Research trends in exercise therapy for the treatment of pain in postmenopausal osteoporosis over the past decade:A bibliometric analysis

BACKGROUND Postmenopausal osteoporosis(PMOP)is the most common form of primary osteoporosis among women,and the associated pain often drives patients to seek clinical intervention.Numerous studies have highlighted the unique clinical benefits of exercise therapy(ET)in alleviating PMOP-related pain.However,bibliometric analyses examining collaboration,development trends,and research frontiers in the field of ET for PMOP pain remain scarce.AIM To explore the research trends in ET for pain treatment in PMOP patients over the past decade.METHODS All scholarly works were meticulously sourced from the Science Citation Index-Expanded within the prominent Web of Science Core Collection.Utilizing the capabilities of CiteSpace 6.2.R5,we conducted a thorough analysis of publications,authors,frequently cited scholars,contributing nations,institutions,journals of significant citation,comprehensive references,and pivotal keywords.Additionally,our examination explored keyword cooccurrences,detailed timelines,and periods of heightened citation activity.This comprehensive search,from 2014 through 2023,was completed within a single day,on October 11,2023.RESULTS In total,2914 articles were ultimately included in the analysis.There was a rapid increase in annual publication output in 2015,followed by stable growth in subsequent years.Boninger,Michael L,is the most prolific author,whereas Ware JE has the most citations.The United States’global influence is significant,surpassing all other nations.The University of California System and Harvard University are the most influential academic institutions.J Bone Joint Surg Am is the most influential journal in this field.“Spinal cord injury”is the keyword that has garnered the most attention from researchers.The developmental pattern in this field is characterized by interdisciplinary fusion,with different disciplines converging to drive progress.CONCLUSION The academic development of the field of ET for pain in PMOP has matured and stabilized.Clinical management and rehabilitation strategies,along with the mechanisms underlying the relationship between ET and bone resorption analgesia,continue to be the current and future focal points of research in this field.

Impacts of radiation therapy on quality of life and pain relief in patients with bone metastases

Bone metastases(BM)are a common complication in advanced cancer patients,significantly contributing to morbidity and mortality due to their ability to cause pain,fractures,and spinal cord compression.Radiation therapy(RT)is vital in managing these complications by targeting metastatic lesions to ease pain,improve mobility,and reduce the risk of skeletal-related events such as fractures.Evidence supports the effectiveness of RT in pain relief,showing its ability to provide significant palliation and lessen the need for opioid painkillers,thereby enhancing the overall quality of life(QoL)for patients with BM.However,optimizing RT outcomes involves considerations such as the choice of radiation technique,dose fractionation schedules,and the integration of supportive care measures to mitigate treatment-related side effects like fatigue and skin reactions.These factors highlight the importance of personalized treatment planning tailored to individual patient needs and tumor characteristics.This mini-review aims to provide comprehensive insights into the multifaceted impacts of RT on pain management and QoL enhancement in BM patients,with implications for refining clinical practices and advancing patient care through the synthesis of findings from various studies.

Clinical efficacy of magnetic vibration magnetoelectric therapy in the treatment of chronic prostatitischronic pelvic pain syndrome

BACKGROUND The prominent symptoms of chronic pelvic pain syndrome(CPPS)are urogenital pain,lower urinary tract symptoms,psychological problems,and sexual dysfunction.Traditional pharmacological treatments have poor efficacy and more untoward reaction and complications.Magnetic vibration magnetoelectric therapy is a non-invasive form of physiotherapy.Nevertheless,its effectiveness in improving urinary discomfort and relieving pain in patients requires further exploration.AIM To investigate the clinical efficacy of the magnetic vibration magnetoelectric therapy instrument in the treatment of chronic prostatitis(CP)/CPPS.METHODS Seventy patients with CP/CPPS were collected from the outpatient clinic and ward of the Department of Male Medicine,Jiangsu Province Hospital of Traditional Chinese Medicine,and were treated with magnetic vibration magnetoelectric therapy once a day for a period of 14 d.National Institutes of healthchronic prostatitis symptom index(NIH-CPSI),international index of erectile function 5(IIEF-5),premature ejaculation diagnostic tool(PEDT),generalized anxiety disorder(GAD),patient health questionnaire,the pain catastrophizing scale(PCS)and traditional Chinese medicine syndrome(TCMS)scores were performed before and after treatment.RESULTS The total effective rate of treatment was 58.5%,and the total NIH-CPSI score,pain symptoms,voiding symptoms,quality of life,IIEF-5,PEDT,GAD,PCS and TCMS scores all decreased significantly(P<0.05).CONCLUSION Magnetic vibration magnetotherapy is effective in improving urinary discomfort,relieving pain,improving quality of life,improving sexual dysfunction and relieving negative emotions such as anxiety in patients with CP/CPPS.

