Significant Improvement In Pain Intensity Research Articles

A cultural adaptation of acceptance and commitment therapy with exercise for older Chinese with chronic pain and depressive symptoms: A mixed-methods study.

Chronic pain and depression are highly prevalent and correlated in older adults. Acceptance and commitment therapy (ACT) and exercise have been shown to be effective for both conditions, mostly in Western literature. Little is known about integrating two approaches, particularly in Asian cultures and among less well-educated people. This article describes the iterative process of developing a culturally adapted ACT with exercise intervention for older Chinese with chronic pain and depressive symptoms. A multidisciplinary expert panel codesigned a culturally adapted ACT with exercise intervention, comprising a weekly 2-hr ACT and a 1½-hr exercise program for 8 weeks, focusing on six ACT core components and low-to-moderate intensity circuit-based resistance exercise. Its feasibility was tested through a mixed-methods, pretest-posttest design with 22 older Chinese experiencing chronic pain and depressive symptoms (Mage = 71.5 years, SD = 7.5, 86% female). Participants showed significant improvements in pain intensity, pain interference, pain self-efficacy, physical performance, pain acceptance, and committed action (all p < .05). We identified five themes to inform protocol revision: (1) contextualizing values, (2) utilizing experiential learning, (3) using culturally appropriate metaphors, (4) establishing linkage between ACT concepts and pain, and (5) promoting application through repetition and prompts. Incorporating these findings, the final protocol emphasized three core ACT components and one set of physical exercises. This is the first study demonstrating the feasibility of a culturally adapted, person-centered tailoring ACT with exercise intervention for improving pain-related outcomes and mental wellness among older Chinese. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of metformin phonophoresis and exercise therapy on pain, range of motion, and physical function in chronic knee osteoarthritis: randomized clinical trial

BackgroundKnee osteoarthritis (KOA) is a common musculoskeletal disorder. Therapeutic ultrasound (US) is a safe and effective treatment for KOA. It relieves knee pain and enhances function. Metformin (MF) regulates chondrocytes, hence providing chondroprotection. Furthermore, it efficiently reduces knee articular cartilage degeneration and retards the progression of osteoarthritis. However, the localized administration of MF by phonophoresis for KOA has yet to be studied.PurposeTo assess the possible effects of metformin phonophoresis (MFPH) plus exercise therapy (EX) compared to MFPH alone or the US on knee pain, function, and range of motion (ROM) in chronic KOA patients.MethodsSeventy-eight patients with unilateral mild to moderate chronic KOA were included. Patients were randomly assigned to three groups: group A (MFPH + EX), group B (MFPH alone), and group C (US). The US group used an acoustic-neutral gel, while the MFPH group used a gel containing 1.2% MF. The exercises included hamstring stretches, calf stretches, and knee strengthening exercises. Treatment in the three groups continued for four weeks (three sessions per week). The Visual Analog Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the goniometer were used to assess knee pain, function disability, and ROM, respectively. All measures were recorded before, 2 weeks, and 4 weeks after the intervention in all groups. Multivariate Analysis of Variance (MNOVA) was performed to compare the effects within and between groups for knee ROM and function disability. The Kruskal-Wallis test and the Friedman test analyzed the pain intensity.ResultsWhen the baseline patient characteristics were compared, there were no significant differences in means of age, gender, body mass index (BMI), or lower limb dominance across the three groups (p > 0.05). After 4 weeks of intervention, clinical outcomes significantly improved in all three groups (p < 0.05). However, patients in the MFPH + EX group improved significantly in all outcomes compared to the MFPH and US groups (p < 0.05).ConclusionPost-treatment results showed a statistically and clinically significant improvement in pain intensity, knee ROM, and function in the MFPH group; however, combining MFPH with exercises is more beneficial in reducing KOA symptoms.Trial registrationClinical Trial Registry at (pactr.samrc.ac.za) database.NO: PACTR202311507335269. Date: November 9, 2023 (retrospectively registered).

