scholarly journals Efficacy of neural prolotherapy versus local corticosteroid soft tissue injection for treatment of chronic anserine bursitis: a prospective randomized clinical trial

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Emmanuel Kamal Aziz Saba
Keyword(s):  
Soft Tissue ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Global Assessment ◽  
Corticosteroid Injection ◽  
Group Analysis ◽  
Pain Severity ◽  
Link Type ◽  
Perineural Injection ◽  
Local Corticosteroid Injection

Abstract Background Anserine bursitis is characterized by the presence of spontaneous pain with tenderness at the inferomedial aspect of the knee joint. Neural prolotherapy aims to relieve pain of a variety of chronic musculoskeletal disorders. The study aim was to explore the short-term efficacy of neural prolotherapy (subcutaneous perineural injection of dextrose 5% solution) versus local corticosteroid injection for pain relief and improvement of function in patients with chronic anserine bursitis. The enrolled patients were randomly assigned to receive neural prolotherapy (subcutaneous perineural injection of dextrose 5% solution) (neural prolotherapy group) or a single local soft tissue injection of corticosteroid (corticosteroid group). Outcome measures included Western Ontario McMasters Universities osteoarthritis index, assessment of overall anserine bursitis pain severity using the visual analogue scale, patient’s global assessment of anserine bursitis severity using the visual analogue scale, and clinical assessment for the presence of tenderness on the anserine bursa region. Patients were evaluated before injection and after intervention by 4 weeks. Results The study included 67 lower limbs from 43 patients with chronic anserine bursitis. No significant differences were found between both treatment groups regarding all assessed parameters at the start of the study. After 4 weeks, within-group analysis showed that there was a statistically significant improvement in Western Ontario McMasters Universities osteoarthritis index and its subscales (P ≤ 0.0001), overall anserine bursitis pain severity (P ≤ 0.0001), and patient’s global assessment of anserine bursitis severity (P ≤ 0.0001), as well as there was significant improvement regarding the presence of tenderness at the anserine bursa region in both groups in comparison to the preinjection assessment. At the postinjection assessment, between-group analysis showed that there were no significant differences regarding all assessed outcome parameters. All patients in both groups tolerated the injection procedure and were satisfied with the procedure. There was no significant difference between the two groups regarding patients’ satisfaction to the procedure results. Improvement was achieved in 86.4% of patients included in the neural prolotherapy group versus 95.2% of patients included in the corticosteroid group. Conclusions Neural prolotherapy was effective in relieving pain, improving local tenderness and function in patients with chronic anserine bursitis similar to local corticosteroid injection. Trial registration ClinicalTrials.gov, registration number: NCT04509440. Registered 12 August 2020—Retrospectively registered,

scholarly journals Full-length silicone insoles versus ultrasound-guided corticosteroid injection in the management of plantar fasciitis: A randomized clinical trial

2013 ◽  
Vol 37 (6) ◽  
pp. 471-476 ◽  
Author(s):  
Ufuk Yucel ◽  
Sami Kucuksen ◽  
Havva T Cingoz ◽  
Emel Anlıacik ◽  
Orhan Ozbek ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Plantar Fasciitis ◽  
Analogue Scale ◽  
Corticosteroid Injection ◽  
Plantar Fascia ◽  
Full Length ◽  
Foot And Ankle ◽  
Ultrasound Guided ◽  
First Line ◽  
Outcome Score

