scholarly journals Use of botulinum toxin in musculoskeletal pain

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 52 ◽  
Author(s):  
Jasvinder A Singh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Botulinum Toxin ◽  
Musculoskeletal Pain ◽  
Tennis Elbow ◽  
Chronic Musculoskeletal Pain ◽  
Low Back ◽  
Hand Pain ◽  
Significant Difference ◽  
And Function

Chronic musculoskeletal pain is a common cause of chronic pain, which is associated with a total cost of $635 billion per year in the U.S. Emerging evidence suggests an anti-nociceptive action of botulinum toxin, independent of its muscle paralyzing action. This review provides a summary of data from both non-randomized and randomized clinical studies of botulinum toxin in back pain and various osteoarticular conditions, including osteoarthritis, tennis elbow, low back pain and hand pain. Three randomized controlled trials (RCTs) of small sizes provide evidence of short-term efficacy of a single intra-articular injection of 100 units of botulinum toxin A (BoNT/A) for the relief of pain and the improvement of both function and quality of life in patients with chronic joint pain due to arthritis. Three RCTs studied intramuscular BoNT/A for tennis elbow with one showing a significant improvement in pain relief compared with placebo, another one showing no difference from placebo, and the third finding that pain and function improvement with BoNT/A injection were similar to those obtained with surgical release. One RCT of intramuscular BoNT/A for low back pain found improvement in pain and function compared to placebo. Single RCTs using local injections of BoNT in patients with either temporomandibular joint (TMJ) pain or plantar fasciitis found superior efficacy compared to placebo. One RCT of intramuscular BoNT/B in patients with hand pain and carpal tunnel syndrome found improvement in pain in both BoNT/B and placebo groups, but no significant difference between groups. Most evidence is based on small studies, but the use of BoNT is supported by a single, and sometimes up to three, RCTs for several chronic musculoskeletal pain conditions. This indicates that botulinum toxin may be a promising potential new treatment for chronic refractory musculoskeletal pain. Well-designed large clinical trials are needed.

Chronic musculoskeletal pain, phantom sensation, phantom and stump pain in veterans with unilateral below-knee amputation

2019 ◽  
Vol 19 (4) ◽  
pp. 779-787
Author(s):  
Mostafa Allami ◽  
Elahe Faraji ◽  
Fatemeh Mohammadzadeh ◽  
Mohammad Reza Soroush
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Pain ◽  
Odds Ratio ◽  
Chronic Musculoskeletal Pain ◽  
Musculoskeletal Symptoms ◽  
Phantom Pain ◽  
Low Back ◽  
Knee Amputation ◽  
Stump Pain

Abstract Background and aims Many individuals with lower limb loss report concerns about other musculoskeletal symptoms resulting from amputation. The objective of this study was to assess chronic musculoskeletal pain in Iranian veterans with unilateral below-knee amputation. Methods The participants agreed to take part in a health needs assessment and were interviewed face-to-face by trained interviewers. The assessment consisted of demographic information, wearing a prosthesis, pain locations in extremities, stump complications, severity of pains related to amputation and low back pain. Results Of 247 unilateral below knee amputees, 97.9% wore a prosthetic limb and times walking or standing with the prosthesis were 12.47 ± 3.84 and 4.22 ± 3.53 h a day, respectively. Low soft tissue coverage of the stump (15.4%) and symptomatic osteoarthritis in the contralateral lower extremity (40.1%) were the most common complications. The prevalence of stump pain, phantom sensations, phantom pain, low back pain, and knee pain was 84.2%, 77.3%, 73.7%, 78.1%, and 54.7% respectively. The odds ratio of stump pain in amputees with phantom pain was 2.22 times higher than those who did not experience phantom pain [OR = 2.22 (CI: 1.19–4.17); p = 0.012] and the odds ratio of low back pain was higher in amputees with stump pain [OR = 3.06 (CI: 1.50–6.21); p = 0.002]. Conclusions This research enhances our understanding of comorbid musculoskeletal problems in below-knee amputees which can help health providers to identify rehabilitation needs and emphasizes the importance of regular assessments. Implications These findings underline the importance of paying closer attention to different dimensions and aspects of musculoskeletal complications in veterans with unilateral below-knee amputation.

