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Choi KE, Grünert J, Werner M, Cramer H, Anheyer D, Dobos G, Saha FJ. Low Inter-Rater Reliability and Reproducibility of Neck Reflex/"Adler-Langer" Points in Neural Therapy Diagnostics but Increased Pressure Pain Threshold after Therapy: Results of a Randomized Controlled Observer-Blind Trial. Complement Med Res 2024; 31:359-366. [PMID: 38744266 DOI: 10.1159/000539230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Neck reflex points or Adler-Langer points are commonly used in neural therapy to detect so-called interference fields. Chronic irritations or inflammations in the sinuses, teeth, tonsils, or ears are supposed to induce tension and tenderness of the soft tissues and short muscles in the upper cervical spine. The individual treatment strategy is based on the results of diagnostic Adler-Langer point palpation. This study investigated the inter- and intra-rater reliability and explored treatment effects. METHODS We performed a randomized controlled trial with 104 inpatients (80.8% female, 51.8 ± 12.74 years) of a German department for internal and integrative medicine. Patients were randomized to individual neural therapy according to the pathological findings (n = 48) or no treatment (n = 56). In each patient, three experienced raters (20-45 years of experience in neural therapy) and two novice raters (medical students) rated Adler-Langer points rigidity on a standardized rating scale ("strong," "weak," "none"). The patients independently evaluated the tenderness on palpation of the eight points using the same scale. Pressure pain thresholds were assessed at the eight Adler-Langer points. All patients were retested after 30 min. The five raters were blinded to treatment allocation and assessments of the other raters. Video recordings were obtained to assess the consistency of the areas tested by the different raters. RESULTS Agreement between patients and raters (Cohen's kappa = 0.161-0.400) and inter-rater reliability were low (Fleiss kappa = 0.132-0.150). Moreover, the individual agreement (pre-post comparisons in untreated patients) was similarly low even in experienced raters (Cohen's kappa = 0.099-0.173). Video documentation suggests that raters do not place their fingers in the correct segments (percentage of correct position: 42.0-60.6%). Pressure pain thresholds at five of the eight Adler-Langer points showed significant changes after treatment compared to none in the control group. CONCLUSION Under this artificial experimental setting, this method of Adler-Langer point palpation has not proven to be a reliable diagnostic tool. But it could be shown that, as claimed by the method, the tenderness in five of eight Adler-Langer points decreased after neural therapy.
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Affiliation(s)
- Kyung-Eun Choi
- Brandenburg Medical School Theodor Fontane, Neuruppin, Center for Health Services Research, Berlin, Germany
- Health Services Research, Research Center Medical Imaging and Artificial Intelligence, Danube Private University, Krems, Austria
| | - Jan Grünert
- Department of Orthopedics and Trauma Surgery, Sana Kliniken Leipziger Land, Borna, Germany
| | - Marc Werner
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Bosch Health Campus, Stuttgart, Germany
| | - Dennis Anheyer
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Bosch Health Campus, Stuttgart, Germany
- Department for Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Gustav Dobos
- Center for Naturopathy and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Felix J Saha
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Vinyes D, Muñoz-Sellart M, Fischer L. Therapeutic Use of Low-Dose Local Anesthetics in Pain, Inflammation, and Other Clinical Conditions: A Systematic Scoping Review. J Clin Med 2023; 12:7221. [PMID: 38068272 PMCID: PMC10707454 DOI: 10.3390/jcm12237221] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 08/13/2024] Open
Abstract
The use of low-dose local anesthetics (LAs) has significantly transformed patient care by providing rapid and effective relief of pain and other clinical conditions while minimizing recovery time. This study aims to identify and describe the existing scientific evidence on the therapeutic use of low-dose LAs in various conditions and to identify gaps in the current literature in order to prioritize future research. This systematic scoping review adhered to the methodological guidelines outlined in the Arksey and O'Malley framework, which includes five distinct stages. Of the 129 studies included, 37.98% (n = 49) were clinical trials, 55.03% (n = 71) were observational studies, and 6.97% (n = 9) were systematic reviews. The most commonly reported indication for the use of low-dose LAs was chronic pain management (72.86%), followed by acute pain management (13.17%). Additionally, non-pain-related indications were also identified (13.95%). Overall, the administration of low-dose, short-acting LAs demonstrated favorable outcomes in terms of pain management and reduction in anxiety and depression scales, thereby having a positive impact on the patients' quality of life. This review represents the first systematic scoping review regarding the therapeutic role of LAs. To substantiate the reported positive effects on efficacy and safety, further rigorous research comprising larger, well-designed randomized controlled trials (RCTs) and long-term outcome monitoring is imperative.
