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The Journal of Pain Aug 2023This report provides a systematic review of the literature to analyze the effects of transcutaneous electrical nerve stimulation (TENS) on analgesia on sensitization... (Meta-Analysis)
Meta-Analysis Review
Effect of Transcutaneous Electrical Nerve Stimulation on Pain-related Quantitative Sensory Tests in Chronic Musculoskeletal Pain and Acute Experimental Pain: Systematic Review and Meta-analysis.
This report provides a systematic review of the literature to analyze the effects of transcutaneous electrical nerve stimulation (TENS) on analgesia on sensitization measures, in studies with chronic musculoskeletal pain and in studies with acute experimental pain. The protocol was registered at PROSPERO (CRD42020213473). The authors searched Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Latin American and Caribbean Health Sciences Literature via Biblioteca Virtual de Saúde, Physiotherapy Evidence Database, PubMed, ScienceDirect, Web of Science, Google Scholar, and hand-searched reference lists were also conducted. Among 22,252 manuscripts found, 58 studies were included in the systematic review and 35 in the meta-analysis. Thirty-four studies assessed pain intensity; 24 studies investigated hyperalgesia; temporal summation was only evaluated in 2 studies; and conditioned pain modulation was not observed in the included studies. Meta-analyses favored TENS, despite its limitations and heterogeneity. Primary hyperalgesia in studies with musculoskeletal pain presented a high level of evidence, while other outcomes presented moderate evidence in the studies that were included. It is not possible to infer results about both temporal summation and conditioned pain modulation. Moderate evidence suggests that TENS promotes analgesia by reducing both central and peripheral sensitization, as shown by the reduction in primary and secondary hyperalgesia, pain intensity at rest, and during movement in experimental acute pain and chronic musculoskeletal pain. Overall, both types of studies analyzed in this review presented meta-analyses favorable to the use of TENS (compared to placebo TENS), showing reductions in both primary and secondary hyperalgesia, as well as decreases in pain intensity at rest and in motion. PERSPECTIVE: This article presents data from the literature on the effect of TENS through sensitization assessments in individuals with chronic musculoskeletal pain, or acute experimental pain. These data contribute to knowledge about pain neuroscience research, using TENS technology.
Topics: Humans; Transcutaneous Electric Nerve Stimulation; Acute Pain; Hyperalgesia; Musculoskeletal Pain; Chronic Pain
PubMed: 37030583
DOI: 10.1016/j.jpain.2023.03.014 -
Deutsche Medizinische Wochenschrift... Nov 2023Epidemiology and pathophysiology: Fibromyalgia is significantly more common in people with rheumatic diseases than in the general population. Nevertheless, it can occur...
Epidemiology and pathophysiology: Fibromyalgia is significantly more common in people with rheumatic diseases than in the general population. Nevertheless, it can occur independent of other diseases. Physical and psychosocial factors are responsible for the genesis for fibromyalgia making it a multifactorial disease. Most importantly, central pain processing seems to be abnormal. The relevance of a small fibre neuropathy is yet to be determined. For the very first time, a study was able to demonstrate that fibromyalgia might be passively transferred from one organism to another in an experimental setting.Diagnosis: Fibromyalgia is a clinical diagnose. Besides generalized pain, sleep disturbances and fatigue are common features. Furthermore, there can be an association with depressive disorders. Determining the Widespread Pain Index (WPI) and the Symptom Severity Score (SSS) can help in diagnosing Fibromyalgia and to determine severity of the disease.Therapy: Cornerstones of the treatment are patient education, physical exercise, physical therapy, and cognitive behavioural therapy. In therapy-resistant cases, a multimodal approach might be considered. Analgesic drugs, particularly opioids, should basically be avoided or only be used for a short period of time. Naltrexone, an opioid antagonist, is a promising treatment candidate. Another possible approach might be the use of TENS. While there are positive observational studies on the therapeutic use of cannabinoids, evidence from controlled trials is still missing.
Topics: Humans; Fibromyalgia; Fatigue; Syndrome; Exercise; Musculoskeletal Pain
PubMed: 37918433
DOI: 10.1055/a-1965-6870 -
Revista Da Escola de Enfermagem Da U S P 2024To identify the presence of musculoskeletal pain during the working day among nursing professionals in material and sterilization centers.
OBJECTIVE
To identify the presence of musculoskeletal pain during the working day among nursing professionals in material and sterilization centers.
