Significant Difference In Pain Level Research Articles

Lateral epicondylitis: comparing ultrasound-guided tenotomy with or without amniotic membrane allograft injection.

Aim: To evaluate the clinical response to augmenting ultrasound-guided tenotomy (USGT) with an amniotic membrane (AM) allograft injection. Design: Retrospective study. Materials& methods: Subjects underwent either a USGT (N=16) or a combined USGT plus AM injection (N=14). Results: Both groups demonstrated a significant reduction in pain from baseline starting after 2 weeks in the USGT plus AM group (p=0.036) and after 8 weeks in the USGT group (p=0.021). The reduction in pain was sustained for the entire duration of the study (52weeks). There was no significant difference in pain levels at 26- or 52-week follow-up or patient satisfaction between the two groups. Conclusion: USGT with or without AM allograft injections results in a significant reduction in pain with high patient satisfaction.

Short-Term Outcomes of Fibrin Glue Versus Absorbable Tackers for Mesh Fixation in Laparoscopic TAPP Inguinal Hernia Repair: A Randomised Clinical Trial

Introduction: Hernia is defined as the protrusion of all or part of a viscus through the wall that contains it. Laparoscopic and tension-free open repairs are the two procedures that are being performed globally in inguinal hernia surgery. Aim: To compare the benefits of fibrin glue versus absorbable tackers in laparoscopic Transabdominal Preperitoneal (TAPP) inguinal hernia repair and to appraise their outcomes. Materials and Methods: A randomised clinical trial was conducted at a tertiary hospital of SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India for 18 months, from March 2021 to August 2022. Total of 54 patients who had laparoscopic TAAP hernia repairs were divided into two groups each with 27 participants, group A mesh fixed using fibrin glue and group B mesh fixed using absorbable tackers. All the patients were followed-up for atleast three months postsurgery. Operating time, postoperative pain and complications data were collected. The Chi-square and Unpaired t-test determined the statistical significance of the data. Results: Total of 54 patients aged 18 to 60 years were included in the study with no significant differences (p-value=0.696). The same was true for gender (11 males and 43 females), with no significant differences (p-value=0.735) in group A and group B between male and female patients. In current study, there was a statistically significant difference in pain levels between groups after 24 hours, hours (group B: 5.33±1.30 and group A: 6.56±0.51) however, after 48 hours (group B: 4.07±0.87 and group A: 4.63±0.49) and 72 hours (group B: 2.74±0.76 and group A: 2.63±0.49), there was no significant difference in the severity of the pain between the groups. At one week follow-up the level of pain score was significantly different. There was also a significant difference in haematoma between groups (p-value=0.038). In addition, there was a significant difference in return to normal activities in one week (p-value=0.033), two weeks (p-value=0.022), and four weeks between groups (p-value=0.019). Conclusion: The use of fibrin sealant for mesh fixation in TAPP surgery has superior short-term outcomes when compared to tackers in terms of postoperative pain, return to normal activities and reduced incidence of haematomas.

EFFECT OF OCCLUSAL REDUCTION ON POSTOPERATIVE PAIN IN MULTIPLE VISIT ROOT CANAL TREATMENT

The study aimed to assess occlusal reduction's effect on postoperative pain in multiple-visit root canal treatment. This randomized control trial was conducted at the Operative Dentistry & Endodontics Department, Baqai Dental College Karachi, from January 2021 to January 2022. A total of 110 patients fulfilling the inclusion criteria were included in the study. The patient was divided into two groups, Group A, occlusal reduction (OR) and Group B, no occlusal reduction (NOR). In group A, all occlusal contacts on the functional and non-functional cuspsand the marginal ridges were reduced by 1 mm by a diamond bur in a high-speed handpiece and confirmed with articulating paper. No occlusal reduction was performed in group B patients. Patients were recalled after 24 hours and 7 days, and their pain level was recorded on VAS; at the same appointment, the root canal was completed, and the tooth was restored permanently. Pain level on the 7th day was taken as the study's primary endpoint. The meanage of patients was 37.41±10.635, with a minimum age of 19 and a maximum of 59 years old. Female patients were 56% and 44%, male. There were two study groups' OR 50% and NOR 50%. The tooth type included were 40% anterior and 60% posterior. Group A patients had reduced pain levels after 24 hours, with a significant difference of P=0.014 compared to group B patients. After 7 days of treatment, no significant difference was found in postoperative pain between both groups with P=0.533. Thus, it can be concluded from the study that the occlusive reduction may not be effective in reducing pain at the 7th postoperative days of multiple visit root canal treatment. Although a significant difference in pain levels was identified after 24 hours of therapy, patients in the occlusion reduction group reported less discomfort than those in the control group.

