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Objectives: The current study aimed to evaluate the effectiveness of using a vibration device to ease pain during upper extremity injections. Specifically, the study aims to compare the pain levels of patients who receive the injection with and without the use of vibration therapy. The results of this study may have implications for improving patient outcomes and satisfaction during routine injection procedures. Material and Methods: This randomized controlled trial included patients aged 18 years or older who were scheduled to receive an injection in the upper extremity. A total of 60 patients were enrolled and randomized to either the intervention group or the control group using a computer‑generated randomization sequence. The level of satisfaction and pain levels were assessed using a visual analog scale. The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board. Results: The mean pain score immediately after the injection was 4.03 ± 2.11 out of 10 in the vibration group (n = 30), compared to 7.4 ± 1.37 out of 10 in the control group (n = 30) (P < 0.001). Patients in the vibration group also reported higher levels of satisfaction and comfort during the injection (P < 0.001). No adverse events were reported in either group. Conclusion: Our study proves that using a vibration device during upper extremity injections can effectively reduce postinjection pain and improve patient satisfaction. Further research is needed to explore this intervention’s long‑term effects and feasibility in different clinical settings. [ABSTRACT FROM AUTHOR]

Objectives: The current study aimed to evaluate the effectiveness of using a vibration device to ease pain during upper extremity injections. Specifically, the study aims to compare the pain levels of patients who receive the injection with and without the use of vibration therapy. The results of this study may have implications for improving patient outcomes and satisfaction during routine injection procedures. Material and Methods: This randomized controlled trial included patients aged 18 years or older who were scheduled to receive an injection in the upper extremity. A total of 60 patients were enrolled and randomized to either the intervention group or the control group using a computer-generated randomization sequence. The level of satisfaction and pain levels were assessed using a visual analog scale. The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board. Results: The mean pain score immediately after the injection was 4.03 ± 2.11 out of 10 in the vibration group (n = 30), compared to 7.4 ± 1.37 out of 10 in the control group (n = 30) (P < 0.001). Patients in the vibration group also reported higher levels of satisfaction and comfort during the injection (P < 0.001). No adverse events were reported in either group. Conclusion: Our study proves that using a vibration device during upper extremity injections can effectively reduce postinjection pain and improve patient satisfaction. Further research is needed to explore this intervention’s long-term effects and feasibility in different clinical settings.

Background: Considering the neuromuscular alterations in Achilles tendinopathy (AT), sensorimotor training (SMT) might be beneficial to restore the neuromuscular capacity of the muscle-tendon complex and thereby improve patients' functions and alleviate symptoms. However, there is still a lack of knowledge concerning the effects of SMT on improving functional (e.g., strength) and pain outcomes in this population. Thus, the purpose of this study was to synthesize current evidence to analyze the efficacy of SMT in people with AT. Methods: A systematic electronic search was performed in PubMed, Web of Science, and Cochrane Central Register of Controlled Trials frominception toDecember 2023. Studies applying SMT in people with AT investigating functional or clinical pain outcomes were considered. Protocols had to incorporate balance, stabilization, proprioception, or vibration training. Patients with insertional or mid-portion AT (=18 years age) diagnosed with clinical or sonographic evaluation were included. Results: The search yielded 823 records. A total of three randomized controlled trials were considered eligible for the analysis. Each trial used a different SMT protocol: balance training, balance with stabilization training, or whole-body vibration training (WBVT) with other co-interventions. Most functional and pain parameters improved compared to baseline. The first study reported a decrease in pain and an increase in performance (i.e., countermovement jump height) and endurance (i.e., number of heel-raises) by 12-week use of a balance training in addition to isometric, concentric/eccentric, and eccentric exercises. The second study evaluated the four weeks effect of SMT (balance and stabilization training plus eccentric exercises) in addition to passive physiotherapy (deep frictions, ice, ultrasound), resulting in an increased plantarflexion peak torque and reduced pain levels. The third study investigating WBVT reported at 12 weeks an increase in flexibility and a decrease in tendon pain. Discussion: SMT in addition to other co-interventions (i.e., eccentric, isometric, concentric/eccentric training, physiotherapy) showed improvements in strength, performance, muscle flexibility, and alleviated clinical outcomes of pain. SMT might therefore be useful as part of a multimodal treatment strategy protocol in patients suffering from AT. However, due to the small number of studies included and the diversity of SMT protocols, the current evidence is weak; its additional effectiveness should be evaluated. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal disorders are increasingly receiving research attention because of their impact on physical and mental health. Daily diet has become one of the biggest factors that determine the health condition of the musculoskeletal system, one of which is a diet with a high glycemic index (GI). High GI foods cause rapid spikes in blood glucose and insulin levels which are implicated as triggers of chronic inflammation and oxidative stress which are contributors to the pathophysiology of musculoskeletal disorders. This review aims to synthesize the evidence linking high GI diets to the development and exacerbation of musculoskeletal problems. Methods: Articles were collected by using a search engine such as google scholar, Pubmed, Medscape, Science direct. The criteria used are articles published in 2003-2024. Result: Reducing dietary GI and glycemic load (GL) may alleviate symptoms and improve functional outcomes in patients with musculoskeletal disorders. For example, low GI diets have been associated with reduced pain as well as improved quality of life for sufferers with musculoskeletal disorders. Conclusion: A high GI diet has been proven to be a significant risk factor that can be modified for the prevention of the development of musculoskeletal disorders. Public health strategies that promote low-GI diets have the potential to reduce symptoms of these disorders and improve the quality of life of sufferers. Despite these findings, more longitudinal and interventional studies are needed to establish causal relationships and better understand the molecular mechanisms involved. [ABSTRACT FROM AUTHOR]

Copyright of Manuelle Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To evaluate the advantages of adding acupuncture to standard postoperative pain management for open radical prostatectomy (RP). Materials and methods: A randomized controlled trial (1:1:1) comparing routine postoperative analgesic care (control [CON]) vs the addition of press tack needle acupuncture (ACU) or press tack placebo acupressure (SHAM) for pain management after open RP was performed. A total of 126 patients were enrolled between February 2020 and April 2021. After open RP, the CON group received standard postoperative analgesia, the ACU group received long‐term acupuncture with press tacks at specific points (P‐6, Shenmen and SP‐6) along with standard analgesia, and the SHAM group received placebo press tacks at the same acupuncture points alongside standard analgesia. The primary endpoint was postoperative pain measured on a numeric rating scale, the NRS‐11, calculated as the area under the curve. The cumulative use of routine postoperative analgesics, time to first defaecation, and quality of life were analysed using the Kruskal–Wallis rank sum test, Fisher's exact test, and Pearson's chi‐squared test. Results: The ACU group reported significantly less postoperative pain compared to the SHAM (P = 0.007) and CON groups (P = 0.02). There were no significant difference in median (interquartile range) cumulative pain medication usage, time to first defaecation (CON: 37 [33, 44] h; SHAM: 37 [33, 42] h; ACU: 37 [33, 41] h; P > 0.9), or health status at discharge (EuroQol five‐dimension, five‐level general health assessment questionnaire: CON: 70 [65–83]; SHAM: 70 [60–80]; ACU: 70 [50–80]). Conclusion: Incorporating acupuncture into postoperative pain management can improve patient postoperative outcomes. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is the most common complex musculoskeletal disorder, resulting from the degeneration of the articular cartilage and characterized by joint pain and dysfunction that culminate in progressive articular cartilage loss. We present our experience in the management of hip and knee OA by means of the intra-articular injection of fat micrograft, describing our approach, which was developed from the belief in the powerful reparative effect of autologous fat graft on damaged tissue, as well as its natural lubricating effect on the joints. Inclusion criteria were as follows: men and women, aged 20 to 80 years, that referred articular pain of the hips and/or knees, showing initial-stage degenerative OA. From October 2018 to July 2023, a total of 250 patients underwent treatment with the Sefficare® device (SEFFILINE srl, Bologna, Italy). The Superficial Enhanced Fluid Fat Injection device was used to perform autologous regenerative treatments in a safe, standardized, easy, and effective way on 160 women, 64%, and 90 men, 36%. A total of 190 procedures (76%) involved the knees, with 20 patients who were bilaterally treated, while 60 procedures, all unilateral, involved the hips (24%). The mean age at treatment was 52.4 years. Before treatment, each patient had undergone X-rays and Magnetic Resonance Imaging (MRI) of the painful hip/knee to evaluate and grade the articular OA. Postoperatively, each patient was assessed after one, three, six, and twelve months. The donor site postoperative course was uneventful other than minimal discomfort. Clinically, the ROM (range of motion) of the treated knee/hip increased an average of 10 degrees 3 months after treatment, but the stiffness was reduced, as reported by the patients. The VAS (Visual Analog Scale) was submitted at 3, 6, and 12 months, demonstrating a progressive reduction of pain, with the best score obtained at six months postoperatively. In total, 85% of patients were satisfied one year after treatment, with a considerable improvement in pain and quality of life. The satisfactory outcome of this minimally invasive procedure indicates that the intra-articular injection of fat micrograft can replace or considerably delay the need for the classical major joint replacement surgery, thanks to its impact on the quality of life of patients and financial cost. [ABSTRACT FROM AUTHOR]