Efficacy and safety of thermobalancing therapy with Dr Allen’s Device for chronic low back pain:A randomised controlled trial

BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients’health-related quality of life(HRQoL).Although empirical evidence has demonstrated that novel Thermobalancing therapy and Dr Allen’s Device can relieve chronic low back pain,there have been no randomised controlled trials for these indications.AIM To evaluate the efficacy of Dr Allen’s Device in lumbar disc herniation(LDH)and non-specific low back pain(NSLBP).METHODS A randomised clinical trial was conducted investigating 55 patients with chronic low back pain due to LDH(n=28)or NSLBP(n=27),out of which 15 were randomly assigned to the control group and 40 were assigned to the treatment group.The intervention was treatment with Dr Allen’s Device for 3 mo.Changes in HRQoL were assessed using the Numerical Pain Rating Scale and the Japanese Orthopedic Association Back Pain Questionnaire.RESULTS Thermobalancing therapy with Dr Allen’s Device showed a significant reduction in pain in the treatment group(P<0.001),with no recorded adverse effects.Both pain assessment scales showed a significant improvement in patients’perception of pain indicating improvement in HRQoL.CONCLUSION The out-of-hospital use of Thermobalancing therapy with Dr Allen’s Device for Low Back Treatment relieves chronic low back pain significantly and without adverse effects,improves the level of activity and HRQoL among patients with LDH and NSLBP.This study demonstrates the importance of this safe first-line therapy that can be used for effective at-home management of chronic low back pain.

Application of five-element music therapy in pain coping skills training in patients with knee osteoarthritis

Objective:The objective of this study is to assess the application effect of five elements music therapy introduced in the pain coping skills training of knee osteoarthritis(KOA).Materials and Methods:Totally,80 patients with KOA were selected and randomly divided into the experimental group(39 cases)and the control group(41 cases).The control group was only given routine nursing measures,and the experimental group was additionally treated with five-element music therapy on the basis of the control group,twice a day,28 days in total.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)was used to evaluate the functional status of the knee joint of the two groups.The clinical efficacy of the two groups was evaluated by Guiding Principles for Clinical Research of New Chinese Medicine in the Treatment of Osteoarthritis.Results:WOMAC score statistically significantly decreased in the experimental group(35.92±9.48 vs.16.17±5.43,P<0.01)and the control group(36.73±6.42 vs.22.53±7.51,P<0.01)after 28 days of intervention when compared with that before intervention;WOMAC score in the experimental group was lower than that of the control group after 28 days of intervention(16.17±5.43 vs.22.53±7.51,P<0.01).The total effective rate of the experimental group was statistically higher than that of the control group(82.0%vs.51.2%,χ2=11.97,P=0.003).Conclusion:The combination of five-element music therapy and routine nursing measures has better effect in relieving pain and bad emotions of patients with KOA when compared with routine nursing measures alone.

Spa therapy relieves knee and shoulder pain:a randomized controlled trial

Objective:To study the effect of spa therapy on relieving knee and shoulder pain.Methods:Participants were randomized to an intervention group(n=26)or a control group(n=23).The intervention group received the hot spring intervention program(1-2 times a day for two weeks),while the control group didn’t receive any intervention.Primary outcomes were assessed by the Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and Shoulder Pain and Disability Index(SPADI).Secondary outcomes were assessed by general physical symptoms and Short Form-36(SF-36)health survey.Results:All parameters before intervention were homogenous between the groups.At baseline,there was no significant difference in WOMAC and SPADI index between the two groups,but there was a statistically significant difference in blurred vision,which was worse in the intervention group than in the control group(P<0.05).After intervention,general physical symptoms were relieved significantly in the intervention group compared with the control group(P<0.05).WOMAC index,SPADI index,social functioning,and general physical symptoms were relieved significantly after intervention in the intervention group(P<0.05).There is a significant difference in the blurred vision before and after the comparison of the control group(P<0.05).Conclusion:Spa therapy may relieve knee and shoulder pain and improve general physical symptoms and quality of life.

