A Randomized Trial of Musculoskeletal Pain Treatment in a Military Population

2004 ◽  
Author(s):  
Robert J. Gatchel
Keyword(s):  
Randomized Trial ◽  
Musculoskeletal Pain ◽  
Pain Treatment ◽  
Military Population

Oxycodone induced euphoria in ED patients with acute musculoskeletal pain. A secondary analysis of data from a randomized trial

2022 ◽  
Author(s):  
Abishake Sapkota ◽  
Mai Takematsu ◽  
Victoria Adewunmi ◽  
Chiraag Gupta ◽  
Andrew R. Williams ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Musculoskeletal Pain ◽  
Secondary Analysis

A nurse-initiated pain protocol in the ED improves pain treatment in patients with acute musculoskeletal pain

2016 ◽  
Vol 27 ◽  
pp. 3-10 ◽  
Author(s):  
Jorien G.J. Pierik ◽  
Sivera A. Berben ◽  
Maarten J. IJzerman ◽  
Menno I. Gaakeer ◽  
Fred L. van Eenennaam ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Pain Treatment

Acceptability of a telecare intervention for persistent musculoskeletal pain

2016 ◽  
Vol 24 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Rebecca E Guilkey ◽  
Claire B Draucker ◽  
Jingwei Wu ◽  
Zhangsheng Yu ◽  
Kurt Kroenke
Keyword(s):  
Musculoskeletal Pain ◽  
Text Messaging ◽  
Pain Treatment ◽  
Median Number ◽  
Stepped Care ◽  
Free Text ◽  
Web Based ◽  
Patient Feedback ◽  
User Friendly ◽  
Patient Use

Introduction Persistent musculoskeletal pain is a prevalent, disabling, and often undertreated condition. This paper examines the acceptability of a telecare intervention for this condition. Methods The Stepped Care to Optimize Pain Care Effectiveness (SCOPE) intervention couples automatic symptom monitoring (ASM) with optimized analgesic care management by a nurse-physician team. Data from participants in the telecare intervention arm (n = 124) of a randomized control trial of SCOPE were analysed to determine the acceptability of the telecare intervention as indicated by patient use and satisfaction. Results Most (93.5%) patients completed at least one ASM report, selecting equally web-based (49%) or interactive voice-recorded (51%) reporting. The median number of ASM reports and nurse contacts per patient was 15 and 12, respectively. Of 12 demographic and clinical factors examined, none predicted the number of ASM reports, whereas nurse contacts were more frequent in patients with higher pain severity or receiving opioids. Only a minority of ASM reports required an expedited nurse call, with the most frequent alerts being for a medication change, a nurse call or side effects. Most (92%) patients rated ASM as easy to use and found the ASM reporting (76%) and nurse contacts (81%) very or moderately helpful. Nearly three-fourths of patients rated their overall pain treatment as good to excellent. The most common suggestions from patient feedback were for a free-text messaging function, more frequent nurse contact and less redundancy in ASM reporting items. Discussion Participants generally found the telecare intervention a user-friendly and helpful approach for treating persistent musculoskeletal pain.

scholarly journals Chronic musculoskeletal pain in neurological practice

2021 ◽  
pp. 22-28
Author(s):  
D. Kh. Khaibullina ◽  
Yu. N. Maksimov ◽  
F. I. Devlikamova
Keyword(s):  
Back Pain ◽  
Musculoskeletal Pain ◽  
Muscle Relaxant ◽  
Clinical Case ◽  
Pain Treatment ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Pain Syndrome ◽  
Chronic Musculoskeletal Pain ◽  
Herniated Disc

