Pain medicine : the official journal of the American Academy of Pain Medicine
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Neuropathic pain is common and debilitating with limited effective treatments. Macrophage/microglial activation along ascending somatosensory pathways following peripheral nerve injury facilitates neuropathic pain. However, polarization of macrophages/microglia in neuropathic pain is not well understood. Photobiomodulation treatment has been used to decrease neuropathic pain, has anti-inflammatory effects in spinal injury and wound healing models, and modulates microglial polarization in vitro. Our aim was to characterize macrophage/microglia response after peripheral nerve injury and modulate the response with photobiomodulation. ⋯ Photobiomodulation effectively reduced mechanical hypersensitivity, potentially through modulating macrophage/microglial activation to an anti-inflammatory phenotype.
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Isometric exercises produce an acute decrease in the pain sensitivity, known as exercise-induced hypoalgesia (EIH). Existing EIH paradigms use exercises at the extremities with more pronounced EIH at local compared to remote body sites, indicating local inhibition in addition to central inhibitory mechanisms. So far the results on EIH in patients with low back pain (LBP) are equivocal and no studies have investigated an EIH paradigm targeting the lower back in order to assess EIH in patients with LBP. Thus, the aim of this pilot study was to assess pressure pain sensitivity at local and remote assessment sites, before and after an isometric back exercise in healthy women and men. ⋯ The results of this pilot study indicate that isometric back exercise produces local and remote hypoalgesia. Remote EIH was only demonstrated in women, supporting the influence of sex in the hypoalgesic response after exercise. The effect of isometric back exercise on pain sensitivity in patients with low back pain should be investigated in future studies.
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Multicenter Study
Back Stiffness Is Associated with Physical Health and Low Back Pain-Related Disability in Community-Dwelling Older Adults.
Back stiffness is a common complaint among older adults with low back pain. Nonetheless, self-reported back stiffness has received little exploration in this patient population. The purpose of this study was to examine the associations of self-reported low back stiffness with physical health and low back pain-related disability among older adults with low back pain. ⋯ Back stiffness in older, community-dwelling adults with low back pain may help explain physical health and low back pain-related disability, above and beyond demographics and pain. Future longitudinal research is needed to evaluate low back stiffness as a predictor of physical health and disability. Ultimately, assessment and treatment of back stiffness in older adults with low back pain may improve patient outcomes.
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Randomized Controlled Trial
Comparison of the Effects of Intermittent Boluses to Simple Continuous Infusion on Patients' Global Perceived Effect in Intrathecal Therapy for Pain: A Randomized Double-Blind Crossover Study.
Intrathecal drug delivery (ITDD) is commonly used for intractable pain management. A paucity of good-quality studies in chronic noncancer patients and concerns over increased dosages have focused interest on different modes of administration. The aim of this international multicenter randomized double-blind crossover trial was to compare the efficacy of the same daily dose of drugs administered by intermittent boluses vs simple continuous infusion. ⋯ The mean PGIC and proportion of positive responders was not substantially different after intermittent bolus vs continuous administration.
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Randomized Controlled Trial
Relationship of the Lateral Rectus Muscle, the Supraorbital Nerve, and Binocular Coordination with Episodic Tension-Type Headaches Frequently Associated with Visual Effort.
To study the relationship between tension-type headaches and the oculomotor system in terms of binocular coordination, mechanosensitivity of the supraorbital nerve, and myofascial trigger points in the lateral rectus muscle, assessing the influence of visual effort caused by using a computer at work. ⋯ The finding of a higher alteration of the sensitivity of the supraorbital nerve, the myofascial trigger points of the lateral rectus, binocular coordination, and the significant influence of visual effort in patients with tension-type headaches suggest a new clinical perspective for problems related to tension-type headaches.