The effectiveness of kinesio taping in addition to conventional treatment in patients with chronic low back pain: a randomized controlled trial

Aims: This study aimed to compare the effects of kinesio taping in combination with conventional treatment on pain intensity, lumbar range of motion (ROM) and flexibility, disability, and depression levels in patients with chronic low back pain (CLBP) with conventional treatment alone. Methods: The 48 individuals with CLBP included in the trial were randomized into the control group (CG, n=24) and the kinesio taping group (KTG, n=24). The CG received only conventional treatment for four weeks, while the KTG received kinesio taping for four weeks in addition to conventional treatment. Before and after the four-week treatment periods, patients were assessed with respect to pain intensity (visual analogue scale), lumbar ROM (goniometric measurement), flexibility (hand-ground distance), disability (Oswestry disability index), and depression (Beck depression inventory). Results: After the treatment programs, there were significant improvements in pain intensity, lumbar ROM and flexibility, disability, and depression levels in both the CG and KTG groups (p

Effects of combining thoracic lymphatic pump technique and exercises on patients with chronic mechanical low back pain

Purpose. The study aimed to compare the effects of combining thoracic lymphatic pump technique (TLPT) and exercises versus exercises alone on pain intensity, lumbar spine mobility, and functional disability in patients with chronic mechanical low back pain (CMLBP), the second most common orthopedic condition. Methods. Fifty-two CMLBP patients, whose mean age was 25 years, were classified into 2 equal groups randomly. Group (A) received exercises (hamstring stretching, lower back stretching, abdominal strengthening, and trunk extensor strengthening). Group (B) received the same exercises plus the thoracic lymphatic pump technique. Both groups received 12 sessions on nonconsecutive days. All patients were evaluated using the Visual Analogue Scale (VAS) for pain intensity, the Modified-Modified Schober test (MMST) for lumbar mobility (flexion-extension), and the Oswestry Disability Index (ODI) for functional disability. Assessments were performed prior to and after the end of treatment. For data analysis, the unpaired t-test, chi-squared test, and mixed MANOVA test were used. Results. The study found significant improvements in pain intensity, lumbar mobility (flexion, extension), and functional disability in both groups (P &lt; 0.05), with no significant difference in pain intensity or lumbar spine mobility. However, group (B) had a statistically significant advantage in functional disability (P &lt; 0.05). Conclusion. The addition of the thoracic lymphatic pump technique to therapeutic exercises significantly enhances pain, lumbar spine mobility, and functional abilities in CMLBP patients than therapeutic exercises alone.

Comparative effectiveness of Maitland Spinal Mobilization versus myofascial techniques on pain and symptom severity in women with Fibromyalgia syndrome: A quasi-randomized clinical trial with 3-month follow up

ObjectiveThe aim of this experimental study was to determine which manual therapy approach is more effective in addressing health status by improving symptoms (sensory, cognitive, emotional, and social) in patients with fibromyalgia. Material and methodsA quasi-randomized clinical trial with 3-month follow-up was conducted in 52 female patients (age 52.5 ± 8.1 years) affected by rheumatologist-diagnosed Fibromyalgia and evaluated at the Asociación de Fibromialgia y Síndrome de Fatiga Crónica (AFINSYFACRO) in Móstoles and AFIBROM, Madrid, Spain. Two manual therapy approaches were applied: the myofascial technique approach (MTA) and Maitland Mobilization Approach (MMA). The study examined the following outcomes: Widespread Pain, Symptom Severity, Impact on Quality of Life, Perceived Pain, Sensitization-Associated Pain, Sleep Quality, Physical Activity, and Psychological, Cognitive, and Emotional Factors. Patient Satisfaction was also assessed. ResultsNo significant differences were found between groups over time for most variables. However, the MTA group showed significant improvements in pain intensity, central sensitization, general health, sleep quality, and anxiety compared with the MMA group. ConclusionsDespite the lack of between-group differences in all variables over time, MTA may be useful in the treatment of fibromyalgia, reducing pain, central sensitization, and negative emotional symptoms, as well as improving general health and sleep quality. Due to problems during the study, randomization was abandoned. This problem becomes a virtue by taking advantage of the situation to apply statistical compensation methods, which will serve as a guide for future research that suffers from this problem. We suggest the inclusion of longer follow-up periods in future studies.

