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Chronic Musculoskeletal Pain (chronic + musculoskeletal_pain)
Selected AbstractsEvidence-Based Manual Therapy for Chronic Musculoskeletal Pain: The ChallengesPAIN PRACTICE, Issue 5 2010Phillip S. Sizer Jr PT No abstract is available for this article. [source] Massage for chronic musculoskeletal pain: effects are positive but short-livedFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 2 2004Article first published online: 14 JUN 2010 [source] The Effects Of Tizanidine HCL (Zanaflex®) In Patients With FibromyalgiaPAIN MEDICINE, Issue 2 2000Article first published online: 25 DEC 200 David McLain, MD, Brookwood Medical Center, Birmingham, AL This open-label, single-center, dose-finding study of Zanaflex (tizanidine hydrochloride) in 43 patients diagnosed with fibromyalgia showed some effectiveness in reducing pain and other symptoms of this syndrome. Fibromyalgia is a common syndrome characterized by chronic musculoskeletal pain in all 4 quadrants and pain in 18 identified tender points. Effects on fatigue, pain, sleep, and tender points were assessed before and during treatment. Starting doses of 2 mg/day were increased to 4 mg/day after 5 days and increased further as tolerated. Most patients stayed at 4 mg/day or 8 mg/day, and the highest dosage achieved was 12 mg/day. After the initial visit, 6 patients discontinued Zanaflex because of side effects (headaches in 3, hallucinations in 1, hypotension in 1, asthenia in 1), and 11 did not return for a follow-up visit. Results are presented for the remaining 26 patients (25 females; average age 50 years (range, 36,64 years); 25 Caucasian, 1 African-American; 9 on disability or applying for it; all stable on one or more of the following concomitant medications: narcotic analgesics 15%, antidepressants 65%, NSAIDs 46%). On average, at the first follow-up visit (average time 7.8 weeks), patients showed reduction in tender points and improvement on global assessment (GA) scores, Fibromyalgia Impact Questionnaire (FIQ) results, and visual assessment (VAS) scores for fatigue, pain, and sleep. The results for patients still working or retired were better than those for patients on disability or applying for it. Of the 26 patients in this ongoing study, 14 have had second follow-up visits (average time 13.3 weeks). Of these, 2 discontinued the drug at the second follow-up visit. Six of these patients responded especially well to long-term treatment (average age 51 years; range 46,60 years; 5 females; 1 on disability or applying for it) and showed the following averaged results: global assessment improved by 47%, FIQ by 35%, VAS-fatigue by 48%, VAS-pain by 40%, VAS-sleep by 37%, and tender points by 18%. Zanaflex appears to be effective in improving overall functioning, reducing pain and fatigue, improving sleep, and reducing the number of painful tender points in some patients with fibromyalgia, especially in those who are not on disability or applying for it. [source] Psychological interventions for long-term conditions: a review of approaches, content and outcomesPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2008Carol Doyle Background.,People living with long-term conditions are more likely to see their GP and experience limitations in their daily activities (Department of Health, 2005). Psychological interventions, specifically cognitive behavioural therapy (CBT), aimed at helping people to cope and self-manage these conditions, are popular. This review aims to summarize the evidence from good-quality systematic reviews of psychological interventions to inform the management of, and future research in, patients with chronic musculoskeletal pain. Cochrane reviews were used as these are considered to be of good quality (Handoll et al., 2002).,Method.,We identified Cochrane reviews of psychological interventions for common chronic health conditions in adults across all healthcare settings. Data on intervention approach, content, delivery and outcomes were extracted and summarized.,Results.,Nine Cochrane reviews, in asthma (n = 1), diabetes (n = 2), coronary heart disease (n = 1) and chronic musculoskeletal pain (n = 5) were identified. These reviews included 131 clinical trials and over 20,200 patients. Psychological interventions were wide ranging, many using a variety of CBT, mostly delivered in secondary care settings by nurses or psychologists. Physiotherapists were involved in some studies as part of multidisciplinary teams. Due to the complexity and diversity of the interventions, individually effective components could not be identified. Interpretation of studies was difficult because of heterogeneity in intervention content, delivery and outcomes measured. Conclusion.,Physiotherapists involved in the management of long-term conditions, particularly