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Latest & greatest articles for chronic pain
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The effect of lumbosacral orthosis on the thickness of deep trunk muscles using ultrasound imaging: A randomized controlled trial in patients with chronic low back pain. This study was conducted to evaluate the changes occurring in the thickness of deep trunk muscles, measured using ultrasound imaging, after four weeks of lumbosacral orthosis (LSO) use in conjunction with routine physical therapy.This parallel-group, randomized, controlled trial was conducted on 44 patients with nonspecific (...) chronic low back pain (CLBP), randomly allocated to the experimental and control groups. Both groups received eight sessions of physical therapy twice per week for four weeks. The experimental group wore non-extensible LSO in addition to undergoing routine physical therapy. The thickness of the transversus abdominis (TrA), obliquus internus (IO) and lumbar multifidus (LM) was measured by ultrasound before and after the four-week intervention.The deep trunk muscles differed in thickness in various test
Effects of motor control exercise and patient education program in the management of chronic low back pain among community-dwelling adults in rural Nigeria: a study protocol for a randomized clinical trial. The impact of chronic low back pain (CLBP) is disproportionally higher in rural Nigeria than in urban areas but lack access to rehabilitation. While exercise and education are commonly advocated interventions for the rehabilitation of CLBP, there is a paucity of community-based randomized (...) to one of three intervention arms; MCE plus PE, MCE, or PE groups. The MCE will be administered twice a week for 8 weeks while the PE will be provided once a week for 8 weeks. Participants will be assessed pre-intervention, immediately post-intervention and at 3-month post-intervention. Primary outcomes will be pain intensity and functional disability. Secondary outcomes will be quality of life, fear-avoidance beliefs, pain catastrophizing, back beliefs, global perceived recovery, and physical
Ropivacaine versus placebo on postoperative analgesia and chronicpain following third molar extraction: A Prospective Randomized Controlled Study. The present study aimed at assessing the efficiency of ropivacaine on post-operative pain for extraction of third molars.In a single centre, prospective, parallel, double blind randomised trial, patients scheduled for removal of all four third molars, ASA I-III patients<65 year-old patients were included. After intubation under general anesthesia (...) when VAS>3/10, followed by oral tramadol 50mg after discharge), patient satisfaction, chronicpain (1-3 month), time in PACU and total hospitalization time were also recorded.A total of 50 patients were analysed in each group with similar characteristics (ropivacaine vs. control, for age (years) 18 [17-21] vs. 18 [17-21], for sex (female) 33 (66%) vs. 25 (50%), and BMI (kg/m2): 20 [19-23] vs. 21 [19-23]). Area Under the Curve for VAS pain (0 to 4h) was lower for Ropivacaine group: 0.43 [0.19-0.66
Clinical meaningfulness of duloxetine's effect in Chinese patients with chronicpain due to osteoarthritis: post hoc analyses of a phase 3 randomized trial. To evaluate the analgesic effect of duloxetine in Chinese patients with osteoarthritis (OA) of the knee/hip at individual patient level and report the relationship between pain intensity reduction, overall improvement, and physical functioning.Post hoc analysis of 13-week, phase 3, parallel-group, randomized, placebo-controlled study (...) of duloxetine in Chinese patients with OA pain. Patients were randomized (1:1, computer-generated, interactive web-response system) to duloxetine (60 mg once daily, n=202) or placebo (n=207). Patients, investigators, and study staff were blinded throughout the study. Duloxetine's efficacy was evaluated using the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) and the Osteoarthritis Research Society International and Outcome Measures in Rheumatology (OARSI-OMERACT
Letter to the Editor concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156 31309332 2019 08 30 1432-0932 28 9 2019 Sep European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J Letter (...) to the Editor concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156]. 2223 10.1007/s00586-019-06061-7 Li Yongchao Y Department of Orthopaedics, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China. Feng Xiaofei X Department of Orthopaedics, Shanghai East Hospital, Tongji University
Answer to the letter to the editor of Y. Li et al. concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Sp 31399848 2019 08 30 1432-0932 28 9 2019 Sep European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J Answer (...) to the letter to the editor of Y. Li et al. concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156]. 2224 10.1007/s00586-019-06063-5 Fischgrund Jeffrey S JS Oakland University William Beaumont School of Medicine, 3535 West 13 Mile Road, Suite 744, Royal Oak, MI, 48073, USA. email@example.com. eng Letter 2019 08 09 Germany
Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronicpain: A systematic review and network meta-analysis Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronicpain: A systematic review and network meta-analysis | Evidence-Based Mental Health Log in using your username and password For personal accounts (...) OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronicpain: A systematic review and network meta
Effects of an anteroposterior mobilization of the glenohumeral joint in overhead athletes with chronic shoulder pain: A randomized controlled trial. Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations.To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead (...) athletes with chronic shoulder pain.Double-blind, controlled, within-subject, repeated-measures design.Thirty-one overhead athletes with chronic shoulder pain participated. The effects of a 9-min, AP mobilization of the glenohumeral joint were compared with manual contact and no-contact interventions. Self-reported pain, pressure pain threshold (PPT), range of movement (ROM), muscle strength, and disability were measured immediately before and after each intervention.No significant differences were
Cannabinoids for ChronicPain Cannabinoids for ChronicPain November 2018 Mailing Address: Therapeutics Initiative The University of British Columbia Department of Anesthesiology, Pharmacology & Therapeutics 2176 Health Sciences Mall Vancouver, BC Canada V6T 1Z3 Tel.: 604 822 0700 Fax: 604 822 0701 E-mail: firstname.lastname@example.org www.ti.ubc.ca 115 C anada’s parliament legalized the recreational use of herbal cannabis (marijuana) in October 2018. The well-publicized limitations of clinical re- search (...) and well-recognized side effects such as canna- bis intoxication have not deterred people from seeking out and using herbal cannabis for chronicpain in in- creasing numbers. This is occurring with or without a physician’s authorization. 1 In fact, half of Canadians reporting a medical use of herbal cannabis used it for pain relief. 2 Adult patients in Canada still require a physician’s ‘au- thorization’ to legally access cannabis from a licensed producer of cannabis for medical purposes. Facilitating
Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham-Controlled Pilot Study Chronicpain is associated with maladaptive reorganization of the central nervous system. Recent studies have suggested that disorganization of large-scale electrical brain activity patterns, such as neuronal network oscillations in the thalamocortical system, plays a key role (...) in the pathophysiology of chronicpain. Yet, little is known about whether and how such network pathologies can be targeted with noninvasive brain stimulation as a nonpharmacological treatment option. We hypothesized that alpha oscillations, a prominent thalamocortical activity pattern in the human brain, are impaired in chronicpain and can be modulated with transcranial alternating current stimulation (tACS). We performed a randomized, crossover, double-blind, sham-controlled study in patients with chronic low
Chronic Knee Pain Revised 2018 ACR Appropriateness Criteria ® 1 Chronic Knee Pain American College of Radiology ACR Appropriateness Criteria ® Chronic Knee Pain Variant 1: Adult or child greater than or equal to 5 years of age. Chronic knee pain. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography knee Usually Appropriate ? Aspiration knee Usually Not Appropriate Varies CT arthrography knee Usually Not Appropriate ? CT knee with IV contrast Usually (...) . Chronic knee pain. Initial knee radiograph negative or demonstrates joint effusion. Next imaging procedure. Procedure Appropriateness Category Relative Radiation Level MRI knee without IV contrast Usually Appropriate O Aspiration knee May Be Appropriate Varies CT arthrography knee May Be Appropriate ? CT knee without IV contrast May Be Appropriate ? US knee May Be Appropriate (Disagreement) O Radiography hip ipsilateral May Be Appropriate ??? Radiography lumbar spine May Be Appropriate ??? MR
Chronic Chest Pain-Noncardiac Etiology Unlikely: Low to Intermediate Probability of Coronary Artery Disease Revised 2018 ACR Appropriateness Criteria ® 1 Chronic Chest Pain–Noncardiac Etiology Unlikely American College of Radiology ACR Appropriateness Criteria ® Chronic Chest Pain-Noncardiac Etiology Unlikely: Low to Intermediate Probability of Coronary Artery Disease Variant 1: Chronic chest pain, noncardiac etiology unlikely: low to intermediate probability of coronary artery disease. Initial (...) chest without and with IV contrast Usually Not Appropriate ??? CT chest without IV contrast Usually Not Appropriate ??? Tc-99m SPECT/CT MPI rest only Usually Not Appropriate ??? ACR Appropriateness Criteria ® 2 Chronic Chest Pain–Noncardiac Etiology Unlikely CHRONIC CHEST PAIN-NONCARDIAC ETIOLOGY UNLIKELY: LOW TO INTERMEDIATE PROBABILITY OF CORONARY ARTERY DISEASE Expert Panel on Cardiac Imaging: Amar B. Shah, MD a ; Jacobo Kirsch, MD b ; Michael A. Bolen, MD c ; Juan C. Batlle, MD d ; Richard K. J
Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial Antidepressants at low dose are commonly prescribed for the management of chronic low back pain and their use is recommended in international clinical guidelines. However, there is no evidence for their efficacy.To examine the efficacy of a low-dose antidepressant compared with an active comparator in reducing pain, disability, and work absence and hindrance in individuals with chronic low back pain.A (...) double-blind, randomized clinical trial with a 6-month follow-up of adults with chronic, nonspecific, low back pain who were recruited through hospital/medical clinics and advertising was carried out.Low-dose amitriptyline (25 mg/d) or an active comparator (benztropine mesylate, 1 mg/d) for 6 months.The primary outcome was pain intensity measured at 3 and 6 months using the visual analog scale and Descriptor Differential Scale. Secondary outcomes included disability assessed using the Roland Morris
Does the Use of Electrotherapies Increase the Effectiveness of Neck Stabilization Exercises for Improving Pain, Disability, Mood, and Quality of Life in Chronic Neck Pain?: A Randomized, Controlled, Single-Blind Study This study was a prospective, randomized, controlled study.The aim of this study was to determine whether transcutaneous electrical nerve stimulation (TENS) or interferential current (IFC) increase the effectiveness of neck stabilization exercises (NSEs) on pain, disability, mood (...) and quality of life for chronic neck pain (CNP).Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Electrotherapies, such as IFC and TENS, have been applied solo or combined with exercise for management of neck pain; however, the efficacy of these combinations is unclear.A total of 81 patients with CNP were included in this study. Patients were randomly assigned into three groups regarding age and gender. First group had NSE, second group had TENS and NSE
Postmenopausal Subacute or Chronic Pelvic Pain New 2018 ACR Appropriateness Criteria ® 1 Postmenopausal Subacute or Chronic Pelvic Pain American College of Radiology ACR Appropriateness Criteria ® Postmenopausal Subacute or Chronic Pelvic Pain Variant 1: Postmenopausal subacute or chronic pelvic pain, localized to the deep pelvis. Initial imaging. Procedure Appropriateness Category Relative Radiation Level US pelvis transvaginal Usually Appropriate O US duplex Doppler pelvis Usually Appropriate (...) Not Appropriate ???? CT pelvis without IV contrast Usually Not Appropriate ??? Radiography abdomen and pelvis Usually Not Appropriate ??? Variant 2: Postmenopausal subacute or chronic pelvic pain, clinically suspected pathologies in perineum, vulva, or vagina. Initial imaging. Procedure Appropriateness Category Relative Radiation Level US duplex Doppler pelvis Usually Appropriate O US pelvis transabdominal Usually Appropriate O US pelvis transvaginal Usually Appropriate O MRI pelvis without and with IV
Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial To investigate the effects of an osteopathic manipulative treatment (OMT), which includes a diaphragm intervention compared to the same OMT with a sham diaphragm intervention in chronic nonspecific low back pain (NS-CLBP).Parallel group randomized controlled trial.Private and institutional health centers.Participants (N=66) (18-60y (...) ) with a diagnosis of NS-CLBP lasting at least 3 months.Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33) or the same OMT protocol with a sham diaphragm intervention (n=33), conducted in 5 sessions provided during 4 weeks.The primary outcomes were pain (evaluated with the Short-Form McGill Pain Questionnaire [SF-MPQ] and the visual analog scale [VAS]) and disability (assessed with the Roland-Morris Questionnaire [RMQ] and the Oswestry Disability Index
Effect of Mobile Device-Supported Single-Patient Multi-crossover Trials on Treatment of Chronic Musculoskeletal Pain: A Randomized Clinical Trial Individually designed single-patient multi-crossover (n-of-1) trials can facilitate tailoring of treatments directed at various conditions, including chronic musculoskeletal pain (CMSP) but are potentially burdensome, which may limit uptake in research and practice.To determine whether patients randomized to participate in an n-of-1 trial supported (...) by a mobile health (mHealth) app would experience less pain and improved global health, adherence, satisfaction, and shared decision making compared with patients assigned to usual care.This randomized clinical trial compared participation in an individualized, mHealth-supported n-of-1 trial vs usual care. The participating 215 patients had CMSP for at least 6 weeks, had a smartphone or tablet with a data plan, were enrolled in northern California from July 2014 through July 2016, and were followed for up