Background: Plantar fasciitis often leads to disability. Optimal treatment for this clinical condition is still unknown. Objective: To compare the effectiveness of wearing a full-length silicone insole with ultrasound-guided corticosteroid injection in the management of plantar fasciitis. Study design: Randomized clinical trial. Methods: Forty-two patients with chronic unilateral plantar fasciitis were allocated randomly to have an ultrasound-guided corticosteroid injection or wear a full-length silicone insole. Data were collected before the procedure and 1 month after. The primary outcome measures included first-step heel pain via Visual Analogue Scale and Heel Tenderness Index. Other outcome measures were the Foot and Ankle Outcome Score and ultrasonographic thickness of the plantar fascia. Results: After 1 month, a significant improvement was shown in Visual Analogue Scale, Heel Tenderness Index, Foot and Ankle Outcome Score, and ultrasonographic thickness of plantar fascia in both groups. Visual Analogue Scale scores, Foot and Ankle Outcome Score pain, Foot and Ankle Outcome Score for activities of daily living, Foot and Ankle Outcome Score for sport and recreation function, and plantar fascia thickness were better in injection group than in insole group (p < 0.05). Conclusions: Although both ultrasound-guided corticosteroid injection and wearing a full-length silicone insole were effective in the conservative treatment of plantar fasciitis, we recommend the use of silicone insoles as a first line of treatment for persons with plantar fasciitis. Clinical relevance Silicone insole may be considered as a first-line treatment option in patients with plantar fasciitis.

THU0407 THE VALUE OF SONOGRAPHY IN THE INTERCRITICAL PHASE OF GOUT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 441.1-441
Author(s):  
E. Cipolletta ◽  
A. DI Matteo ◽  
G. Brunori ◽  
A. Moretti ◽  
W. Grassi ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Global Assessment ◽  
Subsequent Development ◽  
Classification Criteria ◽  
Patient Global Assessment ◽  
The Us ◽  
Patient Pain ◽  
Remission Criteria ◽  
Us Findings

Background:Disease remission is the goal of therapy for many chronic rheumatic diseases. In 2016, provisional gout remission criteria were proposed (1). To the best of our knowledge, no studies have compared ultrasound (US) findings in gouty patients with and without remission.Objectives:To determine the prevalence of US pathologic findings in patients with gout fulfilling and not fulfilling the provisional remission criteria and to investigate the value of the US findings as predictors of a gouty flare within 6 months.Methods:Patients with a diagnosis of gout according to the 2015 classification criteria (2) were recruited in this prospective, monocentric study. The following clinical information was recorded at baseline and after 6 months: number of gouty flares in the preceding 6 months, number of subcutaneous tophi, current serum urate level, and patient reported outcomes (pain visual analogue scale and patient global assessment visual analogue scale). Bilateral US assessment of the following anatomical areas was performed (3): elbow, wrist, II metacarpophalangeal joint, knee, ankle and I metatarsophalangeal joint. US evidence of tophi, aggregates, double contour sign and synovitis were recorded according to the correspondent OMERACT definitions.Results:Forty-nine patients with gout were consecutively enrolled. The remission criteria were satisfied in 9 (18.4%) patients. Monosodium urate (MSU) deposits and findings of synovitis were observed by US less frequently in patients in remission (55.6% and 22.2%), compared with those not fulfilling the criteria (100.0% and 72.5%) (p values<0.01). The US MSU total score was 1.0; 0.0–2.0 (median and inter-quartile range) for patients in remission, compared with 6.0; 5.0–7.0 for those not fulfilling the criteria (p<0.01). US synovitis total score was significantly correlated with patient global assessment (R=0.55, p<0.01), patient pain (R=0.51, p<0.01) and number of gouty attacks in the previous 6 months (R=0.36, p=0.03), whereas MSU total score was associated with the number of gouty attacks in the previous 6 months (R=0.49, p<0.01), the number of subcutaneous tophi (R=0.45, p<0.01), patient pain (R=0.41, p=0.01), patient global assessment (R=0.41, p<0.01). At logistic regression analysis, the presence of subcutaneous tophi (OR=2.8, p=0.02), CRP level (OR=6.5, p=0.04) and US synovitis score (OR=2.0, p=0.04) and were predictors of subsequent development of gouty flare within 6 months.Conclusion:This study provides new insights into the inter-critical phase of gout, highlighting the clinical relevance of US synovitis as a predictor of subsequent development of gouty flare and joint pain. Despite MSU deposits are still detectable in patients satisfying the 2016 provisional remission criteria for gout, the remission is associated with less US detected MSU deposits.References:[1]de Lautour H, et al. Development of preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises. Arthritis Care Res 2016[2]Neogi T, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2015[3]Naredo E, et al. Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout? Ann Rheum Dis 2014Disclosure of Interests: :Edoardo Cipolletta: None declared, Andrea Di Matteo Grant/research support from: the publication was conducted while Dr. Di Matteo was an ARTICULUM fellow, Giada Brunori: None declared, Antonella Moretti: None declared, Walter Grassi Speakers bureau: Prof. Grassi reports personal fees from AbbVie, personal fees from Celgene, personal fees from Grünenthal, personal fees from Pfizer, personal fees from Union Chimique Belge Pharma, outside the submitted work., Emilio Filippucci Speakers bureau: Dr. Filippucci reports personal fees from AbbVie, personal fees from Bristol-Myers Squibb, personal fees from Celgene, personal fees from Roche, personal fees from Union Chimique Belge Pharma, personal fees from Pfizer, outside the submitted work.

