continuous versus pulsed radiofrequency discectomy for management of low backache: Prospective randomized, double-blind study.

Background:Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others.Aim:The aim of this study is to compare different mode of RF - continuous RF (CRF) versus pulsed RF (PRF) along with steroid in the management of low back pain of discogenic origin.Setting and Design:Prospective, randomized, double-blind trial.Materials and Methods:Forty patients with chronic discogenic low back pain were randomized to receive CRF plus intradiscal triamcinolone 40 mg (Group 1) or to receive PRF plus intradiscal triamcinolone 40 mg (Group 2). Outcome measured includes immediate as well as long-term pain relief using visual analog scale, the Oswestry Disability Index and straight leg raising test.Statistical Analysis:The continuous variables were compared by one-way analysis of variance test. Discrete variables were compared by Fisher's exact test/Chi-square test/Student's t-test, whichever appropriate. The value of P < 0.05 was considered statistically significant.Results:There was a significant decrease in pain score after CRF without any added side effect. Pain relief after PRF was insignificant.Conclusion:CRF with steroid seems to be better for treatment of chronic discogenic low back pain than PRF with steroid.

Stepwise tapering of remifentanil at the end of surgery decreased postoperative pain and the need of rescue analgesics after thyroidectomy.

BackgroundThis study was designed to investigate whether stepwise tapering of remifentanil at the end of surgery could decrease postoperative pain scores and requirements of rescue analgesics after remifentanil-desflurane anesthesia in patients with thyroidectomy.MethodsSixty two patients undergoing thyroidectomy under general anesthesia were randomly allocated into two groups. All patients were anesthetised with desflurane and high-dose remifentanil. Remifentnail was infused at the rate of 0.3 μg/kg/min until the end of surgery in patients of the control group (group A) whereas remifentanil was tapered gradually from 0.3 to 0.1 μg/kg/min until the end of surgery for at least 30 minutes in patients with group B. Pain scores (0–100 numerical rating scale, NRS), rescue analgesic requirements and adverse events were assessed at 30 min, 2 h, 6 h, 12 h, and 24 h after operation.ResultsThere was a significant decrease in pain scores at 30 min (20 [0–80] vs. 50 [0–100], P = 0.002) and 2 h (30 [10–60] vs. 40 [20–80], P = 0.018) after surgery in group B compared with group A. In addition, rescue analgesics are less required in group B than in group A postoperatively (2 [1-3] vs. 3 [2,3], P = 0.039). There were no significant differences in adverse events between the two groups.ConclusionsTapering of remifentanil at the end of surgery decreased postoperative pain scores immediately after thyroidectomy with desflurane and high-dose remifentanil anesthesia.Trial registrationClinical Research information Service (CRiS, registration number KCT0000589).

Daily subcutaneous parecoxib injection for cancer pain: an open label pilot study.

Nonsteroidal anti-inflammatory analgesics (NSAIDs) are useful in cancer pain but the specific use of subcutaneous parecoxib has not been previously reported. This pilot study aimed to establish the efficacy and side effect profile of short-term sequential single daily dose subcutaneous parecoxib sodium in patients with severe cancer bone pain. Nineteen hospitalized patients with advanced cancer and uncontrolled malignant bone pain (9 males, 10 females) received 24 courses of one, two, or three days sequential therapy with 'off-label' daily subcutaneous parecoxib. All patients were receiving opioid therapy; the median baseline daily oral equivalent dose (OED) of morphine was 180 mg. Pain was assessed at baseline, 24 hours, 48 hours, and 72 hours. Pain scores as assessed on an 11-point numeric pain rating scale (NPRS), any side effects including subcutaneous site reactions, as well as patient satisfaction rating with analgesia were recorded. A clinically significant decrease in pain scores was defined as a reduction of two or more points on the NPRS. Median pain score of all patient treatments decreased from 7 to 4.5 at 24 hours (p<0.001) and 4.0 at 48 hours. A response was seen in 17 (71%) of the 24 treatments at 24 hours. There was no difference between median negative change in pain scores in 19 (79%) treatments where pain was either strongly movement related, or in 22 (94%) treatments where local bone tenderness was more pronounced. No major side effects were observed during treatment. One patient died from pulmonary embolism after cessation of concurrent prophylactic low molecular weight heparin prior to staging liver biopsy. Subcutaneous site reactions occurred in 2 (8%) treatments and were mild and self limiting. Short-term daily subcutaneous parecoxib injection was effective for malignant bone pain when added to existing analgesic therapy and was well tolerated. Further research is warranted into the short-term use of parecoxib in hospitalized patients with intractable malignant bone pain.