Percutaneous cervical cordotomy for managing refractory pain in a patient with a Pancoast tumor:A case report

BACKGROUND According to the World Health Organization analgesic ladder,cancer-related pain generally begins with pharmacotherapy in a stepwise approach.Nevertheless,some patients continue to experience poorly controlled pain despite medications,particularly when considering adverse effects and self-care quality.Percutaneous cervical cordotomy is an alternative interventional procedure for unremitting unilateral intractable cancer-related pain.CASE SUMMARY The patient was diagnosed with lung cancer with destruction of the brachial plexus and ribs.For 2 mo,the patient experienced progressive severe weakness and pain in the right upper extremity.Notably,the pain intensity reached an extreme level,particularly when lying supine,even under heavy sedation.This heightened pain response posed a significant challenge;as a result,the patient was unable to undergo further evaluation through magnetic resonance imaging.Ultimately,he underwent percutaneous cervical cordotomy for symptom relief,resulting in complete resolution of right arm pain.After a 3-mo follow-up,the pain did not recur,and only a flurbiprofen local patch was required for mild scapular tightness.CONCLUSION Cordotomy,under careful patient selection,appears to enhance the quality of life of patients with unilateral cancerrelated pain.

Biofeedback therapy for chronic pelvic pain syndrome

<abstract>Aim: To evaluate the efficacy of biofeedback therapy in patients with chronic pelvic pain syndrome (CPPS). Methods: From November 2001 to April 2002, patients visiting the Urological Outpatient Clinic of this Hospital were evaluated by means of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and classified by the NIH classification standard. Sixty-two patients of CPPS category Ⅲwere involved in this study. All patients had been treated by conventional approaches such as antibiotics and alpha-blockers for more than half a year without any improvement. The expressed prostatic secretion results were as follows: WBC 5 to 9/high power field, lipid +-+++and bacterial culture negative. Their NIH-CPSI were 12-40. All the 62 cases complained of micturitional irritation (frequency, urgency, splitted stream and sense of residual urine), 32 cases, of pain or discomfort at the testicular, penile, scrotal, pelvic or rectal region and 13 cases, of white secretion-dripping. The patients were treated by the Urostym Biofeedback equipment (Laborie Co., Canada) 5 times a week for 2 weeks with a stimulus intensity of 15 mA-23 mA and duration of 20 minutes. Results: Sixty patients were significantly improved or cured, while no significant improvement in the remaining 2. No apparent side effect was observed. The NIH-CPSI dropped to 6 to 14 with an average reduction of 21 (P<0.01). In the 60 improved cases, pain was relieved after 2-3 treatment courses and other symptoms disappeared after 4-5 courses. Conclusion: Biofeedback therapy is a safe and effective treatment for CPPS. Large randomized clinical trials are needed to confirm its efficacy and to explore the mechanism of action.

Expert consensus of Chinese Association for the Study of Pain on the radiofrequency therapy technology in the Department of Pain

On the basis of continuous improvement in recent years,radiofrequency therapy technology has been widely developed,and has become an effective method for the treatment of various intractable pain.Radiofrequency therapy is a technique that uses special equipment and puncture needles to output ultra-high frequency radio waves and accurately act on local tissues.In order to standardize the application of radiofrequency technology in the treatment of painful diseases,Chinese Association for the Study of Pain(CASP)has developed a consensus proposed by many domestic experts and scholars.

Effect of low-level laser therapy on tooth-related pain and somatosensory function evoked by orthodontic treatment

Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.

Traditional Chinese medicine ointment combined with tuina therapy in treatment of pain and swelling after total knee arthroplasty

