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Objective. Pulsed electromagnetic field (PEMF) therapy is a potentially useful treatment for osteoarthritis (OA), but its effectiveness is still controversial. This study aimed to examine the effects of PEMF therapy and PEMF parameters on symptoms and quality of life (QOL) in patients with OA. Methods. Cochrane Central Register of Controlled Trials, PubMed, CINAHL, EMBASE, PEDro, clinical trial registers, and reference lists were searched until April 2019. This study examined randomized, placebo-controlled trials, patients with OA, symptom and/or QOL related outcomes, and articles published in English. Two authors extracted data and completed quality assessment. Results. Sixteen studies were included in our systematic review, while 15 studies with complete data were included in the meta-analysis. Our primary outcome was the standardized mean difference, which was equal to the treatment effect in the PEMF group minus the treatment effect in the placebo group divided by the pooled standard deviation. For pain, the standardized mean difference was 1.06 (95% CI = 0.61 to 1.51), for stiffness 0.37 (95% CI = 0.07 to 0.67), for function 0.46 (95% CI = 0.14 to 0.78), and for QOL 1.49 (95% CI = -0.06 to 3.04). PEMF parameters did not influence symptoms. Conclusions. Compared with placebo, there was a beneficial effect of PEMF therapy on pain, stiffness, and physical function in patients with OA. Duration of treatment may not be a critical factor in pain management. Further studies are required to confirm the effects of PEMF therapy on QOL. Impact. Our study suggests that PEMF therapy has clinically significant effects on pain in patients with OA. The current evidence was limited to the short-term effects of PEMF therapy., Osteoarthritis (OA) is a chronic degenerative joint disease that occurs most commonly in people over 45 years. OA is characterized by articular cartilage loss, synovial inflammation, and the remodeling of [...]

Background. Virtual reality (VR) is an interactive technology that allows customized treatment and may help in delivering effective person-centered rehabilitation. Purpose. The purpose of this review was to systematically review and critically appraise the controlled clinical trials that investigated VR effectiveness in orthopedic rehabilitation. Data Sources. Pubmed, CINAHL, Embase, PEDro, REHABDATA, and Sage publications were searched up to September 2018. In addition, manual searching and snowballing using Scopus and Web of Science were done. Study Selection. Two reviewers screened studies for eligibility first by title and abstract and then full text. Data Extraction. Articles were categorized into general or region-specific (upper limbs, lower limbs, and spine) orthopedic disorders. Study quality was assessed using the Evaluation Guidelines for Rating the Quality of an Intervention Study scoring. Metaanalysis quantified VR effectiveness, compared with no treatment, in back pain. Data Synthesis. Nineteen studies were included in the quality assessment. The majority of the studies were of moderate quality. Fourteen studies showed that VR did not differ compared with exercises. Compared with the no-treatment control, 5 studies favored VR and 3 other studies showed no differences. For low back pain, the meta-analysis revealed no significant difference between VR and no-treatment control (n = 116; standardized mean difference = -0.21; 95% confidence interval = -0.58 to 0.15). Limitations. Limitations included heterogeneity in interventions and the outcome measures of reviewed studies. Only articles in English were included. Conclusion. The evidence of VR effectiveness is promising in chronic neck pain and shoulder impingement syndrome. VR and exercises have similar effects in rheumatoid arthritis, knee arthritis, ankle instability, and post-anterior cruciate reconstruction. For fibromyalgia and back pain, as well as after knee arthroplasty, the evidence of VR effectiveness compared with exercise is absent or inconclusive., Virtual reality (VR) technology involves an interactive computer environment or games that appear and feel real. (1,2) Users are able to interact with a virtual environment using off-the-shelf (3,4) or [...]

