scholarly journals Neuropathic pain in rheumatoid arthritis

2020 ◽  
Vol 12 (5) ◽  
pp. 60-65
Author(s):  
E. S. Filatova ◽  
A. M. Lila ◽  
V. A. Parfenov

Objective: to identify the signs of neuropathic pain (NP) in patients with rheumatoid arthritis (RA) on the basis of the PainDETECT questionnaire and neurological examination.Patients and methods. A total of 208 RA patients (39 men and 169 women; mean age, 47.7 years) with chronic pain syndrome were examined. The patients underwent rheumatological and neurological examinations; NP was diagnosed using the PainDETECT questionnaire; inflammation severity (DAS28 index), pain intensity (VAS), affective disorders (HADS), and quality of life (EQ-5D) were assessed.Results and discussion. 172 (82.7%) patients had moderate and high disease activity according to the DAS28. The signs of possible and highly probable NP according to the PainDETECT questionnaire were detected in 29.8 and 26.9% of patients, respectively; they were significantly more likely to be detected in patients with more severe pain syndrome, clinically significant anxiety, and worse quality of life, but were unassociated with RA activity according to the DAS28. Somatosensory nervous system injury (polyneuropathy, tunnel syndromes, and cervical myelopathy) was found in 77.6% of patients with possible NP and in 80.4% with highly probable NP. In other patients, NP might be caused by central sensitization. Conclusion. In patients with a RA exacerbation, chronic pain syndrome is caused not only by an active inflammatory process in the joint area and adjacent tissues, but also by somatosensory nervous system injury and central sensitization.

2021 ◽  
Vol 7-8 (217-218) ◽  
pp. 29-36
Author(s):  
Nazira Zharkinbekova ◽  
◽  
Aiganym Khamidulina ◽  
Zhazira Barat ◽  
Botagoz Rustemova ◽  
...  

The quality of life of patients with chronic pain syndrome remains one of the most pressing issues. Pain is considered chronic if it lasts or recurs for more than 3-6 months. This contributes to disability, depression, sleep disorders, poor quality of life, and what is important in this situation, the cost of treatment. According to statistics, the average prevalence of chronic pain in the adult population is 20%. Practitioners everywhere are in search of new methods of pain relief. Purpose of research. The quality of life of patients with chronic pain syndrome has traditionally remained a topical issue. Given the permanent nature of pain and the completeness of approaches to its relief, the modern Clinician is constantly looking for new treatment methods that meet the principles of evidence-based medicine and safety. Material and methods. This paper presents the results of using Neurouridine® in 30 patients with peripheral neuropathy. 30 patients were randomized for a 3-week treatment period. Average age: 47.5±1.5 years. All patients received standard symptomatic therapy, and an oral combination drug containing b vitamins, folic acid, choline, and Uridine was added to the treatment in the 150 mg mode once a day. Patients made three visits to the outpatient neurological office: visit 1-to evaluate pre-treatment, visit 2-after 10 days of treatment, and visit 3-after 20 days of treatment. Each patient was presented with two performance evaluations at each study visit: pain assessment on the CRS NRS scale, and the fps Face scale. Results and discussion. Analysis of the results of the treatment showed improvement in the form of reduced pain, improved quality of life in 65.90%, rapid recovery of performance in 32.10%, reduced need for analgesics in 59.90% and complete disappearance of symptoms in 25.30% of patients. Pain was assessed using the HI NRG scale, the AZA Face scale, and the frequency of analgesics at the patient's first, second, and third visits. Conclusion. The use of Neurouridine® for analgesic purposes has shown a positive effect on reducing symptoms in patients with peripheral neuropathy. The results confirm that this therapy provides a clear regeneration of the nerves, relieving pain, and reducing the soreness characteristic of nerve damage. Keyword: peripheral neuropathy, Neurouridine®, pain assessment, quality of life.


2021 ◽  
Vol 27 (3) ◽  
pp. 3950-3954
Author(s):  
Stamenka Mitova ◽  
◽  
Mariya Gramatikova ◽  
Margarita Avramova ◽  
Georgi Stoyanov ◽  
...  