Measurement of Pain in the Prehospital Setting Using a Visual Analogue Scale

2003 ◽  
Vol 18 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Bill A. Lord ◽  
Brian Parsell
Keyword(s):  
Pain Management ◽  
Visual Analogue Scale ◽  
Pain Score ◽  
Analogue Scale ◽  
Management Practice ◽  
Mean Value ◽  
Pain Severity ◽  
Assessment Process ◽  
Measurement Tool ◽  
The Mean

AbstractIntroduction:The aim of this study was to use a visual analogue scale (VAS) to measure the adequacy of prehospital pain management. Patients reported pain severity at two points in time during treatment and transport by ambulance paramedics. The change in pain score was compared with a benchmark reduction of 20 mm that has been shown to correspond with the minimum clinically significant change in pain perception reported by patients.Methods:This prospective, observational study used a VA S to record pain severity among patients reporting pain who were transported to a hospital by paramedics. Patients used a VAS to score pain severity during the initial patient assessment process (T0), and again at the hospital of destination (Tend). This study reports the mean changes in the scores, and the percentage of cases for whom the difference between T0and Tend in the study population achieved or exceeded the 20 mm benchmark. A survey also was administered to paramedics who participated in this study in order to identify attitudes, values, and beliefs relating to the measurement of pain.Results:A total of 262 patients were enrolled in this study. The mean value for thereduction in VAS (T0-Tend) was 18.2±23.9 mm [±SD] (Median = 14.0mm, 95% confidence interval (CI) = 15.3–21.1 mm). One hundred and thirty-four patients (51.1%) did not receive analgesia (either morphine sulfate or methoxyflurane). The mean initial (T0) pain score for the no-analgesia group was 54.5 ±24.7 mm [±SD], with the mean value for the change in VAS (T0-Tend) = 10.6 mm (median = 5 mm, 95% CI = 6.4–14.8 mm). Fo rty-six patients (17.6%) recorded some deterioration in their pain score at Tend (T0-Tend<0 mm). Survey results identified attitudes that may affect paramedics' pain management practice.Conclusion:The results suggest that inadequate analgesia is an issue in this study setting. Effective analgesia requires formal protocols or guidelines supported by effective analgesic therapies along with education that addresses attitudes that may inhibit pain assessment or management by paramedics. Regular audits form part of clinical quality assurance programs that assess analgesic practice. However, such auditsmust have access to data obtained from patient self-reporting of pain using a valid and reliable pain measurement tool.

The effect of 2 different techniques in second stage implant surgery

2019 ◽  
Vol 31 (1) ◽  
pp. 25-30
Author(s):  
Hassanien A Al-Jumaily
Keyword(s):  
Soft Tissue ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Gingival Tissue ◽  
Pain Level ◽  
Implant Surgery ◽  
Second Stage ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Insignificant Difference

