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Pain Reports Jan 2024Movement-evoked pain (MEP) is the primary symptom in patients with knee osteoarthritis (KOA).
INTRODUCTION
Movement-evoked pain (MEP) is the primary symptom in patients with knee osteoarthritis (KOA).
OBJECTIVES
This study aimed to investigate the contribution of joint structural changes and pain sensitization to the mechanisms of MEP in patients with KOA.
METHODS
A total of 86 patients were assessed for demographic characteristics, osteoarthritis severity, Whole-Organ Magnetic Resonance Imaging Score-Hoffa synovitis and bone marrow lesions, pressure pain threshold and temporal summation of pain at the knee and forearm, Central Sensitization Inventory-9, and MEP. In measure of MEP, knee pain was scored using a numerical rating scale (NRS, 0-10) before and every minute during a 6-minute walking test (6MWT), and the MEP index was defined as the change in NRS pain score from baseline to the sixth minute of walking.
RESULT
On average, pain during 6MWT increased by 1.4 ± 1.5 points on the NRS relative to baseline, with 30.2% of patients showing an increase of 2 points or more. The hierarchical linear regression analysis revealed that Hoffa synovitis, pressure pain threshold at the forearm, and temporal summation of pain at the knee were associated with the MEP index.
CONCLUSION
The findings of this study suggest that both synovitis and neural mechanisms, such as pain sensitization, play a role in the development of MEP in KOA.
PubMed: 38274197
DOI: 10.1097/PR9.0000000000001124 -
Journal of Dairy Science Sep 2023Caustic paste disbudding is increasing in popularity on commercial dairy farms in the United States, but little research has explored the pain and welfare implications...
Caustic paste disbudding is increasing in popularity on commercial dairy farms in the United States, but little research has explored the pain and welfare implications beyond the acute period of this procedure. In contrast, researchers have reported it takes 7 to 9 wk, on average, for hot-iron disbudding wounds to re-epithelialize in dairy calves. Our objective was to describe wound healing and sensitivity following caustic paste disbudding. Jersey and Holstein female calves were disbudded using caustic paste (H. W. Naylor Company Inc.) at 3 d of age (n = 18), and control calves received a sham procedure (n = 15). Before disbudding, calves received a local block and a nonsteroidal anti-inflammatory drug. Calves ≥34 kg and <34 kg at birth had 0.3 or 0.25 mL of paste applied per unshaved horn bud, respectively. Following disbudding, wounds were scored 2×/wk for the presence or absence of 8 tissue categories, including the final stages: new epithelium and fully healed. Control calves were removed from the experiment after 6 wk to be hot-iron disbudded. Mechanical nociceptive threshold (MNT) measures were collected weekly to evaluate wound sensitivity until calves were removed from the study or healed. Wounds were slow to re-epithelialize (16.2 ± 5.7 wk, mean ± SD; range: 6.2-32.5 wk) and contract to be considered fully healed (18.8 ± 6 wk, mean ± SD; range: 8.7-34.1 wk). Compared with non-disbudded controls, paste calves exhibited lower MNT values for all 6 wk (mean ± SE; control: 1.46 ± 0.16; paste: 1.18 ± 0.12 N). These data indicate that wounds from caustic paste disbudding are more sensitive than undamaged tissue for at least 6 wk and take twice as long to heal compared with cautery methods described in the literature. In conclusion, caustic paste disbudding wounds took 18.8 wk to fully heal and were more sensitive than intact horn buds for 6 wk. Future work should examine whether aspects of paste application (e.g., amount used, time rubbed in, calf age, pain mitigation) could improve healing time and sensitivity.
Topics: Animals; Cattle; Female; Caustics; Horns; Pain; Wound Healing; Iron
PubMed: 37268589
DOI: 10.3168/jds.2023-23238 -
International Journal of Exercise... 2023Work-related Musculoskeletal Disorders can cause neck and shoulder pain in office workers. The research objective was to investigate the efficacy of Ruesi Dadton...
Work-related Musculoskeletal Disorders can cause neck and shoulder pain in office workers. The research objective was to investigate the efficacy of Ruesi Dadton exercise (RD) and Yoga exercise (YE) compared with Stretching exercise (SE) on reducing neck and shoulder pain in office workers. A single-blind randomized controlled trial was conducted at Thai Traditional Health Promotion Center, Thai Traditional and Alternative Medicine Hospital. A total number of 80 participants, equally divided into three groups: two intervention groups of RD (n=26), YE (n=28), and a control group of stretching exercise (SE) (n=26) who completed the 4-week intervention program. The primary outcomes were pain relief assessed by Visual Analog Scale, Pressure Pain Threshold, muscle flexibility by Cervical Range of Motion. The secondary outcome was World Health Organization's Quality of Life test. ANOVA, paired t-tests and repeated ANOVA were used to analyze the data. The results showed that the comparison of all three groups before and after the exercises revealed a decrease in pain, better tolerance to pain and more flexibility of the neck muscles with statistical significance (p< 0.05). With respect to the quality of World Health Organization's Quality of Life, the comparison of all four domains in all three groups before and after the exercises indicated a statistically significant improvement in quality of life (p< 0.05). However, there were no differences in pain, neck muscle flexibility and quality of life between groups.
