Pain physician
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Observational Study
Subchondral Bone Changes Following Sacroiliac Joint Arthrodesis - A Morpho-mechanical Assessment of Surgical Treatment of the Painful Joint.
Sacroiliac joint arthrodesis is an ultima ratio treatment option for sacroiliac joint dysfunction. Fusion drastically reduces sacroiliac joint movement providing long-lasting pain-relief associated with tension-relief to the innervated sacroiliac joint structures involved in force closure. ⋯ Sacroiliac joint arthrodesis results in an increased morpho-mechanical conformity in the anterior and inferior sacrum and reflects variable morpho-mechanical density patterns compared to the healthy state due to permanent alterations in the kinematics of the posterior pelvis.
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Acute and degenerative musculoskeletal disorders are among the most common etiologies of disability worldwide. Recently, there has been interest in the field of regenerative medicine to bridge the gap between conservative and surgical management of these conditions. Autologous bone marrow concentrate is one type of injectate that has increased in popularity over the last few decades. Though there is promising evidence supporting its efficacy, standard of care practice guidelines to govern the appropriate use and implementation of such technology are currently lacking. ⋯ There is significant consensus among a panel of physicians performing bone marrow concentrate injections regarding best practice guidelines for musculoskeletal conditions.
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Control of chronic pain and mainly the partial or complete loss of response to analgesics is a major unmet need. Multiple mechanisms underline the development of tolerance to analgesics in general and specifically to opioids. The autonomic nervous system (ANS) plays a role in the development of analgesic tolerance and chronobiology. ⋯ The described variability-based system may ensure prolonged effects of analgesics while reducing the toxicity associated with increasing dosages.
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Randomized Controlled Trial
The Effect of Acupuncture and Physiotherapy on Patients with Knee Osteoarthritis: A Randomized Controlled Study.
Osteoarthritis is the most prevalent form of joint disease, and the most common location is the knee. ⋯ The acupuncture and physiotherapy performed twice weekly for 6 weeks have similar effects with regard to pain, functional status, and QOL. There were no significant differences between the acupuncture and physiotherapy groups in relief of pain, improved functional status, and QOL in the treatment of KOA. Both acupuncture and physiotherapy treatments were found to yield significantly superior results when compared with baseline values.