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Affiliation(s)
- David Vinyes
- Institute of Neural Therapy and Regulatory Medicine, 08202 Sabadell, Spain;
- Master of Permanent Training in Medical and Dental Neural Therapy, University of Barcelona—IL3, 08018 Barcelona, Spain
- Neural Therapy Research Foundation, 08202 Sabadell, Spain
| | - Montserrat Muñoz-Sellart
- Institute of Neural Therapy and Regulatory Medicine, 08202 Sabadell, Spain;
- Master of Permanent Training in Medical and Dental Neural Therapy, University of Barcelona—IL3, 08018 Barcelona, Spain
- Neural Therapy Research Foundation, 08202 Sabadell, Spain
| | - Lorenz Fischer
- Formerly Neural Therapy, Institute of Complementary and Integrative Medicine (IKIM), University of Bern, 3012 Bern, Switzerland;
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Oliveira JD, Rodrigues da Silva GH, de Moura LD, Göethel G, Papini JZB, Casadei BR, Ribeiro LNDM, Cabeça LF, Garcia SC, Martinez EF, Tofoli GR, de Paula E. DoE development of ionic gradient liposomes: A successful approach to improve encapsulation, prolong anesthesia and decrease the toxicity of etidocaine. Int J Pharm 2023; 634:122672. [PMID: 36738810 DOI: 10.1016/j.ijpharm.2023.122672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 01/19/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
Etidocaine (EDC) is a long-acting local anesthetic of the aminoamide family whose use was discontinued in 2008 for alleged toxicity issues. Ionic gradient liposomes (IGL) are nanostructured carriers for which an inner/outer gradient of ions increases drug upload. This work describes IGLEDC, a formulation optimized by Design of Experiments, composed of hydrogenated soy phosphatidylcholine:cholesterol:EDC, and characterized by DLS, NTA, TEM/Cryo-TEM, DSC and 1H NMR. The optimized IGL showed significant encapsulation efficiency (41 %), good shelf stability (180 days) and evidence of EDC interaction with the lipid bilayer (as seen by DSC and 1H NMR results) that confirms its membrane permeation. In vitro (release kinetics and cytotoxicity) tests showed that the encapsulation of EDC into the IGL promoted sustained release for 24 h and decreased by 50 % the intrinsic toxicity of EDC to Schwann cells. In vivo IGLEDC decreased the toxicity of EDC to Caenorhabditis elegans by 25 % and extended its anesthetic effect by one hour, after infiltrative administration, at clinically used (0.5 %) concentration, in rats. Thus, this novel drug delivery system is a promise for the possible reintroduction of EDC in clinics, aiming at the control of operative and postoperative pain.
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Affiliation(s)
- Juliana Damasceno Oliveira
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (Unicamp), Campinas, SP, Brazil
| | | | - Ludmila David de Moura
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Gabriela Göethel
- Toxicology Laboratory, Pharmacy Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Juliana Z B Papini
- São Leopoldo Mandic Institute and Research Center, Campinas-São Paulo, Brazil
| | | | | | - Luis Fernando Cabeça
- Department of Chemistry, Federal Technological University of Parana, Londrina, PR, Brazil
| | - Solange Cristina Garcia
- Toxicology Laboratory, Pharmacy Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | | | - Eneida de Paula
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (Unicamp), Campinas, SP, Brazil.
