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The 10th Anniversary of Healthcare—Pain Management
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The 10th Anniversary of Healthcare—Pain Management

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Pain Management".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 17916

Special Issue Editor

Dr. Gianluigi Pasta

E-Mail Website
Guest Editor
Department of Orthopaedics and Traumatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
Interests: hemophilic arthropathy; orthopedic surgery; joint replacement; motion analysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal pain is a challenging condition for both patients and physicians. Many adults have experienced one or more episodes of musculoskeletal pain at some time in their lives, regardless of age, gender, or economic status. It affects approximately 47% of the general population. Of these, about 39–45% have long-lasting problems that require medical consultation. Inadequately managed musculoskeletal pain can adversely affect quality of life and impose significant socioeconomic problems. This Special Issue will cover the pathophysiology, classifications, patient assessments, and different diagnostic and management tools of musculoskeletal pain. Special focus will be given to multimodal analgesia and multidisciplinary approaches that are fundamental elements of the effective management of musculoskeletal pain.

Dr. Gianluigi Pasta
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Published Papers (7 papers)

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Research

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24 pages, 395 KiB  
Article
Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities
by Sînziana Călina Silişteanu, Elisabeta Antonescu, Lavinia Duică, Maria Totan, Andrei Ionuţ Cucu and Andrei Ioan Costea
Healthcare 2024, 12(8), 853; https://doi.org/10.3390/healthcare12080853 - 18 Apr 2024
Cited by 1 | Viewed by 1405
Abstract
Background: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence [...] Read more.
Background: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. Methods: The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. Results: The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. Conclusions: Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training. Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)
14 pages, 265 KiB  
Article
The Behavioral Adaptations and Barriers of Patients Employing Non-Pharmacological Strategies for Cancer Pain Management—A Qualitative Study
by Man-Ting Liu, Shu-Yuan Liang, Ta-Chung Chao, Ling-Ming Tseng and John Rosenberg
Healthcare 2023, 11(22), 2911; https://doi.org/10.3390/healthcare11222911 - 7 Nov 2023
Viewed by 1711
Abstract
The use of non-pharmacological strategies to complement pharmacological approaches can enhance cancer pain management by promoting patient autonomy and increasing management effectiveness. This study aimed to explore the required behavioral adaptations and situational barriers that cancer patients encounter when utilizing non-pharmacological strategies to [...] Read more.
The use of non-pharmacological strategies to complement pharmacological approaches can enhance cancer pain management by promoting patient autonomy and increasing management effectiveness. This study aimed to explore the required behavioral adaptations and situational barriers that cancer patients encounter when utilizing non-pharmacological strategies to manage pain. We adopted an exploratory–descriptive qualitative research approach, purposive sampling, and semi-structured interview guidelines to conduct face-to-face interviews with 18 cancer patients experiencing moderate or severe levels of worst pain. Data were analyzed using inductive content analysis to explore patients’ experiences. Five themes described the behavioral adaptations of patients using non-pharmacological strategies to deal with cancer pain: finding complementary therapies, utilizing assistive skills, adapting to assistive skills, diverting attention, and seeking help. Situational barriers faced by patients include being in the workplace or in a climate-affected environment. Behavioral adaptation is necessary for non-pharmacological strategies to coping with cancer pain. The behavioral skills can help the patients to overcome situational barriers to engagement with these strategies. Thus, health professionals are expected to help the patients acquire adequate behavioral adaptation and skills for self-pain management, and assess the effectiveness of the strategies. Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)