Effect of Selected Yoga Interventions on Psycho-Physiological Function in IT Professionals with Chronic Back Pain - A Randomized Controlled Trial

Purpose: This study sought to explore the effects of specific yoga practices on psycho-physiological function in IT professionals suffering from CLBP. Material and Methods: IT professionals with CLBP (n=83) were randomly allocated to intervention group (n=41) in which they practiced yoga interventions for 12 weeks, while the control group (n=42) received standard care without any special intervention. Pain intensity, quality of life (QoL), chronic pain self-efficacy, and self-efficacy for managing chronic disease were evaluated before and after the 12-week intervention period using the brief pain inventory (BPI), rand 36-item health survey, chronic pain self-efficacy scale (CPSS), and 6-item stanford self-efficacy for managing chronic disease (SSMCD-6) scale. Yoga group participants (n=32) demonstrated significant improvements in pain intensity, QoL, chronic pain self-efficacy, and self-efficacy for managing chronic disease compared to the control group (n=34). Results: Specifically, the yoga group showed a mean reduction in intensity of pain from 6.8±1.2 to 4.2±1.0 (p&lt;0.001) on the BPI scale, an increment in QoL scores from 45.6±9.3 to 62.4±10.5 (p&lt;0.001), an enhancement in chronic pain self-efficacy from 60.2±8.5 to 78.5±6.7 (p&lt;0.001) on the CPSS, and another enhancement in self-efficacy for managing chronic disease from 25.4 ± 4.6 to 32.8 ± 5.2 (p &lt; 0.001) on the SSMCD-6 scale. Conclusion: Selected yoga interventions demonstrated favorable effects on psycho-physiological function in IT professionals with CLBP. Integrating these postures into management strategies for CLBP could offer promising outcomes in terms of pain reduction, enhanced quality of life, and improved self-efficacy for pain management. Further research is needed to validate these findings and explore long-term effects.

A Review of Remote Monitoring in Neuromodulation for Chronic Pain Management.

Neuromodulation techniques have emerged as promising strategies for managing chronic pain. These techniques encompass various modalities of nerve stimulation, including Spinal Cord Stimulation (SCS), Dorsal Root Ganglion Stimulation (DRG-S), and Peripheral Nerve Stimulation (PNS). Studies consistently demonstrate significant improvements in pain intensity, quality of life, and reduced opioid usage among patients treated with these modalities. However, neuromodulation presents challenges, such as the need for frequent in-person follow-up visits to ensure proper functionality of the implanted device. Our review explored factors impacting compliance in current neuromodulation users and examined how remote monitoring can mitigate some of these challenges. We also discuss outcomes of recent studies related to remote monitoring of neuromodulation. While remote monitoring capabilities for neuromodulation devices is an emerging development, there are promising results supporting its role in improving outcomes for chronic pain patients. Higher patient satisfaction, improved pain control, and reduced caretaker burdens have been observed with the use of remote monitoring. This review discusses the current challenges with neuromodulation therapy and highlights the role of remote monitoring. As the field continues to evolve, understanding the importance of remote monitoring for neuromodulation is crucial for optimizing pain management outcomes.

Efficacy of rehabilitation interventions on functioning in patients with hemophilic arthropathy: A systematic review with meta-analysis.