Purpose: The study aims to evaluate the effect of kinesiotape methodology on chronic pain syndrome in the lumbosacral region. Material and Methods: 42 participants with chronic low back pain were recruited and randomly divided into two groups – control (n=19) and experimental (n=23). Foreword and lateral tilt, Borg and Modified Merld’Aubigne Scale for pain were used for assessment before and after treatment. Roland-Morris Questionnaire was done to assess the quality of life before and three months after treatment. The participants received a specialized kinesitherapy program combined with kinesio tape daily for 15 days with a duration of 40 minutes per procedure. They all received a home kinesitherapy program. Data were analyzed using GraphPad prism 3.02. Results: 42 participants, including 20 women and 22 men, were examined. The mean age (X±SD) of the control group was 45±9.08years, and for experimental was49.13±8.3 years. Median values of the Borg pain scale were as follows: 7.53±0.84 before, and 6.05±0.78 after treatment for the control group and 7.39±0.99 and 4.61±0.78 for the experimental group. Merld’AubigneScaleshows before and after treatment for control group 4.26±065 and 3.12±0.49 respectively, while in experimental was 4.26±0.68 and 2.09±0.44 after treatment. The average of forwarding tilts measured before and after treatment was13.79±3.77cm and 10±3.6cm for the control group and 13.13±3.76 and 7.52±2.25 for the experimental group. Initially, the quality of life questionnaire shows 17.26±1.66 and three months later was 12±1.45 for the control group and 17.35±1.5 before, and descend to 9.00±1.04 for the experimental group. There were statistically significant differences before and after treatment (p <0.05). Conclusions: Treatment significantly reduces pain and muscle spasms after application and improves thefunctionality of the lumbar spine. Kinesiotape not only helps the reduction of pain symptoms in musculoskeletal pathologies but is also a valuable addition to the kinesitherapy procedures.


Author(s):  
Honorine Delivet ◽  
Sophie Dugue ◽  
Alexis Ferrari ◽  
Silvia Postone ◽  
Souhayl Dahmani

2016 ◽  
Vol 33 (S1) ◽  
pp. S500-S501
Author(s):  
M. Domijan ◽  
Z. Lončar ◽  
S. Udovičić

IntroductionAbout 15–20% of the population suffering from the chronic pain. Over time, chronic pain can result in different emotional problems, social isolation, sleep disturbances, which reduce the quality of life. Chronic pain syndrome (CPS) indicates persistent pain, subjective symptoms in excess of objective findings, associated dysfunctional pain behavious and self-limitation in activities of daily living. Duloxetine is a potent antidepressant approved by the Food and Drug Administration for the chronic musculoskeletal disorder, diabetic neuropathic pain, fibromyalgia, generallized anxiety disorder and major depressive disorder.ObjectiveTo determine the effect of duloxetine on the reduction of pain and psychosocial suffering.AimsThe goal of the treatment should be to effectively reduce pain while improving function and reducing psychosocial suffering.MethodsThirty-six adult, nondepressed patients, already on tramadol therapy were included. Patients with VAS (visual analogue scale) ≥ 4were treated with duloxetine for 13 weeks. We measured pain intensity with the McGill Pain Questionnaire-Short Form (MPQ-SF) and compared VAS before starting the treatment with duloxetine and weekly for 13 weeks.ResultsPain response was defined as a 30%decrease in the MPQ-SF. A total of 62.5% of the sample met these criteria for response. Among them, 13.8% of patients were discontinued because of adverse effects. Duloxetine significantly improved functioning and the quality of life in patients with CPS.ConclusionsBecause of it is analgesic properties, duloxetine in the lower antidepressant doses (60 mg taken ones daily) combined with tramadol (another analgesic agent) can be useful in CPS for patients who do not respond satisfactory to monotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2221
Author(s):  
Thomas Julian ◽  
Rubiya Syeed ◽  
Nicholas Glascow ◽  
Efthalia Angelopoulou ◽  
Panagiotis Zis

Neuropathic pain describes a range of unpleasant sensations caused by a lesion or disease of the somatosensory nervous system. The sensations caused by neuropathic pain are debilitating and improved treatment regimens are sought in order to improve the quality of life of patients. One proposed treatment for neuropathic pain is vitamin B12, which is thought to alleviate pain by a number of mechanisms including promoting myelination, increasing nerve regeneration and decreasing ectopic nerve firing. In this paper, the evidence for B12 as a drug treatment for neuropathic pain is reviewed. Twenty four published articles were eligible for inclusion in this systematic review in which a range of treatment regimens were evaluated including both B12 monotherapy and B12 in combination with other vitamins or conventional treatments, such as gabapentinoids. Overall, this systematic review demonstrates that there is currently some evidence for the therapeutic effect of B12 in the treatment of post-herpetic neuralgia (level II evidence) and the treatment of painful peripheral neuropathy (level III evidence).