The prevalence and impact of chronic pain in individuals worldwide necessitate effective management strategies. This narrative review specifically aims to assess the effectiveness of neurofeedback, an emerging non-pharmacological intervention, on the management of chronic pain. The methodology adopted for this review involves a meticulous search across various scientific databases. The search was designed to capture a broad range of studies related to neurofeedback and chronic pain management. To ensure the quality and relevance of the included studies, strict inclusion and exclusion criteria were applied. These criteria focused on the study design, population, intervention type, and reported outcomes. The review synthesizes the findings from a diverse array of studies, including randomized controlled trials, observational studies, and case reports. Key aspects evaluated include the types of neurofeedback used (such as EEG biofeedback), the various chronic pain conditions addressed (like fibromyalgia, neuropathic pain, and migraines), and the methodologies employed in these studies. The review highlights the underlying mechanisms by which neurofeedback may influence pain perception and management, exploring theories related to neural plasticity, pain modulation, and psychological factors. The results of the review reveal a positive correlation between neurofeedback interventions and improved pain management. Several studies report significant reductions on pain intensity, improved quality of life, and decreased reliance on medication following neurofeedback therapy. The review also notes variations in the effectiveness of different neurofeedback protocols and individual responses to treatment. Despite the promising results, the conclusion of the review emphasizes the need for further research. It calls for larger, well-designed clinical trials to validate the findings, to understand the long-term implications of neurofeedback therapy, and to optimize treatment protocols for individual patients. [ABSTRACT FROM AUTHOR]

Globally, over 1 million lower limb amputations are performed annually, with approximately 75% of patients experiencing significant pain, profoundly impacting their quality of life and functional capabilities. Targeted muscle reinnervation (TMR) has emerged as a surgical solution involving the rerouting of amputated nerves to specific muscle targets. Originally introduced to enhance signal amplification for myoelectric prosthesis control, TMR has expanded its applications to include neuroma management and pain relief. However, the literature assessing patient outcomes is lacking, specifically for lower limb amputees. This systematic review aims to assess the effectiveness of TMR in reducing pain and enhancing functional outcomes for patients who have undergone lower limb amputation. A systematic review was performed by examining relevant studies between 2010 and 2023, focusing on pain reduction, functional outcomes and patient-reported quality of life measures. In total, 20 studies were eligible encompassing a total of 778 extremities, of which 75.06% (n = 584) were lower limb amputees. Average age was 46.66 years and patients were predominantly male (n = 70.67%). Seven studies (35%) reported functional outcomes. Patients who underwent primary TMR exhibited lower average patient-reported outcome measurement information system (PROMIS) scores for phantom limb pain (PLP) and residual limb pain (RLP). Secondary TMR led to improvements in PLP, RLP and general limb pain as indicated by average numeric rating scale and PROMIS scores. The systematic review underscores TMR's potential benefits in alleviating pain, fostering post-amputation rehabilitation and enhancing overall well-being for lower limb amputees. [ABSTRACT FROM AUTHOR]

Background: Spinal tuberculosis, predominantly affecting the thoraco-lumbar region, often requires surgical intervention when conservative treatments fail. This study evaluates the effectiveness of the posterior approach debridement, decompression, and stabilization with pedicle screw fixation in patients with thoraco-lumbar spinal tuberculosis. Methods: A prospective study was conducted on 17 patients, with surgical outcomes assessed through kyphotic angle correction, ESR, VAS, and ODI scores. Results: Post-operative results demonstrated a mean kyphotic angle correction of 12 degrees. ESR levels significantly decreased from a pre-operative mean of 37 mm/h to 9 mm/h post-operatively. Pain and functional disability also improved markedly, with VAS scores reducing from 6.0 to 0.6, and ODI scores from 34 to 3. Conclusion: The posterior approach for thoraco-lumbar spinal tuberculosis is effective in achieving significant spinal alignment correction, reducing inflammation, and improving pain and functional outcomes. This study supports its use as a viable surgical option in appropriately selected patients. [ABSTRACT FROM AUTHOR]

Knee osteoarthritis (KOA) represents a progressive and painful disease that in time can lead to loss of function and disability. Early diagnosis and correct treatment are essential in preventing the advancement of the condition to a stage where it can affect the quality of life. The development of new imagistic methods and devices can help detect changes in the structure of the join before the onset of symptoms. At the moment there are no diseasemodifying drugs approved, so the current treatment is symptomatic, focusing on pain reduction, improving function and trying to prevent progression towards disability. [ABSTRACT FROM AUTHOR]

Despite the very controversial results in various clinical studies, transcutaneous electrical nerve stimulation (TENS) is a frequently used therapy method in interdisciplinary multimodal pain therapy (IMST). A great advantage of this procedure for the patient is the possibility to determine the frequency of the applications and the intensity of the therapy themselves and thus to be able to actively participate in the therapy. There are also only a few contraindications and hardly any side effects when using TENS. By stimulating the Aβ fibers in the periphery, segmental pain inhibition is set in motion and pain transmission is inhibited. However, the results of the clinical studies published in recent years regarding the effect of TENS in the pain therapy set- ting are extremely controversial. Our clinical study on the subject also shows clear differences in the treatment results. In summary, however, it can be seen that even if the pain-relieving effect of TENS therapy cannot be observed in all patients, a large proportion still benefit from the use of TENS. [ABSTRACT FROM AUTHOR]