BACKGROUND The most effective treatment for knee joint pain is total knee arthroplasty(TKA),but the risk of pain and swelling in patients after surgery is high.Ice application,ankle pump exercise and non-steroidal anti-inflammatory painkillers are the primary clinical treatments after surgery.However,long-term use of nonsteroidal anti-inflammatory pain relievers can easily cause gastrointestinal damage.Traditional Chinese medicine(TCM)ointments and tuina therapy integrate TCM and manipulation,which effectively promotes the penetration of TCM into the skin lesions,improves local blood circulation and inflammatory reaction and has good long-term effects on patients.AIM To evaluate the efficacy of TCM ointment combined with tuina therapy in the treatment of pain and swelling after TKA.METHODS The randomized controlled clinical trial enrolled 80 patients who underwent TKA via the same procedure.The patients were randomly divided among the treatment group(n=40)and the control group(n=40).The control group was given an analgesia pump in addition to oral painkillers as the postoperative intervention.The treatment group received TCM ointment with tuina therapy in addition to the analgesia pump and oral painkillers in the postoperative period.The following variables were recorded 3 d before surgery and 3 d,7 d and 14 d after surgery:Visual analogue scale(VAS)score;skin temperature;circumferences at 15 cm above and below the patella;maximum active knee flexion angle;and the knee injury and Osteoarthritis Outcome score(KOOS).RESULTS After treatment,VAS was significantly lower in the treatment group than the control group at 7 d(t=7.536,P<0.001)and 14 d(t=8.563,P<0.001).The skin temperature of participants in the treatment group was significantly lower than that in the control group at 7 d(t=2.968,P=0.004)and 14 d(t=4.423,P<0.001).The circumference values of the two positions in the treatment group were lower than those in the control group at 7 d[t=2.315,P=0.023(above);t=2.121,P=0.037(below)]and 14 d[t=2.374,P=0.020(above);t=2.095,P=0.039(below)].After 14 d of treatment,the maximum active knee flexion angle and KOOS of the two groups were significantly improved but were significantly higher in the treatment group(P<0.05 for both).CONCLUSION TCM ointment and tuina therapy have significant advantages over standard care in the treatment of pain and swelling after TKA.This additional treatment may improve knee function but additional studies are needed to confirm our observations.

Efficacy and Safety of Transdermal Fentanyl(TDF)in Treatment of Pain Caused by Interventional Embolization Therapy

Objective： Interventional embolization therapy is well accepted in cancer treatment, but patient may suffer from a moderate-to-severe pain after therapy and its quality of life （QoL） is influenced, this study is to observe the efficacy and safety of transdermal fentanyl （TDF） in the management of pain caused by interventional embolization therapy. Methods： Morphine 10mg and TDF 25μg/h were immediately used in 52 patients who had moderate-to-severe pain complicated by interventional embolization therapy, the pain intensity was evaluated by visual analogue scale （VAS）. If VAS≥4 at t2 h after treatment, the dosage of TDF added into 50 μg/h. At 0h, 12h, 24h, 72h, 1 week, 2 weeks after TD, the vas and adverse events were observed respectively. Result： There was an obvious decrease in VAS at 12h after TDF treatment in the patients of which only 9 patients used 50ug/h dosage after partial splenic embolization （PSE） therapy. Most patients got satisfactory pain relief both the TDF 25 μg/h and TDF 50 μg/h group （VAS 0-1）. The adverse events were nausea, vomiting and dizzy, especially in the TDF 50 μg/h group. No respiratory depression was observed and only one patient got retention of urine. Conclusion： TDF was effective and safe in the treatment of moderate-to-severe pain after interventional embolizafion therapy.

Minimally invasive interventional therapy for pain

Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseases.Compared with traditional destructive surgery,interventional pain therapy is considered a better and more economical choice of treatment.In recent years,a variety of minimally invasive pain interventional therapy techniques,such as neuroregulation,spinal cord electrical stimulation,intervertebral disc ablation,and intrasheath drug infusion systems,have provided effective solutions for the treatment of patients with post-herpetic neuralgia,complex regional pain syndrome,cervical/lumbar disc herniation,and refractory cancer pain.

Cupping therapy for acute and chronic pain management:a systematic review of randomized clinical trials

Objective:Cupping as a traditional therapy is used to treat a myriad of health conditions,including pain.This systematic review assessed the effectiveness and safety of cupping for different types of pain.Methods:Thirteen databases and four trial registries were searched for randomized clinical trials.Meta-analysis of data was conducted if there was non-significant clinical and statistical heterogeneity(measured by I2 test)among trials.Results:Sixteen trials with 921 participants were eligible and included.Six trials were assessed as low risk of bias,another six trials were of unclear risk of bias,and the remaining four trials were of high risk of bias.Pain was related to three acute and seven chronic diseases.Metaanalysis showed a beneficial effect of cupping compared to wait-list control(visual analogue scale(VAS),MD
1.85 cm,95%CI
2.66 to
1.04)and heat therapy(numerical rating scale,MD
2.05 cm,95%CI
2.93 to
1.17).Cupping combined with acupuncture was superior to acupuncture alone on post-treatment pain intensity(VAS,MD
1.18 cm,95%CI
1.68 to
0.68),however,no difference was found between this comparison based on changes in pain intensity(difference of VAS,MD 0.16 cm,95%CI
0.54 to 0.87).Results from other single studies showed significant benefit of cupping compared with conventional drugs or usual care.Hematoma and pain at the treated site,increasing local pain or tingling were reported as mild adverse effects of cupping.Conclusion:This review suggests a potential positive short-term effect of cupping therapy on reducing pain intensity compared with no treatment,heat therapy,usual care,or conventional drugs.

