Comparing the association of widespread pain, multi-joint pain and low back pain with measures of pain sensitization and function in people with knee osteoarthritis

2019 ◽  
Vol 39 (3) ◽  
pp. 873-879 ◽  
Author(s):  
Olivier Guérard ◽  
Samuel Dufort ◽  
Laurence Forget Besnard ◽  
Alexis Gougeon ◽  
Lisa Carlesso
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Knee Osteoarthritis ◽  
Joint Pain ◽  
Low Back ◽  
Widespread Pain ◽  
Pain Sensitization ◽  
And Function

Lumbar Facet–Mediated Pain

2016 ◽  
Author(s):  
Vikram B Patel
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Back Pain ◽  
Joint Pain ◽  
Facet Joint ◽  
Low Back ◽  
Lower Back ◽  
Facet Joint Pain ◽  
And Function ◽  
Lumbar Facet

Lumbar or lower back pain is a very debilitating condition that affects  almost one fifth of the adult population during a given year. Almost everyone walking on two feet is bound to suffer from some back pain during their lifetime. The health care burden for treating low back pain is enormous, especially if the lost work hours are combined with the amount used in diagnosing and treating low back pain. Lumbar facet (zygapophysial) joints are one of the major components involved in causing lower back pain. Diagnosing the pain generator is more of an art than a science. Combining various parameters in the patient’s history, physical examination, and diagnostic studies is not much different from solving a murder mystery. Although facet joint pain may be accompanied by other pain generators, that is, lumbar intervertebral disks, nerve roots, and vertebral bodies, once treated, the relief in pain is more helpful in performing proper rehabilitation and improving further deterioration in low back pain. Muscles are almost always painful due to myofascial pain syndrome that accompanies the facet joint–related pain. Treating one without addressing the other leads to failure in management and optimization of patient’s pain and function. Several treatments are available for treatment of facet joint–mediated pain, including steroid injections using a miniscule amount and radiofrequency ablation of the nerves supplying the facet joints (medial branches of the dorsal primary ramus of the lumbar nerve root). With proper diagnosis and treatment, a patient’s pain and function can be optimized to a level where it may not impact the day-to-day activities or even resumption of the patient’s routine job function. The following review describes the anatomy, pathophysiology, diagnosis, and treatment of lumbar facet joint–mediated pain.   Key words: facet joint pain, facet joint syndrome, low back pain, medial branch radiofrequency, spondylolisthesis

scholarly journals Brain-Derived Neurotrophic Factor and Immune Cells in Osteoarthritis, Chronic Low Back Pain, and Chronic Widespread Pain Patients: Association with Anxiety and Depression

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 327
Author(s):  
Dominique Josephine Dimmek ◽  
Christoph Korallus ◽  
Sabine Buyny ◽  
Gutenbrunner Christoph ◽  
Ralf Lichtinghagen ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Immune Cells ◽  
Chronic Widespread Pain ◽  
Anxiety And Depression ◽  
Low Back ◽  
Widespread Pain ◽  
Chronic Pain Patients ◽  
Pain Patients

Background and Objectives: Musculoskeletal dysfunction can induce several types of chronic pain syndromes. It is of particular interest to elucidate the pathomechanism of different forms of chronic pain. It is possible that patients who have developed chronic widespread pain (CWP) may endure different pathomechanisms as compared to those who suffer from local pain (osteoarthritis, OA) and regional pain (chronic low back pain, cLBP), especially with regard to pain regulation and its related biomediators. The aim of this study was to determine the differences in pathomechanisms among these patients by measuring pain-related biomediators, particularly brain-derived neurotrophic factor (BDNF). Additionally, subpopulations of immune cells were determined in parallel. Materials and Methods: Patients and healthy subjects (HSs) were recruited (age and gender-matched). BDNF was measured from serum samples of patients and HSs and the data of body composition parameters were recorded. Additionally, both patients and HSs were asked to fill in questionnaires related to pain intensity, anxiety, and depression. Results: Our results highlight that the levels of both free and total BDNF are significantly lower in pain patients compared to HSs, with p values of 0.041 and 0.024, respectively. The number of CD3− CD56bright natural killer (NK) cells shows significant differences between the groups. Comparing all chronic pain patients with HSs reveals a significantly lower number of CD4+ CD8+ T cells (p = 0.031), CD3− CD56bright NK cells (p = 0.049) and CD20+ CD3− cells (p = 0.007). Conclusions: To conclude, it seems that a general conformity between the pathomechanisms of different chronic pain diseases exists, although there are unique findings only in specific chronic pain patients.

