Pain physician
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Randomized Controlled Trial
Development of an effective topical liposomal formulation for localized analgesia and anti-inflammatory actions in the Complete Freund's Adjuvant rodent model of acute inflammatory pain.
Peripheral opioid receptor targeting has been well established as a novel target in clinical pain management for acute and chronic peripheral inflammatory pain. The physiochemical properties of the peripheral mu-opioid receptor agonist, loperamide HCl, limit the use of the free drug as an analgesic or anti-inflammatory agent, particularly for dermal delivery across intact skin. ⋯ The study demonstrates that topically applied loperamide encapsulated within liposomal systems has improved therapeutic efficacy over conventional formulations for the local treatment of acute peripheral inflammatory pain conditions where the skin has remained intact. Once in the inflamed peripheral tissue, loperamide provides analgesic and anti-inflammatory effects in a similar manner to peripheral endogenous opioids. This preparation optimises the retention of drug at the site where action is required.
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Ice hockey is a competitive sport and ice hockey injuries can be influenced by many physical and psychological factors. Young ice hockey players are especially vulnerable to injury due to their relative lack of experience and rapid physical growth during their juvenile years. Up to now there has been no survey of the physical, psychological, and environmental etiological factors based on the Korean high school ice hockey players population. ⋯ The multiple aspects of this etiological factor analysis showed modest results. However, based on our results, in order to reduce the long-term implications of youth ice hockey injuries and associated public health costs, comprehensive efforts, including psychological and environmental factor modification, should be put in place.
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Approximately 6% to 8% of lumbar pain cases, whether associated with radicular pain or not, may be attributed to the presence of piriformis muscle syndrome. Available treatments, among others, include pharmacotherapy, physical therapy, and injections of different substances into the muscle. Various methods have been used to confirm correct needle placement during these procedures, including electromyography (EMG), fluoroscopy, computed tomography (CT), or magnetic resonance imaging (MRI). Ultrasonography (US) has now become a widely used technique and therefore may be an attractive alternative for needle guidance when injecting this muscle. ⋯ Ultrasound-guided puncture may be a reliable and simple procedure for injection of the piriformis muscle, as long as good education and training are provided to the operator. US has a number of advantages over traditional approaches, including accessibility and especially no ionizing radiation exposure for both health care providers and patients.
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The shoulder joint is an enarthrodial or ball-and-socket joint. A complex network of anatomic structures endows the human shoulder with tremendous mobility, greater than any other joint in the body. Many pathologies can been found in those patients with chronic shoulder pain. ⋯ Her pain and shoulder range of motion in all planes improved dramatically. Peripheral nerve stimulation (PNS) of the suprascapular nerve, in addition to multimodality pain management, is one approach to the difficult task of treating adhesive capsulitis with accompanying pain and the inability to move the shoulder. We conducted a literature review on PubMed and found no case describing a similar patient to our knowledge.
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We report a new technique for pulsed radiofrequency (PRF) of the entire nerve supply of the knee as an option in treating osteoarthritis (OA) of knee. We targeted both sensory and motor nerves supplying all the structures around the knee: joint, muscles, and skin to address the entire nociception and stiffness leading to peripheral and central sensitization in osteoarthritis. Ten patients with pain, stiffness, and loss of function in both knees were treated with ultrasonography (USG) guided PRF of saphenous, tibial, and common peroneal nerves along with subsartorial, peripatellar, and popliteal plexuses. ⋯ The sustained pain relief and muscle relaxation enabled the patients to optimize physiotherapy thereby improving endurance training to include the daily activities of life. We conclude that OA knee pain is a product of neuromyopathy and that PRF of the sensory and motor nerves appeared to be a safe, effective, and minimally invasive technique. The reduction of pain and stiffness improved the knee function and probably reduced the peripheral and central sensitization.