Objectives: This study is based on data collected at the Acupuncture clinic of the Local Health Authority (ASL) in Turin from 2008 to 2022 and aims at evaluating the effectiveness of acupuncture in the treatment of musculoskeletal pain using the Numeric Rating Scale (NRS) which analyzes changes in pain perceived by patients in different body regions. Methods: The database consists of data provided by patients during the initial visit and the last session. Only patients who provided data at the beginning and end of treatment were included. The data were processed using JASP 0.17.2.1 software. The sample consisted of 932 patients with musculoskeletal conditions, excluding 254 subjects with internal medical conditions, who were treated during the same period. The selected population includes individuals aged 23-94, comprising 242 men and 690 women. Patients followed a therapeutic protocol based on the initial diagnosis and underwent an initial cycle of six weekly sessions, with the possibility of four additional sessions if needed. Acupuncture was performed by experienced medical personnel following Traditional Chinese Medicine guideline. Results: The average NRS values were 7.49 at the beginning and 4.27 at the end, with a 43% reduction in pain. The data were analyzed using the Wilcoxon test, confirming statistical significance (p < 0.001). They were then divided by body region, showing a reduction in pain ranging from 40% to 55%. Statistical analysis among different conditions was performed using the Kruskal--Wallis test, with further comparisons using the Dunn test. Discussion: The study demonstrates that acupuncture is effective in reducing musculoskeletal suffering, with a significant decrease in pain perceived by patients. The results suggest that acupuncture can be a valid treatment for a wide range of conditions, with pain reduction ranging from 40% to 55% and greater effectiveness for elbow-related conditions. However, it is important to note that sample size may influence the results, and further research is needed to confirm and expand these findings, especially for less-represented conditions by the sample. [ABSTRACT FROM AUTHOR]

The goal of burn wound treatment is to ensure rapid epithelialization in superficial burns and the process of rebuilding the lost skin in deep burns. Topical treatment plays an important role. One of the innovations in the field of synthetic materials dedicated to the treatment of burns is epidermal skin substitutes. Since the introduction of Suprathel®, the alloplastic epidermal substitute, many research results have been published in which the authors investigated the properties and use of this substitute in the treatment of wounds of various origins, including burn wounds. Burn wounds cause both physical and psychological discomfort, which is why ensuring comfort during treatment is extremely important. Alloplastic epidermal substitute, due to its biodegradability, plasticity, no need to remove the dressing until healing, and the associated reduction in pain, is an alternative for treating burns, especially in children. [ABSTRACT FROM AUTHOR]

The prevalence and impact of chronic pain in individuals worldwide necessitate effective management strategies. This narrative review specifically aims to assess the effectiveness of neurofeedback, an emerging non-pharmacological intervention, on the management of chronic pain. The methodology adopted for this review involves a meticulous search across various scientific databases. The search was designed to capture a broad range of studies related to neurofeedback and chronic pain management. To ensure the quality and relevance of the included studies, strict inclusion and exclusion criteria were applied. These criteria focused on the study design, population, intervention type, and reported outcomes. The review synthesizes the findings from a diverse array of studies, including randomized controlled trials, observational studies, and case reports. Key aspects evaluated include the types of neurofeedback used (such as EEG biofeedback), the various chronic pain conditions addressed (like fibromyalgia, neuropathic pain, and migraines), and the methodologies employed in these studies. The review highlights the underlying mechanisms by which neurofeedback may influence pain perception and management, exploring theories related to neural plasticity, pain modulation, and psychological factors. The results of the review reveal a positive correlation between neurofeedback interventions and improved pain management. Several studies report significant reductions on pain intensity, improved quality of life, and decreased reliance on medication following neurofeedback therapy. The review also notes variations in the effectiveness of different neurofeedback protocols and individual responses to treatment. Despite the promising results, the conclusion of the review emphasizes the need for further research. It calls for larger, well-designed clinical trials to validate the findings, to understand the long-term implications of neurofeedback therapy, and to optimize treatment protocols for individual patients.

Clinical Scenerio: Neck pain is a costly symptom in both civilian and military worlds. While traditional treatments include deep neck flexor stabilizing exercises, manual therapy, electrical therapy, and other nonsurgical interventions, scapular orientation and stability training has emerged as a possible tool to reduce neck pain severity. Methods that can be coached at a distance could be of value in virtual appointments or circumstances where access to a qualified manual therapist is limited. Focused Clinical Question: What is the effectiveness of including exercise programs targeting scapular kinematics and stability to decrease neck pain? Summary of Key Findings: Exercise programs targeting scapular kinematics and stability, with coaching and individualized progressions, appear to reduce neck pain severity. Clinical Bottom Line: Evidence supports the inclusion of exercises for scapular kinematics and stability at a prescription of 3 sessions per week, with a duration of 4 or 6 weeks. Exercise programs should include a "learning" or coaching phase to ensure exercises are performed as intended, and exercise progressions should be based on participant ability rather than predetermined timelines. Further research is needed to better understand the benefits of this potential strategy and the statistical impact of scapular-focused exercise interventions on neck pain in specific populations like military and athletes. Strength of Recommendation: There is 'Fair' to 'Good' evidence from 2 level 1b single-blind randomized control studies and 1 level 2b pre-post test control design study supporting the inclusion of exercise programs targeting scapular kinematics and stability to decrease chronic neck pain severity. [ABSTRACT FROM AUTHOR]

ObjectivesThis study is based on data collected at the Acupuncture clinic of the Local Health Authority (ASL) in Turin from 2008 to 2022 and aims at evaluating the effectiveness of acupuncture in the treatment of musculoskeletal pain using the Numeric Rating Scale (NRS) which analyzes changes in pain perceived by patients in different body regions.MethodsThe database consists of data provided by patients during the initial visit and the last session. Only patients who provided data at the beginning and end of treatment were included. The data were processed using JASP 0.17.2.1 software. The sample consisted of 932 patients with musculoskeletal conditions, excluding 254 subjects with internal medical conditions, who were treated during the same period. The selected population includes individuals aged 23–94, comprising 242 men and 690 women. Patients followed a therapeutic protocol based on the initial diagnosis and underwent an initial cycle of six weekly sessions, with the possibility of four additional sessions if needed. Acupuncture was performed by experienced medical personnel following Traditional Chinese Medicine guideline.ResultsThe average NRS values were 7.49 at the beginning and 4.27 at the end, with a 43% reduction in pain. The data were analyzed using the Wilcoxon test, confirming statistical significance (p

Objective: To investigate pain reduction, physical performance, and psychological status compared between Hatha yoga and stretching exercises. Design: Randomized controlled non-inferiority trial Subjects: 150 sedentary office workers with mild/moderate neck/shoulder pain. Interventions: Participants received group Hatha yoga or stretching exercise once a week (30 min for 4 weeks), and were asked to practice at home. Subjects were followed up at 4 and 8 weeks. Main outcome measures: The primary outcome was a numeric rating scale (NRS) score. The secondary outcomes were a sit-and-reach test, Functional Reach Test, Neck Disability Index, pain pressure threshold, Patient Health Questionnaire-9, General Anxiety Disorder-7, and the EuroQoL. Results: Of the 150 subjects, 59 and 71 participants in the Hatha yoga and stretching groups were analyzed. At baseline, no significant differences between groups were found. After 4 weeks, the mean difference in the NRS score was statistically significant between groups (p 0.05 between groups). The most common adverse events were musculoskeletal pain and muscle tension. Repeated measures analysis of variance that compared among weeks 0, 4, and 8 revealed no significant difference between groups. Conclusion: Hatha yoga was tentatively found to be non-inferior to stretching exercise relative to safety, for decreasing pain, anxiety, and depression, and for improving flexibility, neck functions, and quality of life.