Effectiveness of Virtual Reality (VR) technology towards pain management during initial fixed orthodontic procedures: A case-control study

The goal of this research is to see how effective virtual reality (VR) is in reducing discomfort during early fixed orthodontic operations. The research comprised 70 individuals, all of whom were between the ages of 15 to 18 years randomly divided into two groups- research group (n=35) and the control group (n=35). Patients in the experimental group received a virtual reality headset and watched interesting movies during orthodontic procedures, while those in the control group received regular care. The VR headgear was placed over the patient's eyes as the dental procedure began in the study group, whereas the controls group's eyes were kept open as they viewed the clinic and dental procedures going on around them. After adopting virtual reality movies before and after dental treatments, there was a statistically significant difference in pain levels between the control and study groups. The mean pain ratings during orthodontic treatment were 8.6 and 6.3 in the control and study groups, respectively. Following orthodontic treatment, the control and study groups reported mean pain levels of 7.4 and 6.7, respectively. VR is found to be an effective method in pain alleviation during initial fixed orthodontic procedures.

A STUDY TO ASSESS THE EFFECTIVENESS OF KEGELEXERCISE IN REDUCING MENSTRUAL CRAMPS AMONGTHE STAFF NURSES IN SELECTED HOSPITALS,GANDHINAGAR, GUJARAT

A study to assess the effectiveness of Kegel exercise inreducing menstrual cramps among the staff nurses inselectedhospitals,Gandhinagar, Gujarat. Pre-experimental research approach was used with the group pre-test post test design. The study was conducted in selected hospital of Gandhinagar, Gujarat. The investigator used random sampling technique for selecting 30 samples. In the view of the experimental study on staff nurses for reducing menstrual cramps by performing Kegel exercise. Data were analysed by using descriptive and inferential statistics. The mean pre-test pain score was 5.7 whereaspost-test pain score was 2.93.The mean post-test pain score is significantly lower than the mean pre test pain score with the mean difference of 2.77 and calculated t value (t = 18.53) was lower than degree of freedom (29) which was statistically proved at 0.05 level of significance. The findings of the study reveal that there is significant difference in pain level before and after Kegel exercise.

Evaluation of Breast Animation Deformity following Pre- and Subpectoral Direct-to-Implant Breast Reconstruction: A Randomized Controlled Trial.

Background The incidence of breast animation deformity (BAD) is reported to be substantial after direct-to-implant breast reconstruction with subpectoral implant placement. It has, however, never been examined if BAD can occur following prepectoral implant placement. Our primary aim was to compare the incidence and degree of BAD after direct-to-implant breast reconstruction using either subpectoral or prepectoral implant placement. Secondary aim of this study was to assess and compare the level of pain between sub- and prepectoral reconstructed women. Methods In this randomized controlled trial, patients were allocated to reconstruction by either subpectoral or prepectoral implant placement in accordance with the CONSORT guidelines. The degree of BAD was assessed by the “Nipple, Surrounding skin, Entire breast (NSE)” grading scale 12 months after surgery. The level of postoperative pain was assessed on a numerical pain rating scale. Results We found a significant difference in the degree of BAD favoring patients in the prepectoral group (23.8 vs. 100%, p < 0.0001; mean NSE grading scale score: 0.4 vs. 3.6, p < 0.0001). The subpectoral reconstructed group reported higher levels of pain on the three subsequent days after surgery. No significant difference in pain levels could be found at 3 months postoperatively. Conclusion The incidence and degree of BAD was significantly lower in women reconstructed by prepectoral direct-to-implant breast reconstruction. Unexpectedly, we found mild degrees of BAD in the prepectoral group. When assessing BAD, distortion can be challenging to discern from rippling.

