المؤلفون: Stefan Milosevic, Mikkel Mylius Rasmussen, Ane Simony, Leah Y. Carreon, Mikkel Østerheden Andersen, Gustav Østerheden Andersen, Mads Mose Jensen

المصدر: Milosevic, S, Andersen, G, Jensen, M M, Rasmussen, M M, Carreon, L, Andersen, M & Simony, A 2021, ' The efficacy of coccygectomy in patients with persistent coccydynia : a retrospective cohort study of 134 consecutive patients with a minimum follow-up of one year ', The Bone & Joint Journal, vol. 103-B, no. 3, pp. 542-546 . https://doi.org/10.1302/0301-620X.103B3.BJJ-2020-1045.R2

مصطلحات موضوعية: Male, Adult, medicine.medical_specialty, Adolescent, Coccyx, Denmark, DaneSpine, Coccygectomy, coccygect, Disability Evaluation, Low Back Pain/physiopathology, Surveys and Questionnaires, medicine, Humans, Orthopedics and Sports Medicine, In patient, Registries, Pain Management/methods, Aged, Pain Measurement, business.industry, coccyx, Follow up studies, Middle Aged, Surgery, Coccydynia, instability, medicine.anatomical_structure, patient-reported outcome measure, coccygectomy, Female, medicine.symptom, business, Follow-Up Studies, Coccyx/physiopathology

الوصف: AimsThe aim of this study was to investigate the efficacy of coccygectomy in patients with persistent coccydynia and coccygeal instability.MethodsThe Danish National Spine Registry, DaneSpine, was used to identify 134 consecutive patients who underwent surgery, performed by a single surgeon between 2011 and 2019. Routine demographic data, surgical variables, and patient-reported outcomes, including a visual analogue scale (VAS) (0 to 100) for pain, Oswestry Disability Index (ODI), EuroQol five-dimension questionnaire (EQ-5D), and the Physical Component Score (PCS) and Mental Component Score (MCS) of the 36-Item Short-Form Health Survey questionnaire (SF-36) were collected at baseline and one-year postoperatively.ResultsA total of 112 (84%) patients with a minimum follow-up of one year had data available for analysis. Their mean age was 41.9 years, and 15 (13%) were males. At 12 months postoperatively, there were statistically significant improvements (p < 0.001) from baseline for the mean VAS for pain (70.99 to 35.34), EQ-5D (0.52 to 0.75), ODI (31.84 to 18.00), and SF-36 PCS (38.17 to 44.74). A total of 78 patients (70%) were satisfied with the outcome of treatment.ConclusionPatients with persistent coccydynia and coccygeal instability resistant to nonoperative treatment may benefit from coccygectomy. Cite this article: Bone Joint J 2021;103-B(3):542–546.

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https://findresearcher.sdu.dk:8443/ws/files/182270111/efficacy.pdf

المؤلفون: Thomas K. Ringsted, Jacob Rosenberg, Joakim M. Bischoff, Henrik Kehlet, Morten Aagaard Petersen, Mads U. Werner, E. Jensen

المصدر: Medicine
Jensen, E K, Ringsted, T K, Bischoff, J M, Petersen, M A, Rosenberg, J, Kehlet, H & Werner, M U 2019, ' A national center for persistent severe pain after groin hernia repair : Five-year prospective data ', Medicine (Baltimore), vol. 98, no. 33, pp. e16600 . https://doi.org/10.1097/MD.0000000000016600

مصطلحات موضوعية: Male, Hernia, Inguinal/psychology, medicine.medical_treatment, Groin/innervation, Hernia, Inguinal, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Pain Management/methods, chronic post-surgical pain, groin, Pain, Postoperative/etiology, pathophysiology, Pain Measurement, Analgesics, Pain, Postoperative, longitudinal study, General Medicine, Middle Aged, Hernia repair, 3. Good health, nociceptive pain, medicine.anatomical_structure, Treatment Outcome, patient-reported outcomes, 030220 oncology & carcinogenesis, Neuropathic pain, Analgesics/therapeutic use, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, Cohort study, Research Article, Reoperation, medicine.medical_specialty, Observational Study, Groin, 03 medical and health sciences, Pharmacotherapy, Herniorrhaphy/adverse effects, Humans, Pain Management, Hernia, Herniorrhaphy, neuropathic pain, business.industry, Neurectomy, medicine.disease, Surgery, Neuralgia/etiology, Reoperation/statistics & numerical data, Quality of Life, Neuralgia, business, hernia repair