scholarly journals Even Worse — Risk Factors and Protective Factors for Transition from Chronic Localized Low Back Pain to Chronic Widespread Pain in General Practice

Spine ◽  
2015 ◽  
Vol 40 (15) ◽  
pp. E890-E899 ◽  
Author(s):  
Annika Viniol ◽  
Nikita Jegan ◽  
Markus Brugger ◽  
Corinna Leonhardt ◽  
Jürgen Barth ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Low Back Pain ◽  
Back Pain ◽  
Protective Factors ◽  
Chronic Widespread Pain ◽  
Low Back ◽  
Widespread Pain

scholarly journals Influence of pilates method on the treatment of nonspecific chronic low back pain: a protocol study for a randomized, controlled, blind trial

2020 ◽  
Vol 18 ◽  
pp. 1-5
Author(s):  
Bianca Martins de Souza ◽  
Daiane Oliveira da Silva ◽  
Lais Paraguai Justo ◽  
Leandro Lazzareschi ◽  
Daniela Aparecida Biasotto-Gonzalez ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Central Sensitization ◽  
Personal Information ◽  
Treatment Session ◽  
Control Group ◽  
Low Back ◽  
Pilates Method ◽  
Type Of Exercise ◽  
And Function

Background: Low back pain is one of the most common musculoskeletal problems among workers. Studies estimate that 90% of the adults will suffer at least one episode of low back pain in life that will lead to the temporary interruption of work. A type of exercise that has gained increasing popularity among individuals with low back pain in the last decade is the Pilates method. Objective: Determine the influence of the Pilates method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain. Methods: Thirty-four male and female volunteers between 18 and 35 years of age with a complaint of nonspecific low back pain for at least three months will be divided into two groups: Pilates method and control group. An evaluation chart created by the authors will be used to collect data on personal information, history of diseases, alcohol use, smoking, pain intensity (visual analog scale) and medications used. The Tampa Scale for Kinesiophobia, Central Sensitization Questionnaire and Oswestry Disability Index will also be administered. Pilates exercises will be performed three time per week for four weeks and administered by a researcher with adequate training in the method. Reevaluations will be performed after the sixth treatment session in the Pilates group, two weeks after the initial evaluation in the control group, after the 12th session in the Pilates group and after four weeks in the control group. Another reevaluation will be performed three months after treatment. Results: The data will be submitted to statistical analysis and the level of significance will be set to 5%. Conclusion: Based on the results analyzed it will be possible to determine the influence of Pilates Method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain.

scholarly journals Effects of Manual Therapy on Pain and Function of Patients with Chronic Low Back Pain

2017 ◽  
Vol 29 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Kyoung Kim ◽  
Kwan-sub Lee ◽  
Seok-Joo Choi ◽  
Chun-Bae Jeon ◽  
Gook-Joo Kim
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Manual Therapy ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
And Function

scholarly journals Efficacy and safety of fasinumab in patients with chronic low back pain: a phase II/III randomised clinical trial

2020 ◽  
pp. annrheumdis-2020-217259
Author(s):  
Paula Dakin ◽  
Alan J Kivitz ◽  
Joseph S Gimbel ◽  
Nebojsa Skrepnik ◽  
Stephen J DiMartino ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Phase Ii ◽  
Chronic Low Back Pain ◽  
Randomised Clinical Trial ◽  
Controlled Study ◽  
Low Back ◽  
Efficacy And Safety ◽  
Double Blind ◽  
And Function