Background: Botulinum toxin A (Botox) therapy is safe and effective for hemifacial spasm, however, the associated discomfort and pain from injections limit its usefulness. Objective: To evaluate pain, preparation difficulty, and satisfaction following application of a eutectic mixture of local anesthetic (EMLA) cream, ice application, and placebo before Botox injections for hemifacial spasm. Materials and Methods: Twenty-two patients received four Botox injections in the facial area to treat hemifacial spasm, between June 2022 and March 2023. The initial treatment began in June 2022, followed by treatments at 3, 6, and 9 months. The EMLA cream, ice application, control, and placebo were administered consecutively for each Botox treatment. Pain, preparation difficulty, and satisfaction were evaluated on a 0 to 10 scale. Neurological and bleeding complications were recorded. Results: The mean pain score for EMLA cream application was the lowest, followed by cold compressions. The mean pain score in the control with placebo intervention was not significantly different from that in the control. The control without placebo intervention had the lowest difficulty in preparation score at 0.82 and showed no significant difference with EMLA application. Whereas cold compression had the highest difficulty in preparation score. The highest satisfaction score was obtained with the EMLA cream application at 9.45. The satisfaction score was higher in the control with placebo intervention at 8.32 than in the control, which had the lowest satisfaction score at 6.91. The number of injections and neurological complications did not differ among the four methods. The bleeding site ratio was the lowest with the cold compression method. Conclusion: EMLA cream application resulted in the lowest mean pain and the highest satisfaction scores. Control with placebo intervention increased the satisfaction score without reducing the mean pain score. Cold compression decreased bleeding complications, and the second- lowest mean pain scores. [ABSTRACT FROM AUTHOR]

Application of dextran sodium sulfate (DSS) is often used to induce experimental colitis. Current state of the art is to refrain from the use of analgesics due to their possible interaction with the model. However, the use of analgesics would be beneficial to reduce the overall constraint imposed on the animals. Here, we analyzed the effect of the analgesics Dafalgan (paracetamol), Tramal (tramadol) and Novalgin (metamizole) on DSS-induced colitis. To study the effect of those analgesics in colitis mouse models, acute and chronic colitis was induced in female C57BL6 mice by DSS administration in the drinking water. Analgesics were added to the drinking water on days four to seven (acute colitis) or on days six to nine of each DSS cycle (chronic colitis). Tramadol and paracetamol had minor effects on colitis severity. Tramadol reduced water uptake and activity levels slightly, while mice receiving paracetamol presented with a better overall appearance. Metamizole, however, significantly reduced water uptake, resulting in pronounced weight loss. In conclusion, our experiments show that tramadol and paracetamol are viable options for the use in DSS-induced colitis models. However, paracetamol seems to be slightly more favorable since it promoted the overall wellbeing of the animals upon DSS administration without interfering with typical readouts of colitis severity. [ABSTRACT FROM AUTHOR]

"Nonspecific shoulder pain" encompasses various non-traumatic musculoskeletal shoulder disorders, diverging from diagnostic terminologies that refer to precise tissue-oriented clinical diagnosis. Blood flow restriction (BFR) training, involving partial arterial inflow and complete venous outflow restriction, has exhibited acute hypoalgesic effects primarily in healthy populations by increasing their pain thresholds. This study aims to examine whether a single BFR session with low-load exercises can alleviate pain perception among nonspecific shoulder pain patients. Conducted as a single-blind crossover randomised clinical trial, 48 adults (age range: 18 to 40) presenting with nonspecific shoulder pain will partake in two trial sessions. Random assignment will place participants into BFR or sham BFR groups and ask them to perform one exercise with BFR. Subsequently, participants will complete a shoulder girdle loading regimen comprising six exercises. The second session will involve participants switching treatment groups. Pain pressure thresholds (PPTs), shoulder pain and disability via the shoulder pain and disability index (SPADI), maximal voluntary isometric contraction (MVIC) of shoulder external rotators, pain during active abduction, and peak pain during shoulder external rotation will be evaluated using the numeric pain rating scale (NPRS). Immediate post-exercise assessments will include patient-perceived pain changes using the global rating of change scale (GROC) and participant-rated perceived exertion (RPE), employing a modified Borg's scale (Borg CR10) post-BFR or sham BFR exercise session. Each session will encompass three assessment periods, and a combination of mixed-effect models and descriptive statistics will underpin the analysis. This protocol was approved by Cyprus National Bioethics Committee (ΕΕΒΚ/2023/48), and was registered in ClinicalTrials.gov (Registration number: NCT05956288). Conclusion: The anticipated outcomes of this study illuminated the acute effects of BFR training on pain perception within the context of nonspecific shoulder pain, potentially advancing strategies for managing pain intensity using BFR techniques. [ABSTRACT FROM AUTHOR]

Copyright of Wiener Medizinische Wochenschrift is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Turmeric (Curcuma longa Linn) has been used by Indonesian people for a long time to treat pain in digestive disorders. The purpose of this study was to determine the efficacy of turmeric decoction on pain in gastritis patients. This study employed a quasi-experimental design with a one-group pre- and posttest approach. The consecutive sampling method was employed to recruit 100 participants in Samarinda, Indonesia. After assessing baseline pain levels (Pretest), participants were administered the intervention, which involved the consumption of turmeric decoction for 14 consecutive days, with a regimen of 2 × 150 ml daily, specifically 15 minutes before breakfast and dinner. Post-test measurements were recorded on days 5, 10, and 14. Pain scores were evaluated using the Numeric Rating Scale, Data analysis utilized the paired T-test to determine differences in mean gastritis pain levels before and after the intervention. The findings revealed a significant reduction in gastritis pain scores between the Pretest measurements is 3.8 and the post-test on day 5 (1.34), day 10 (0.62), and day 14 (0.31). The statistical analysis yielded a p-value of 0.000. The study demonstrated the efficacy of turmeric decoction in alleviating pain among gastritis patients, with notable improvements observed as early as day 5 of the treatment regimen. Consequently, we recommend the incorporation of turmeric decoction as a complementary and non-pharmacological therapeutic approach for the effective management of gastritis symptoms.

Pain is usually experienced by patients on ventilator in the ICU. Efforts to reduce pain with foot massage done independently on the patient. Foot massage safe complementary therapy, providing relaxing effect, feeling comfortable and reducing pain. This study used quasi experiment research design with pre and post test control group design. The total sample of 40 respondents was divided into an intervention group 30 respondents were given foot massage once a day for 2 consecutive days, the control group was 10 respondents given analgesic therapy for 2 consecutive days. Post test pain scores 30 minutes after getting treatment on first and second days. Results showed that majority of the age group 46-55 years 30%, majority male 57%, 65% were suctioned, and body position changes 82%, there was difference in pre-test (p = 0.001) and post-test (p=0.007) the intervention group, there was difference in the level of pain after foot massage in the intervention group and the administration of analgesics the control group (p=0.000), there was effect of suctioning mucus (p=0.003), there was effect of changes in body position (p=0.008). This means that foot massage has effect reducing pain levels in patients. This study recommends the need for further research and foot massage one of independent nurse interventions in nursing care for patients with ventilatory pain. [ABSTRACT FROM AUTHOR]