الوصف: Supplemental Digital Content is available in the text
Severe persistent pain after groin hernia repair impairs quality-of-life. Prospective, consecutive cohort study including patients with pain-related impairment of physical and social life. Relevant surgical records were obtained, and examinations were by standardized clinical and neurophysiological tests. Patients demonstrating pain sensitivity to pressure algometry in the operated groin underwent re-surgery, while patients with neuropathic pain received pharmacotherapy. Questionnaires at baseline (Q0) and at the 5-year time point (Q5Y) were used in outcome analyses of pain intensity (numeric rating scale [NRS] 0–10) and pain-related effect on the activity-of-daily-living (Activities Assessment Scale [AAS]). Data are mean (95% CI). Analyses were made in 172/204 (84%) eligible patients. In 54/172 (31%) patients re-surgery (meshectomy/selective neurectomy) was performed, while the remaining 118/172 (69%) patients received pharmacotherapy. In the re-surgery group, activity-related, and average NRS-scores at Q0 were 6.6 (5.6–7.9) and 5.9 (5.6–5.9), respectively. Correspondingly, NRS-scores at Q5Y was 4.1 (3.3–5.1) and 3.1 (2.3–4.0; Q0 vs. Q5Y: P

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https://pubmed.ncbi.nlm.nih.gov/31415351

المؤلفون: Bill Vicenzino, Michael Skovdal Rathleff, Jens Lykkegaard Olesen, Henrik Riel, Sinead Holden, Martin Bach Jensen

المصدر: Riel, H, Vicenzino, B, Jensen, M B, Olesen, J L, Holden, S & Rathleff, M S 2018, ' The effect of isometric exercise on pain in individuals with plantar fasciopathy : a randomised crossover trial ', Scandinavian Journal of Medicine & Science in Sports, vol. 28, no. 12, pp. 2643-2650 . https://doi.org/10.1111/sms.13296

مصطلحات موضوعية: Male, Adult, Pain Threshold, medicine.medical_specialty, Heel, Plantar fasciitis, Pain, Physical Therapy, Sports Therapy and Rehabilitation, Isometric exercise, Walking, Fasciitis, Plantar/therapy, plantar fasciopathy, 03 medical and health sciences, 0302 clinical medicine, Threshold of pain, medicine, Pain Management, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, tendinopathy, Exercise, Pain Management/methods, Cross-Over Studies, exercise, business.industry, Forefoot, 030229 sport sciences, Middle Aged, medicine.disease, Crossover study, Exercise Therapy, medicine.anatomical_structure, Fasciitis, Plantar, Physical therapy, Plantar fascia, Female, medicine.symptom, Tendinopathy, business, human activities

الوصف: Isometric exercise is commonly recommended for immediate pain relief in individuals suffering from lower limb tendinopathies, despite the limited evidence supporting its analgesic effect. Due to the similarities between plantar fasciopathy and tendinopathies, the aim of this trial was to investigate the acute effect of isometric exercise on pain, compared to isotonic exercise, or walking, in individuals with plantar fasciopathy. We recruited 20 individuals with plantar fasciopathy for this prospectively-registered, participant-blinded, randomized, superiority crossover trial (ClinicalTrials.gov: NCT03264729). Participants attended three exercise sessions (isometric, isotonic, or walking) in a randomized order, within a 2-week period. Both isometric and isotonic exercises were performed standing with the forefoot on a step bench, while walking was performed barefoot. The primary outcome was pain (measured on a 0-100-mm VAS) during a pain-aggravating activity. Secondary outcomes included pressure pain threshold (PPT) under the heel, and plantar fascia thickness (PFT). All outcomes were measured before and after each exercise session. There were no significant differences between the three exercises on pain (P = 0.753), PPTs (P = 0.837), or PFT (P = 0.718). Further, there was no change in pain from before to after any of the exercises (isometric exercise 2.7 mm [95% CI: −12.2; 6.8], isotonic exercise −3.4 mm [95% CI: −5.0; 11.8], or walking 1.6 mm [95% CI: −16.1; 12.9]). Contrary to expectations, isometric exercise was no better than isotonic exercise or walking at reducing pain in individuals with plantar fasciopathy. None of the exercises induced any systematic analgesic effect.