Hemophilic arthropathy is a detrimental condition that crucially affects functional outcomes in hemophilic patients.In recent years, due to the advances in systemic therapies, growing attention has been raised in the rehabilitation field in order to improve functional outcomes of hemophilic patients. However, the optimal rehabilitation modalities in these patients are far from being fully characterized. The present study aimed to assess the effects of different rehabilitation interventions on physical functioning and health-related quality of life of hemophilic arthropathic patients. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Five databases were systematically searched for randomized controlled trials (RCTs) published until June 22nd, 2023. The selection criteria included adult patients with hemophilia A and B receiving rehabilitation interventions. The outcomes were muscle strength, physical function, pain intensity, physical performance, and health-related quality of life. Out of 1,743 identified records, 17 studies were included in the qualitative synthesis. Rehabilitation interventions were categorized into exercise intervention, fascial therapy, and multimodal intervention. The findings suggested positive outcomes in terms of muscle modifications, range of motion improvements, joint health enhancements, pain intensity reduction, and quality of life improvements. More in detail, meta-analyses showed significant improvements in pain intensity [ES: -1.10 cm (-1.37, -0.82), p< 0.00001], joint health [ES: -1.10 (-1.38, -0.82), p< 0.00001], In accordance, exercise interventions showed significant benefits in terms of joint health [ES: -2.54 (-3.25, -1.83), p< 0.00001)] and quality of life [ES: 1.17 (0.48, 1.86), p< 0.0000)]. Rehabilitation interventions have a positive impact on functional outcomes and health-related quality of life of hemophilic arthropathic patients. Further studies are needed to better elucidate the role of a comprehensive intervention combining different rehabilitation approaches to treat hemophilic arthropathy.

Clinical benefit of botulinum toxin for treatment of persistent TMD-related myofascial pain: A randomized, placebo-controlled, cross-over trial.

Injections of botulinum toxin type A (BoNT-A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)-related myofascial pain (MFP). BoNT-A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo-controlled crossover study was to evaluate the clinical benefit of a moderate dose (50 U) of BoNT-A. Sixty-six subjects were randomized into two groups, one which received BoNT-A first and a second which received a saline solution (SS) first. Follow-ups were performed 2, 11, and 16 weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain-related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated. The within-group analysis showed a significant improvement in pain intensity and pain-related disability after BoNT-A (p < 0.001, p = 0.005, p = 0.011) and SS (p = 0.003, p = 0.005, p = 0.046) injections up to week 16. The between-group analysis of pain-related variables revealed no differences between groups at any time. Nonetheless, BoNT-A, but not SS, caused a significant decline in muscle performance. The number needed to treat (NNT) regarding a clinically significant pain reduction (≥30%) was 6.3, 57.0, and 19.0 at 2, 11, and 16-week follow-ups favoring BoNT-A. Injections of 50 U of BoNT-A might improve MFP symptoms, but the specific effect of the drug on pain compared to the placebo is not obvious.

Evaluating the Efficacy of Two Pharmaceutical Therapies for Burning Mouth Syndrome

ABSTRACT Background: Burning mouth syndrome (BMS) is a chronic pain disorder characterized by a persistent burning sensation in the oral cavity, affecting quality of life significantly. Pharmacological therapy is commonly employed in the management of BMS, but the comparative efficacy of different pharmaceutical agents remains uncertain. Materials and Methods: This study was conducted involving 80 participants diagnosed with BMS, randomly assigned to two treatment groups: Group A received tricyclic antidepressants (TCAs), while Group B received anticonvulsants. Baseline assessments of pain intensity, oral health-related quality of life, and psychological distress were conducted using standardized measures. Treatment outcomes were evaluated at 3-month and 6-month follow-up visits. Pain intensity was assessed using a visual analog scale (VAS), while oral health-related quality of life and psychological distress were measured using validated questionnaires. Results: Both treatment groups demonstrated significant improvements in pain intensity, oral health-related quality of life, and psychological distress compared to baseline. At the 6-month follow-up, Group A (TCAs) showed a mean reduction of 70% in pain intensity from baseline, whereas Group B (anticonvulsants) exhibited a mean reduction of 65%. The difference in pain reduction between the two groups was not statistically significant (P = 0.35). Both groups also showed similar improvements in oral health-related quality of life and psychological distress measures. Conclusion: TCAs and anticonvulsants are both effective pharmaceutical therapies for managing BMS, resulting in significant improvements in pain intensity, oral health-related quality of life, and psychological distress.