Treatment of musculoskeletal back pain is an essential problem for doctors of many specialties, including neurologists. In some cases, the chronic course of the pain syndrome is accompanied with complaints and clinical manifestations characteristic of neuropathic pain in the absence of significant damage to the neural structures, which is explained by the mechanism of central sensitization. In this case, there may be diagnostic errors in determining the nature of the pain, which entails inadequate therapy that does not lead to the desired result.The presented clinical case is devoted to the treatment of exacerbation of chronic musculoskeletal pain. Treatment of the patient for a herniated disc complicated by radiculopathy, carried out earlier, did not lead to the desired result due to the inconsistency of the diagnosis, inadequacy and lack of systematic therapy. Based on the analysis of the physical and paraclinical studies, the diagnosis was changed to « Lower back pain. Myofascial pain syndrome. Toxic polyneuropathy. Herniated disc LV-SI. Residual radiculopathy S1». Therapeutic measures were adjusted in accordance with the diagnosis. In order to relieve the pain syndrome at the first stage, a combined drug Neurodiclovit, a muscle relaxant, a drug of the SYSADOA group, soft tissue techniques of manual therapy, phonophoresis with glucocorticosteroids, and cognitive behavioral therapy were used. The assessment of the patient’s condition carried out after 7 days showed the effectiveness of the treatment, which allowed to cancel the use of a nonsteroidal anti-inflammatory drug, a muscle relaxant and a glucocorticosteroid. At the post-treatment stage, the patient was prescribed a combination of B vitamins (Neuromultivitis) and therapeutic gymnastics, as well as continued therapy with a slowacting symptomatic agent and non-drug treatment methods. Relief of the pain syndrome in the absence of adverse events confirmed the adequacy and effectiveness of the therapy.The presented clinical case demonstrates the importance of placing emphasis at the stage of diagnosis, taking into account the data of clinical and paraclinical research methods, and also illustrates the possibility of successful conservative therapy for exacerbation of chronic musculoskeletal pain in the practice of a neurologist.

Acupuncture for Posttraumatic Stress Disorder: A Randomized Trial in a Military Population

2008 ◽  
Author(s):  
Charles C. Engel ◽  
Elizabeth Harper Cordova ◽  
David Benedek ◽  
Wayne Jonas ◽  
Robert Ursano
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Randomized Trial ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Military Population

scholarly journals Genome-wide association study of nociceptive musculoskeletal pain treatment response in UK Biobank

2022 ◽  
Author(s):  
Song Li ◽  
Geert Poelmans ◽  
Rianne van Boekel ◽  
Marieke Coenen
Keyword(s):  
Association Study ◽  
Treatment Response ◽  
Musculoskeletal Pain ◽  
Genome Wide Association Study ◽  
Pain Treatment ◽  
Genome Wide Association ◽  
Uk Biobank ◽  
Primary Analysis ◽  
Analgesic Ladder ◽  
Genome Wide

Drug treatment for nociceptive musculoskeletal pain (NMP) follows a three-step analgesic ladder proposed by the World Health Organization (WHO), starting from non-steroidal anti-inflammatory drugs (NSAIDs), followed by weak or strong opioids until the pain is under control. However, effective pain treatment is challenged by inter-individual differences, and unsatisfied pain treatment response (PTR) rates ranging from 34 to 79% in those suffering from NMP. To investigate the underlying genetic component of PTR, we performed a genome-wide association study (GWAS) in ~ 23,000 participants with NMP from the UK Biobank. In our primary analysis, we compared NSAID vs. opioid users as a reflection of (non)response to NSAIDs, adjusting for age, sex, BMI, population substructure, and study-specific covariates. One genome-wide significant hit was identified in an intergenic region on chromosome 4, rs549224715 (P = 3.88x10-8), and seven signals pass the suggestively significant threshold (P < 1x10-6). All identified loci were in non-coding regions, but most variants showed potential regulatory functions. SNPs in LD (r2 > 0.6) with the lead SNPs passing the nominal significant threshold (P < 0.05) were mapped to 28 target genes in FUMA. Eight of these 28 genes are involved in processes linked to neuropathic pain and musculoskeletal development. Pathway and network analyses with Ingenuity resulted in the identification of immunity-related processes and a (putative) central role of EGFR. Genetic correlation analysis including 596 traits resulted in the identification of 67 nominally significant (P < 0.05) genetic correlations, and these traits were significantly enriched for chronic pain and socioeconomic status traits (P = 3.35 x 10-12). Additionally, we conducted a subtype GWAS for inflammatory NMP and a secondary GWAS for participants with NMP disease history, but no significant hits or overlap with the primary analysis were observed. Overall, we identified one genome-wide significant association in this first GWAS focusing on pain treatment using the analgesic ladder as phenotype. However, we realize that this study lacked power and should be viewed as a first step to elucidate the genetic background of NMP treatment.

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