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https://vbn.aau.dk/ws/files/287166711/Riel_et_al_2018_Scandinavian_Journal_of_Medicine_26_Science_in_Sports.pdf

المؤلفون: Ole Simonsen, Mogens Berg Laursen, Søren Thorgaard Skou, Michael Skovdal Rathleff, Lars Arendt-Nielsen, Sten Rasmussen, Ewa M. Roos

المصدر: Skou, S T, Roos, E M, Simonsen, O, Laursen, M B, Rathleff, M S, Arendt-Nielsen, L & Rasmussen, S 2016, ' The efficacy of non-surgical treatment on pain and sensitization in patients with knee osteoarthritis : a pre-defined ancillary analysis from a randomized controlled trial ', Osteoarthritis and Cartilage, vol. 24, no. 1, pp. 108–116 . https://doi.org/10.1016/j.joca.2015.07.013
Skou, S T, Roos, E M, Simonsen, O, Laursen, M B, Rathleff, M S, Arendt-Nielsen, L & Rasmussen, S 2016, ' The efficacy of non-surgical treatment on pain and sensitization in patients with knee osteoarthritis : a pre-defined ancillary analysis from a randomized controlled trial ', Osteoarthritis and Cartilage, vol. 24, no. 1, pp. 108-116 . https://doi.org/10.1016/j.joca.2015.07.013

مصطلحات موضوعية: Male, Ibuprofen, Osteoarthritis, Ibuprofen/therapeutic use, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Single-Blind Method, Orthopedics and Sports Medicine, Pain Management/methods, Sensitization, Pain Measurement, Osteoarthritis, Knee/physiopathology, Anti-Inflammatory Agents, Non-Steroidal, Non surgical treatment, Analgesics, Non-Narcotic, Osteoarthritis, Knee, Middle Aged, Exercise Therapy, Clinical trial, medicine.anatomical_structure, Female, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Acetaminophen/therapeutic use, Analgesics, Non-Narcotic/therapeutic use, Pain Threshold, medicine.medical_specialty, Diet, Reducing, Total knee replacement, Biomedical Engineering, Pain, Foot Orthoses, Therapeutics, 03 medical and health sciences, Patient Education as Topic, Rheumatology, Forearm, medicine, Pain Management, Humans, Knee, In patient, Acetaminophen, Aged, 030203 arthritis & rheumatology, business.industry, medicine.disease, Exercise Therapy/methods, Physical therapy, business, 030217 neurology & neurosurgery

الوصف: Objective: To report the efficacy of a 3-month treatment program consisting of neuromuscular exercise, education, diet, insoles and pain medication (MEDIC-treatment) compared to usual care (two leaflets with information and treatment advice) in reducing pain-related measures and sensitization in patients with knee osteoarthritis (OA) not eligible for total knee replacement (TKR). Method: A pre-defined ancillary analysis of the results at 3 months of a randomized controlled trial (RCT) of 100 patients randomized to MEDIC-treatment or usual care. Trial registration: ClinicalTrials.gov (NCT01535001). Outcomes were sensitization assessed at the knee, the lower leg and forearm using a handheld algometer, peak pain intensity in the previous 24 h, pain intensity after 30 min of walking, pain location and pattern, spreading of pain (a region-divided body chart) and the usage of pain medication. Results: The MEDIC group had larger improvements from baseline to 3 months in peak pain intensity (P = 0.02) and pain after 30 min of walking (P < 0.001) and in the number of body sites with pain (P = 0.04). There was no difference in the change in sensitization from baseline to 3 months between groups (P = 0.87), but sensitization decreased in both groups (P < 0.001). Conclusion: A non-surgical treatment program is more efficacious in reducing pain-related measures than usual care, while both are equally efficacious in reducing sensitization, indicating that mechanisms other than pain sensitization contribute to the perceived pain. The patients did not have severe symptomatic knee OA and hence pain sensitization may not yet have developed into a clinically relevant parameter or subgroups with less sensitization may exist.