chronic musculoskeletal pain, can perhaps learn from this evidence base. Future research should investigate the effectiveness of individual components of CBT and the role of physiotherapists in delivering this type of intervention. Copyright © 2008 John Wiley & Sons, Ltd. [source] Musculoskeletal pain in women working in small-scale agriculture in South AfricaAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009S. Naidoo MBChB Abstract Background Musculoskeletal pain is associated with demographic, occupational and physical factors. Methods Our study investigated the prevalence and factors associated with musculoskeletal pain in 911 women working in small-scale agriculture in rural northern KwaZulu-Natal, South Africa in 2006 using a questionnaire survey. Results In total, 67% (n,=,574) of women reported any chronic musculoskeletal pain. The 12-month prevalence of pain ranged from 63.9% to 73.3% and the prevalence of specific chronic pain lasting more than 3 months ranged from 42.8% to 48.3%. Older age, carrying heavy loads, working with hands above shoulder height, and frequently squatting and kneeling were associated with chronic musculoskeletal pain. Conclusion The prevalence of pain reported in our study, was similar to other developing countries, but considerably higher than in developed countries. Ergonomic interventions including improved and adapted work techniques and tools should be considered to reduce the prevalence of pain in our study population. Am. J. Ind. Med. 52:202,209, 2009. © 2008 Wiley-Liss, Inc. [source] Thalamic atrophy associated with painful osteoarthritis of the hip is reversible after arthroplasty: A longitudinal voxel-based morphometric studyARTHRITIS & RHEUMATISM, Issue 10 2010Stephen E. Gwilym Objective Voxel-based morphometry (VBM) is a method of assessing brain gray matter volume that has previously been applied to various chronic pain conditions. From this previous work, it appears that chronic pain is associated with altered brain morphology. The present study was undertaken to assess these potential alterations in patients with painful hip osteoarthritis (OA). Methods We studied 16 patients with unilateral right-sided hip pain, before and 9 months after hip arthroplasty. This enabled comparison of gray matter volume in patients with chronic musculoskeletal pain versus healthy controls, as well as identification of any changes in volume following alleviation of pain (after surgery). Assessment involved self-completion questionnaires to assess pain, function, and psychosocial variables, and magnetic resonance imaging scanning of the brain for VBM analysis. Results Significant differences in brain gray matter volume between healthy controls and patients with painful hip arthritis were seen. Specifically, areas of the thalamus in patients with chronic OA pain exhibited decreased gray matter volume. Furthermore, when these preoperative changes were compared with the brain morphology of the patients 9 months after surgery, the areas of reduced thalamic gray matter volume were found to have "reversed" to levels seen in healthy controls. Conclusion Our findings confirm that gray matter volume decreases within the left thalamus in the presence of chronic pain and disability in patients with hip OA. The results also show that these thalamic volume changes reverse after hip arthroplasty and are associated with decreased pain and increased function. These findings have potential implications with regard to optimizing the timing of orthopedic interventions such as arthroplasty. [source] Hypertension-associated hypalgesia: a clue to the comorbidity of headache and other pain disordersACTA NEUROLOGICA SCANDINAVICA, Issue 2009L. J. Stovner Background ,, Primary headaches and chronic musculoskeletal pain are prevalent disorders with incompletely known causes. Aims ,, To review the data from the HUNT studies on the comorbidity of these pain disorders, and their relation to blood pressure levels Materials & Methods ,, Cross-sectional and prospective data from more than 50 000 persons participating in the HUNT studies, a large Norwegian population-based health survey Results ,, Headache and chronic musculoskeletal complaints in all parts of the body were comorbid, and the prevalence of pain in all locations was inversely related to blood pressure levels. Discussion ,, A likely cause for this is hypertension-associated hypalgesia, described in both animal and human experimental models, involving interactions between cardiovascular and pain modulating centres at the brainstem level, and probably also peripheral baroreceptor mechanisms. Conclusion ,, Better understanding of these mechanisms may be crucial for enabling better prevention and treatment of these very prevalent, costly and disabling disorders. [source] | ||||||||||