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Schaefer LV, Bittmann FN. Case report: Individualized pulsed electromagnetic field therapy in a Long COVID patient using the Adaptive Force as biomarker. Front Med (Lausanne) 2023; 9:879971. [PMID: 36714125 PMCID: PMC9874300 DOI: 10.3389/fmed.2022.879971] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
The increasing prevalence of Long COVID is an imminent public health disaster, and established approaches have not provided adequate diagnostics or treatments. Recently, anesthetic blockade of the stellate ganglion was reported to improve Long COVID symptoms in a small case series, purportedly by "rebooting" the autonomic nervous system. Here, we present a novel diagnostic approach based on the Adaptive Force (AF), and report sustained positive outcome for one severely affected Long COVID patient using individualized pulsed electromagnetic field (PEMF) at the area C7/T1. AF reflects the capacity of the neuromuscular system to adapt adequately to external forces in an isometric holding manner. In case, maximal isometric AF (AFisomax) is exceeded, the muscle merges into eccentric muscle action. Thereby, the force usually increases further until maximal AF (AFmax) is reached. In case adaptation is optimal, AFisomax is ~99-100% of AFmax. This holding capacity (AFisomax) was found to be vulnerable to disruption by unpleasant stimulus and, hence, was regarded as functional parameter. AF was assessed by an objectified manual muscle test using a handheld device. Prior to treatment, AFisomax was considerably lower than AFmax for hip flexors (62 N = ~28% AFmax) and elbow flexors (71 N = ~44% AFmax); i.e., maximal holding capacity was significantly reduced, indicating dysfunctional motor control. We tested PEMF at C7/T1, identified a frequency that improved neuromuscular function, and applied it for ~15 min. Immediately post-treatment, AFisomax increased to ~210 N (~100% AFmax) at hip and 184 N (~100% AFmax) at elbow. Subjective Long COVID symptoms resolved the following day. At 4 weeks post-treatment, maximal holding capacity was still on a similarly high level as for immediately post-treatment (~100% AFmax) and patient was symptom-free. At 6 months the patient's Long COVID symptoms have not returned. This case report suggests (1) AF could be a promising diagnostic for post-infectious illness, (2) AF can be used to test effective treatments for post-infectious illness, and (3) individualized PEMF may resolve post-infectious symptoms.
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Affiliation(s)
- Laura V. Schaefer
- Regulative Physiology and Prevention, Department of Sports and Health Sciences, University Potsdam, Potsdam, Germany
- Practice of Integrative Medicine Bittmann, Potsdam, Germany
| | - Frank N. Bittmann
- Regulative Physiology and Prevention, Department of Sports and Health Sciences, University Potsdam, Potsdam, Germany
- Practice of Integrative Medicine Bittmann, Potsdam, Germany
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ONCU J, BARAN G, MURAT S, ALTINBILEK T, ALPTEKIN HK. Long-term results of therapeutic local anesthesia (neural therapy) in migraine patients: a randomized-controlled-single blind trial. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.20.04260-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Boluk Senlikci H, Ozen S. Sacroiliac Joint Dysfunction Treated Using Neural Therapy to the Temporomandibular Joint: A Case Report. Complement Med Res 2021; 28:379-381. [PMID: 33429385 DOI: 10.1159/000513131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/17/2020] [Indexed: 11/19/2022]
Abstract
Temporomandibular joint disorders (TMJD) include temporomandibular joint dysfunction and bruxism. Sacroiliac joint dysfunction (SJD) is a frequent cause of non-discogenic low back pain. Studies suggest a relationship between TMJD and SJD; however, the link remains unclear. Neural therapy (NT) utilises local anaesthetic injections to treat pain by normalising a dysfunctional autonomic nervous system held responsible for initiating or propagating chronic pain. A 31-year-old female presented with a 1-year history of mechanical left-sided low back pain and sleep bruxism. Examination revealed crepitation of the left TMJ and a trigger point in the masseter muscle. Range of motion of the spine and hip joints were normal, Patrick and Geanslen tests were positive on the left side. Spine and standing flexion tests were also positive. Magnetic resonance imaging of the lumbar spine and sacroiliac joints were normal. A diagnosis of SJD was made, and the patient was treated using NT. Injections of lidocaine 0.5% to the left TMJ, the masseter muscle and intradermal segmental injections at the level of C4 were administered. The patient's back pain and TMJ tenderness reduced and continued so throughout the 3-month follow-up period. SJD may be related to TMJD, and NT may be used in its treatment.