METHOD
A cross-sectional study with 36 nursing professionals who answered a questionnaire for personal characterization and diagnosis of musculoskeletal disorders and Corlett and Manenica's diagram of painful areas at the beginning and end of the working day. Frequency distribution analysis, Fisher's exact test and likelihood ratio were carried out.
RESULTS
The presence of pain was reported by 80.6% (n = 29) of the participants at the start of the working day and 94.4% (n = 34) at the end, and the prevalence of musculoskeletal disorders was 66.6% (n = 24). There was a statistically significant difference in the number of segments with pain between professionals with and without a diagnosis of musculoskeletal disorders, in the initial and final assessments. The lumbar spine had a higher prevalence of pain in both assessments.
CONCLUSION
The prevalence of pain increased towards the end of the working day and indicates that there may be a relationship between the work process and the development of pain. It is important to identify working conditions that may contribute to the onset of pain and to adopt preventive measures.
Topics: Humans; Musculoskeletal Pain; Cross-Sectional Studies; Occupational Diseases; Musculoskeletal Diseases; Surveys and Questionnaires; Prevalence; Risk Factors
PubMed: 38224561
DOI: 10.1590/1980-220X-REEUSP-2023-0019en -
Drug and Alcohol Dependence Jul 2023Pain treatment guidelines prioritize nonopioid therapies over opioid medications to prevent opioid-related harms. We examined trends in receipt and intensity of...
INTRODUCTION
Pain treatment guidelines prioritize nonopioid therapies over opioid medications to prevent opioid-related harms. We examined trends in receipt and intensity of nonpharmacologic, nonopioid medication, and opioid therapies among Medicare beneficiaries.
METHODS
Using a 20% national random sample of Medicare data from 2016 to 2019, we identified fee-for-service beneficiaries with ≥2 diagnoses of back, neck, fibromyalgia, or osteoarthritis/joint pain annually. We excluded beneficiaries with cancer. We calculated annual proportions of beneficiaries who received physical therapy (PT), chiropractic care, gabapentin, and opioids, overall and in demographic, geographic, and clinical subgroups. We estimated the intensity of therapies using the annual number of visitsor prescription fills, prescription days' supply, and opioid dose.
RESULTS
During 2016-2019, PT receipt increased (22.8% to 25.5%) and the mean number of visits among recipients of PT went from 12 to 13. Chiropractic receipt (~18%) and mean annual visits (~10) remained unchanged. The prevalence of gabapentin receipt was stable at ~22% and the mean annual number of fills was unchanged though gabapentin days increased slightly. Opioid prescribing decreased (56.7% to 46.5%) and reductions in opioid dose and duration were observed. Opioid receipt was high among beneficiaries who were under 65 years, American Indian/Alaska Native, Black/African American, or had opioid use disorder (OUD), in whom nonpharmacologic therapies were also received the least.
CONCLUSION
Utilization of nonopioid therapies lagged opioids among Medicare beneficiaries with musculoskeletal pain, with limited changes from 2016 to 2019. As opioid prescribing declines and alternative pain therapy receipt remains low, there are potential increasing risks of pain going untreated or undertreated and individuals seeking illicit opioids to alleviate their pain.
Topics: Aged; Humans; United States; Analgesics, Opioid; Musculoskeletal Pain; Pain Management; Medicare; Gabapentin; Prevalence; Practice Patterns, Physicians'
PubMed: 37269776
DOI: 10.1016/j.drugalcdep.2023.109930 -
BMC Musculoskeletal Disorders Oct 2023To construct a new prediction nomogram to predict the risk of musculoskeletal pain in patients with primary osteoporosis who receive zoledronic acid intravenously for...
Prediction of musculoskeletal pain after the first intravenous zoledronic acid injection in patients with primary osteoporosis: development and evaluation of a new nomogram.
OBJECTIVE
To construct a new prediction nomogram to predict the risk of musculoskeletal pain in patients with primary osteoporosis who receive zoledronic acid intravenously for the first time.
METHOD
Clinical data of 368 patients with primary osteoporosis who received the first intravenous injection of zoledronic acid in our hospital from December 2019 to December 2022 were studied. Patients were divided into a musculoskeletal pain group (n = 258) and a non-musculoskeletal pain group (n = 110) based on the presence or absence of musculoskeletal pain 3 days after injection. Statistically significant predictors were screened by logistic regression analysis and the minimum absolute contraction and selection operator (LASSO) to construct a nomogram. The nomogram was evaluated by the receiver operating characteristic (ROC) curve, the calibration curve, the C-index, and the decision curve analysis (DCA) and verified in a validation cohort.
