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Barlas P, Craig JA, Robinson J, Walsh DM, Baxter GD, Allen JM. Managing delayed-onset muscle soreness: lack of effect of selected oral systemic analgesics. Arch Phys Med Rehabil 2000;81:966-72. Objective: To investigate the efficacy of commonly available analgesics in the management of delayed-onset muscle soreness over an 11-day period. Design: Double-blind, placebo-controlled randomized trial. Setting: University laboratory. Participants: Sixty healthy volunteers (30 men, 30 women) with no current arm pain or pathology completed the experimental procedure. Interventions: Subjects were randomly allocated to one of five experimental groups: control; placebo; aspirin (900mg); codeine (60mg); and paracetamol (1000mg) ( n = 12 in all groups). Delayed soreness was induced in the nondominant elbow flexors using a standardized exercise protocol of repeated eccentric contractions. Main Outcome Measures: Pain (visual analogue scale; McGill pain questionnaire [MPQ]), range of extension, flexion and resting angle (universal goniometer), and mechanical pain threshold (pressure algometer). Measurements were taken before and after drug administration each day, except for the MPQ, which was completed on the first and third days of the experiment. Results: Analysis of results using repeated-measures analysis of variance and relevant post hoc tests provided no evidence of the effectiveness of any of the preparations. Conclusion: There is no beneficial effect from the medications, at least at the doses stated, in the management of delayed-onset muscle soreness. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Objective To systematically review the evidence examining effects of walking interventions on pain and self-reported function in individuals with chronic musculoskeletal pain. Data Sources Six electronic databases (MEDLINE, CINAHL, PsychINFO, PEDro, Sport Discus, and the Cochrane Central Register of Controlled Trials) were searched from January 1980 to March 2014. Study Selection Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis, or fibromyalgia comparing walking interventions to a nonexercise or nonwalking exercise control group. Data Extraction Data were independently extracted using a standardized form. Methodological quality was assessed using the U.S. Preventive Services Task Force system. Data Synthesis Twenty-six studies (2384 participants) were included, and suitable data from 17 studies were pooled for meta-analysis, with a random effects model used to calculate between-group mean differences and 95% confidence intervals (CIs). Data were analyzed according to the duration of follow-up (short-term, ≤8wk postrandomization; medium-term, >2mo to 12mo; long-term, >12mo). Interventions were associated with small to moderate improvements in pain at short-term (mean difference , −5.31; 95% CI, −8.06 to −2.56) and medium-term (mean difference, −7.92; 95% CI, −12.37 to −3.48) follow-up. Improvements in function were observed at short-term (mean difference, −6.47; 95% CI, −12.00 to −0.95), medium-term (mean difference, −9.31; 95% CI, −14.00 to −4.61), and long-term (mean difference, −5.22; 95% CI, −7.21 to −3.23) follow-up. Conclusions Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared with control interventions but longer-term effectiveness is uncertain. With the use of the U.S. Preventive Services Task Force system, walking can be recommended as an effective form of exercise or activity for individuals with chronic musculoskeletal pain but should be supplemented with strategies aimed at maintaining participation. Further work is required for examining effects on important health-related outcomes in this population in robustly designed studies.