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 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.

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

The Effects of a Digital Health Program Using Chatbot Through a Mobile Messaging App on Musculoskeletal Problems: Randomized Controlled Trial of the Self-Management Program in Workers with Neck/Shoulder Pain/Stiffness and Low Back Pain (Preprint)

2021 ◽  
Author(s):  
Tomomi Anan ◽  
Shigeyuki Kajiki ◽  
Hiroyuki Oka ◽  
Tomoko Fujii ◽  
Kayo Kawamata ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Shoulder Pain ◽  
Health Program ◽  
Digital Health ◽  
Intervention Group ◽  
Musculoskeletal Symptoms ◽  
Control Group ◽  
Low Back ◽  
Musculoskeletal Problems

BACKGROUND Musculoskeletal symptoms, such as neck and shoulder pain and stiffness and low back pain, are common health problems in the working population. They are the leading causes of presenteeism (employees being physically present at work but unable to be fully engaged). However, current medical systems do not spare sufficient resources for non-specific musculoskeletal problems. OBJECTIVE This study aimed to evaluate the improvements in musculoskeletal symptoms after use of an exercise-based artificial intelligence (AI)-assisted interactive health promotion system that operates through a mobile messaging app (the AI-assisted health program). METHODS We conducted a two-armed, randomized, controlled, and unblinded trial in workers with neck/shoulder stiffness and/or low back pain. We recruited participants with these symptoms through email notifications. We obtained 48 participants in the intervention group and 46 in the control group. The intervention group received the AI-assisted health program, in which the chatbot sent messages to users with the exercise instructions at a fixed time every day through the smart phone’s chatting app (LINE) for 12 weeks. The exercises could be performed within 1 minute. The control group continued with their usual care routines, which included exercising for 3 minutes at recess time provided by the company to prevent stiff shoulders and back pain. We assessed the subjective severities of the neck and shoulder pain/stiffness and low back pain in participants using a scoring scale of 1 to 5 for both the intervention and the control group at baseline and after 12 weeks of intervention using an online form. RESULTS We analyzed 47 patients in the intervention group and 40 in the control group. The participants in the intervention group showed significant improvements in the severities of the neck/shoulder pain/stiffness and low back pain compared to those in the control group (OR 12.74, P <.001). Based on the subjective assessment of the improvement of the pain/stiffness at 12 weeks, 36 (77%) participants in the intervention group and 3 (8%) in the control group had improved (improved, slightly improved) (OR 54.23, P <.001). CONCLUSIONS This study showed that the short exercises provided by the AI-assisted health program improved both neck/shoulder pain/stiffness and low back pain in 12 weeks. Digital health programs are low cost and safe and can save experts’ working hours and labor costs. Further studies are needed to identify the elements of the AI-assisted health program that worked. CLINICALTRIAL University hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) 000033894; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000038307.

scholarly journals Public Status and Prevalence of Acupuncture in Japan

2010 ◽  
Vol 7 (4) ◽  
pp. 493-500 ◽  
Author(s):  
Naoto Ishizaki ◽  
Tadashi Yano ◽  
Kenji Kawakita
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Symptoms ◽  
Low Back ◽  
Shoulder Stiffness ◽  
Face To Face ◽  
Western Countries ◽  
Public Status ◽  
Lifetime Experience ◽  
Musculoskeletal Problems

Acupuncture originated in China and is widespread throughout Asia. It is expected that a higher utilization of this remedy exists in these countries compared to Western countries. We conducted annual nationwide surveys from 2003 through 2006 on the utilization of acupuncture in Japan. Face-to-face interviews were conducted with 2000 individuals randomly chosen from the resident database. Annual utilization percentages, based on the number of respondents, from 2003 to 2006 were 6.5%, 4.8%, 6.4%, and 6.7%, respectively, while lifetime experiences determined in each surveys were estimated as 26.7, 19.4, 24.4 and 25.4, respectively. Respondents who had utilized acupuncture and/or moxibustion tended to be older than those who had no experience. Acupuncture was mainly used for musculoskeletal symptoms, and a detailed breakdown of the musculoskeletal symptoms identified in the 2005 survey showed 50.9% for low back pain, 35.9% for shoulder stiffness and 12.0% for knee pain. Reasons given for continuing therapy included the effective amelioration of symptoms, comfort of the procedure and low number of side-effects, while those who decided against continuing cited no improvement of symptoms, cost and lack of time for treatment. In conclusion, annual utilization of acupuncture and/or moxibustion was estimated at more than 6%, and the percentage of those with a lifetime experience was ∼25%, thus demonstrating the relatively higher utilization of the remedy in Japan over utilization in western countries. Application of the treatment for musculoskeletal problems and utilization by the older population were specific standouts of the use of acupuncture and/or moxibustion in Japan.

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