Laser and acupuncture can be a treatment for myofascial temporomandibular disorder? A randomized, controlled, single-blind clinical trial

Background: Temporomandibular disorder (TMD) is a set of conditions with a multifactor etiology that affect the temporomandibular joint and muscles of mastication. Objective: The aim of the present study was to assess the effectiveness of treatment for myofascial TMD using acupuncture and low-level laser therapy compared to occlusal splint. Methods: 23 patients recruited through announcements and online publications. The diagnosis of TMD was confirmed using the Research Diagnostic Criteria for TDM (RDC/TMD) and all participants had moderate to severe pain upon palpation. The participants were randomly allocated to three groups: Group 1–occlusal splint; Group 2–10 sessions of acupuncture (once per week); Group 3–low-level laser therapy at 48-h intervals until the remission of symptoms or until completing 10 sessions. The participants were submitted to evaluations before and after treatment as well as 30 days after the end of treatment involving the determination of pain intensity, maximum vertical mandibular movement, as well as extraoral and intraoral palpations e analyze intra e extra group. Results: Statistically significant improvements in pain intensity were found in the acupuncture and laser groups (p=0.002). Improvements in the masseter and temporal muscles as well as the lateral pole of the temporomandibular joint were achieved with acupuncture and laser. Significant improvement was found in the posterior mandibular region using all three treatment modalities. Improvement in the submandibular region was only achieved with laser therapy. Conclusion: Treatments with acupuncture and low-level laser were more effective at reducing symptoms in individuals with myofascial TMD compared occlusal splint.

Efficacy of occupational rehabilitation in return to work for back pain: A systematic literature review.

Currently, there is no standard procedure for a return to work (RTW) rehabilitation program used by practitioners. The aim is to investigate the efficacy of occupational rehabilitation programs for workers with back pain. Two independent reviewers screened abstracts and full-text articles in a systematic literature search in three databases conducted in 2023. Subsequently, they extracted data according to the PRISMA Statement. Among the 4,010 articles retrieved, 20 met the inclusion criteria. Data from accepted studies were abstracted into tables relating to the RTW, improvement of pain intensity, quality of life (QOL), and degree of disability in persons with back pain. The risk of bias was assessed using the (SIGN)-criteria. Significant improvements in RTW were shown by a workplace intervention with a physical approach and a multidisciplinary intervention but with a wide range of effect sizes. Five studies showed significant improvements in pain intensity and QOL, six studies observed significant improvements in disability. The studies that stated positive effects on work-related data differed between intervention programs and traditional care. A combination of activity, maintenance therapy, stretching, and manual therapy showed promising results in improving RTW. In addition, the relationship and mediation between employer/workplace and employee seems to be an important aspect of RTW. However, pain intensity, disability, and QOL were enhanced with interventions that included a high proportion of physical activity. However, the intervention programs differed widely, leading to the assumption that the treatment effect of the intervention programs is not established, yet.