Review

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0 pages, 5104 KiB  
Review
Transcranial Magnetic Stimulation to Treat Neuropathic Pain: A Bibliometric Analysis
by Bruno Daniel Carneiro and Isaura Tavares
Healthcare 2024, 12(5), 555; https://doi.org/10.3390/healthcare12050555 - 28 Feb 2024
Viewed by 2184
Abstract
Neuropathic pain is caused by a lesion or disease of the somatosensory system and is one of the most incapacitating pain types, representing a significant non-met medical need. Due to the increase in research in the field and since innovative therapeutic strategies are [...] Read more.
Neuropathic pain is caused by a lesion or disease of the somatosensory system and is one of the most incapacitating pain types, representing a significant non-met medical need. Due to the increase in research in the field and since innovative therapeutic strategies are required, namely in intractable neuropathic pain, neurostimulation has been used. Within this approach, transcranial magnetic stimulation (TMS) that uses a transient magnetic field to produce electrical currents over the cortex emerges as a popular method in the literature. Since this is an area in expansion and due to the putative role of TMS, we performed a bibliometric analysis in Scopus with the primary objective of identifying the scientific production related to the use of TMS to manage neuropathic pain. The research had no restrictions, and the analysis focused on the characteristics of the literature retrieved, scientific collaboration and main research topics from inception to 6 July 2023. A total of 474 articles were collected. A biggest co-occurrence between the terms “neuropathic pain” and “transcranial magnetic stimulation” was obtained. The journal “Clinical Neurophysiology” leads the Top 5 most productive sources. The United States is the most productive country, with 50% of US documents being “review articles”, followed by France, with 56% of French documents being “original articles”. Lefaucheur, JP and Saitoh, Y are the two most influential authors. The most frequent type of document was “original article”. Most of the studies (34%) that identified the neuropathic pain type focused on traumatic neuropathic pain, although a large proportion (38%) did not report the neuropathic pain type. This study allows us to provide a general overview of the field of TMS application for neuropathic pain and is useful for establishing future directions of research in this field. Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)
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17 pages, 701 KiB  
Review
The Role of Physical Exercise in Chronic Musculoskeletal Pain: Best Medicine—A Narrative Review
by Hortensia De la Corte-Rodriguez, Juan M. Roman-Belmonte, Cristina Resino-Luis, Jorge Madrid-Gonzalez and Emerito Carlos Rodriguez-Merchan
Healthcare 2024, 12(2), 242; https://doi.org/10.3390/healthcare12020242 - 18 Jan 2024
Cited by 5 | Viewed by 4558
Abstract
The aim of this paper is to provide a narrative review of the effects of physical exercise in the treatment of chronic musculoskeletal pain. Physical inactivity and sedentary behavior are associated with chronic musculoskeletal pain and can aggravate it. For the management of [...] Read more.
The aim of this paper is to provide a narrative review of the effects of physical exercise in the treatment of chronic musculoskeletal pain. Physical inactivity and sedentary behavior are associated with chronic musculoskeletal pain and can aggravate it. For the management of musculoskeletal pain, physical exercise is an effective, cheap, and safe therapeutic option, given that it does not produce the adverse effects of pharmacological treatments or invasive techniques. In addition to its analgesic capacity, physical exercise has an effect on other pain-related areas, such as sleep quality, activities of daily living, quality of life, physical function, and emotion. In general, even during periods of acute pain, maintaining a minimum level of physical activity can be beneficial. Programs that combine several of the various exercise modalities (aerobic, strengthening, flexibility, and balance), known as multicomponent exercise, can be more effective and better adapted to clinical conditions. For chronic pain, the greatest benefits typically occur with programs performed at light-to-moderate intensity and at a frequency of two to three times per week for at least 4 weeks. Exercise programs should be tailored to the specific needs of each patient based on clinical guidelines and World Health Organization recommendations. Given that adherence to physical exercise is a major problem, it is important to empower patients and facilitate lifestyle change. There is strong evidence of the analgesic effect of physical exercise in multiple pathologies, such as in osteoarthritis, chronic low back pain, rheumatoid arthritis, and fibromyalgia. Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)
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17 pages, 919 KiB  
Review
Extracorporeal Shock Wave Therapy for the Treatment of Musculoskeletal Pain: A Narrative Review
by Hortensia De la Corte-Rodríguez, Juan M. Román-Belmonte, Beatriz A. Rodríguez-Damiani, Aránzazu Vázquez-Sasot and Emérito Carlos Rodríguez-Merchán
Healthcare 2023, 11(21), 2830; https://doi.org/10.3390/healthcare11212830 - 26 Oct 2023
Cited by 6 | Viewed by 5434
Abstract
Extracorporeal shock waves are high-intensity mechanical waves (500–1000 bar) of a microsecond duration with a morphology characterized by a rapid positive phase followed by a negative phase. Background: Extracorporeal shock waves have been used for pain treatment for various sub-acute and chronic musculoskeletal [...] Read more.
Extracorporeal shock waves are high-intensity mechanical waves (500–1000 bar) of a microsecond duration with a morphology characterized by a rapid positive phase followed by a negative phase. Background: Extracorporeal shock waves have been used for pain treatment for various sub-acute and chronic musculoskeletal (MSK) problems since 2000. The aim of this article is to update information on the role of extracorporeal shock wave therapy (ESWT) in the treatment of various pathologies that cause MSK pain. Methods: Given that in the last two years, articles of interest (including systematic reviews and meta-analyses) have been published on less known indications, such as low back pain, nerve entrapments, osteoarthritis and bone vascular diseases, a literature search was conducted in PubMed, the Cochrane Database, EMBASE, CINAHL and PEDro, with the aim of developing a narrative review of the current literature on this topic. The purposes of the review were to review possible new mechanisms of action, update the level of evidence for known indications and assess possible new indications that have emerged in recent years. Results: Although extracorporeal shock waves have mechanical effects, their main mechanism of action is biological, through a phenomenon called mechanotransduction. There is solid evidence that supports their use to improve pain in many MSK pathologies, such as different tendinopathies (epicondylar, trochanteric, patellar, Achilles or calcific shoulder), plantar fasciitis, axial pain (myofascial, lumbar or coccygodynia), osteoarthritis and bone lesions (delayed union, osteonecrosis of the femoral head, Kienbock’s disease, bone marrow edema syndrome of the hip, pubis osteitis or carpal tunnel syndrome). Of the clinical indications mentioned in this review, five have a level of evidence of 1+, eight have a level of evidence of 1−, one indication has a level of evidence of 2− and two indications have a level of evidence of 3. Conclusions: The current literature shows that ESWT is a safe treatment, with hardly any adverse effects reported. Furthermore, it can be used alone or in conjunction with other physical therapies such as eccentric strengthening exercises or static stretching, which can enhance its therapeutic effect. Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)
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Other