Effect of moxibustion combined with five‑element music therapy on postoperative pain relief after mixed hemorrhoid operation

Objective:To investigate the effect of moxibustion combined with five‑element music therapy on the postoperative pain relief of patients undergoing surgical operation for mixed hemorrhoid with damp‑heat syndrome.Methods:Totally,159 patients meeting the inclusion criteria were assigned to the control group,study group 1,and study group 2,with 53 cases in each group.All patients received routine care after surgical treatment,including acupoint application and Chinese herbal fumigation.In addition,patients in the study group 1 received moxibustion,and those in the study group 2 were given moxibustion combined with five‑element music therapy.The degree of postoperative pain was evaluated using visual analog scale(VAS).Results:There was no significant difference in VAS score on pain during dressing changes among three groups(P>0.05).After 3,5,and 7 days of intervention,there was a significant difference in VAS score on pain at rest among three groups(P<0.001),and VAS score in the study group 2 was lower than that in the study group 1 and the control group after 3 and 5 days of intervention,respectively(P<0.05).Conclusion:Moxibustion combined with five‑element music therapy is effective to relieve the postoperative pain of patients undergoing a surgical operation for mixed hemorrhoids with damp‑heat syndrome.

Effect of microenvironment modulation on stem cell therapy for spinal cord injury pain

Spinal cord injury （SCI） currently ranks second after mental retarda- tion among neurological disorders in terms of cost to society. Pain is a debilitating consequence of SCI related to the nature of the lesion, neurological structures damaged, and secondary pathophysiological changes of surviving tissues （Yezierski, 2005; D＇Angelo et al., 2013）.

Effects of individual shock wave therapy vs celecoxib on hip pain caused by femoral head necrosis

BACKGROUND Celecoxib has been used to treat hip discomfort and functional difficulties associated with osteonecrosis of the femoral head(ONFH),although significant adverse reactions often follow long-term use.Extracorporeal shock wave therapy(ESWT)can delay the progression of ONFH,alleviate the pain and functional limitations it causes,and avoid the adverse effects of celecoxib.AIM To investigate the effects of individual ESWT,a treatment alternative to the use of celecoxib,in alleviating pain and dysfunction caused by ONFH.METHODS This was a randomized,controlled,double-blinded,non-inferiority trial.We examined 80 patients for eligibility in this study;8 patients were excluded based on inclusion and exclusion criteria.A total of 72 subjects with ONFH were randomly assigned to group A(n=36;celecoxib+alendronate+sham-placebo shock wave)or group B(n=36;individual focused shock wave[ESWT based on magnetic resonance imaging three-dimensional(MRI-3D)reconstruction]+alendronate).The outcomes were assessed at baseline,at the end of treatment,and at an 8-wk follow-up.The primary outcome measure was treatment efficiency after 2 wk of intervention using the Harris hip score(HHS)(improvement of 10 points or more from the baseline was deemed sufficient).Secondary outcome measures were post-treatment HHS,visual analog scale(VAS),and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores.RESULTS After treatment,the pain treatment efficiency of group B was greater than that of group A(69%vs 51%;95%CI:4.56%to 40.56%),with non-inferiority thresholds of-4.56%and-10%,respectively.Furthermore,the HHS,WOMAC,and VAS scores in group B dramatically improved during the follow-up period as compared to those in group A(P<0.001).After therapy,the VAS and WOMAC in group A were significantly improved from the 2nd to 8th wk(P<0.001),although HHS was only significantly altered at the 2 wk point(P<0.001).On the 1st d and 2nd wk after treatment,HHS and VAS scores were different between groups,with the difference in HHS lasting until week 4.Neither group had severe complications such as skin ulcer infection or lower limb motorsensory disturbance.CONCLUSION Individual shock wave therapy(ESWT)based on MRI-3D reconstruction was not inferior to celecoxib in managing hip pain and restrictions associated with ONFH.