ObjectivesTo study the efficacy and safety of fasinumab in moderate-to-severe, chronic low back pain (CLBP).MethodsIn this phase II/III, double-blind, placebo-controlled study, patients with CLBP aged ≥35 years with inadequate pain relief/intolerance to acetaminophen, non-steroidal anti-inflammatory drugs and opioids were randomised to fasinumab 6 or 9 mg subcutaneous every 4 weeks (Q4W), 9 mg intravenous every 8 weeks (Q8W) or placebo. Primary endpoint was change from baseline to week 16 in average daily low back pain intensity (LBPI) numeric rating score. Key secondary efficacy variables included Roland-Morris Disability Questionnaire (RMDQ) and Patient Global Assessment (PGA). The results are based on a modified intent-to-treat analysis of 563/800 planned patients when enrolment was stopped early given emerging signals of joint risk in other osteoarthritis (OA) studies at doses being tested here.ResultsSignificant placebo-adjusted LBPI reductions at week 16 were observed for fasinumab 9 mg Q4W and Q8W (least squares mean (standard error) −0.7 (0.3); both nominal p<0.05), but not 6 mg (–0.3 (0.3); p=0.39). RMDQ and PGA improvements to week 16 were greatest for fasinumab 9 mg intravenous. Numerically greater efficacy occurred in patients with, versus those without, peripheral OA (pOA) over 16 weeks. Treatment-emergent adverse events (AEs) occurred in 274/418 (65.6%) patients in the combined fasinumab groups and 94/140 (67.1%) placebo patients. Joint AEs, mostly rapid progressive OA type 1, were more frequent in the combined fasinumab groups (19 events in 16 patients (3.8%) vs 1 event in 1 patient (0.7%) for placebo); all except one occurred in pOA patients.ConclusionsFasinumab highest doses, but not lower dose, improved both CLBP pain and function. Most joint AEs occurred in pOA patients, consistent with earlier findings in symptomatic OA. Further study is needed of patients with CLBP with and without pOA to determine optimal benefit–risk.

scholarly journals Efficacy and safety of two generic copies of nimesulide in patients with low back pain or knee osteoarthritis

Reumatismo ◽  
2011 ◽  
Vol 61 (1) ◽  
Author(s):  
K.V. Ilic ◽  
M. Sefik-Bukilica ◽  
S. Jankovic ◽  
N. Vujasinovic-Stupar
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Knee Osteoarthritis ◽  
Low Back ◽  
Efficacy And Safety

scholarly journals Causal mechanisms of a healthy lifestyle intervention for patients with musculoskeletal pain who are overweight or obese

2019 ◽  
Vol 33 (6) ◽  
pp. 1088-1097 ◽  
Author(s):  
Amanda Williams ◽  
Hopin Lee ◽  
Steven J Kamper ◽  
Kate M O’Brien ◽  
John Wiggers ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Knee Osteoarthritis ◽  
Lifestyle Intervention ◽  
Chronic Low Back Pain ◽  
Healthy Lifestyle ◽  
Low Back ◽  
Pain Beliefs ◽  
Causal Mechanisms

Purpose: To assess the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis, who are overweight or obese. Methods: We conducted causal mediation analyses of aggregated data from two randomized controlled trials (RCTs); which included 160 patients with chronic low back pain, and 120 patients with knee osteoarthritis. The intervention consisted of brief advice and referral to a six-month telephone-based healthy lifestyle coaching service. We used causal mediation to estimate the indirect, direct and path-specific effects of hypothesized mediators including: self-reported weight, diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Results: The intervention did not reduce weight, improve diet or physical activity or change pain beliefs, and these mediators were not associated with the outcomes. Sensitivity analyses showed that our estimates were robust to the possible effects of unknown and unmeasured confounding. Conclusions: Our findings show that the intervention did not cause a meaningful change in the hypothesized mediators, and these mediators were not associated with patient-reported outcomes.

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