Copyright of Der Schmerz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Evidence shows that Electrical Stimulation Therapy (EST) accelerates healing and reduces pain, but EST has yet to become widely used. One reason is the historical use of complex, clinic‐based EST devices. This evaluation assessed the early response of different hard‐to‐heal wounds to a simple, wearable, single‐use, automated microcurrent EST device (Accel‐Heal, Accel‐Heal Technologies Limited ‐ Hever, UK). Forty wounds (39 patients: 18 female ‐ 21 male), mean age 68.9 ± 14.0 years comprised of: seven post‐surgical, three trauma, 12 diabetic foot (DFU), 10 venous (VLU), four pressure injuries (PI), four mixed venous or arterial ulcers (VLU/arterial) received automated microcurrent EST for 12 days. Early clinical responses were scored on a 0–5 scale (5‐excellent—0‐no response). Pain was assessed at 48 h, seven days, and 14 days on a 0–10 visual analogue scale (VAS). Overall, 78% of wounds showed a marked positive clinical response (scores of 5 and 4). Sixty eight percent of wounds were painful with a mean VAS score of 5.5. Almost every patient (96%) with pain experienced reduction within 48 h. All patients with painful wounds experienced pain reduction after seven days: 2.50 VAS (45% reduction) and further pain reduction after 14 days: 1.83 VAS (33%). [ABSTRACT FROM AUTHOR]

Aim: This study was conducted in order to determine the efficacy of bifluoride 10 versus conventional fluoride in the management of hypersensitivity of exposed cervical area in adult patient. Material and method: The study design was A two arms, parallel-group, randomized, controlled trial study was conducted on 24 patient with 68 teeth suffering from cervical dentin hypersensitivity received desensitizing agents using either Bifluorid 10 or sodium fluoride varnish . Teeth are divided into two groups based on the received treatment (n = 34 for each groupn): group (1): Bifluorid 10 ; group(2): sodium fluoride varnish (5%) . The degree of hypersensitivity was measured by using a visual analogue scale (VAS) before the agents were applied, 2 minutes after application, after 1, 4 and 8 weeks . Human extracted premolars were used to prepare dentin discs for use as a hypersensitivity model specimen. The sample was used on a fixed appliance. two months after using a different desinsitizer product. A scanning electron microscope was used to examine the dentinal tubules occlusion of the specimen . Result: Regarding VAS, Intergroup comparison between both materials showed no statistically significant difference after 2 minutes and 1 week (P = 0.2960, P = 0.5893), while at pre-intervention, 4- and 8-weeks interventions (P = 0.0208, P = 0.002, P < 0.0001) intergroup comparison revealed statistically significant difference in favor of bifluorid 10. Intragroup comparison within Bifluorid 10 and NaF have shown statistically significant difference between different follow-up periods(P < 0.0001*). More fully occluded tubules were observed in Bifluoride 10 than in sodium fluoride varnish. Conclusion: In office desensitizing agents are reliable methods for immediate relief of pain, Bifluorid 10 is an effective desensitizing agent and its effect increase with time, Sodium fluoride desensitizing agents provide instant relief but effect is constant and doesn't improve with time. [ABSTRACT FROM AUTHOR]

Objective: To compare the mean pain score with prophylactic corticosteroid injection versus placebo in the management of wrist pain on the ulnar aspect in patients presenting with fracture of distal radius. Material and methods: Study Design: Randomized controlled trial Setting: Orthopedic Surgery Department, Benazir Bhutto Hospital, Rawalpindi Duration: Six months (March 5, 2018 to Sept 5, 2018) Data Collection Procedure: 80 patients were included by using non-probability consecutive sampling after fulfilling the selection criteria. A demographic profile (patient name, age, gender, anatomical side and contact details) was obtained. Patients were split into two random groups by a simple lottery method. Patients of group A were given one shot of 80mg corticosteroid in the area of the ulnar styloid process near TFCC and group B patients were given a shot of distilled water (2 cc). Both groups of patients were followed in OPD for 3 months in their postoperative visits. A visual analogue scale (VAS) score was recorded. Data was analyzed using SPSS version 21. Results: The mean age of the patients was 41.05 ± 11.05 years an age range of 40 years. The mean age in the corticosteroid and placebo groups was 39.68±10.67 years and 42.42 ± 11.39 years respectively. There were 42 (52.50%) male and 38 (47.50%) female patients with a higher male ratio i.e., 1.10:1. In corticosteroid and placebo groups there were 21 (52.50%) male and 19 (47.50%) female cases. The mean pain at baseline was 7.72 ± 1.66 while in the corticosteroid and placebo group, the mean pain was 7.60 ± 1.67 and 7.85 ± 1.65 respectively with statistically equal mean pain p-value = 0.504. After 3 months of treatment, mean pain in the corticosteroid group was 1.30 ± 0.66 and was 2.60 ± 1.58 in the placebo group, p-value < 0.001. Conclusion: Our findings suggested that prophylactic corticosteroid injection is more effective in reducing pain in patients with distal radial fracture than placebo. By using prophylactic corticosteroid injections in the future, we can reduce pain to achieve more satisfaction for patients. [ABSTRACT FROM AUTHOR]

Background: Plantar fasciitis is a common cause of heel pain, characterized by inflammation and micro-tears in the plantar fascia. Corticosteroid injections have been used as a treatment option due to their potent anti-inflammatory properties. However, the long-term effectiveness and potential side effects of corticosteroid injections are still debated. Methods: This review study evaluated the effectiveness of corticosteroid injections in plantar fasciitis by analyzing 10 randomized controlled trials (RCTs). A systematic search was conducted on PubMed and the Cochrane Central Register of Controlled Trials. The selected RCTs were assessed using the Jadad scoring system. The analysis focused on pain reduction and functional outcomes as the main outcome measures. Results: The analysis of the selected RCTs demonstrated that corticosteroid injections significantly reduced pain associated with plantar fasciitis. Patients receiving corticosteroid injections showed improved mobility, increased ability to perform daily activities, and enhanced overall quality of life compared to control groups. However, the effectiveness varied across studies, possibly due to differences in study design, injection techniques, dosages, and follow-up durations. Temporary adverse effects, such as pain at the injection site and local tissue atrophy, were reported in some studies. Conclusion: Corticosteroid injections can be an effective treatment option for plantar fasciitis, providing significant pain reduction and improved functional outcomes. However, individual patient characteristics and potential risks should be considered when deciding on treatment. Further well-designed studies are needed to assess the long-term effects and safety profile of corticosteroid injections in plantar fasciitis management. [ABSTRACT FROM AUTHOR]

The goal of burn wound treatment is to ensure rapid epithelialization in superficial burns and the process of rebuilding the lost skin in deep burns. Topical treatment plays an important role. One of the innovations in the field of synthetic materials dedicated to the treatment of burns is epidermal skin substitutes. Since the introduction of Suprathel®, the alloplastic epidermal substitute, many research results have been published in which the authors investigated the properties and use of this substitute in the treatment of wounds of various origins, including burn wounds. Burn wounds cause both physical and psychological discomfort, which is why ensuring comfort during treatment is extremely important. Alloplastic epidermal substitute, due to its biodegradability, plasticity, no need to remove the dressing until healing, and the associated reduction in pain, is an alternative for treating burns, especially in children.

