European journal of pain : EJP
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Randomized Controlled Trial Multicenter Study
Acupuncture and electro-acupuncture for people diagnosed with subacromial pain syndrome: A multicentre randomized trial.
Musculoskeletal disorders have been identified globally as the second most common healthcare problem for 'years lived with disability', and of these shoulder conditions are amongst the most common, frequently associated with substantial pain and morbidity. Exercise and acupuncture are often provided as initial treatments for musculoskeletal shoulder conditions but their clinical effectiveness is uncertain. This study compared group exercise with group exercise plus either acupuncture or electro-acupuncture in patients with subacromial pain syndrome. ⋯ Shoulder pain is common and associated with substantial morbidity. Acupuncture is a popular treatment for shoulder pain. The findings suggest that acupuncture and electro-acupuncture offer no additional benefit over exercise in the treatment of shoulder pain of musculoskeletal origin.
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Drugs activating the mu opioid receptor are routinely used to treat severe acute and chronic pain. Unfortunately, side effects including nausea, constipation, respiratory depression, addiction and tolerance can limit clinical utility. In contrast, kappa opioid receptor (KOPr) agonists, such as Salvinorin A (SalA), have analgesic properties with little potential for abuse. ⋯ Salvinorin A and the novel analogue β-THP Salvinorin B show analgesic effects in the tail-withdrawal and formalin assays. They reduce oedema and decrease neutrophil infiltration into inflamed tissue, and suppress mechanical and cold allodynia in paclitaxel-induced neuropathic pain.
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The phenomenon of temporal summation to repetitive pressure pain stimuli is an important central neural mechanism for pain intensity encoding. This study evaluated the time-dependent behaviour of mechanical characteristics of soft tissue during repeated cuff stimulation used for eliciting temporal summation of cuff pressure-evoked pain. Such information of tissue mechanics is important for the interpretation of the pain response evoked during sequential stimulations. ⋯ The temporal summation of pain during sequential cuff stimulation is inexplicable by the time-dependent response of mechanical stress and strain in soft tissue.