Background. Over the past few decades, physical therapists have emerged as key health care providers in emergency departments (EDs), especially for patients with musculoskeletal disorders (MSKD). Purpose. The purpose of this review was to update the current evidence regarding physical therapist care for patients with MSKD in EDs and to update current recommendations for these models of care. Data Sources. Systematic searches were conducted in 5 bibliographic databases. Study Selection. The studies selected presented quantitative data related to the care of patients with MSKD by physical therapists in an ED setting. Data Extraction. Raters reviewed studies and used the Effective Public Health Practice Project Quality Assessment Tool to assess their methodological quality. Data Synthesis. Fifteen studies were included. Two studies, 1 of weak and 1 of strong quality, demonstrated that physical therapist care in EDs was as effective as or more effective than usual medical care for pain reduction, and 6 studies of varying quality reported that physical therapist care in EDs was as effective as usual care in EDs in reducing disability. Eight studies of varying quality reported that physical therapist care could significantly reduce waiting time in EDs. Four studies of varying quality reported that physical therapists ordered no more, or even fewer, medical images than physicians. In terms of health care costs, 2 studies of moderate to high quality' found no significant differences in costs between physical therapist care and usual care in EDs. Finally, 6 studies of varying quality reported that patients were as satisfied or more satisfied with physical therapist care as with usual medical care in EDs. Limitations. The roles of physical therapists in EDs vary depending on the setting, legislation, and training of providers. Only a limited number of high-quality' studies were identified. Conclusions. Although the quality of the evidence is heterogeneous, physical therapist care for patients with MSKD in EDs may be beneficial., Over the past few decades, rising health care costs and physician shortages have made health care transformations a priority. (1-4) These transformations have resulted in the development of new models [...]

Background. Patients with pelvic pain due to pelvic floor myofascial pain syndrome are often referred for pelvic floor physical therapy, the primary treatment option. However, many patients do not adhere to the treatment. Objective. The purpose of this study was to examine the adherence rate and outcomes of patients referred for physical therapy for pelvic floor myofascial pain syndrome and identify risk factors associated with nonadherence. Design. This was a retrospective cohort study. Methods. ICD-9 codes were used to identify a cohort of patients with pelvic floor myofascial pain syndrome during a 2-year time period within a single provider's clinical practice. Medical records were abstracted to obtain information on referral to physical therapy, associated comorbidities and demographics, and clinical outcomes. 'Primary outcomes' was defined as attendance of at least 1 visit. Secondary outcomes included attendance of at least 6 physical therapist visits and overall improvement in pain. Statistical analysis was performed using chi-square, Fisher exact, and independent t tests. Nonparametric comparisons were performed using Wilcoxon signed rank test. Multivariate analysis was completed to adjust for confounders. Results. Of the 205 patients, 140 (68%) attended at least 1 session with physical therapy. At least 6 visits were attended by 68 (33%) patients. Factors associated with poor adherence included parity and a preexisting psychiatric diagnosis. The odds of attending at least 1 visit were 0.75 (95% confidence interval = 0.62-0.90) and 0.44 (95% confidence interval = 0.21-0.90), respectively. Patients who attended [greater than or equal to] 6 visits were more likely to have private insurance (78%) and travel shorter distances to a therapist (mean = 16 miles vs 22). Patients with an improvement in pain (compared with those who were unchanged) attended an average of 3 extra physical therapist visits (mean = 6.9 vs 3.1). Limitations. Limitations include reliance on medical records for data integrity; a patient population derived from a single clinic, reducing the generalizability of the results; the age of the data (2010-2012); and the likely interrelatedness of many of the variables. It is possible that maternal parity and psychiatric diagnoses are partial surrogates for social, logistic, or economic constraints and patient confidence. Conclusions. Initial adherence to pelvic floor physical therapy was less likely for multiparous women and women with a history of psychiatric diagnosis. Persistent adherence was more likely with private insurance or if the physical therapist location was closer. Pain improvement correlated with increased number of physical therapist sessions., Pelvic pain, defined as noncyclic pain that is present for at least 3 to 6 months, is one of the most common patient reports encountered by gynecologists and affects nearly [...]