PubMed: 38287934
DOI: No ID Found -
The Journal of Pain Feb 2024Identifying and resolving molecular complexities underlying chronic neuropathic pain is a significant challenge. Among the numerous classes of histone deacetylases,...
Identifying and resolving molecular complexities underlying chronic neuropathic pain is a significant challenge. Among the numerous classes of histone deacetylases, Class I (HDAC 1-3) and Class III (sirtuins) have been best studied in experimental pain models where inhibitor pre-treatments but not post-treatments abrogate the development of pain-related behaviors. Post-treatment here in week 3 with less well-studied Class IIa HDAC4/5 selective inhibitor LMK235 diminishes the trigeminal ganglia increases of HDAC5 RNA and protein in two chronic orofacial neuropathic pain models to levels measured in naïve mice at week 10 post-model induction. HDAC4 RNA reported in lower limb inflammatory pain models is not evident in the trigeminal models. Many other gene alterations persisting at week 10 in the trigeminal ganglia (TG) are restored to naïve levels in mice treated with LMK235. Important pain-related upregulated genes Hoxc8,b9,d8; P2rx4, Cckbr, growth hormone (Gh), and schlafen (Slfn4) are greatly reduced in LMK235-treated mice. Fold increase in axon regeneration/repair genes Sostdc1, TTr, and Folr1 after injury are doubled by LMK235 treatment. LMK235 reduces the excitability of trigeminal ganglia neurons in culture isolated from nerve injured mice compared to vehicle-treated controls, with no effect on neurons from naïve mice. Electrophysiological characterization profile includes a shift where ∼20% of the small neurons recorded under LMK235-treated conditions are high threshold, whereas none of the neurons under control conditions have high thresholds. LMK235 reverses long-standing mechanical and cold hypersensitivity in chronic trigeminal neuropathic pain models in males and females (5,10 mg/kg), preventing development of anxiety- and depression-like behaviors. PERSPECTIVE: Data here support HDAC5 as key epigenetic factor in chronic trigeminal neuropathic pain persistence, validated with the study of RNA alterations, TG neuronal excitability, and pain-related behaviors. HDAC5 inhibitor given in week 3 restores RNA balance at 10 weeks, while upregulation remains for response to wound healing and chronic inflammation RNAs.
Topics: Animals; Male; Mice; Axons; Epigenesis, Genetic; Histone Deacetylases; Nerve Regeneration; Neuralgia; Trigeminal Ganglion; Histone Deacetylase Inhibitors; Benzamides
PubMed: 37777035
DOI: 10.1016/j.jpain.2023.09.015 -
British Journal of Pain Dec 2023Low-back and neck pain affect a great number of individuals worldwide. The pressure pain threshold has the potential to be a useful quantitative measure of mechanical...
BACKGROUND AND OBJECTIVE
Low-back and neck pain affect a great number of individuals worldwide. The pressure pain threshold has the potential to be a useful quantitative measure of mechanical pain in a clinical setting, if it proves to be reliable in this population. The objectives of this systematic review are to: (1) analyze the literature evaluating the reliability of pressure pain threshold (PPT) measurements in the assessment of neck and low-back pain, (2) summarize the evidence from these studies, and (3) characterize the limitations of PPT measurement.
DATABASES AND DATA TREATMENT
Relevant literature from PubMed and the Web of Science electronic databases were screened in a 3-step process according to inclusion/exclusion criteria. Relevant studies were assessed for risk of bias using the Quality Appraisal of Reliability Studies (QAREL) tool, and results of all studies were summarized and tabulated.
RESULTS
Of 922 citations identified, 11 studies were deemed relevant for critical appraisal, and 8 studies were deemed to have low risk-of bias. Intra-rater reliability, reported in all studies ( = 637) and inter-rater reliability, reported in 2 studies ( = 200) were consistently reported to be good to excellent (ICC 0.75-0.99 and ICC 0.81-0.90, respectively). Studies were also found to have significant variation in PPT measurement procedures.
CONCLUSIONS
Though intra- and inter-rater reliability was found to be high in all studies, the variation in PPT measurement protocols could affect validity and absolute reliability. As such, it is recommended that standard guidelines be developed for clinical use.