Previously promising short-term H-Wave® device stimulation (HWDS) outcomes prompted this retrospective cohort study of the longer-term effects on legacy workers' compensation chronic pain claimants. A detailed chart-review of 157 consecutive claimants undergoing a 30-day HWDS trial (single pain management practice) from February 2018 to November 2019 compiled data on pain, restoration of function, quality of life (QoL), and polypharmacy reduction into a summary spreadsheet for an independent statistical analysis. Non-beneficial trials in 64 (40.8%) ended HWDS use, while 19 (12.1%) trial success charts lacked adequate data for assessing critical outcomes. Of the 74 final treatment study group charts, missing data points were removed for a statistical analysis. Pain chronicity was 7.8 years with 21.6 ± 12.2 months mean follow-up. Mean pain reduction was 35%, with 89% reporting functional improvement. Opioid consumption decreased in 48.8% of users and 41.5% completely stopped; polypharmacy decreased in 36.8% and 24.4% stopped. Zero adverse events were reported and those who still worked usually continued working. An overall positive experience occurred in 66.2% (p < 0.0001), while longer chronicity portended the risk of trial or treatment failure. Positive outcomes in reducing pain, opioid/polypharmacy, and anxiety/depression, while improving function/QoL, occurred in these challenging chronic pain injury claimants. Level of evidence: III [ABSTRACT FROM AUTHOR]

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“Nonspecific shoulder pain” encompasses various non-traumatic musculoskeletal shoulder disorders, diverging from diagnostic terminologies that refer to precise tissue-oriented clinical diagnosis. Blood flow restriction (BFR) training, involving partial arterial inflow and complete venous outflow restriction, has exhibited acute hypoalgesic effects primarily in healthy populations by increasing their pain thresholds. This study aims to examine whether a single BFR session with low-load exercises can alleviate pain perception among nonspecific shoulder pain patients. Conducted as a single-blind crossover randomised clinical trial, 48 adults (age range: 18 to 40) presenting with nonspecific shoulder pain will partake in two trial sessions. Random assignment will place participants into BFR or sham BFR groups and ask them to perform one exercise with BFR. Subsequently, participants will complete a shoulder girdle loading regimen comprising six exercises. The second session will involve participants switching treatment groups. Pain pressure thresholds (PPTs), shoulder pain and disability via the shoulder pain and disability index (SPADI), maximal voluntary isometric contraction (MVIC) of shoulder external rotators, pain during active abduction, and peak pain during shoulder external rotation will be evaluated using the numeric pain rating scale (NPRS). Immediate post-exercise assessments will include patient-perceived pain changes using the global rating of change scale (GROC) and participant-rated perceived exertion (RPE), employing a modified Borg’s scale (Borg CR10) post-BFR or sham BFR exercise session. Each session will encompass three assessment periods, and a combination of mixed-effect models and descriptive statistics will underpin the analysis. This protocol was approved by Cyprus National Bioethics Committee (ΕΕΒΚ/2023/48), and was registered in ClinicalTrials.gov (Registration number: NCT05956288). Conclusion: The anticipated outcomes of this study illuminated the acute effects of BFR training on pain perception within the context of nonspecific shoulder pain, potentially advancing strategies for managing pain intensity using BFR techniques.

Current chronic pain treatments primarily target symptoms and are often associated with harmful side-effects and complications, while safer non-invasive electrotherapies like H-Wave® device stimulation (HWDS) have been less explored. The goal of this study is to evaluate first responder-reported effects of HWDS on job-related and quality-of-life measures. This is a retrospective cohort study where first responders were surveyed following voluntary use of HWDS regarding participant experience, frequency of use, job-related performance, and quality-of-life. Responses were analyzed using means comparison tests, while bivariate analysis assessed responses associated with HWDS usage. Overall, 92.9% of first responder HWDS users (26/28) reported a positive experience (p < 0.0001), with 82.1% citing pain reduction (p = 0.0013), while 78.6% indicated it would be beneficial to have future device access (p = 0.0046). Participants using H-Wave® were at least six times more likely to report higher rates of benefit (100% vs. 0%, p = 0.022), including pain reduction (91.3% vs. 8.7%, p = 0.021) and improved range-of-motion (93.3% vs. 69.2%, p = 0.044). Spending more time with family was associated with better job performance following frequent HWDS use (50% vs. 8.3%, p = 0.032). Repetitive first responder H-Wave® use, with minimal side effects and easy utilization, resulted in significant pain reduction, improvements in job performance and range-of-motion, and increased time spent with family, resulting in overall positive experiences and health benefits. Level of Evidence: III. [ABSTRACT FROM AUTHOR]

Background: Considering the debilitating burden of neuroma resulting in a significant loss of function and excruciating pain, the use of muscle-in-vein conduits (MVCs) for the reconstruction of painful neuroma of sensory nerves of the fingers was assessed. Methods: We retrospectively analyzed 10 patients who underwent secondary digital nerve repair by MVCs. The recovery of sensibility was evaluated by static and moving two-point discrimination (2PDs, 2PDm) and Semmes-Weinstein monofilament testing (SWM). The minimum follow-up was set 12 months after the operation. Results: The median period between trauma and nerve repair was 13.4 weeks (IQR 53.5). After neuroma resection, defects ranged from 10–35 mm (mean 17.7 mm, SD 0.75). The successful recovery of sensibility was achieved in 90% of patients after a median follow-up of 27.0 months (IQR 31.00). The mean 2PDs and 2PDm was 8.1 mm (SD 3.52) and 5.2 mm (SD 2.27), respectively. Assessment by SWM resulted in a mean value of 3.54 (SD 0.69). Reduction in pain was achieved among all patients; eight patients reported the complete relief of neuropathic pain. There was no recurrence of neuroma in any patient. Conclusions: Muscle-in-vein conduits provide an effective treatment for painful neuroma of digital nerves, resulting in satisfactory restoration of sensory function and relief of pain. [ABSTRACT FROM AUTHOR]

Background: A series of multi-sensory interventions are proved to be effective in reducing pain among premature infants. Nevertheless, there lacks a comparison of these interventions to find the most suitable and optimal one for clinical decision-making., Objective: This systematic review and network meta-analysis aims to compare the effectiveness of various multi-sensory interventions, and to identify the optimal intervention for alleviating pain in premature infants., Methods: A comprehensive literature search was performed on August 19, 2024 to identify pertinent clinical trials. The Cochrane Risk of Bias (version 2) was used to assess the quality and potential bias of each included study. Network meta-analysis was used to assess the effectiveness of various interventions and to identify the optimal ones., Results: A total of 18 clinical trials involving 1408 premature infants were included. Three multi-sensory interventions were shown to be superior to routine practice in reducing pain among premature infants, including tactile-kinesthetic intervention, tactile-auditory intervention and tactile-visual-gustatory-olfactory intervention (all, P < 0.05). Among these interventions, tactile-kinesthetic intervention ranks the best for its effectiveness in alleviating procedural pain among premature infants. Subgroup network meta-analysis demonstrated that the tactile-visual-gustatory-auditory-olfactory intervention ranked the best for its effectiveness in reducing pain from invasive procedures, with the tactile-auditory intervention best for non-invasive procedures., Conclusions: Our study suggests that cautious assessment and identification should be prioritized to select appropriate multi-sensory interventions based on pain procedures, thus to effectively reduce pain in premature infants. Subsequent studies are needed to refine and optimize these strategies for broader application., Prospero Registry: CRD42024510352., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction: Cardiac catheterisation is crucial for diagnosing and treating paediatric heart diseases, but it is poorly tolerated by small children, infants, and newborns without sedation. This study investigated whether maternal voice during sedation could lower stress and pain in children undergoing cardiac catheterisation and also assessed mothers' stress levels before and after the procedure., Methods: This was a prospective, monocentric, randomised, controlled interventional study at the University Hospital Bonn. Children aged 4 years or younger scheduled for elective cardiac catheterisation under procedural sedation and American Society of Anaesthesiologists class between 1 and 3 were eligible., Results: At the end of cardiac catheterisation, the intervention group showed a higher Newborn Infant Parasympathetic Evaluation index with an adjusted mean difference of 9.5 (± 4.2) ( p = 0.026) and a lower median Children's and Infants Postoperative Pain Scale score of 2.0 (IQR: 0.0-5.0) versus 4.5 (IQR: 3.0-6.0) than the control group ( p = 0.027). No difference in the children's cortisol level was found ( p = 0.424). The mothers in the intervention group had a lower cortisol level than those in the control group before cardiac catheterisation (adjusted mean difference: -4.5 nmol/l (± 1.8 nmol/l), p = 0.011)., Conclusion: Listening to the maternal voice during cardiac catheterisation could lead to less postoperative pain and significantly lower stress and discomfort level in children. Less pain could reduce the incidence of postoperative delirium.Additionally, mothers perceived involvement as positive. A reduced stress level of mothers can positively influence children and possibly reduce pain and anxiety.