Background. Descending nociceptive inhibitory pathways often malfunction in people with chronic pain. Conditioned pain modulation (CPM) is an experimental evaluation tool for assessing the functioning of these pathways. Spinal cord stimulation (SCS), a well-known treatment option for people with failed back surgery syndrome (FBSS), probably exerts its pain-relieving effect through a complex interplay of segmental and higher-order structures. Objective. To the best of our knowledge, no clinical studies have thoroughly investigated the associations between SCS and CPM. Design. This was a prospective cohort study in people with FBSS. Methods. Seventeen people who had FBSS and were scheduled for SCS were enrolled in this study. The CPM model was evaluated at both sural nerves and was induced by electrical stimulation as the test stimulus and the cold pressor test as the conditioning stimulus. Results. Before SCS, less than 30% of the participants with FBSS showed a CPM effect. Significant increases in the electrical detection threshold on the symptomatic side and the nonsymptomatic side were found. On the symptomatic side, no differences in the numbers of CPM responders before and after SCS could be found. On the nonsymptomatic side, more participants showed a CPM effect during SCS. Additionally, there were significant differences for CPM activation and SCS treatment. Limitations. Limitations were the small sample size and the subjective outcome parameters in the CPM model. Conclusions. This study revealed a bilateral effect of SCS that suggests the involvement of higher-order structures, such as the periaqueductal gray matter and rostroventromedial medulla (key regions in the descending pathways), as previously suggested by animal research., Failed back surgery syndrome (FBSS) (1) is denned as the surgical end-stage after 1 or several operative interventions on the lumbar neuroaxis, indicated to relieve lower back pain, radicular pain, [...]

Years ago, the scientist Letizia Marsili was skiing with her sister in Trentino, high in the Italian Alps, when she lost her balance on a double black diamond run and [...]

The purpose of this pilot study was to determine the effect of virtual reality (VR) on acute pain in pediatric patients with sickle cell disease experiencing vaso-occlusive crisis in one acute-care pediatric emergency department (ED). The randomized sample consisted of 15 participants aged 8 to 17 years admitted to the ED with vaso-occlusive crisis. The control group received standard ED treatment consisting of intravenous (IV) narcotics administered every 30 minutes as needed for up to 3 doses while the intervention group received VR for 15 minutes along with standard treatment. Pain was assessed using the Numerical Rating Scale (NRS) and the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Data were analyzed using an independent samples t test. Counter to hypotheses, results showed pain scores reported by patients using the NRS were not significantly lower when using VR (M=5.71, SD=2.752) than for those who received standard treatment. However, there was a statistically significant difference in the FLACC pain scores (behavioral scale) after 5 minutes of using the VR (p=0.01). Additionally, the average length of stay was shorter for the patients in the intervention group. Although the self-reported pain scores by patients in this sample did not vary significantly when using VR, there was a significant difference in the observed pain scores. This pilot study's data findings support the use of VR with standard treatment in pediatric patients with sickle cell disease who present to the ED in vaso-occlusive crisis. Using multi-modal pain management strategies may decrease length of stay and improve pain scores. Key Words: Virtual reality, sickle cell crisis, pain, children, pediatrics., Sickle cell disease affects approximately 100,000 Americans, and according to global newborn estimates, approximately 300,000 infants are born with sickle cell disease each year (Piel, Steinberg, & Rees, 2017). Vaso-occlusive [...]

Background. Numerous instruments are available to measure the impact of chronic pain, yet most have been developed with little or no patient involvement. This study seeks to start bridging that gap by determining which health aspects or attributes (to be included in a future instrument) are considered most important by people with chronic pain. Objective. The goal of this study was to reveal which attributes reflecting impact of chronic pain are considered most important by people with chronic pain and to analyze differences in importance according to gender, age categories, diagnostic subgroups, and pain intensity categories. Design. This study used a sequential explanatory mixed-methods design: literature search, focus group meetings, and online survey. Methods. First, a literature search was performed to identify the attributes in existing instruments. In 68 instruments meeting inclusion criteria, 155 unique attributes were identified, 85 of which remained after applying the exclusion criteria. Second, 2 focus group meetings, with 6 and 4 patients, respectively, were held to verify that no attributes had been missed. Three attributes were subsequently added. Third, individuals with chronic pain were then sent an online survey through several patient organizations. Results. A total of 939 patients were asked to select the 8 attributes they deemed most important, which resulted in the following list: fatigue, social life, cramped muscles, sleeping, housekeeping, concentration, not being understood, and control over pain. The importance assigned to these 8 attributes varied slightly according to age, gender, and diagnostic subgroup. Limitations. Participation rate could not be established because of the online survey. Conclusions. Attributes reflecting impact of chronic pain deemed most important by patients are revealed. Importance of impact differs according to subgroups. The 'patients-first' methodology used here revealed attributes that were not comprehensively covered in currently available instruments for measuring the impact of chronic pain., Health-related quality of life (HRQoL)--embracing functionality, social interaction, and physical, emotional, and psychological well-being--is reduced in people who suffer from chronic pain. (1,2) There are numerous instruments to measure distinct [...]