RESULTS
The independent predictors of the nomogram were age, serum 25-hydroxyvitamin D, NSAIDs, prior Vitamin D intake, and BMI. The area under the ROC curve (AUC) was 0.980 (95% CI, 0.915-0.987), showing excellent predictive performance. The nomogram c index was 0.980, and the nomogram c index for internal verification remained high at 0.979. Moreover, calibration curves show that the nomogram has good consistency. Finally, the DCA showed that the net benefit of the nomogram was 0.20-0.49.
CONCLUSION
Musculoskeletal pain is a common symptom of APR in OP patients treated with intravenous zoledronic acid. Risk factors for musculoskeletal pain after zoledronic acid injection in OP patients were: non-use of NSAIDs, youth (<80 years old), serum 25 (OH) D<30ng /mL, no prior intake of vitamin D, BMI<24 kg /m. A nomogram constructed from the above predictors can be used to predict musculoskeletal pain after the first zoledronic acid injection.
Topics: Adolescent; Humans; Aged, 80 and over; Musculoskeletal Pain; Nomograms; Zoledronic Acid; Vitamin D; Anti-Inflammatory Agents, Non-Steroidal; Osteoporosis
PubMed: 37880626
DOI: 10.1186/s12891-023-06965-y -
Archivos de Prevencion de Riesgos... Sep 2023The World Health Organization considers the workplace as one of the best contexts for the prevention and control of non-communicable diseases. Implementing combined and...
The World Health Organization considers the workplace as one of the best contexts for the prevention and control of non-communicable diseases. Implementing combined and de-medicalised interventions in Occupational Health Services (OHS) in a sustainable way over time can facilitate access to early detection, and management of musculoskeletal pain at work and improve workers' health. However, developing and implementing such interventions is challenging. Therefore, it is necessary to share previous interventions that describe both implementation and evaluation, in order to be used as practical examples that can inspire different OHS to implement sustainable interventions….
Topics: Humans; Musculoskeletal Pain; Workplace; Occupational Health; Occupational Health Services; Occupational Diseases; Musculoskeletal Diseases
PubMed: 37859488
DOI: 10.12961/aprl.2023.26.04.01 -
Brain, Behavior, and Immunity Feb 2024Recent studies have confirmed an association between pain and dementia. Whether musculoskeletal pain in the spine, upper limbs, and lower limbs is associated with...
BACKGROUND
Recent studies have confirmed an association between pain and dementia. Whether musculoskeletal pain in the spine, upper limbs, and lower limbs is associated with dementia risk remains unclear. The longitudinal effect of musculoskeletal pain on dementia risk also remains unclear.
AIMS
This work aimed to investigate the association between musculoskeletal pain and dementia risk score.
METHODS
We conducted cross-sectional and longitudinal analyses using data from the China Health and Retirement Longitudinal Study. Participants aged 45 years or older were recruited in 2011. A total of 10,759 participants with complete pain information at baseline were eligible for the cross-sectional analysis, and 5,855 were eligible for the longitudinal analyses. We utilized the Rotterdam Study Basic Dementia Risk Model (BDRM) to assess dementia risk. Generalized estimating equations were used to investigate the associations.
RESULTS
Compared with participants without persistent musculoskeletal pain, those with persistent musculoskeletal pain (standardized, β = 0.83; 95 % CI: 0.06, 1.61, p = 0.036), multisite pain (sites≧5; β = 1.52; 95 % CI: 0.13, 2.91, p = 0.032), neck pain (β = 2.33; 95 % CI: 0.41, 4.25, p = 0.018), back pain (β = 2.12; 95 % CI: 0.43, 3.82, p = 0.014), waist pain (β = 1.09; 95 % CI: 0.07, 2.11, p = 0.037), shoulder pain (β = 1.74; 95 % CI: 0.46, 3.02, p = 0.008), wrist pain (β = 2.72; 95 % CI: 0.42, 5.02, p = 0.021), and knee pain (β = 1.91; 95 % CI: 0.70, 3.13, p = 0.002) had a higher BDRM score during 4 years of follow-up.
CONCLUSIONS
Promoting the management of musculoskeletal pain may be beneficial in reducing the dementia risk score.
Topics: Adult; Humans; Longitudinal Studies; Musculoskeletal Pain; Retirement; Cross-Sectional Studies; Risk Factors; Dementia
PubMed: 38081434
DOI: 10.1016/j.bbi.2023.12.015 -
Clinical Anatomy (New York, N.Y.) Jul 2024Technological developments and the pandemic have popularized the distance learning model at universities. In this educational model, students spend more time in front of...
