The effectiveness of whirlpool for patients with neuropathic pain due to knee osteoarthritis (original) (raw)
Related papers
Journal of Physical Therapy Science, 2015
The aim of the present study was to investigate and compare the effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome. [Subjects and Methods] Sixty outpatients (30 per group) with complex regional pain syndrome participated. They received 15 treatment 5 days per week for 3 weeks. The outcome measures were the visual analogue scale for pain, edema, range of motion of the wrist (flexion and extension), fingertip-to-distal palmar crease distance, hand grip strength, and pinch strength. All parameters were measured at baseline (week 0) and at the trial end (week 3). [Results] There were significant improvements in all parameters after therapy in both groups. The whirlpool bath group showed significantly better improvements in the visual analogue score, hand edema, hand grip strength, wrist range of motion (both flexion and extension), fingertip-to-distal palmar crease distance, and the three-point and fingertip pinch strengths than the neuromuscular electrical stimulation group; however, the lateral pinch strengths were similar. [Conclusion] Both whirlpool bath and neuromuscular electrical stimulation are effective in the treatment of complex regional pain syndrome, but the efficacy of the whirlpool bath treatment was better.
Do We Pay Enough Attention to Neuropathic Pain in Knee Osteoarthritis Patients?
Acta clinica Croatica, 2018
The aim of the study was to determine the prevalence of neuropathic pain in knee osteoarthritis patients using painDETECT questionnaire, and to evaluate correlations between pain intensity, gender, age and types of treatment, and the presence of neuropathic pain. The study included 122 patients. All participants completed a questionnaire on sociodemographic data, duration of symp-toms, types of treatment and preventable risk factors (body mass index and waist circumference). The presence of neuropathic pain was assessed by painDETECT, according to which subjects were classified into three groups (neuropathic pain likely, possible, or unlikely). Neuropathic pain was likely in 18 (14.8%), possible in 30 (24.6%) and unlikely in 74 (60.7%) subjects. A significant positive correlation was found between visual analog scale for pain and painDETECT score. There was no statistically significant difference in gender, age, waist circumference and body mass index among three groups of participa...
Seminars in Arthritis and Rheumatism, 2014
Objectives: Osteoarthritis (OA) is the leading cause of musculoskeletal pain and functional disability worldwide, affecting a growing number of individuals in the western society. Despite various conservative and interventional treatment approaches, the overall management of the condition is problematic, and pain-the major clinical problem of the disease-remains sub-optimally controlled. The objectives of this review are to present the pathophysiologic mechanisms underlying the complexity of pain in OA and to discuss the challenges for new treatment strategies aiming to translate experimental findings into daily clinical practice. Methods: A narrative literature review of studies investigating the existence of a neuropathic component in OA pain was conducted. We searched PubMed, Embase and Scopus for English language publications. A hand-search of reference lists of relevant studies was also performed. Results: Recent advances have shed additional light on the pathophysiology of osteoarthritic pain, highlighting the contribution of central pain pathways together with the sensitisation of peripheral joint receptors and changes of the nociceptive process induced by local joint inflammation and structural bone tissue changes. Thus, a neuropathic pain component may be predominant in individuals with minor joint changes but with high levels of pain refractory to analgesic treatment, providing an alternative explanation for osteoarthritic pain perception. Conclusion: A growing amount of evidence suggests that the pain in OA has a neuropathic component in some patients. The deeper understanding of multiple mechanisms of OA pain has led to the use of centrally acting medicines that may have a benefit on alleviating osteoarthritic pain. The ineffective pain management and the increasing rates of disability associated with OA mandate for change in our treatment paradigm.
Sensory stimulation (acupuncture) for the treatment of idiopathic anterior knee pain 2002.pdf
A randomized controlled study was conducted to evaluate the effect of acupuncture treatment in idiopathic anterior knee pain, a pain syndrome without known aetiology. Fiftyeight patients, clinically and radiologically examined, were randomly assigned to either deep or minimal super cial acupuncture treatment. The patients were treated twice weekly for a total of 15 treatments. The main outcome measurements were one leg vertical jump, functional score, daily VAS recording and skin temperature. Fifty-seven patients completed the study. Pain measurements on VAS decreased signi cantly within both groups; in the deep acupuncture group from 25 before treatments to 10 afterwards, and in the super cial (placebo) acupuncture group from 30 to 10. There was no signi cant difference between the groups. The improvement on the VAS recordings remained signi cant even after 3 and 6 months. Even though the pain decreased after sensory stimulation, neither the ability to jump on one leg, the functional score nor the skin temperature changed. This study shows that patients with idiopathic anterior knee pain bene t from both electroacupuncture treatment and subcutaneous needling. The pain-relieving effect remains for at least 6 months. Central pain inhibition, caused by either afferent stimulation or by non-speci c therapeutic (placebo) effects, is a plausible explanation behind the treatment effects.