scholarly journals Prevalence, burden of disease, and lost in health state utilities attributable to chronic musculoskeletal disorders and pain in Chile

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pedro Zitko ◽  
Norberto Bilbeny ◽  
Carlos Balmaceda ◽  
Tomas Abbott ◽  
Cesar Carcamo ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Chronic Low Back Pain ◽  
Population Level ◽  
Chronic Musculoskeletal Pain ◽  
Health State ◽  
Low Back ◽  
Health State Utilities

Abstract Background Musculoskeletal disorders are a leading cause of disability adjusted life years (DALY) in the world. We aim to describe the prevalence and to compare the DALYs and loss of health state utilities (LHSU) attributable to common musculoskeletal disorders in Chile. Methods We used data from the Chilean National Health Survey carried out in 2016–2017. Six musculoskeletal disorders were detected through the COPCOPRD questionnaire: chronic musculoskeletal pain, chronic low back pain, chronic shoulder pain, osteoarthritis of hip and knee, and fibromyalgia. We calculated the DALY for each disorder for 18 sex and age strata, and LHSU following an individual and population level approaches. We also calculated the fraction of LHSU attributable to pain. Results Chronic musculoskeletal pain disorder affects a fifth of the adult population, with a significant difference between sexes. Among specific musculoskeletal disorders highlights chronic low back pain with the highest prevalence. Musculoskeletal disorders are a significant cause of LHSU at the individual level, especially in the case of fibromyalgia. Chronic musculoskeletal pain caused 503,919 [283,940 - 815,132] DALYs in 2017, and roughly two hundred thousand LSHU at population level, which represents 9.7% [8.8–10.6] of the total LSHU occurred in that year. Discrepancy in the burden of musculoskeletal disorders was observed according to DALY or LSHU estimation. The pain and discomfort domain of LHSU accounted for around half of total LHSU in people with musculoskeletal disorders. Conclusion Chronic musculoskeletal pain is a major source of burden and LHSU. Fibromyalgia should deserve more attention in future studies. Using the attributable fraction offers a straightforward and flexible way to explore the burden of musculoskeletal disorders.

scholarly journals Osteopathic Medicine in Four Chronic Musculoskeletal Pain Diseases: An Observational Trial with Follow-Up

2021 ◽  
pp. 1-14
Author(s):  
Gabriele Rotter ◽  
Sylvia Binting ◽  
Tatjana Tissen-Diabaté ◽  
Miriam Ortiz ◽  
Benno Brinkhaus
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Pain ◽  
Routine Care ◽  
Mean Difference ◽  
Chronic Musculoskeletal Pain ◽  
Osteopathic Medicine ◽  
Low Back ◽  
Observational Trial

<b><i>Background and Aim:</i></b> Patients with chronic musculoskeletal pain diseases (CMPDs) often use osteopathic medicine (OM), although the changes in patients with pain diseases are still insufficiently investigated. This study aimed to observe changes along and after OM in addition to routine care on pain, functioning, and quality of life in patients with four CMPDs. <b><i>Methods:</i></b> In this observational trial with follow-up, patients suffering from chronic neck pain (CNP, <i>n</i> = 10), chronic low back pain (CLBP, <i>n</i> = 10), chronic shoulder pain (CSP, <i>n</i> = 10), or chronic knee pain (CKP, <i>n</i> = 10) received up to six OM sessions in addition to routine care. <b><i>Results:</i></b> A total of 40 patients (73% female, mean age 47.7 ± 8.3 years, mean pain intensity 59.4 ± 12.5 mm, measured by a visual analog scale [VAS] 0–100 mm) were included. After 26 weeks, there was an improvement in the VAS pain score in the whole population (mean difference to baseline –33.1 mm [95% CI –40.5 to –25.7]), as well in the patients with the four diseases: CNP (–33.7 mm [–54.7 to –12.6]), CLBP (–28.2 mm [–47.9 to –8.4]), CSP (–32.4 [–46.8 to –18.0]), and CKP (–38.1 mm [–49.1 to –27.0]). Regarding disease-specific outcomes, we found improvements in CNP, as measured by the neck disability index (scale 0–50; mean difference –3.6 [–9.0 to 1.9]), CLBP, as measured by the low back pain rating scale (scale 0–60; –3.4 [–12.5 to 5.7]), CSP, as measured by the disabilities of the arm, shoulder and hand score (scale 0–100; –13.4 [–23.1 to –3.7]), and CKP, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (scale 0–96; –13.0 [–23.5 to –2.5]). These improvements persisted through week 52. No adverse events were observed. <b><i>Conclusion:</i></b> The study observed beneficial changes along and after the OM treatment in addition to routine care in patients with four different CMPDs. High-quality, multicenter randomized controlled trials are strongly needed to compare the effectiveness of OM and standard care interventions in treating CMPDs in the future. We have provided sufficient data for sample size calculations for these trials.