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21 pages, 7219 KiB  
Case Report
Managing Surgical Risks in Hemophilic Elbow Arthropathy: An In-Depth Case Study and Literature Review
by Gianluigi Pasta, Salvatore Annunziata, Roberta Ruggieri, Dario Abruzzi, Paolo Arrigoni, Eugenio Jannelli, Francesco Benazzo, Luisella Pedrotti, Erika Maria Viola, Emérito Carlos Rodriguez-Merchan and Mario Mosconi
Healthcare 2024, 12(17), 1776; https://doi.org/10.3390/healthcare12171776 - 5 Sep 2024
Viewed by 389
Abstract
This study presents a detailed case analysis of a 40-year-old male patient with hemophilia A and severe chronic elbow arthropathy, exploring the surgical challenges and outcomes within the context of the current literature. The patient, with a history of multiple comorbidities including Hodgkin’s [...] Read more.
This study presents a detailed case analysis of a 40-year-old male patient with hemophilia A and severe chronic elbow arthropathy, exploring the surgical challenges and outcomes within the context of the current literature. The patient, with a history of multiple comorbidities including Hodgkin’s lymphoma and cardiomyopathy, exhibited significant joint damage and functional impairment. A comprehensive approach was employed, collecting all relevant clinical data, including radiographic and MRI findings, to inform treatment decisions. Clinical findings and treatment decisions are presented as they occurred in real time, simulating the clinical reasoning process. Subsequent references to the clinical and instrumental findings as well therapeutic interventions are discussed in light of the current literature to reinforce the decision-making framework. This report underscores the importance of multidisciplinary care in optimizing patient outcomes and contributes to the ongoing discourse on the management of advanced musculoskeletal conditions in hemophilic patients. The findings emphasize the necessity for early intervention and specialized care to mitigate complications and improve long-term prognosis. Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)
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18 pages, 1635 KiB  
Systematic Review
Exercise-Based Interventions Are Effective in the Management of Patients with Thumb Carpometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
by Stefanos Karanasios, Dimitra Mertyri, Fotis Karydis and George Gioftsos
Healthcare 2024, 12(8), 823; https://doi.org/10.3390/healthcare12080823 - 12 Apr 2024
Viewed by 1528
Abstract
Exercise-based interventions are a common management strategy in patients with thumb carpometacarpal joint osteoarthritis (CMCJ OA); however, their exact effect on or the use of an optimal training programme for reducing pain and disability remains unclear. Our purpose was to evaluate the effectiveness [...] Read more.
Exercise-based interventions are a common management strategy in patients with thumb carpometacarpal joint osteoarthritis (CMCJ OA); however, their exact effect on or the use of an optimal training programme for reducing pain and disability remains unclear. Our purpose was to evaluate the effectiveness of exercise-based interventions compared with other conservative interventions in patients with CMCJ OA. We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fourteen randomised clinical trials with 1280 patients were finally included. Exercise-based interventions present statistically and clinically better outcomes in reducing pain intensity (mean difference [MD]: −21.91; 95% confidence interval [CI]: −36.59, −7.24; p = 0.003) and wrist disability (MD: −8.1, 95% CI: −4.6, −11.5; p = 0.02) compared with no treatment at short-term follow-up. Proprioceptive exercises have statistically and clinically better outcomes compared with standard care only in pain intensity at very short-term (standardised mean difference [SMD]: −0.76; 95% CI: −1.30, −0.21; p = 0.007) and short-term (SMD: −0.93; 95% CI: −1.86, −0.01; p = 0.049) follow-up and statistically better results in wrist disability at very short-term (SMD: −0.94; 95% CI: −1.68, −0.21; p = 0.01) follow-up. No differences were found between the comparators at mid- and long-term follow-up. Low to moderate certainty of evidence suggests that exercise-based interventions can provide clinically better outcomes compared with no treatment in patients with thumb CMCJ OA, at least in the short term. Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)
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