2021 ◽  
pp. 201-207
Author(s):  
O. S. Kochergina ◽  
E. F. Rakhmatullina ◽  
B. E. Gubeev

Back pain and insomnia (insomnia) significantly impair the quality of life of patients. Pain contributes to the development of sleep disorders and vice versa, poor quality sleep increases pain. Sleep disorders are widespread in the population, and in chronic pain syndrome, almost 70% of patients suffer from insomnia. The National Sleep Association singles out pain as one of the leading causes of sleep disorders. The article discusses a typical clinical case of the combination and interaction of chronic pain syndrome and insomnia. A patient with acute back pain developed a sleep disorder for which therapy was not carried out. The prescribed standard therapy for back pain, which included a non-steroidal anti-inflammatory drug, muscle relaxant, made it possible to relieve pain in a short time. However, the patient’s insomnia not only persisted, but also progressed, which led to the appearance of symptoms of asthenia in the form of fatigue, irritability, decreased performance, and ultimately significantly reduced the quality of life. In order to normalize sleep, the patient was prescribed a histamine H1 receptor blocker from the ethanolamine group, namely the drug Doxylamine. Follow-up observation for 1 year showed no exacerbation of back pain and sleep disturbances. In the treatment of patients with chronic back pain, it is necessary to pay attention to the presence of sleep disturbances and provide appropriate therapy. Today, three groups of hypnotics are used in clinical practice: melatonin receptor agonists (insufficient effectiveness in acute sleep disorders), benzodiazepines (addictive and addictive), and antihistamines. The modern drug Doxylamin belongs to the group of antihistamine hypnotics, has a good efficacy and safety profile and is included in the domestic recommendations for the treatment of insomnia.


Folia Medica ◽  
2020 ◽  
Vol 62 (4) ◽  
pp. 645-654
Author(s):  
Tiffany Ostovar-Kermani ◽  
Daniel Arnaud ◽  
Andrea Almaguer ◽  
Ismael Garcia ◽  
Stephanie Gonzalez ◽  
...  

Insomnia is a chronic condition that occurs a minimum of three times per week over a period of three or more subsequent months. There are multiple causes of insomnia, and even though it is considered a symptom, it can be associated with chronic illnesses. Chronic pain syndrome, which is defined as pain that persists for a period longer than 3 months, is one of several etiologies of insomnia. The prevalence of insomnia among chronic pain patients is greater in comparison with the general population (percentage or ratio). Chronic pain is common in patients with rheumatoid arthritis, spinal pain (such as chronic back pain) and fibromyalgia. The prevalence of in-somnia is also higher in cancer patients when compared to the general population. When the clinical history indicates a straightforward diagnosis of chronic pain syndrome, patients will complain of insomnia as part of their symptomatology. It is imperative to manage their underlying illness to alleviate their sleep disorder. Various medications may be used to relieve and even improve pain symptoms. Other than pharmacological interventions, non-pharmacological alternatives such as yoga, meditation, acupuncture, and psychotherapy can help improve the quality of life of these patients. The purpose of this article is to review the diagnosis and management of insomnia in chronic pain syndrome and its impact on the quality of life.


Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 816
Author(s):  
Rosmara Infantino ◽  
Consalvo Mattia ◽  
Pamela Locarini ◽  
Antonio Luigi Pastore ◽  
Sabatino Maione ◽  
...  

Chronic pain, including neuropathic pain, represents an untreated disease with important repercussions on the quality of life and huge costs on the national health system. It is well known that opioids are the most powerful analgesic drugs, but they represent the second or third line in neuropathic pain, that remain difficult to manage. Moreover, these drugs show several side effects that limit their use. In addition, opioids possess addictive properties that are associated with misuse and drug abuse. Among available opioids compounds, buprenorphine has been suggested advantageous for a series of clinical reasons, including the effectiveness in neuropathic pain. Some properties are partly explained by its unique pharmacological characteristics. However, questions on the dynamic profile remain to be answered. Pharmacokinetics optimization strategies, and additional potentialities, are still to be explored. In this paper, we attempt to conceptualize the potential undiscovered dynamic profile of buprenorphine.


Author(s):  
Maksim Vladimirovich Shpagin ◽  
Mikhail Valerievich Kolesnikov ◽  
Olga Yurievna Khutorskaya ◽  
Dmitriy Evgenievich Timoshkin ◽  
Artem Andreevich Belikin ◽  
...  

From the informational and structural point of view, the chronicity of pain is associated with the migration of nociogenic zones. The phenomenon of migration is based on the mechanisms of neuroplasticity, compensatory-restorative processes in the nervous system. On the basis of the phenomenon of migration of the nociogenic zone, a system of regional integrative therapy of chronic pain syndrome has been developed. Recommendations on the advisability of invasive shutdown of the nociogenic zone using invasive pharmacotherapy or surgical denervation have been proposed. In the course of studying the characteristics of chronic pain, depending on the duration of the disease, a direct proportional correlation was revealed between the increase in the components of pain and the duration of the pain syndrome, which can be explained by the increase in the number of nociogenic structures that form the complexity and stability of the pain syndrome. Thus, the necessity of neurodestructive interventions increases for attaining positive results. An important area of therapy is the inclusion of psychotherapy, pharmacotherapy and neuromodulation into the system of regional-integrative influence.


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