Physiotherapy,Yoga and Educational Project for Patients Suffering from Pain Due to Hormone Therapy after Breast Cancer:The SKYPE Feasibility Study

Approximately 50%of breast cancer patients under hormone therapy experience osteoarticular pain,which increases the risk of treatment discontinuation and relapse.The aim of the study was to assess the feasibility of yoga practice associated with patient education(PE)for at-home practice in breast cancer patients under hormone therapy.We also evaluated osteoarticular pain,flexibility and patients’satisfaction.In this study,intervention was split into two 6-week periods(P):P1 consisting of a supervised yoga-PE session of 90 minutes/week and 15-minutes of daily at-home yoga,and P2,involving daily autonomous athome yoga sessions.Feasibility was evaluated by patient adherence defined as completion of at least 4 out of the 6 supervised yoga-PE sessions and 70%or more of the at-home yoga sessions.Evaluations(at inclusion and at the end of each period)consisted in assessment of osteoarticular pain,forward flexibility and patient satisfaction.Twenty-four women with a median age of 53 years[36–72]were included.Feasibility was validated with a successful adherence rate reaching 83%,combined with a mean satisfaction score of 10/10[8–10].In addition,58%of patients reported reduced osteoarticular pain,with a 2-point reduction on the numerical rating scale.The forward flexibility also improved,with a median gain of 8 cm.Combined physiotherapy-yoga-PE intervention is a feasible strategy,increasing at-home yoga practice with potential benefit on pain,flexibility,and patient satisfaction.Evaluation of this innovative program is ongoing in a larger randomized multicenter trial.

Extracorporeal shock wave therapy treatment of painful hematoma in the calf:A case report

BACKGROUND Extracorporeal shock wave therapy (ESWT) can be applied to variousmusculoskeletal conditions including calcific tendinitis. Muscle injuries can leadto hematomas, and unabsorbed hematomas sometimes cause pain. We report acase of painful hematoma successfully treated with ESWT. To our knowledge, thisis the first reported case of painful intramuscular hematoma treated with ESWT.CASE SUMMARY A 65-year-old man visited the outpatient department for left calf pain withswelling that had persisted since he slipped two weeks prior. The calf pain hadpersisted and was rated visual analog scale 7. On physical examination, there wasa localized, stiff, ovoid mass on his left upper posterior calf. The pain wasaggravated by dorsiflexion of the left ankle or weight-bearing on the left foot.Initial diagnostic ultrasonography showed a hematoma in the left gastrocnemiusmuscle;its texture was firm with low heterogeneity. We applied ESWT to thehematoma. His pain decreased immediately to a visual analog scale 3, and themass was softened. The texture of the hematoma became more heterogeneous onultrasonography. Due to planned overseas travel, he returned three months afterthe initial visit to report that the pain and swelling were dramatically relievedafter ESWT.CONCLUSION We propose that painful hematomas could be a new indication for ESWT. Furtherinvestigation on the effects of ESWT for hematomas is needed.

The Effects of Pain Neuroscience Education with Conventional Physical Therapy on Chronic Plantar Fasciitis: A Case Study

Background and Purpose: Plantar Fasciitis (PF) is a condition that affects the foot and causes complaints such as pain and stiffness. The most common symptom of this condition is pain. There are many treatment options to deal with this condition, such as conservative therapy, medications, and surgical interventions in rare cases. This case study aims to investigate the potential impact of pain neuroscience education (PNE), combined with a conventional Physical Therapy (PT) program on a 37-year-old-patient with chronic plantar fasciitis. Case description: A 37-year-old male health care professional presented to an outpatient physical therapy clinic with a diagnosis of chronic PF for around two years. The participant had tried several treatment options with no improvement of his symptoms. After undergoing a physical therapy evaluation, he was given a plan of care for twelve sessions by a skilled physical therapist for a six-week period, with each session consisting of 30 minutes of conventional PT, followed by 5 to 15 minutes of PNE. Results: After completing the prescribed plan of care, the patient reported a reduction in subjective symptoms via the Visual Analog Scale (VAS). He also reported improvement with symptoms and functional independence via the Foot Function Index (FFI). The patient reported no change in the quality of sleep via Pittsburg Sleep Quality Index (PSQI). Lastly, he demonstrated no objective improvement in foot pressure with the Navicular Drop Test. Discussion: This case report indicates that PNE, combined with conventional PT for PF can have a positive impact on subjective pain and foot function. PNE should involve many topics about the physiology of pain and the nervous system and should be administered by a certified therapeutic pain specialist. Further studies are recommended to investigate the impact of this intervention in combination with traditional PT for PF in larger populations.