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https://doi.org/10.1016/j.joca.2015.07.013

المؤلفون: Lars Arendt-Nielsen, Davide Ligato, Kristian Kjær Petersen, Carsten Dahl Mørch

المصدر: Ligato, D, Petersen, K K, Mørch, C D & Arendt-Nielsen, L 2018, ' Offset analgesia : The role of peripheral and central mechanisms ', European Journal of Pain, vol. 22, no. 1, pp. 142-149 . https://doi.org/10.1002/ejp.1110

مصطلحات موضوعية: Adult, Male, TEMPERATURE DECREASE, Hot Temperature, Visual analogue scale, Pain, Stimulus (physiology), Hypesthesia, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Forearm, 030202 anesthesiology, Healthy volunteers, medicine, Journal Article, Humans, Pain Management, Pain Management/methods, Pain Measurement, business.industry, Healthy subjects, Hypesthesia/physiopathology, Peripheral, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Treatment Outcome, Dermatome, Anesthesia, Pain/physiopathology, Female, Analgesia/methods, Analgesia, business, 030217 neurology & neurosurgery

الوصف: Background: Offset Analgesia (OA) can be evoked by a three-heat-stimulus train (T1-T2-T3), with T1 (5 s) and T3 (20 s) having the same temperature (e.g. 48 °C) and T2 (5 s) being slightly higher (1–3 °C). OA is defined as a disproportional pain reduction caused by the slight temperature decrease from T2 to T3. As the pain modulatory mechanisms behind OA are still poorly understood, the current study aimed to investigate the role of peripheral and central mechanisms by applying heat stimuli to the same location and to different unilateral and bilateral locations. Method: Young healthy volunteers participated in the study. A ‘standard-OA’ paradigm (48–49–48 °C) was applied to the non-dominant volar forearm (T1–T2–T3 applied on the same location). ‘Unilateral-OA’ trials were applied on three different locations of the non-dominant volar forearm (the same dermatome). ‘Bilateral-OA’ trials were applied by shifting T1–T2–T3 between dominant and non-dominant volar forearms. A constant stimulus of 48 °C was applied as control for the evoked pain. The pain intensities were continuously recorded using an electronic visual analogue scale. Results: The largest pain intensity reduction was reported for the ‘standard-OA’ paradigm (p

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https://pubmed.ncbi.nlm.nih.gov/28898500

المؤلفون: Ming Ding, Line Andersen, Sophie Blancheflor Kristensen, Anne-Marie Heegaard, Charlotte Gabel-Jensen, Manasi Sayilekshmy, Camilla Kristine Appel, Sarah Falk, Simone Gallego-Pedersen

المصدر: Scientific Reports
Appel, C K, Gallego-Pedersen, S, Andersen, L, Kristensen, S B, Ding, M, Falk, S, Sayilekshmy, M, Gabel-Jensen, C & Heegaard, A-M 2017, ' The Src family kinase inhibitor dasatinib delays pain-related behaviour and conserves bone in a rat model of cancer-induced bone pain ', Scientific Reports, vol. 7, no. 1, 4792 . https://doi.org/10.1038/s41598-017-05029-1
Scientific Reports, Vol 7, Iss 1, Pp 1-14 (2017)
Appel, C K, Gallego-Pedersen, S, Andersen, L, Blancheflor Kristensen, S, Ding, M, Falk, S, Sayilekshmy, M, Gabel-Jensen, C & Heegaard, A-M 2017, ' The Src family kinase inhibitor dasatinib delays pain-related behaviour and conserves bone in a rat model of cancer-induced bone pain ', Scientific Reports, vol. 7, 4792, pp. 1-14 . https://doi.org/10.1038/s41598-017-05029-1