Background. In the management of chronic low back pain (LBP), identifying and managing more patients who are at high risk and who have psychological barriers to recovery is important yet difficult. Objective. The objective of this study was to test physical therapists' ability to allocate patients into risk stratification groups, test correlations between therapists' assessments of psychological factors and patient questionnaires, and explore relationships between psychological factors and therapists' self-reported competence to manage patients with chronic LBP. Design. This was a pragmatic, observational study. Methods. Patients completed the STarT Back Tool (SBT, for risk stratification), the Four-Dimensional Symptom Questionnaire (distress, depression, anxiety), and the Tampa Scale of Kinesiophobia (kinesiophobia) prior to the intake session. After this session, physical therapists estimated patient prognostic risk using the 3 SBT categories and rated patient psychological factors using a 0-to-10 scale. Finally, therapists reported their self-reported competence to manage the patient. Intraclass and Spearman rank correlations tested correlations between therapists' intuitive assessments and patient questionnaires. A linear-mixed model explored relationships between psychological factors and therapists' self-reported competence. Results. Forty-nine patients were managed by 20 therapists. Therapists accurately estimated SBT risk allocation in only 41% of patients. Correlations between therapist perceptions and patient questionnaires were moderate for distress (r = 0.602) and fair for depression (r = 0.304) and anxiety (r = 0.327). There was no correlation for kinesiophobia (r = -0.007). Patient distress was identified as a negative predictor of therapists' self-reported competence. Limitations. This was a cross-sectional study, conducted in only 1 center. Conclusions. Physical therapists were not very accurate at allocating patients into risk stratification groups or identifying psychological factors. Therapists' self-reported competence in managing patients was lowest when patients reported higher distress., Chronic low back pain (LBP) is a complex and multidimensional health problem associated with a high personal and economical burden. (1-5) Psychological factors play an important role in the development [...]

In last month's Townsend Letter, Dr. Chris Meletis discussed the International Center for Cannabis Therapy (ICCT) cannabinoid certification programs for dietary supplement manufacturers and healthcare practitioners. As the Chief Medical [...]

The implementation of recent Centers for Disease Control and Prevention recommendations to move away from opioids and toward nonpharmacological therapies for the treatment of chronic pain could involve a difficult transition period for patients and practitioners. The focus of treatment should shift from eliminating pain completely to minimizing the impact of pain on quality of life. Many patients with chronic pain take opioids either because opioids were previously prescribed as a first-line treatment for chronic pain, on the basis of old standards of care, or because opioids were initially prescribed for acute pain. Patients currently taking opioids will need a tapering period during which they transition their pain management to interdisciplinary care and nonpharmacological treatments. To provide useful treatment options, physical therapists need to have a good understanding of the neuroscientific mechanisms of chronic pain, biopsychosocial components of chronic pain management, issues related to opioid use, and pain management strategies used by other health care professionals. Armed with knowledge and good communication skills, physical therapists can work within an interdisciplinary team to adapt care to each patient's needs and abilities. This perspective article provides guidance for physical therapists to effectively treat patients with chronic pain during the opioid tapering process. A framework has been created to help health care providers structure their reasoning as they collaborate to develop a unique approach for each patient., The implementation of recent Centers for Disease Control and Prevention (CDC) recommendations to move away from opioids and toward nonpharmacological therapies for the treatment of chronic pain could involve a [...]