894 Comparison of Intraoperative Neural Changes During Tonic Versus High-Frequency Spinal Cord Stimulation in Chronic Pain Patients

INTRODUCTION: Chronic pain is a prevalent issue that may affect up to 34% of US adults, and spinal cord stimulation (SCS) is a promising therapy. However, SCS device selection remains a challenge because there are currently no objective biomarkers to evaluate chronic pain, or to predict which patients will be responders. METHODS: Intraoperative EEG signals were recorded in 24 chronic pain patients (14 women) during permanent SCS electrode placement surgery. Neural responses were captured with respect to tonic (60 Hz/300 µs) and high-frequency (1 kHz/30 µs) SCS paradigms in a randomized manner and correlated to Numeric Rating Scale (NRS) scores. All data were analyzed offline in MATLAB and SPSS v28.0.1.1. RESULTS: Our analyses for the main effects demonstrated a significant difference between cortical regions (F(2.88,57.7) = 7.60 , p &lt; 0.001) and a marginal difference between stimulation conditions (F(2,40) = 2.970, p = 0.063). The post hoc analysis for these factors revealed that alpha/theta peak power ratio was significantly different between in central regions (C3-C4) between tonic and HF stimulation (p = 0.006) and temporal regions (T3-T4) between baseline and HF stimulation (p = 0.049). The comparison of NRS scores before and 3 months after surgery indicated a significant improvement in pain intensity (p &lt; 0.001) at the group level. The neural features found to be significantly correlated with preoperative NRS scores in PFC (p = 0.036 and p = 0.025) and temporal regions (p = 0.041 and p = 0.012) under both stimulations. CONCLUSIONS: Our preliminary results support the possibility that different stimulation patterns affect the electrophysiological activity differently in various cortical regions. Such differences might account for the variability in pain suppression in patients with chronic pain treated with SCS. Future work will utilize this dataset to develop a machine learning classifier to support objective device selection strategies.

Promoting pain coping skills in haemophilia: A remote intervention integrating exercise and pain education.

Chronic joint pain is a significant and widespread symptom in people with haemophilia (PWH). Despite medical advancements, effective pain management remains challenging. This study presents an innovative approach that integrates remote physical exercises, pain neuroscience education, and coping strategies to address chronic pain in PWH. The remote intervention consisted of sixteen 5-min videos encompassing physical exercises for chronic pain management and pain education strategies. These videos formed an 8-week remote intervention program. Clinical and physical assessments were conducted before and after the intervention. A total of thirty-one PWHs, with a median age of 34 years (ranging from 16 to 59years), completed the remote intervention. The study revealed significant improvements in pain intensity, disability, and physical performance among PWH with chronic pain. Enhanced functional capacity was evident in the Timed Up and Go and Single Leg Stance tests, accompanied by improved scores on the Functional Independence Score in Haemophilia (FISH). Although lacking a control group, our findings are consistent with other successful exercise and pain education programs. This innovative intervention holds promise for managing chronic pain in PWH, underscoring patient empowerment, education, and collaboration. Notably, our study stands out by uniquely combining pain education and coping strategies, bolstering evidence for effective pain management.

Efficacy of Core Muscle Exercise Combined with Interferential Therapy in Alleviating Chronic Low Back Pain in High-Performance Fighter Pilots: A Randomized Controlled Trial

BackgroundChronic low back pain (LBP) related to flight is a prevalent health issue in military aviation, impacting pilots. The objective of this investigation was to ascertain if the application of core muscle training in conjunction with interferential current (IFC) therapy results in a reduction in pain severity and associated disability, consequently enhancing core muscle functionality in Chinese Air Force high-performance fighter pilots experiencing chronic LBP.MethodsFifty-three fighter pilots with chronic LBP were randomized into 3 groups: a core muscle exercise combined with IFC group (CG, n = 19), a core muscle exercise group (EG, n = 19), and an IFC group (IG, n = 15). The three groups underwent therapeutic intervention 5 times a week for 12 weeks. The primary outcomes were pain intensity, Oswestry Disability Index (ODI) score and SF-12 health-related quality of life (PCS and MCS) score. Secondary outcomes included evaluations of trunk muscle strength, endurance, and range of motion (ROM) during medial/lateral rotation to assess muscle functionality. Measurements were obtained both before and after the implementation of the intervention therapy.ResultsAfter 12 weeks of intervention therapy, all the health condition parameters significantly improved among the three groups. However, the CG had a significant improvement in pain intensity compared to the EG (MD = − 0.84 scores; 95% CI = − 1.54 to − 0.15; p = 0.013) and the IG (MD = − 1.22 scores; 95% CI = − 1.96 to − 0.48; p = 0.000). Additionally, the CG led to greater conservation of ODI and improved SF-12 PCS scores than did the IG (p < 0.05). Finally, compared with those at baseline, the core muscle function parameters in the CG and EG improved significantly at the end of the study, but no statistically significant differences were observed between the two groups (p > 0.05).ConclusionAmong participants with chronic LBP, three intervention therapies appear effective in reducing pain, diminishing disability, and enhancing quality of life. Also, combined therapy significantly improved pain and disability compared to the other two monotherapies; moreover, combined therapy and core muscle exercise provided similar benefits in terms of core muscle function after 12 weeks of intervention therapy.