Effectiveness of Valsalva Maneuver on Pain among Patients Undergoing Peripheral Intravenous Cannulation

Background: Peripheral intravenous cannulation is a frequent procedure nurses perform that causes pain and anxiety to patients. The valsalva maneuver performed during venous cannula insertion can effectively reduce the incidence and severity of venipuncture pain in adults. Aim: This study was designed to evaluate the effectiveness of valsalva maneuver in reducing pain among adult patients undergoing peripheral intravenous cannulation. Method: A quasi-experimental research design was adopted in this study, which was conducted at the surgical and medical departments of Mansoura University Hospital. A purposive sample of 60 patients who were randomly classified into two groups: The study group consisted of 30 patients who underwent peripheral intravenous cannulation during valsalva maneuver, and the control group comprised 30 patients who were punctured using the routine method. The patients’ pain scores were evaluated 2 min after cannulation using the numerical rating scale for pain, and the Pain Anxiety Symptoms Scale-20 was used to assess the level of anxiety. Results: In the control group, 40% of the patients had severe pain, whereas, in the study group, 43.3% had mild pain. A statistically significant difference was observed between the control and study groups (p = 0.0023). Moreover, statistically significant differences in pain level and anxiety symptoms were observed between the control and study groups (p < 0.05). Conclusion: The valsalva maneuver is a simple cost-effective method for decreasing pain and level of anxiety during Peripheral intravenous cannulation. Recommendation: we recommend the use of the Valsalva maneuver before performing the Peripheral intravenous cannulation for reducing pain and related stress during venous cannulation in adults.

Effect of a Posture-Cueing Shirt on Sitting Posture During a Functional Task in Healthy Participants: A Randomized Cross-Over Study

ObjectivesThe purpose of this study was to investigate the effect of a posture-cueing shirt on sitting posture during a functional task. MethodsThirty healthy male participants were seated at a standardized workstation while completing 3 laptop writing tasks of 15-minute duration wearing either a posture-cueing shirt, a compression shirt, or no shirt. Posture was assessed based on photos taken at minutes 1 and 15 into the writing task from which the head and shoulder angles were measured and extracted for analysis. After each task, participants rated any potential pain they felt during the task on an 11-point numeric rating scale (NRS). ResultsThe results showed that none of the shirts significantly affected the head or shoulder angles at any time point. Participants reported lower pain levels after using the posture-cueing shirt (NRS 0 [0-1]) compared with no shirt (NRS 1 [0-2]; P = .012). No significant difference in pain levels was observed between shirts. ConclusionAlthough posture did not change in any conditions for these healthy male participants, the posture-cueing shirt resulted in a lower pain intensity compared with no shirt but not with a compression shirt. Although a significant difference was found for pain intensity favoring the posture-cueing shirt, this difference was negligible, and thus its value to reduce pain or improve posture in healthy participants remains in question.

New Thoracotomy Closure, a Simple Way to Decrease Chronic Post-Operative Pain in Selected Patients-Blinded Prospective Study.

Background and Objectives: Chronic post-thoracotomy pain syndrome (PTPS) is a very common and uncomfortable complication, occurring frequently after thoracic operations, leading to the necessity of further medication and hospitalizations. One important risk factor in developing chronic pain is the chest closure technique, which can lead to chronic intercostal nerve damage. This study proposes an alternative nerve-sparring closure technique to standard peri-costal sutures, aimed toward minimizing the risk of chronic pain in selected patients. Materials and Methods: We performed a prospective randomized study on 311 patients operated for various thoracic pathology over a period of 12 months, evaluating incision types, chest closure technique, and number of drains with drainage duration. The patients were divided into three groups: peri-costal (PC), proposed extra-costal (EC), and simple (SC) suture, respectively. Pain was measured on day 1, 2, 5, 7, and at 6 months post-operatively using the Visual Analogic Scale. Results: No significant differences in pain level were recorded in the first two post-operative days between the PC and EC groups. However, a significant decrease in pain level was observed on day 5 and at 6 months post-operatively, with a mean level of 3.5 ± 1.8, 1.2 ± 1 for the EC group compared to a mean value of 5.3 ± 1.6, 3.2 ± 1.5, respectively. No significant differences were observed regarding other evaluated variables. Conclusions: The lower recorded pain scores in patients with extra-costal chest closure are a strong argument to use this technique. Its ease of use is similar to the classic peri-costal closure, and the time needed to perform it is not significantly increased. The association of this technique with less invasive procedures and short drainage duration limits chronic post-operative pain. This procedure may represent an option for decreasing healthcare costs associated with the management of PTPS.