Geriatric low back pain (LBP) can have a profound impact on physical activity and can cause a decline in physical function, which is a major health risk for older adults. Within the last decade, physical therapist management of LBP has shifted from an emphasis on pathoanatomical mechanisms, such as spine degeneration, to addressing psychological distress factors. Although this approach is promising, the complexity of LBP in older adults (including biological, psychological, cognitive, and social influences), which may differ from that in younger adults, must be considered. Further, outcome assessment should represent not only the LBP experience (eg, pain intensity, pain with movement) but also LBP consequences, such as physical activity decline and physical function decline. This perspective discusses influences on geriatric LBP, experiences, and consequences with the goal of facilitating standardized and comprehensive physical therapist management., Geriatric low back pain (LBP) is the global leader in musculoskeletal disability for older adults, eclipsing other age-related conditions, such as chronic obstructive pulmonary disease, diabetes, and osteoarthritis (OA). (1) [...]

Background. Available evidence favors the use of pain neuroscience education (PNE) in patients with chronic pain. However, PNE trials are often limited to small sample sizes and, despite the current digital era, the effects of blended-learning PNE (ie, the combination of online digital media with traditional educational methods) have not yet been investigated. Objective. The study objective was to examine whether blended-learning PNE is able to improve disability, catastrophizing, kinesiophobia, and illness perceptions. Design. This study was a 2-center, triple-blind randomized controlled trial (participants, statistician, and outcome assessor were masked). Setting. The study took place at university hospitals in Ghent and Brussels, Belgium. Participants. Participants were 120 people with nonspecific chronic spinal pain (ie, chronic neck pain and low back pain). Intervention. The intervention was 3 sessions of PNE or biomedically focused back/neck school education (addressing spinal anatomy and physiology). Measurements. Measurements were self-report questionnaires (Pain Disability Index, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Illness Perception Questionnaire, and Pain Vigilance and Awareness Questionnaire). Results. None of the treatment groups showed a significant change in the perceived disability (Pain Disability Index) due to pain (mean group difference posteducation: 1.84; 95% CI = -2.80 to 6.47). Significant interaction effects were seen for kinesiophobia and several subscales of the Illness Perception Questionnaire, including negative consequences, cyclical time line, and acute/chronic time line. In-depth analysis revealed that only in the PNE group were these outcomes significantly improved (9% to 17% improvement; 0.37 [less than or equal to] Cohen d [greater than or equal to] 0.86). Limitations. Effect sizes are small to moderate, which might raise the concern of limited clinical utility; however, changes in kinesiophobia exceed the minimal detectable difference. PNE should not be used as the sole treatment modality but should be combined with other treatment strategies. Conclusions. Blended-learning PNE was able to improve kinesiophobia and illness perceptions in participants with chronic spinal pain. As effect sizes remained small to medium, PNE should not be used as a sole treatment but rather should be used as a key element within a comprehensive active rehabilitation program. Future studies should compare the effects of blended-learning PNE with offline PNE and should consider cost-effectiveness., Chronic spinal pain accounts for a large proportion of the chronic pain population and is generally perceived as highly disabling with tremendous personal, social and economic impact. (1-4) Within the [...]

Background. Musculoskeletal pain is a societal epidemic because it is highly prevalent and a leading contributor to disability; however, physical therapists are still challenged when predicting which patients are at high risk for persistent symptoms. Objective. The objectives of this study were to identify patient characteristics predictive of persistent musculoskeletal pain 12 months following physical therapist care and to determine the influence of anatomical region. Design. The design included a secondary analysis of a cohort study. Methods. Participants ranged in age from 18 to 65 years, had a primary report of knee, shoulder, back, or neck pain, were receiving physical therapy, and were enrolled in the Orthopedic Physical Therapy Investigative Network (OPT-IN) Optimal Screening for Prediction of Referral and Outcome (OSPRO) validation cohort study. Candidate predictor variables included demographic and clinical characteristics, comorbidities, and OSPRO Review of Systems (OSPRO-ROS) and OSPRO Yellow Flag (OSPRO-YF) tool scores. Persistent musculoskeletal pain was assessed by self-report responses to questions on the duration of pain and activity limitation. Logistic regression was used for completed cases to identify predictors of persistent pain at 12 months in full and parsimonious models. Results. Follow-up assessment at 12 months was performed for 63.4% of participants (279/440). Participants with persistent pain at 12 months (n = 101; 36.2%) had more comorbidities, higher numerical pain rating scale scores, and higher OSPRO-ROS and OSPRO-YF tool scores at baseline than those without persistent pain, and the findings were independent of anatomical region. The number of comorbidities (odds ratio [OR] range = 0.30-0.46), numerical pain rating scale scores (OR at baseline = 1.44-1.75; OR at 4 weeks = 1.37-1.39), and OSPRO-ROS (plus additional items) scores (OR = 1.33-1.54) were predictors in full and parsimonious models. Limitations. Convenience sampling was used, with a follow-up rate at 12 months (63.4%) that was lower than anticipated, and an operational definition for chronic low back pain was applied to persistent musculoskeletal pain in other body regions. Conclusions. The OSPRO-ROS tool may be used to improve the prediction of persistent musculoskeletal pain at 12 months in conjunction with comorbidities and pain intensity (baseline and 4 weeks). These are potentially important findings because persistent pain was not commonly evaluated in previous screening studies; however, it is a relevant outcome in an era of front-line nonpharmacological pain management., Musculoskeletal pain conditions are highly prevalent and rank among the leading causes of years lived with disability worldwide. (1) In the United States, chronic musculoskeletal pain is an epidemic because [...]