scholarly journals Prevalence, Burden of Disease, and Lost in Health State Utilities Attributable to Chronic Musculoskeletal Disorders and Pain in Chile

2020 ◽  
Author(s):  
Pedro Zitko ◽  
Norberto Bilbeny ◽  
Carlos Balmaceda ◽  
Tomas Abbott ◽  
Cesar Carcamo ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Population Level ◽  
Attributable Fraction ◽  
Chronic Musculoskeletal Pain ◽  
Health State ◽  
Low Back ◽  
Health State Utilities

Abstract Background: Musculoskeletal disorders are a leading cause of disability adjusted life years (DALY) in the world. In addition to DALY, other approaches such as the attributable fraction have been proposed to estimate the burden of diseases. We aim to describe the prevalence and to compare the DALYs and loss of health state utilities (LHSU) attributable to common musculoskeletal disorders in Chile.Methods: We used data from the Chilean National Health Survey carried out in 2016-2017. Six musculoskeletal disorder were detected through the COPCOPRD questionnaire: chronic musculoskeletal pain, chronic low back pain, chronic shoulder pain, osteoarthritis of hip and knee, and fibromyalgia. We calculated the DALY for each disorder for 18 sex and age strata, and LHSU at individual and population level. We also calculated the fraction of LHSU attributable to pain.Results: Chronic musculoskeletal pain disorder affects a fifth of the adult population, with a significant difference between sexes. Among specific musculoskeletal disorders highlights chronic low back pain with the highest prevalence. Musculoskeletal disorders are a significant cause of LHSU at the individual level, especially in the case of fibromyalgia. Chronic musculoskeletal pain caused 503,919 [283,940 - 815,132] DALYs in 2017, and roughly two hundred thousand LSHU at population level, which represents 9.7% [8.8 - 10.6] of the total LSHU occurred in that year. Discrepancy in the burden of musculoskeletal disorders was observed according to DALY or LSHU estimation. The pain and discomfort domain of LHSU accounted for around half of total LHSU in people with musculoskeletal disorders. Conclusion: chronic musculoskeletal pain is a major source of burden and LHSU. Fibromyalgia should deserve more attention in future studies. Using the attributable fraction offers a straightforward and flexible way to explore the burden of musculoskeletal disorders.

Central Sensitization in Chronic Musculoskeletal Pain Disorders in Different Populations: A Cross-Sectional Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2958-2963
Author(s):  
Cristina Roldán-Jiménez ◽  
David Pérez-Cruzado ◽  
Randy Neblett ◽  
Robert Gatchel ◽  
Antonio Cuesta-Vargas
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Neck Pain ◽  
Musculoskeletal Pain ◽  
Central Sensitization ◽  
Cross Sectional Study ◽  
Chronic Musculoskeletal Pain ◽  
Low Back ◽  
Sectional Study ◽  
Cross Sectional