Background: Dental implant is one of the most important options for teeth replacement. In two stage implant surgery, a few options could be used for uncovering implants, scalpel and laser are both considered as effective methods for this purpose. The Aim of the study: To compare soft tissue laser and scalpel for exposing implant in 2nd stage surgery in terms of the need for anesthesia, duration of procedure and pain level assessment at day 1 and day 7 post operatively using visual analogue scale . Materials and methods: Ten patients who received bilateral implants participated after healing period completed, gingival depth over each implant was recorded and then implant(s) were exposed by either scalpel or laser with determination for the need of anesthesia. Duration of the procedure was calculated in each case and post-operative pain was assessed by Visual analogue scale at day 1 and day 7. Results: Statistically significant difference in the need of anesthesia was found. A non-significant difference in the duration of the operation was found between the two methods. Non-significant difference was found between the two methods regarding post-operative pain at day 1, with the day 7 scores "no pain or zero pain score" in all the cases by the two methods. A directional significant correlation was found between depth of the gingival tissue over the implants and duration of the procedures regardless of the method used. Conclusion: diode laser can be used effectively for uncovering implants, providing both the dentist and the patient with additional advantages over the conventional methods. Although there was insignificant difference in pain scoring, however implant exposure by laser was more preferred by the patients.

scholarly journals A Comparative Study of Patients with Periarthritis Shoulder on Treatment with Analgesics Only and Analgesics Plus Exercises

2021 ◽  
pp. 795-799
Author(s):  
Nikita Rajgadia ◽  
R. Kalanithi ◽  
Damodharan Vasudevan
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Shoulder Joint ◽  
Analogue Scale ◽  
Frozen Shoulder ◽  
Significant Loss ◽  
Pain Severity ◽  
Painful Condition ◽  
Medical College

Background: Frozen Shoulder is known to be a painful condition affecting the shoulder joint that results in significant loss of range of motion. A number of published comprehensive studies have suggested the different modalities of treatment. In this study, we focussed on the effect of exercise on enhancing the restricted motion and reducing the severity of pain. Objective: The objective is to study the influence of exercise on range of motion and pain severity in Frozen shoulder patients. Materials and Methods: Thirty patients diagnosed with Periarthritis Shoulder were selected from orthopaedic outpatient in Saveetha Medical College, Chennai. These patients were randomly divided in two groups, receiving analgesics as well as exercises and another receiving only analgesic. They were assessed using the Visual Analogue Scale for the severity of their pain and range of motion with a Goniometer and results noted. Results: The group receiving exercise in addition to analgesics showed greater reduction in pain severity and range of motion. Conclusion: Physical exercise of the Shoulder joint helps in restoring the mobility and relieves stiffening of the muscles and hence should be added as the mainstay of treatment with pain relief.

Ten years’ experience with a pyrocarbon prosthesis replacing the proximal interphalangeal joint. A prospective clinical and radiographic follow-up

2013 ◽  
Vol 39 (6) ◽  
pp. 587-595 ◽  
Author(s):  
M. Tägil ◽  
M. Geijer ◽  
A. Abramo ◽  
P. Kopylov
Keyword(s):  
Soft Tissue ◽  
Visual Analogue Scale ◽  
Grip Strength ◽  
Scale Score ◽  
Analogue Scale ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Range Of Movement ◽  
Pain At Rest

We prospectively assessed the subjective, objective, and radiographic results at 1, 2, and 5 years in 65 patients who had pyrocarbon proximal interphalangeal prostheses inserted between 2001 and 2010. Further operations were done on 10 of the 89 joints (four for prosthetic extraction and arthrodesis, two for component changes, and four for soft tissue procedures). At 1 year, the visual analogue scale score for pain at rest had improved to 0 cm from a pre-operative 4 cm, pain at activity from 6 to 1.8 cm, and Disability of the Arm, Shoulder and Hand score from 40 to 25. Range of movement and grip strength were unchanged. At 5 years, 31 joints (21 patients) had a complete radiographic follow-up. Seven proximal and 12 distal components showing zones of osteolysis at 1 year had stabilized and were inert or integrated at 5 years. Three proximal and three distal components had osteolytic zones at 5 years. Forty-seven of 59 patients were pain-free at rest at 1 year, and 19 of 21 at 5 years. No late revisions or loosening occurred.

Intoxication Perception Visual Analogue Scale

2010 ◽  
Author(s):  
Jennifer R. Cromer ◽  
Jason A. Cromer ◽  
Paul Maruff ◽  
Peter J. Snyder
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale
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