The Effect of Cold Therapy Applied to the Incision Area After Abdominal Surgery on Postoperative Pain and Analgesic Use

BackgroundCold therapy is one of the most common nonpharmacologic pain treatments. Despite the existence of many studies about cold therapy, few have examined the effects of cold therapy after abdominal surgery. AimsThe purpose of the study was to investigate the effect of cold therapy applied to the incision area after abdominal surgery on postoperative pain and analgesic use. DesignThis study was a randomized controlled trial MethodsThe sample included 60 patients (30 control, 30 experimental) undergoing abdominal surgery. Researchers recorded information from a patient information form, a visual analogue scale (VAS), a pain evaluation form, and the vital signs recording form. ResultsThere was no statistically significant difference in pain level between the experimental and control groups as measured by VAS at postoperative hour 1 (p > .05). Furthermore, no statistically significant difference in VAS pain levels between groups was observed at postoperative hours 1, 2, and 8 prior to application of cold therapy (p > .05). Then, when cold therapy was applied at hours 1, 2 and 8, the pain level decreased significantly in the experimental group (p =.001). Pain also decreased in the control group between hours 1 and 8, but this decrease was not as great as that in the experimental group (p = .024). ConclusionsBoth groups had decreased pain levels, and the decrease in the experimental group was greater than in the control group but cold therapy had no statistically significant effect on analgesics use.

THE EFFECT OF KNEE EXERCISE AND PARAM GINGER TO REDUCE KNEE PAIN IN ELDERLY

Background: Higher life expectancy in Indonesia contribute to the increasing number of elderly populations. Due to this situation, dependent burden of productive age to non-productive expanding. Many diseases occur in the elderly, including degenerative joint disease, account for 11.9% in Indonesia and 6% occurring in Special Region of Yogyakarta. Among 34 provinces in Indonesia, Yogyakarta and 4 other provinces identified to have an old population structure where the proportion of elderly reached 10 percent or above. In 2019, elderly population in Yogyakarta account for 14.50 percent (BPS, 2019). Following changes on the population structure in which number of elderly people is rising and occupied as province with highest elderly population rate, arthritis became the second highest disease incidence in Yogyakarta. Current evidence related exercise and ginger, did not present any studies that combine both of the intervention methods as researchers aimed to identify scientific evidence of exercise and ginger to reduce knee pain in the elderly. Objective: This study aimed to determine the effect of knee exercise and param ginger to reduce knee pain in the elderly. Methods: This is a quantitative study implementing quasi-experimental research, randomized pretest-posttest control design. Population of this study were elderly originated from Pringwulung Village, Yogyakarta. Purposive sample design was intended to recruit participants with age 55-70 years, experiencing knee pain, have no ginger allergy and willing to participate. Eligible sample of this study was 40 participants. The intervention was carried out for 4 weeks from September to October 2020. Results: Study identified significant differences in pain levels before and after knee exercise (p=0.004), before and after knee exercise and param ginger (p=0.004), and before and after receiving param ginger (p=0.006). Conclusion: Knee exercise and param ginger provide significant effect to reduce knee pain in the elderly.