Transcutaneous electrical nerve stimulation for chronic post-herpetic neuralgia.

Postherpetic neuralgia remains a therapeutic challenge for the clinician. Many modalities have been utilized with limited success. In this pilot randomized study of patients who were refractory to previous medicinal treatment, the patients were treated with transcutaneous nerve stimulation with a biofeedback capability. After every two treatments with the sham and true device, the patients were required to fill out a standard neuropathic pain scale score. The patients were allowed to select the other device after three consecutive treatments if they felt an inadequate decrease in their pain. The true device was chosen over the sham device by all patients. The majority of these patients treated by the true device reported a statistically significant decrease in pain scores (P<0.001). Further investigation of this Food and Drug Administration, class 2 accepted, electronic device for relief of pain is warranted for patients with a history of recalcitrant postherpetic neuralgia.

Similar Efficacy Seen with Ultrasound-Guided Injections of PRP or Saline for Epicondylitis

Platelet-rich plasma (PRP) was not more effective in relieving the pain due to epicondylitis (tennis elbow) compared with saline when each was delivered by ultrasound-guided injection. However, both groups showed significant decreases in pain scores from baseline at 6 months, suggesting to investigators that tendon stimulation may be the actual mechanism behind the observed lesion repair and improvement in pain symptoms.

Effects of unstable shoes on chronic low back pain in health professionals: A randomized controlled trial

ObjectiveThe aim of this study was to evaluate the effectiveness of unstable shoes in reducing low back pain in health professionals. MethodsOf a volunteer sample of 144 participants, 40 with nonspecific chronic low back pain were eligible and enrolled in this study. Participants were randomized to an intervention group, who wore unstable shoes (model MBT Fora), or a control group, who wore conventional sports shoes (model Adidas Bigroar). The participants had to wear the study shoes during their work hours, and at least 6hours per workday, over a period of 6weeks. The primary outcome was low back pain assessed on a Visual Analog Scale. The secondary outcomes were patient satisfaction, disability evaluated using Roland-Morris questionnaire and quality of life evaluated using EQ-VAS. ResultsThe intervention group showed a significant decrease in pain scores compared to the control group. The rate of satisfaction was higher in the intervention group (79%) compared to the control group (25%). There was no significant difference for the Roland-Morris disability questionnaire score and the EQ-VAS scale. ConclusionsThe results of this clinical trial suggest that wearing unstable shoes for 6weeks significantly decreases low back pain in patients suffering from chronic low back pain but had no significant effect on quality of life and disability scores.

Is inflammatory pulpal pain a risk factor for amnesia

The aim of this study was to investigate the effect of inflammatory pulpal pain on spatial learning and memory in male Wistar rats. Fifty-six adult rats were divided into eight groups as follows (n=7 per group): control, sham-operated group that received normal saline, sham vehicle group that received vehicle of capsaicin, three capsaicin treated groups that received intradental injection of 10, 25 and 100 μg capsaicin, respectively, formalin treated group that received 10 μl formalin 2.5% and ibuprofen treated group that received ibuprofen 20 min before capsaicin (100 μg) injection. After preparing cavities via cutting 2 mm of the distal extremities of the mandibular incisors, the polyethylene crowns were placed on the teeth. Based on the study group, different algesics were administrated under the crowns. After recording the pain scores, spatial learning and memory was assessed using Morris water maze test. Capsaicin 25, 100 μg and formalin 2.5% applications induced significantly more painful stimulation compared with control groups (p< 0.001). Capsaicin 25, 100 μg and also formalin-treated groups significantly showed increased escape latency and traveled distance (p<0.05). Oral administration of ibuprofen, 20 min before capsaicin injection, caused significant decrease in pain scores, escape latency and traveled distance. Our data suggest that capsaicin- and formalin-induced pulpal pain can impair spatial learning and memory of male rats in Morris water maze task.