PubMed: 37969131
DOI: 10.1177/20494637231196647 -
BMC Musculoskeletal Disorders Aug 2023The aim was to study associations between chronic widespread pain, widespread pain sensitivity, leptin, and metabolic factors in individuals with knee pain. A secondary...
OBJECTIVE
The aim was to study associations between chronic widespread pain, widespread pain sensitivity, leptin, and metabolic factors in individuals with knee pain. A secondary aim was to study these associations in a subgroup of individuals with normal BMI.
METHOD
This cross-sectional study included 265 individuals. The participants were categorised into three different pain groups: Chronic widespread pain (CWP), chronic regional pain (ChRP), or no chronic pain (NCP). The pressure pain thresholds (PPTs) were assessed using computerised pressure algometry. Low PPTs were defined as having PPTs in the lowest third of all tender points. Leptin and metabolic factors such as BMI, visceral fat area (VFA), lipids, and glucose were also assessed.
RESULT
Sixteen per cent reported CWP, 15% had low PPTs, and 4% fulfilled both criteria. Those who fulfilled the criteria for CWP were more often women, more obese, and had increased leptin levels. In logistic regression, adjusted for age and gender, leptin was associated with fulfilling criteria for CWP, OR 1.015 (95% CI 1.004-1.027, p = 0.008). In logistic regression, adjusted for age and gender, leptin was associated with low PPTs, OR 1.016 (95% CI 1.004-1.029, p = 0.012). Leptin was also associated with fulfilling both criteria, adjusted for age, sex, and visceral fat area (VFA), OR 1.030 (95% CI 1.001-1.060), p = 0.040.
CONCLUSION
Leptin was associated with fulfilling the combined criteria for chronic widespread pain and low PPTs, even after adjusting for the visceral fat area (VFA). Longitudinal studies are needed to study the causal relationships between leptin and the development of widespread pain.
TRIAL REGISTRATION
clinicalTrials.gov Identifier: NCT04928170.
Topics: Humans; Female; Pain Threshold; Leptin; Cross-Sectional Studies; Pain Measurement; Chronic Pain
PubMed: 37559026
DOI: 10.1186/s12891-023-06773-4 -
World Journal of Orthopedics Jul 2023Active myofascial trigger points (TrPs) often occur in the upper region of the upper trapezius (UT) muscle. These TrPs can be a significant source of neck, shoulder, and... (Clinical Trial)
Clinical Trial
BACKGROUND
Active myofascial trigger points (TrPs) often occur in the upper region of the upper trapezius (UT) muscle. These TrPs can be a significant source of neck, shoulder, and upper back pain and headaches. These TrPs and their related pain and disability can adversely affect an individual's everyday routine functioning, work-related productivity, and general quality of life.
AIM
To investigate the effects of instrument assisted soft tissue mobilization (IASTM) extracorporeal shock wave therapy (ESWT) on the TrPs of the UT muscle.
METHODS
A randomized, single-blind, comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo. Forty patients (28 females and 12 males), aged between 20-years-old and 40-years-old, with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups (A and B). Group A received IASTM, while group B received ESWT. Each group was treated twice weekly for 2 weeks. Both groups received muscle energy technique for the UT muscle. Patients were evaluated twice (pre- and post-treatment) for pain intensity using the visual analogue scale and for pain pressure threshold (PPT) using a pressure algometer.
RESULTS
Comparing the pre- and post-treatment mean values for all variables for group A, there were significant differences in pain intensity for TrP1 and TrP2 ( = 0.0001) and PPT for TrP1 ( = 0.0002) and TrP2 ( = 0.0001). Also, for group B, there were significant differences between the pre- and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2 ( = 0.0001). There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1 ( = 0.9) and TrP2 ( = 0.76) and PPT for TrP1 ( = 0.09) and for TrP2 ( = 0.91).
CONCLUSION
IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs. There is no significant difference between either treatment method.
PubMed: 37485429
DOI: 10.5312/wjo.v14.i7.572 -
Revista Da Associacao Medica Brasileira... 2023The aim of this study was to compare the pressure pain threshold and the thickness of the cervical muscles in patients with tension-type headache versus healthy... (Observational Study)
Observational Study
OBJECTIVE
The aim of this study was to compare the pressure pain threshold and the thickness of the cervical muscles in patients with tension-type headache versus healthy participants.
METHODS
An observational, retrospective, cross-sectional study was conducted at the Universidad Europea de Madrid between May and June 2022. Adults aged 18-65 years with tension-type headache diagnosed for more than 6 months were compared to healthy controls. B-mode ultrasound imaging was employed to measure the thickness of the neck stabilizing muscles, longus colli, and multifidus at the C5 and C6 levels, respectively. pressure pain threshold measurements were assessed bilaterally in the following regions: upper trapezius, masseter, temporalis, anterior tibialis, and median nerve.