Su Jok as a complementary therapy for reducing level of pain: A retrospective study

PurposeThis study aimed to evaluate pain levels before and after Su Jok therapy. MethodsThis research was a retrospective study from data collected in September–December 2019 in Indonesia. A total of 33 females and 13 males complaining of physical pain when visiting community services’ activities and treated by a certified Su Jok therapist were included in this study. Physical pain scale was analyzed before and after therapy. Wilcoxon signed-rank tests were used for statistical analysis. ResultsAs many as 57 physical complaints were recorded from 46 respondents. The most common area of pain was the extremities (32%). The types of therapy were energy therapy, correspondence therapy and combined therapy (energy and correspondence therapy). Combination therapy had 100% success in reducing the pain scale. There were significant differences in pain level before and after Su Jok therapy (p < 0.01). ConclusionSu Jok therapy provides an effective treatment in reducing pain.

Efeito do volume da solução anestésica local aplicada no bloqueio retrobulbar na cirurgia de catarata na duração da anestesia e no conforto do paciente

Abstract Objective: To compare the use of 2 different local anesthetic solution (LAS) volumes of 1.5 mL and 3 mL in retrobulbar block in patients undergoing cataract surgery in terms of anesthesia, akinesia, and pain levels. Methods: 80 patients between 18-90 years old, ASA I-II-III, were included in the study. For retrobulbar anesthesia, 1.5 mL LAS was applied to one group (Group LV), and 3 mL LAS to the other group (Group HV). The patients' ocular and eyelid motion scores were evaluated and recorded in the first, third, fifth, and tenth minutes after the block, and at 30-minute intervals for 4 hours post-operatively. One day later, the first hour of analgesic need and the number of times they took analgesic agents were asked and recorded. In addition, side effects were questioned and recorded. Results: The 39 (48.75%) patients were male and 41 (51.25%) patients were female. The criteria determined in terms of ocular motor score after the retrobulbar block (ocular motor score≤4) were met in 92.5% of patients in Group LV in all patients in Group HV, and the time to fulfill the determined criteria in Group HV was found to be significantly lower compared to Group LV (p=0.004). The movements of the eye in all direction except the inward movement recovered in Group LV in a significantly shorter time than Group HV (p=0.004). There was no significant difference in pain levels and side effects between the groups (p=0.34). Conclusions: After 1.5 mL LAS administration in retrobulbar block, adequate akinesia was not achieved in about one tenth of patients, but no significant difference was found between 1.5 mL and 3 mL LAS volumes in analgesic efficacy and side effects.

The impact of a standard pain assessment protocol on pain levels and consumption of analgesia among postoperative orthopaedic patients

BackgroundPain is a leading concern in post-surgical orthopaedic settings; andeffective pain assessment tools are important aspects of pain management. ObjectiveThis study assessed the effect of using standard pain assessment protocols (SPAP) on pain levels, pain management, and analgesia consumption among patients in the first 24 h following orthopaedic surgery. MethodsIn total, 101 patients were recruited and assigned to the comparison group (n = 50) and experimental group (n = 51). SPAP was used in the experimental group while the comparison group received routine care. Pain levels at rest and during movement and analgesic consumption were compared between the two groups. FindingsThere were significant differences in pain levels between the comparison and experimental groups. The experimental group consumed significantly less pain medication at 8–11 h of opioid medications and 12–15 h of non-opioid medications (P < .001). The use of non-pharmacological modalities was significantly higher in the experimental group compared to the comparison group (P < .001). ConclusionsRegular pain assessment and management using SPAP can promote pain management and reduce pain levels as well as reduce analgesia administration and promote the use of non-pharmacologic approaches. These outcomes can result in fewer side effects for patients. ImplicationsThe findings suggest that using SPAP can result in improved outcomes as well as the use of non-pharmacologic approaches to pain management. This approach can result in better outcomes and increased communication between the nurse and the patient.

Lack of association between angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and pain improvement in patients with oral cancer.