Evaluating the Effectiveness of Treatment Options for Pain: Literature Review
Orthopedic Research Online Journal
Objectives: This literature review assesses the short and long term effectiveness for chronic pain management of single modality treatment approaches such as opioid use, non-steroidal anti-inflammatory drugs, massage therapy, manual therapy (soft tissue mobilization), instrument assisted soft tissue mobilization, myofascial release, acupuncture, soft tissue release, dry needle, trigger point injection, joint manipulation/joint mobilization, active release technique, strain counter strain, craniosacral therapy, stretching/exercise, McKenzie method, and kinesio taping in comparison to treatment methods that follow the biopsychosocial model such as the multidisciplinary approach, cognitive behavioral rehabilitation and Advanced Soft Tissue Release. Methods: A comprehensive literature search was conducted in major search databases including Medline, ScienceDirect, Pubmed, Embase, Google Scholar, Cinahl, BioMed Central, and Cochrane. 16,145 articles were found. Studies that met the inclusion criteria included systematic reviews and metaanalyses evaluating the treatment options for musculoskeletal pain. Results: 57 studies met the criteria of this study, with 50 being systematic reviews, 4 randomized controlled trials (RCT), 1 non-RCT, and 2 literature reviews. The single modality studies were 47 studies, totalled as 53 individual different findings because some studies evaluated several single modalities in the same study. The findings of the 47 studies were consistent regarding that the single modalities provided short term pain reduction or no pain reduction. The biopsychosocial model studies were 7 systematic reviews, 1 literature review, 1 cohort study that consistently showed long term pain reduction, improved range of motion, and improvement in functional activities. Conclusion: Based on the studies evaluated, treatment methods following the biopsychosocial model seem to yield long term pain reduction, increased range of motion, and improvement in functional activities. On the other hand the single modality treatment methods seemed to yield either short term pain reduction or no pain reduction.
Background: Osteoarthritis (OA) of knee is an important cause of pain and functional limitation in older people. Some studies show pulsed electromagnetic energy therapy (PEME) reduces pain and disability. The efficacy of PEME therapy in knee osteoarthritis is not known in Indian population. Aims & Objective: To compare the effect of PEME therapy versus conventional therapy on pain and function in participants with knee OA. Materials and Methods: A quasi experimental study of 20 participants fulfilling the inclusion and exclusion criteria, by selective sampling was conducted at college of physiotherapy. Participants were randomly allocated into 2 groups. Group A was given PEME therapy with Magnetodyne with frequency 15Hz for 30 minutes, 6 days/week for 2 weeks. Group B was given conventional physiotherapy in the form of hot pack to the knee for 10-15 minutes. Both groups also received a set of 10 repetitions of quadriceps drill and stretching of tight muscles for 30sec-3 repetitions. Visual Analogue Scale (VAS) was used to assess knee pain and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) was used to measure knee pain, stiffness and physical function. Results: Difference in VAS and WOMAC scores were calculated using t-test. Mean difference in VAS score for Group A (4.08 ± 1.10) and Group B (1.40 ± 0.21) was significant with significant difference in favor of Group A (t= 7.57, p <0.001). Mean difference in WOMAC for Group A (27.50 ± 13.80) and Group B (8.50 ± 3.71), also showed a significant difference with more difference in Group A (t= 4.20, p<0.001). Conclusion: PEME therapy reduces pain and improves physical function in participants with knee OA.
Knee Osteoarthritis Related Pain : A Narrative Review of Diagnosis and Treatment
International Journal of Health Sciences, 2014
Background: Osteoarthritis is a common progressive joint disease, involving not only the joint lining but also cartilage, ligaments, and bone. For the last ten years, majority of published review articles were not specific to osteoarthritis of the knee, and strength of evidence and clinical guidelines were not appropriately summarized.