Effects of Myofascial Release Technique along with Cognitive Behavior Therapy in University Students with Chronic Neck Pain and Forward Head Posture: A Randomized Clinical Trial.

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture.

Efficacy and safety of add-on mirogabalin to conventional therapy for the treatment of peripheral neuropathic pain after thoracic surgery: the multicenter, randomized, open-label ADMIT-NeP study

BackgroundFor chronic pain after thoracic surgery, optimal timing of its diagnosis and effective treatment remains unresolved, although several treatment options are currently available. We examined the efficacy and safety of mirogabalin, in combination with conventional pain therapy (nonsteroidal anti-inflammatory drugs and/or acetaminophen), for treating peripheral neuropathic pain (NeP) after thoracic surgery.MethodsIn this multicenter, randomized, open-label, parallel-group study, patients with peripheral NeP were randomly assigned 1:1 to mirogabalin as add-on to conventional therapy or conventional treatment alone.ResultsOf 131 patients of consent obtained, 128 were randomized (mirogabalin add-on group, 63 patients; conventional treatment group, 65 patients). The least squares mean changes (95% confidence interval [CI]) in Visual Analogue Scale (VAS) score for pain intensity at rest from baseline to Week 8 (primary endpoint) were − 51.3 (− 54.9, − 47.7) mm in the mirogabalin add-on group and − 47.7 (− 51.2, − 44.2) mm in the conventional group (between-group difference: − 3.6 [95% CI: − 8.7, 1.5], P = 0.161). However, in patients with Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) score (used for the screening of NeP) ≥ 12 at baseline, the greater the S-LANSS score at baseline, the greater the decrease in VAS score in the mirogabalin add-on group, while no such trend was observed in the conventional treatment group (post hoc analysis). This between-group difference in trends was statistically significant (interaction P value = 0.014). Chronic pain was recorded in 7.9% vs. 16.9% of patients (P = 0.171) at Week 12 in the mirogabalin add-on vs. conventional treatment groups, respectively. Regarding activities of daily living (ADL) and quality of life (QOL), changes in Pain Disability Assessment Scale score and the EQ-5D-5L index value from baseline to Week 8 showed significant improvement in the mirogabalin add-on group vs. conventional treatment group (P < 0.001). The most common adverse events (AEs) in the mirogabalin add-on group were dizziness (12.7%), somnolence (7.9%), and urticaria (3.2%). Most AEs were mild or moderate in severity.ConclusionsAddition of mirogabalin to conventional therapy did not result in significant improvement in pain intensity based on VAS scores, but did result in significant improvement in ADL and QOL in patients with peripheral NeP after thoracic surgery.Trial registrationJapan Registry of Clinical Trials jRCTs071200053 (registered 17/11/2020).