It is important for oncologists who provide comprehensive cancer care to be familiar with the principles of primary palliative care and interdisciplinary team-based approaches to palliative care. Palliative care is a medical subspecialty that provides specialized care to individuals with serious illnesses, with a primary focus on providing symptom relief, pain management, and relief from psychosocial distress, regardless of diagnosis or prognosis. Ideally, palliative care is provided by a team of physicians, nurses, social workers, psychologists, and chaplains. The core of palliative care is addressing, in depth, the physical, emotional, and spiritual suffering that a patient can experience. Palliative care is a key component of oncologic care, and we highly recommend that it be integrated into the plan of care for patients with advanced cancer. Early integration of palliative care has been shown to provide improved outcomes in patients with advanced cancer. This article reviews the ways in which palliative care and oncology teams can collaborate to provide high-quality care to patients and their families; it also provides practical tips for oncologists who wish to initiate primary palliative care for their patients. Prior to referral to a specialized interdisciplinary palliative care team, oncologists may start advance-care planning discussions, provide basic pain and non-pain symptom relief, and utilize assessment tools. If a specialized palliative care team is not available, the oncologist will often address additional aspects of palliative care, with assistance from social work departments and other resources in the community., What Is Palliative or Supportive Care? Palliative care is a medical subspecialty that provides care for people with serious illnesses; its primary focus is on providing symptom relief, pain management, [...]

Is acupuncture an effective treatment for pain? Are there any adverse effects? Learn the answers to these and other questions in this review. An estimated 39.4 million US adults suffer [...]

When I first heard of acupuncture in medical school in the late 1960s, I became convinced that it worked. I read impressive media reports from China touting it for everything [...]

2020 DEC 5 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Health and Medicine - Emergency Medicine have been [...]

BACKGROUND: Vaccine injections can cause acute pain and distress in infants, which can contribute to dissatisfaction with the vaccination experience and vaccine hesitancy. We sought to compare the effectiveness of additive pain interventions administered consistently during vaccine injections in the first year of life. METHODS: We conducted a multicentre, longitudinal, double-blind, add-on, randomized controlled trial. Healthy infants were randomly assigned to 1 of 4 levels of pain management for all vaccine injections at 2, 4, 6 and 12 months: (i) placebo control; (ii) parent-directed video education about infant soothing; (iii) the video plus sucrose administered orally or (iv) the video plus sucrose plus liposomal lidocaine applied topically. All infants benefit from injection techniques that minimize pain. We used a double-dummy design; hence all parents watched a video (active psychological intervention or placebo) and all infants received oral solution (sucrose or placebo) and topical cream (lidocaine or placebo). We assessed infant distress during 3 phases--preinjection (baseline), vaccine injection (needle), and 1 minute postinjection (recovery)--using the Modified Behavioural Pain Scale (range 0-10). We compared scores between groups and across infant ages using a mixed-model repeated-measures analysis. RESULTS: A total of 352 infants participated in the study, from Jan. 17, 2012, to Feb. 2, 2016. Demographics did not differ among intervention groups (p > 0.05). Baseline pain scores did not differ among intervention groups (p = 0.4), but did differ across ages (p < 0.001). Needle pain scores differed among groups (p = 0.003) and across ages (p < 0.001). The mean ([+ or -] standard deviation) needle score was 6.3 ([+ or -] 0.8) in the video-sucrose-lidocaine group compared with 6.7 ([+ or -] 0.8) in each of the other groups. There were no other between-group differences. Recovery scores did not differ among groups (p = 0.98), but did differ across ages (p < 0.001). INTERPRETATION: Only liposomal lidocaine provided consistent analgesia within an additive pain intervention regimen during vaccinations in infants. Trial registration: ClinicalTrials.gov, no. NCT01503060, Vaccine injections are associated with acute distress in infants, (1,2) which can contribute to dissatisfaction with the vaccination experience and vaccine hesitancy. (3-5) Mitigating pain is therefore clinically relevant and [...]