Background: Biofeedback-based virtual reality (VR-BF) is a novel, nonpharmacologic method for teaching patients how to control their breathing, which in turn increases heart rate variability (HRV) and may reduce pain. Unlike traditional forms of biofeedback, VR-BF is delivered through a gamified virtual reality environment, increasing the accessibility of biofeedback. This is the first study to systematically integrate VR-BF use in the pediatric perioperative setting, with the ultimate goal of evaluating the efficacy of VR-BF to reduce pain, anxiety, and opioid consumption once feasibility and acceptability have been established., Objectives: The primary objective was to develop a clinical trial protocol for VR-BF use in the pediatric perioperative setting, including preoperative education and training, and postoperative application of VR-BF in children undergoing surgery. A secondary objective was to evaluate the patient and parent experience with VR-BF., Methods: A total of 23 patients (12-18 years of age) scheduled for surgery at Nationwide Children's Hospital were recruited using purposive sampling. Following training, participants independently completed a daily, 10-minute VR-BF session for 7 days before surgery and during their inpatient stay. Participants could use VR-BF up to 2 weeks after hospital discharge. Patient- and session-level data of VR-BF usage and achievement of target HRV parameters were measured to identify the optimal frequency and duration of sessions before and after surgery for this population. Standardized questionnaires and semistructured interviews were conducted to obtain qualitative information about patients' experiences with VR-BF., Results: Patient-level data indicated that the highest odds of achieving 1 session under target HRV parameters was after 4 sessions (odds ratio [OR] 5.1 for 4 vs 3 sessions, 95% CI 1.3-20.6; OR 16.6 for 3 vs 2 sessions, 95% CI 1.2-217.0). Session-level data showed that a session duration of 9 to 10 minutes provided the greatest odds of achieving 1 session under target HRV parameters (OR 1.3 for 9 vs 8 min, 95% CI 1.1-1.7; OR 1.4 for 8 vs 7 min, 95% CI 1.1-1.8; OR 1 for 10 vs 9 min, 95% CI 0.9-1.2). Qualitative data revealed patient satisfaction with the VR-BF technology, particularly in managing perioperative stress (17/20, 85%). Few patients reported VR-BF as beneficial for pain (8/20, 40%)., Conclusions: Children and adolescents undergoing surgery successfully learned behavioral strategies with VR-BF with 10-minute sessions once daily for 5 days. To integrate VR-BF as a therapeutic intervention in a subsequent clinical trial, patients will be instructed to complete three 10-minute sessions a day for 7 days after surgery., Trial Registration: ClinicalTrials NCT04943874; https://clinicaltrials.gov/ct2/show/NCT04943874., (©Zandantsetseg Orgil, Anitra Karthic, Nora F Bell, Lisa M Heisterberg, Sara E Williams, Lili Ding, Susmita Kashikar-Zuck, Christopher D King, Vanessa A Olbrecht. Originally published in JMIR Perioperative Medicine (http://periop.jmir.org), 16.09.2024.)

This multicenter observational study aimed to assess how pain reduction, induced by local anesthesia, affects the relative angular contributions of the shoulder girdle and trunk to the maximal angular performance during a semi-constrained overhead reach task in patients with ongoing shoulder pain. Twenty-nine individuals (age 59.0 SD 12.8 years;16-male) with symptomatic shoulders were administered corticosteroid and lidocaine injections by their attending orthopedic surgeon. Immediately before and after the injections, participants reached for a target on the ceiling ten times as high as possible while their pain levels, shoulder, and trunk movements were recorded. The analysis revealed that there was a significant reduction in pain following the injections. However, there were no significant differences in maximum shoulder and trunk inclination angles between the pre- and post-injection conditions. Notably, there were slight but statistically significant alterations in humeroscapular kinematics during the initial phase of arm elevation following the injections. In conclusion, acute pain relief following local anesthetics is not associated with immediate alterations in maximum shoulder girdle and trunk inclination angles during a semi-constrained overhead reach task in patients with ongoing shoulder pain. However, there are signs of small alterations in humeroscapular kinematics during the initial phase of arm elevation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Chronic ankle instability (CAI) is a common consequence of lateral ankle sprains, resulting in persistent pain, instability, and functional limitations. This case report investigates the effectiveness of a physiotherapy intervention for a 25-year-old female patient with CAI, marked by recurrent ankle sprains and persistent symptoms despite prior conservative treatments. The patient exhibited swelling, pain, and instability, with clinical assessment revealing significant ligament laxity and a high longitudinal arch in both feet. A comprehensive physiotherapy regimen focused on core, hip, and ankle muscle strength, dynamic balance, and proprioception was implemented, incorporating ankle stretches, joint mobilization, core strengthening, hip strengthening, and dynamic balance exercises on unstable surfaces. Pre-rehabilitation outcome measures included a numeric pain rating of 7/10, a Cumberland ankle instability tool (CAIT) score of 15/30, and a foot and ankle outcome score (FAOS) of 63%. Gait analysis revealed a speed of 0.79 m/s, a cadence of 99.24 steps/min, and a distance of 14.23 meters. Post-intervention, significant improvements were observed: pain reduced to 1/10, the CAIT score increased to 28/30, and the FAOS rose to 89%. Gait parameters also improved, with speed increasing to 0.90 m/s and distance to 15 meters. This case underscores the effectiveness of a targeted physiotherapy approach in managing CAI, highlighting the importance of a multi-dimensional rehabilitation strategy to enhance functional outcomes and reduce associated symptoms of CAI., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gangwani et al.)

Aim: The aim of this review is to identify and summarise the key in vitro evidence available to support the use of HydroTac (HRWD-2) to address specific aspects associated with the treatment of both acute and hard-to-heal wounds. Background: The provision of a moist wound healing environment to support optimal wound healing has been a basic tenet in wound care since the pioneering work on the benefits of occlusion to support wound healing. Modern wound dressings have adopted the benefits of moist healing through their innovative development. HRWD-2 has been shown in clinical studies to enable and support good healing outcomes and the in vitro evidence in support of this dressing is presented in this article. Method: An online literature search (supplemented with a manual search of resources not available online) was conducted to identify articles and studies describing in vitro evidence in support of HRWD-2 in aspects important for promoting a healing response in the clinical environment. Results: In vitro studies showed that HRWD-2 contributes to balancing moisture levels and enhances the availability of growth factors known to be important for re-epithelialisation. Pre-clinical studies indicate that HRWD-2 enhances wound re-epithelialisation. Together these results suggest that HRWD-2 promotes a moist healing environment leading to the dressing supporting re-epithelialisation. In vitro data indicating an intrinsic lower in vitro adherence of HRWD-2 likely translate clinically to the benefits of an atraumatic wound dressing, including reduced pain (specifically at dressing change). Conclusion: The in vitro evidence presented in this review supports the successful clinical results reported for HRWD-2 in terms of fluid management, wound healing and pain reduction at dressing change. [ABSTRACT FROM AUTHOR]

Transurethral cystoscopy (CS) is a common urological procedure, performed mostly for diagnostic but also for therapeutic purposes. Although CS is generally well tolerated, some patients describe the pain related to the procedure as high or even “unbearable”. As a result, many patients fear and avoid both primary and/or follow-up cystoscopies. This may lead to uncontrolled progression of neoplastic disease. Therefore, it is crucial to maximally increase the comfort of the patient and to implement safe and effective analgesia before the procedure. Providing the patients with appropriate care during CS can encourage them to comply with diagnostic schedules and improve their prognosis. The aim of this review is to analyze the available literature on various methods of pain reduction during transurethral CS. The PubMed electronic database limited to English articles published until January 2021 was used in the process. Meta-analyses, systematic reviews, randomized controlled trials, clinical trials, prospective randomized studies, multicenter comparisons, reviews and retrospective comparisons were used. As a result, 65 articles were included in this review.