Abstract Objective Chronic musculoskeletal pain disorders (CMPDs) are among the leading causes of disabilities across populations, resulting in high social and financial burden. This persistent pain condition may include the central sensitization (CS) phenomenon, which implies a wide range of symptoms and that may be taken into account in CMPD treatment. CS symptoms can be measured by the Central Sensitization Inventory (CSI). The aims of the study were to describe CS symptoms in patients suffering from several CMPDs and to analyze differences due to gender, age, and body mass index (BMI). Design This cross-sectional study recruited a total of 395 Spanish participants suffering from several CMPDs. Setting CS symptoms were measured with the Spanish Version of the CSI. The total score (0–100) and a cutoff score of 40 were recorded. Subjects A total of 395 participants were included. Results The mean CSI total score for the whole sample was 24.6 ± 12.0 points. CSI total score had subclinical values in the whole sample, whereas participants with scores &gt;40 were found across different CMPDs, such as low back pain (37.8%) and neck pain (32.4%); 14.6% of females and 1.7% of males presented CSI scores &gt;40. Patients showed significant differences in CSI cutoff point by gender (P = 0.010) and CSI total score by age (P = 0.014). Conclusions Given the high prevalence of clinically relevant CSI scores (&gt;40) in people with a CMPD, especially low back pain and neck pain, we recommend that clinicians supplement their assessment with the CSI for improved decision-making during treatment.

A systematic review of the prevalence of musculoskeletal pain, back and low back pain in people with spinal cord injury

2013 ◽  
Vol 36 (9) ◽  
pp. 705-715 ◽  
Author(s):  
Christina Michailidou ◽  
Louise Marston ◽  
Lorraine H. De Souza ◽  
Ian Sutherland
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Pain ◽  
Low Back ◽  
Cord Injury

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 Effect of back school protocol on the referral rate of patients with low back pain to an industrial physiotherapy clinic

2006 ◽  
Vol 62 (4) ◽  
Author(s):  
D. O. Odebiyi ◽  
A. O. Akinpelu ◽  
M. O. B. Olaogun
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Work Place ◽  
Low Back ◽  
Back School ◽  
Soap Making ◽  
Significant Difference ◽  
Back Care ◽  
Chi Square Analysis ◽  
Physiotherapy Clinic

Back schools are educational programmes originally developed in a work place (Volvo factory in Sweden) for patients with back pain, to enable them to manage their own back problems better. ‘Back school’ was originally aimed at modifying the behaviours of patients with low back pain (LBP), with the view to prevent relapses. In an effort to encourage and stimulate the use of ‘back school’ among health workers in Nigeria, this study was designed to evaluate the efficacy of a back school protocol in a Soap Making Industry in Lagos, Nigeria. One hundred and ten (110) workers of a Soap Making Industry in Lagos, Nigeria,  participated in this study. A pre-test, post-test experimental design was employed. The participants were divided into two groups - office workers and factory workers for the purpose of the training in the content of the back school protocol. The ‘back school’ consisted of classroom teaching and the use of two videotapes titled “lifting technique” and “back pain”. Data on demographic information, knowledge of back structures and back care were collected using a questionnaire with closed ended questions, which was completed before, immediately after and 8 weeks after the administrations of the contents of the back school protocol (Akinpelu and Odebiyi, 2004). The records of the factory’s clinic were also reviewed for the 12-months before and 12 months after the study. The mean values of the participants’ age, height, weight and body mass index (BMI) were 36.60 ± 9.10 years, 1.65 ± 0.10 m,69.13 ± 7.70 kg and 25.40 ± 3.30 kg/m2 respectively. The results showed that the 12-months prevalence of low back pain (LBP) among the workers was 71%. The result also showed that over 50% of the participants never had any  information or lesson on back care, and those that had some form of information obtained it by chance. There was 23% reduction in referral for care of back pain 12 months after the administration of the back school protocol. However, Chi square analysis showed that there was no significant difference (p = 0.23) between the number of  physiotherapy referrals to the factory’s clinic 12-months before the study and 12-months after the studyThe findings of this study suggest that the back school protocol was able to impart some knowledge (of back pain and back care) in the industrial workers. This knowledge seems to have assisted this group of individuals to cultivate good postural habits, particularly at work. This might have led to the 23% reduction in the reported cases of patients with LBP to the factory’s Physiotherapy Clinic.

Sign in / Sign up

Export Citation Format

Share Document