مصطلحات موضوعية: Bone density, Dasatinib, Osteoclasts, Administration, Oral, Tyrosine-kinase inhibitor, Rats, Sprague-Dawley, 0302 clinical medicine, Genes, Reporter, hemic and lymphatic diseases, Luciferases/genetics, Src family kinase, Phosphorylation, Luciferases, Pain Measurement/methods, Pain Management/methods, Pain Measurement, Osteosarcoma, Multidisciplinary, Tartrate-Resistant Acid Phosphatase/antagonists & inhibitors, Receptors, N-Methyl-D-Aspartate/genetics, Phosphorylation/drug effects, 3. Good health, Gene Expression Regulation, Neoplastic, src-Family Kinases, src-Family Kinases/antagonists & inhibitors, medicine.anatomical_structure, Osteosarcoma/complications, 030220 oncology & carcinogenesis, Medicine, Bone Neoplasms/complications, Female, medicine.symptom, Antineoplastic Agents/pharmacology, Tyrosine kinase, Signal Transduction, Proto-oncogene tyrosine-protein kinase Src, medicine.drug, medicine.medical_specialty, medicine.drug_class, Science, Pain, Antineoplastic Agents, Bone Neoplasms, Mammary Neoplasms, Animal, Dasatinib/pharmacology, Receptors, N-Methyl-D-Aspartate, Article, Bone and Bones, 03 medical and health sciences, Pain/drug therapy, Osteoclast, Cell Line, Tumor, Internal medicine, medicine, Pain Management, Animals, Mammary Neoplasms, Animal/complications, Author Correction, Bone pain, Protein Kinase Inhibitors, Tartrate-Resistant Acid Phosphatase, business.industry, Bone and Bones/drug effects, Rats, Endocrinology, Protein Kinase Inhibitors/pharmacology, Cancer research, Osteoclasts/drug effects, business, 030217 neurology & neurosurgery

الوصف: Pain is a severe and debilitating complication of metastatic bone cancer. Current analgesics do not provide sufficient pain relief for all patients, creating a great need for new treatment options. The Src kinase, a non-receptor protein tyrosine kinase, is implicated in processes involved in cancer-induced bone pain, including cancer growth, osteoclastic bone degradation and nociceptive signalling. Here we investigate the role of dasatinib, an oral Src kinase family and Bcr-Abl tyrosine kinase inhibitor, in an animal model of cancer-induced bone pain. Daily administration of dasatinib (15 mg/kg, p.o.) from day 7 after inoculation of MRMT-1 mammary carcinoma cells significantly attenuated movement-evoked and non-evoked pain behaviour in cancer-bearing rats. Radiographic - and microcomputed tomographic analyses showed significantly higher relative bone density and considerably preserved bone micro-architecture in the dasatinib treated groups, suggesting a bone-preserving effect. This was supported by a significant reduction of serum TRACP 5b levels in cancer-bearing rats treated with 15 mg/kg dasatinib. Furthermore, immunoblotting of lumbar spinal segments showed an increased activation of Src but not the NMDA receptor subunit 2B. These findings support a role of dasatinib as a disease modifying drug in pain pathologies characterized by increased osteoclast activity, such as bone metastases. Pain is a severe and debilitating complication of metastatic bone cancer. Current analgesics do not provide sufficient pain relief for all patients, creating a great need for new treatment options. The Src kinase, a non-receptor protein tyrosine kinase, is implicated in processes involved in cancer-induced bone pain, including cancer growth, osteoclastic bone degradation and nociceptive signalling. Here we investigate the role of dasatinib, an oral Src kinase family and Bcr-Abl tyrosine kinase inhibitor, in an animal model of cancer-induced bone pain. Daily administration of dasatinib (15 mg/kg, p.o.) from day 7 after inoculation of MRMT-1 mammary carcinoma cells significantly attenuated movement-evoked and non-evoked pain behaviour in cancer-bearing rats. Radiographic - and microcomputed tomographic analyses showed significantly higher relative bone density and considerably preserved bone micro-architecture in the dasatinib treated groups, suggesting a bone-preserving effect. This was supported by a significant reduction of serum TRACP 5b levels in cancer-bearing rats treated with 15 mg/kg dasatinib. Furthermore, immunoblotting of lumbar spinal segments showed an increased activation of Src but not the NMDA receptor subunit 2B. These findings support a role of dasatinib as a disease modifying drug in pain pathologies characterized by increased osteoclast activity, such as bone metastases.

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