Introduction: Patello-femoral Pain Syndrome (PFPS) is a common musculoskeletal disorder characterised by anterior knee pain, particularly during activities like climbing stairs and squatting and long running. Despite its prevalence, effective rehabilitation strategies for PFPS remain a topic of research. Aim: To assess the significance of a novel backward drill exercise protocol in reducing pain and improving strength among PFPS patients. Materials and Methods: A randomised controlled trial will be conducted with 40 PFPS patients aged 18-30 years. Participants will be randomly assigned to either the backward drill exercise group or a control group (receive standard physiotherapy treatment protocol). Both groups will undergo a 6-week interventional program. Pain levels will be assessed by using the Visual Analog Scale (VAS), and muscle strength will be measured using a dynamometer, EMG study will be done for Vastus Medialis Obliquus muscle to check its activation before and after the intervention. Discussion: This study will test whether backward drill exercise protocol is a significant intervention for PFPS patients to effectively reduce pain, enhancing quadriceps strength and activation of the Vastus medialis obliquus muscle. Implementing this exercise protocol in the rehabilitation of PFPS patients may offer a promising alternative to standard physiotherapy approaches, potentially improving patient outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Study Design: Porcine intervertebral discs (IVDs) were excised and then drilled to simulate degeneration before being electrically stimulated for 21 days while undergoing mechanical loading. The discs were then analyzed for gene expression and morphology to assess regeneration.Objective: The purpose of this study was to investigate the effectiveness of the electrical stimulation of IVD treatment as an early intervention method in halting the progression of degenerative disc disease using an ex-vivo porcine model.Summary Of Background Data: Treatments for degenerative disc disease are limited in their efficacy and tend to treat the symptoms of the disease rather than repairing the degenerated disc itself. There is a dire need for an early intervention treatment that not only halts the progression of the disease but contributes to reviving the degenerated disc.Methods: Lumbar IVDs were extracted from a mature pig within 1 hour of death and were drilled with a 1.5 mm bit to simulate degenerative disc disease. Four IVDs at a time were then cultured in a dynamic bioreactor system under mechanical loading for 21 days, two with and two without the electrical stimulation treatment. The IVDs were assessed using histological analysis, magnetic resonance imaging, and quantitative reverse transcriptase polymerase chain reaction to quantify the effectiveness of the treatment on the degenerated discs.Results: IVDs with electrical stimulation treatment exhibited extensive annular regeneration and prevented herniation of the nucleus pulposus (NP). In contrast, the untreated group of IVDs were unable to maintain tissue integrity and exhibited NP herniation through multiple layers of the annulus fibrosus. Gene expression showed an increase of extracellular matrix markers and antiinflammatory cytokine interleukin-4 (IL-4), while decreasing in pro-inflammatory markers and pain markers in electrically stimulated IVDs when compared to the untreated group.Conclusion: The direct electrical stimulation application in NP of damaged IVDs can be a viable option to regenerate damaged NP and annulus fibrosus tissues. [ABSTRACT FROM AUTHOR]

Objective: Pressure ulcers (PUs) are hard-to-heal, open wounds that affect millions of adults worldwide. Patients experience physical, mental, social and financial impairment. On average, <50% of stage 3 and 4 PUs heal by the sixth month. Treatment of PUs is highly variable due to a patient's comorbidities, demographics and wound characteristics. Because of this, there exists no standard dressing for PUs. Altrazeal transforming powder dressing (TPD, Uluru Inc., US) offers a promising new form of wound treatment; however, little evidence exists for TPD in the treatment of hard-to-heal PUs. This case series sought to examine the effect of TPD in hard-to-heal PUs that have previously undergone unsuccessful standard of care (SoC) wound therapy. Methods: This case series used retrospective data from patients with stage 2–4 PUs that failed to heal after SoC therapies. Factors examined were: number of dressing changes; time between dressing changes; time to wound closure; and pain level. While data were assessed for all patients, we focused on the six particular cases that most clearly illustrated the effect of TPD on wound healing. Results: Each of the 21 patients treated with TPD experienced successful and expedited wound closure. Stage 4 PUs took an average of 87 days with approximately six dressing changes to closure. Stage 3 PUs took an average of 41 days with approximately four dressing changes, and stage 2 PUs an average of 13 days to closure with approximately one dressing change. In the cases presented herein for which pain scores were reported, each showed a reduction in pain from an 8 or 9/10 to a 1 or 2/10 with the first dressing change. Conclusion: In this case series, TPD effectively reduced pain and healed PUs that had previously failed SoC interventions. We suggest future prospective studies in order to more effectively measure the wound healing capability and healthcare utilisation of TPD for treatment of PUs. [ABSTRACT FROM AUTHOR]

Murine translational models are an important tool to understand pain pathophysiology. One procedure used frequently in murine research is the sciatic nerve block. This study sought to demonstrate the use of ultrasound-guided sciatic nerve block in a cadaveric murine model. A total of 40 injections were performed in 20 Sprague–Dawley male 18-month-old rat cadavers. Necropsy was performed to identify staining of the sciatic nerve. Staining with methylene blue occurred in 40 of 40 ultrasound-guided injections. The extremely accurate nature of this block under ultrasound guidance is favorable for future translational studies in rats undergoing sciatic nerve blocks. This method may represent a significant improvement in current methods. [ABSTRACT FROM AUTHOR]

The aim of this article is to report the results obtained by the use of HAM in surgical wound healing and the reduction of relapse in patients affected by Medication-related osteonecrosis of the jaw (MRONJ).The study involved patients with the diagnosis of MRONJ, surgically treated between October 2016 and April 2019, in a case–control setting. Enrolled patients were randomly divided into 2 groups. One group will be treated with resective surgery and with the insertion of HAM patch (Group A), while the second group had been treated exclusively with resective surgery (Group B).The patients underwent MRONJ surgical treatment with the placement of amniotic membrane patches at the wound site. Data regarding the long-term complications/functions were evaluated at 3, 6, 12, and 24 months after surgery. Pain measurements were performed before the intervention (T0), 7(T1) and 30(T2) days after surgery. 49 patients were included in the study. 2 patients of GROUP A after 30 days since they were surgically treated showed persistent bone exposure. 5 patients of group B demonstrated a lack of healing of the surgical wound with the persistence of bone exposed to 30 days after surgery. Statistical analysis ruled out any difference in OUTCOME (relapse) between GROUP A and B (p = 0.23). However, the Fisher test highlighted a significant difference between the use of HAM and only surgical treatment in pain at rest (p = 0.032). The use of amniotic membrane implement the patient's quality of life and reduce pain perception. has a learning curve that is fast enough to justify its routine use. [ABSTRACT FROM AUTHOR]