A Systematic Review on the Efficacy of Multidisciplinary Approaches in the Management of Chronic Pain

Background: Chronic pain presents widespread challenges globally. Multidisciplinary team (MDT) interventions have emerged as comprehensive approaches involving specialists from various medical fields to address the complexities of chronic pain management. This systematic review aims to synthesize evidence about the efficacy of multidisciplinary approaches in management of chronic non-specific musculoskeletal pain. Methods: This systematic review included randomized controlled trials (RCTs) of adults with chronic non-specific musculoskeletal pain. Multidisciplinary treatments involved at least three of: psychotherapy, physiotherapy, relaxation techniques, medical treatment, patient education, or vocational therapy. Exclusions were specific pathological entities, non-English studies, and follow-up less than one month. Searches were conducted across Cochrane evidence library, PubMed, and EMBASE. Primary outcomes encompassed pain intensity, quality of life, disability, and other functional measures. Results: Of the 100 articles identified, 6 studies met the inclusion criteria. These RCTs were conducted in Western countries, published between 2008 and 2019, and their sample size ranged from 132 to 401. Their interventions included Comprehensive Symptom Management, Assistance with Pain Management, physiotherapy, and telecare management. Two studies found significant improvements in pain intensity, while one demonstrated improved social functioning. However, no study found significant differences in disability scores or mental health outcomes. None of the studies assessed patient satisfaction with the interventions. Conclusion: Multidisciplinary team interventions for chronic pain show promise in improving pain intensity, particularly with Comprehensive Symptom Management and Pain Management Assistance. To strengthen these findings and address study limitations, future research with larger sample sizes is necessary.

The Impact of Mineral Water Balneotherapy on Pain and Physical Function in Patients with Knee Osteoarthritis: A Pilot Study

Objectives: This pilot study aimed to evaluate the effectiveness of a 2-week rehabilitation program consisting of electrotherapy, physical therapy, and balneotherapy in patients with knee osteoarthritis (KOA); (2) Methods: A total of 98 patients were enrolled in the study and assigned to either an experimental group or a control group. The primary outcome measures were pain intensity and knee function scores, while secondary outcomes included functional tests such as the 30s chair stand test, stair climbing test, and 40-meter walk test; (3) Results: Results showed significant improvements in pain intensity, knee function scores, and the 30s chair stand test in both groups. However, the experimental group showed more significant improvement in the 40-meter walk test than the control group. Linear Model ANOVA test showed that after the 2-week treatment, participants receiving balneotherapy showed significant progress compared to the control group in pain intensity, knee function scores, and walking test. The results for the stair climbing test did not differ significantly between the two groups, but it improved in both; (4) Conclusions: Study findings suggest that a rehabilitation program consisting of electrotherapy, physical therapy, and balneotherapy can show significant improvement in regards to pain and function in patients with KOA.

Piloting a Mediterranean Ketogenic Nutrition Program to Address Pain in Older Adults with Mild Cognitive Impairment

AbstractBackgroundPain is a persistent problem in older adults associated with poorer quality of life, greater risk of falls, functional impairment, and risk for cognitive impairment. Psychosocial and lifestyle interventions may be especially important to consider in older populations who may be more susceptible to negative side effects of pain medications. Ketogenic nutrition (KN) is one promising option that may offer a nonpharmacologic pathway for treating pain; however, KN is also a relatively strict and complex diet associated with challenges in dissemination and long‐term adherence, especially in older adults with memory impairments.MethodThis pilot clinical trial (N = 58) evaluated a 6‐week Mediterranean KN program designed to evaluate adherence and preliminary effects of the program on pain in individuals with possible mild cognitive impairment (aged 60‐85). Participants completed daily at‐home urine ketone testing during the program, weekly evaluations of psychosocial and health characteristics, and three in‐person assessments of health, ketones, pain, and other relevant measures.ResultsAnalyses demonstrated significant improvement in pain intensity across the assessment period. Average daily urine ketone level and average self‐reported adherence across the 6‐week program were both positively correlated with improvements in pain‐related quality of life (ps&lt;.05).ConclusionFindings offer preliminary evidence that a group, Mediterranean KN program and adherence to this type of nutrition may reduce the experience of pain and pain‐related outcomes for older adults.