BackgroundThere is a growing body of literature implicating angiotensin II in the modulation of tumour-associated inflammation and pain. However, the impact of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs) on pain and inflammation has not yet been studied in oral cancers. The objective is to investigate the role of ACEi and ARB pharmacotherapy on preoperative pain and inflammatory biomarkers, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR), in patients with oral cancer.MethodsWe performed a retrospective study on patients who underwent oral cancer surgery. The Wilcoxon rank-sum test or Kruskal–Wallis analysis was used to evaluate differences in demographic, tumour-related and preoperative characteristics and amongst patients using ARBs, ACEis and no treatment. Multivariable analysis was fitted to estimate the effects of important covariates on severe preoperative pain.ResultsA total of 162 patients with oral malignancies were included in the study. After adjusting for significant covariates, patients with perineural invasion were found to have higher levels of pain (p = 0.0278). Similarly, patients taking ARBs were found to have lower levels of perineural invasion (p = 0.035). The analysis did not demonstrate a significant difference in pain levels when comparing ARBs or ACEis to the no treatment group (p = 0.250). Furthermore, the use of ARB or ACEi did not significantly alter preoperative NLR (p = 0.701) or MLR (p = 0.869).ConclusionsWhen compared to no treatment, ARBs and ACEis are not associated with significant analgesic effect or decreased inflammatory scores (NLR, PLR and MLR).

Effects of preemptive analgesia with intravenous acetaminophen on postoperative pain relief in patients undergoing third molar surgery: a prospective, single-blind, randomized controlled trial.

Background The efficacy of preemptive analgesia in managing postoperative pain remains controversial. The aim of this study was to compare the efficacy of intravenous (IV) acetaminophen administered before or immediately after the surgical extraction of an impacted mandibular third molar. Material and Methods This prospective randomized clinical trial included 120 patients. The patients were assigned to one of three groups: the preoperative-treatment group (pre-group), which received 1000 mg of IV acetaminophen 20 min before surgery; the postoperative-treatment group (post-group), which received 1000 mg of IV acetaminophen after surgery; the no-treatment group (control-group), which did not receive any analgesic. Rescue analgesic (60 mg loxoprofen) was issued to each patient, with instructions on self-administration if needed. For the rescue medication usage, the time of first loxoprofen usage and the total amount of loxoprofen consumption were obtained for a 17-hour period after surgery. We measured pain using the visual analogue scale at 1 hour and at 2, 3, 4, 5, and 15 hours after surgery. Results There was no significant difference in pain level among the three groups at any time interval. However, the pre-group demonstrated significantly lower rescue analgesic consumption and longer time until initial administration. Conclusions Administration of IV acetaminophen before third molar surgery provides more effective pain control than postoperative administration and no treatment. Key words:Preemptive analgesia, acetaminophen, impacted third molar, pain relief, randomized controlled trial.

The impact of tooth-borne vs computer-guided bone-borne rapid maxillary expansion on pain and oral health–related quality of life: A parallel cohort study

The primary aim of this study was to investigate and compare perceived pain intensity and oral health-related quality of life (OHRQOL) results during the activation phase of rapid maxillary expansion (RME), with tooth-borne and bone-borne devices. In addition, a secondary aim of this study was to evaluate the correlation between pain scales and the shortened Oral Health Impact Profile (OHIP-14) questionnaire. Thirty-six subjects (16 girls and 20 boys) with a mean age of 12.3years (standard deviation, 0.82years) were randomized into 2 groups. Group A received treatment with hyrax appliance, and group B received a computer-guided skeletal RME appliance. The same type of expansion screw and screw activation or expansionprotocol were used. Two rating scales were used to assess the subject's pain during the activation phase of RME: a Graphic Rating Scale for Pain (GRS) and the Wong-Baker Faces Pain Scale (FPS). The OHIP-14 was used to evaluate the impact of RME on OHRQOL before the beginning of the treatment at day 3 and day 7 follow-ups. Painkillers were forbidden during the active phase of RME. Descriptive statistics, Student t test, and Pearson correlation were used. Significance was set at P≤0.05. A total of 36 subjects, divided into 2 groups, were treated in the study. Regarding the level of pain, the Student t test showed statistically significant higher pain in group B-although only on the first day of screw activation (GRS, P=0.01; FPS, P<0.01). For the following days, there were no significant differences in pain levels between groups. The OHIP-14 showed no statistically significant difference at baseline (P=0.32) and day 3 (P=0.88) and day 7 (P=0.85) follow-ups between the 2 groups. The Pearson correlation coefficient showed a statistically significant association between the 2 different scales of pain (GRS and FPS) but not a statistically significant correlation between GRS and FPS scales and OHIP-14. A higher perceived pain intensity in the patients treated using a bone-borne computer-guided skeletal RME appliance was limited to the first day of screw activation. There were no statistically significant differences between the 2 types of treatment in terms of their impact on OHRQOL and no statistically significant correlation between pain scales and the OHIP-14 questionnaire.