Background. Tai chi is recommended for musculoskeletal conditions; however, the evidence for its clinical effectiveness is uncertain. Purpose. The aim of this study was to determine whether tai chi is beneficial for clinical outcomes in people with musculoskeletal pain. Data Sources. Seven databases were searched: Embase, PEDro, AMED, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Central Register of Controlled Trials. Study Selection. Randomized controlled trials of tai chi for people with a chronic musculoskeletal condition were included. Data Extraction. Two reviewers extracted data and rated risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were calculated for individual trials and pooled effect sizes were calculated using a random-effects model. Data Synthesis. Fifteen studies were identified; these studies included people with osteoarthritis (80%), back pain (13%), and headache (7%). Using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach, moderate-quality evidence was found that tai chi was more effective than no treatment or usual care at short term on pain (SMD = -0.66 [95% CI = -0.85, -0.48]) and disability (SMD = -0.66 [95% CI = -0.85, -0.46]). The evidence for other outcomes was of low or very low quality and there was little information regarding long-term effects. Thus, although the number of publications in this area has increased, the rigor has not, hindering physical therapists' ability to provide reliable recommendations for clinical practice. Limitations. The evidence provided in this review is limited by trials with small sample sizes, low methodological quality, and lack of long-term assessment. Conclusions. In order for tai chi to be recommended as an effective intervention, more high-quality trials with large sample sizes assessing tai chi versus other evidence-based treatments at short term and at long term are needed., Chronic musculoskeletal pain conditions such as low back pain and osteoarthritis are leading causes of disability worldwide. (1) These conditions affect millions of people's ability to perform work-related tasks or [...]

Marie-Eileen Onieal's November editorial, The Pain Paradox, touched a pain point with readers. Here are substantial, articulate comments as to what the underlying problem is and how we can attempt [...]

Over-prescribing of opioids for pain management has garnered significant media attention in recent years, in the context of stories reporting high rates of abuse and addiction among the nation's general [...]

2020 NOV 28 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Health and Medicine - Otology and Neurotology have [...]

2020 OCT 17 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on Leg Pain have been presented. According to news reporting [...]

2020 OCT 10 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on Cardiovascular Diseases and Conditions - Arteriovenous Fistula have been [...]

2020 OCT 10 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- According to news reporting based on a preprint abstract, our journalists obtained [...]

2020 OCT 8 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- According to news reporting based on a preprint abstract, our journalists obtained the following [...]

2020 AUG 29 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in Opioids. According to news reporting originating from [...]

2020 AUG 1 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Post-Operative Pain have been published. According to news [...]

2020 JUL 11 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on Health and Medicine - Oral Health. According [...]

2020 JUN 27 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on Opioids have been presented. According to news reporting out [...]

2020 JUN 27 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Immune System Diseases and Conditions - Hypersensitivity have [...]

2020 JUN 13 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Research findings on Opioids are discussed in a new report. According to [...]

2020 MAY 23 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- According to news reporting based on a preprint abstract, our journalists obtained [...]

2020 MAY 16 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Oncology - Pancreatic Cancer have been published. According [...]

2020 MAR 28 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Surgery - Craniotomy have been published. According to [...]

2020 MAR 28 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Cardiovascular Diseases and Conditions - Arteriovenous Fistula. [...]