RESULTS
A total of 40 participants (90% females; 36.3±12.9 years, BMI 24.2±3.7 kg/m2) participated in the study. Compared with the control group (n=20), participants in the tension-type headache group (n=20) presented statistically significant lower values in all pressure pain threshold measures. Additionally, the tension-type headache group presented statistically significant lower values in the thickness of the following muscles: right multifidus at rest (1.0±0.2 cm versus 1.3±0.2 cm; p<0.001), left multifidus at rest (1.1±0.1 cm versus 1.3±0.1 cm; p<0.001) and during contraction (1.2±0.1 cm versus 1.5±0.2 cm; p<0.001), left longus colli at rest (1.0±0.2 cm versus 1.2±0.1 cm; p=0.01) and during contraction (1.2±0.2 cm versus 1.4±0.1 cm; p<0.001), and right longus colli during contraction (1.2±0.2 cm versus 1.4±0.2 cm; p=0.02).
CONCLUSION
This study concluded that patients with tension-type headache showed lower thickness and lower pressure pain threshold of cervical muscles compared to healthy controls.
Topics: Adult; Female; Humans; Male; Tension-Type Headache; Cross-Sectional Studies; Retrospective Studies; Pain; Neck Muscles; Atrophy
PubMed: 37729231
DOI: 10.1590/1806-9282.20230841 -
Brain Sciences Nov 2023Dropping objects from hands (DOH) is a common symptom of carpal tunnel syndrome (CTS). We evaluated the clinical, neurophysiological, and psychophysiological features of...
BACKGROUND
Dropping objects from hands (DOH) is a common symptom of carpal tunnel syndrome (CTS). We evaluated the clinical, neurophysiological, and psychophysiological features of 120 CTS patients to elucidate the DOH pathophysiology. Forty-nine healthy controls were included.
METHODS
In the patients, the Boston Carpal Tunnel Questionnaire (BCTQ), the Douleur Neuropathique 4 questions (DN4), and a numeric rating scale for pain (NRS) were evaluated. In patients and controls, we evaluated bilateral median and ulnar motor and sensory nerve conduction studies, cutaneous silent period and cutaneomuscular reflexes (CMR) of the abductor pollicis brevis, cold-detection threshold (CDT) and heat-pain detection threshold (HPT) at the index, little finger, and dorsum of the hand, and vibratory detection threshold at the index and little finger by quantitative sensory testing.
RESULTS
CTS with DOH had higher BCTQ, DN4 and NRS, lower median sensory action potential, longer CMR duration, lower CDT and higher HPT at all tested sites than controls and CTS without DOH. Predictive features for DOH were abnormal CDT and HPT at the right index and dorsum (OR: 3.88, : 0.03) or at the little finger (OR: 3.27, : 0.04) and a DN4 higher than 4 (OR: 2.16, < 0.0001).
CONCLUSIONS
Thermal hypoesthesia in median and extra-median innervated territories and neuropathic pain are predictive of DOH in CTS.
PubMed: 38002536
DOI: 10.3390/brainsci13111576 -
Langenbeck's Archives of Surgery Oct 2023Optimal pain management is one of the core elements of Enhanced Recovery After Surgery (ERAS®) protocols and remains a challenge. Acupuncture (AC) is an effective...
BACKGROUND
Optimal pain management is one of the core elements of Enhanced Recovery After Surgery (ERAS®) protocols and remains a challenge. Acupuncture (AC) is an effective treatment for various pain conditions. Systematic and personalized allocation of acupoints may be decisive for efficacy.
METHODS
Based on the predominant pressure sensitivity of six gastrointestinal (GI) checkpoints (G1-G6), we devised a method to detect personalized patterns of pain and a corresponding set of acupoints. We performed a single AC treatment with semi-permanent needles and assessed the visual analogue scale (VAS) score, pain threshold based on pressure algometry (PA), and temperature changes on abdominal skin areas before and 5 min after AC.
RESULTS
Between April and June 2021, thirty-eight patients were prospectively included in this pilot study. The mean reduction in subjective pain sensation as assessed by VAS was 86%, paralleled by an augmentation of the pain threshold as measured by PA by 64%. A small but significant increase in the skin temperature was observed above the abdominal surface. These effects were independent of the type of surgery.
CONCLUSION
Checkpoint acupuncture may be a complementary tool for postoperative pain management. Further investigations are needed to explore this analgesic effect.
Topics: Humans; Pilot Projects; Acupuncture Therapy; Pain, Postoperative; Pain Management; Pain Measurement
PubMed: 37814175
DOI: 10.1007/s00423-023-03051-8