Properties of Thermal Analgesia in a Human Chronic Low Back Pain Model.

PurposeFor years, heat has been used for comfort and analgesia is recommended as a first-line therapy in many clinical guidelines. Yet, there are questions that remain about the actual effectiveness of heat for a condition as common as chronic low back pain, and factors such as time of onset, optimal temperature, and duration of effect.Materials and MethodsA randomized double-blinded controlled trial was designed to compare the analgesic response to heat delivered via pulses at 45°C (experimental group, N=49) to steady heat at 37°C (control group, N=51) in subjects with longstanding low back pain. Treatment lasted 30 minutes with follow-up out to four hours. The hypothesis was that the experimental group would experience a higher degree of analgesia compared to the control group. Time of onset and duration of effect were also measured.ResultsBoth groups were similar in average duration of pain (10.3 years). The primary outcome measure was pain reduction at 30 minutes after the end of treatment, using a 10-points numeric pain scale. Reduction in pain was greater for the experimental group than the control group (difference in mean reduction = 0.72, 95% CI 0.15–1.29, p = 0.014). Statistically significant differences in pain levels were observed from the first measure at 5 minutes of treatment through 120 minutes after completion of treatment. Reduction in pain associated movement was greater in the active heat group than the placebo group (p = 0.04).ConclusionHigh-level pulsed heat (45°C) produced significantly more analgesia as compared to steady heat at 37°C at the primary end point and for an additional 2 hours after treatment. The onset of analgesia was rapid, <5 minutes of treatment. The results of this trial provide insight into the mechanisms and properties of thermal analgesia that are not well understood in a chronic low back pain model.

Squeezing a squishy object effectively controls pain in children during intravenous catheter insertion.

This study aimed to identify the effect of distraction technique involving squeezing a squishy object on pain in children during intravenous catheter insertion. In this work, the control group posttest-only quasiexperimental design was used. This study involved 50 participants aged 3-15 years and was assigned into either intervention or control group. The intervention group was provided with a squishy object to squeeze as a form of distraction during intravenous catheter insertion, whereas the control group received the standard intervention. The pain was measured by using the Wong- Baker Faces Scale for 3-8 years old and the Visual Analog Scale or Numeric Rating Scale for children older than 8 years. Mann–Whitney analysis reveals significant difference in pain level between the intervention and control groups (P<0,001; α=0.05). The distraction technique involving squeezing a squishy object effectively reduced pain in children during intravenous catheter insertion and is recommended for pain management in nursing care in the pediatric ward.

Comparison of Physiotherapy Approaches in Low Back Pain: A Randomized Controlled Trial.

BackgroundThe purpose of this study was to compare the effectiveness of rehabilitation approaches in individuals with low back pain (LBP) on pain, spinal mobility, disability, and muscular strength.MethodsNinety volunteers were included and divided into four groups depending on the rehabilitation approach: group 1, soft tissue mobilization techniques and stabilization exercises (n=24; 11 females [F], 13 males [M]); group 2, Kinesio Taping and stabilization exercises (n=24; 12F, 12M); group 3, stabilization exercises (n=22; 11F, 11M); and group 4, reflex therapy and stabilization exercises (n=20; 10F, 10M). Visual Analog Scale for pain intensity, an isokinetic evaluation for strength at 60°/s and a side-plank position test for trunk stabilization were measured before and assessed at the beginning, after a 4-week treatment and during 4 weeks of follow-up. The functional status was evaluated with the Oswestry Disability Index.ResultsIndividuals in all groups showed similar decrease in pain after the treatment and at 1-month follow-up, but there were no significant differences in pain levels between the groups (P<0.05).ConclusionAll therapeutic approaches were found to be effective in diminishing pain and thus helpful in increasing strength and stabilization in patients with LBP.