Technological developments and the pandemic have popularized the distance learning model at universities. In this educational model, students spend more time in front of screens, and screen-related health conditions have become important. This cross-sectional study of 177 undergraduate students was designed to investigate the effect of block and traditional scheduling in online distance education (ODE) on their musculoskeletal pain and to investigate their perceptions of block scheduling. A two-stage method was used: a quantitative design to compare pain levels, and a qualitative design to determine the students' perceptions of block scheduling using an online survey. Pain intensity was assessed using the Numeric Rating Scale (NRS-11). Data were collected in the university health sciences department. Pain intensity following the block and traditional lessons was analyzed using a paired t-test. Students in the block schedule had significantly more pain, with a large effect size on the whole trunk and upper limbs. Pain levels were also clinically meaningful for the upper (5.73 ± 2.75), lower (5.59 ± 2.87), and neck (4.92 ± 2.60) regions. Students reported positive experiences with block scheduling in ODE such as saving time (43%) and maintaining subject integrity (26%), but also negative experiences such as distraction (56%), fatigue (33%), pain (17%), and boredom (11%). Block scheduling in ODE could cause clinically significant neck and back pain. In distance learning, keeping the course duration short and ensuring student mobility in the classroom are important.
Topics: Humans; Cross-Sectional Studies; Musculoskeletal Pain; Education, Distance; Male; Female; Young Adult; Pain Measurement; Adult; Students, Medical
PubMed: 38546148
DOI: 10.1002/ca.24163 -
Experimental Physiology Jan 2024Proprioceptors are non-nociceptive low-threshold mechanoreceptors. However, recent studies have shown that proprioceptors are acid-sensitive and express a variety of... (Review)
Review
Proprioceptors are non-nociceptive low-threshold mechanoreceptors. However, recent studies have shown that proprioceptors are acid-sensitive and express a variety of proton-sensing ion channels and receptors. Accordingly, although proprioceptors are commonly known as mechanosensing neurons that monitor muscle contraction status and body position, they may have a role in the development of pain associated with tissue acidosis. In clinical practice, proprioception training is beneficial for pain relief. Here we summarize the current evidence to sketch a different role of proprioceptors in 'non-nociceptive pain' with a focus on their acid-sensing properties.
Topics: Humans; Musculoskeletal Pain; Acid Sensing Ion Channels; Sensory Receptor Cells; Mechanoreceptors; Proprioception
PubMed: 37417654
DOI: 10.1113/EP090989 -
European Journal of Obstetrics,... Mar 2024To systematically investigate the association between musculoskeletal pain during pregnancy and birth outcomes including caesarean section, newborn birthweight, newborn... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically investigate the association between musculoskeletal pain during pregnancy and birth outcomes including caesarean section, newborn birthweight, newborn birth length, and gestational age at birth.
METHODS
Medline, Embase, Web of Science, Cinahl and Scopus were systematically searched to identify eligible studies. Odds ratios, mean differences, and confidence intervals were used to describe results. Risk of Bias was assessed using the Newcastle-Ottawa Scale for observational studies. GRADE (The Grading of Recommendation Assessment, Development, and Evaluation) was used to assess the quality of each outcome.
RESULTS
Seven studies were included with a total population of 85,991 participants. There is low- quality evidence that pregnant women with musculoskeletal pain had 1.59 greater odds to experience delivery by caesarean section compared to those without musculoskeletal pain ([OR] 1.59, 95 % confidence interval [CI] 1.09 to 2.31). Both newborn birth weight (Mean Difference [MD] 77.79 g, 95 % [CI] -23.09 to 178.67) and newborn birth length ([MD] 0.55 cm, 95 % [CI] -0.47 to 1.56) were not affected by musculoskeletal pain, with very low-quality and low-quality evidence, respectively. There was moderate evidence that pregnant women with musculoskeletal pain had shorter gestational age (weeks), although the effect was small and possibly not clinically relevant ([MD] -0.41, 95 % [CI] -0.41 to -0.07).
CONCLUSION
Pregnant women experiencing musculoskeletal pain are at greater odds of delivering their babies via caesarean than those without musculoskeletal pain, however, musculoskeletal pain during pregnancy does not appear to affect newborn birth weight, length, or gestational age at birth.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Birth Weight; Cesarean Section; Musculoskeletal Pain; Gestational Age; Pregnancy Outcome
PubMed: 38286038
DOI: 10.1016/j.ejogrb.2024.01.027