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Affiliation(s)
- Huma Boluk Senlikci
- Başkent University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara, Turkey
| | - Selin Ozen
- Başkent University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara, Turkey,
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Atalay SG, Gezginaslan Ö. Effect of neural therapy versus extracorporeal shock wave therapy for the treatment of lateral epicondylitis: A randomized-controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Management of resistant de Quervain tenosynovitis with local anesthetic (neural therapy): A case report. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.679149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Comparison of Ultrasound-Guided Transgluteal and Finger-Guided Transvaginal Pudendal Nerve Block Techniques: Which One is More Effective? Int Neurourol J 2019; 23:310-320. [PMID: 31905278 PMCID: PMC6944786 DOI: 10.5213/inj.1938112.056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/03/2019] [Indexed: 12/30/2022] Open
Abstract
Purpose Pudendal neuralgia (PN) is a painful and disabling condition, which reduces the quality of life as well. Pudendal nerve infiltrations are essential for the diagnosis and the management of PN. The purpose of this study was to compare the effectiveness of finger-guided transvaginal pudendal nerve infiltration (TV-PNI) technique and the ultrasound-guided transgluteal pudendal nerve infiltration (TG-PNI) technique. Methods Forty patients who underwent PNI for the diagnosis of PN were evaluated. Thirty-five of these 40 patients, who were diagnosed as PN, underwent a total of 70 further unilateral PNI. All the patients underwent PNI for twice after the first diagnostic PNI, 1 week apart. Results In the ultrasound (US)-guided TG-PNI group, the success rate was 68.8% (11 of 16) in both “pain in the sitting position” and “pain in the region from the anus to the clitoris.” The success rate of blocks in the US-guided TG-PNI group was 75% (12 of 16) in terms of pain during/after intercourse. In the finger-guided TV-PNI group, the success rate was 84.2% in both “pain in the sitting position” and “pain in the region from the anus to the clitoris.” The success rate of blocks in the fingerguided TV-PNI group was 89.5% (17 of 19) in terms of pain during/after intercourse. There was no statistically significant difference in the success rate of the 3 assessed conditions between the 2 groups (P>0.05). Conclusions The TV-PNI may be an alternative to US-guidance technique as a safe, simple, effective approach in pudendal nerve blocks.
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Chung MK, LaRiccia PJ. Rapid resolution of concussion related symptoms in an 11-month-old male with integrative medicine assessment and treatment: Case report. Clin Case Rep 2019; 7:371-374. [PMID: 30847209 PMCID: PMC6389480 DOI: 10.1002/ccr3.1993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 10/29/2018] [Accepted: 12/06/2018] [Indexed: 11/08/2022] Open
Abstract
Neural therapy may have promise as a helpful, fast acting, and safe method of treating concussion symptoms.
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Affiliation(s)
- Myung Kyu Chung
- Cooper Medical School of Rowan UniversityMoorestownNew Jersey
| | - Patrick J. LaRiccia
- Center for Clinical Epidemiology and BiostatisticsPerelman School of Medicine University of PennsylvaniaPhiladelphiaPennsylvania
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Nazlıkul H, Ural FG, Öztürk GT, Öztürk ADT. Evaluation of neural therapy effect in patients with piriformis syndrome. J Back Musculoskelet Rehabil 2019; 31:1105-1110. [PMID: 30010101 DOI: 10.3233/bmr-170980] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this study was to explore the effect of neural therapy on pain and functionality in patients with low back pain due to piriformis syndrome. It also aimed to find out any possible links between the clinical changes and demographic features. METHOD One hundred and two patients were randomly divided into two groups (neural therapy and control). All patients were given stretching exercises for the piriformis muscle. The patients in the neural therapy group additionally received 6 sessions of neural therapy. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were noted before and after the treatment in both groups. RESULTS The VAS and ODI improved in both groups. However, improvement of the VAS and ODI scores were more obvious in the neural therapy group. The changes of VAS and ODI values did not show any correlations with the demographic features. CONCLUSION After the neural therapy, the patients with low back pain due to piriformis syndrome may have improvement in both pain and functioning.
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Affiliation(s)
| | - Fatma Gülçin Ural
- Department of Physical Medicine and Rehabilitation, Yıldırım Beyazıt University Medical School, Ankara, Turkey
| | - Gökhan Tuna Öztürk
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
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Gurevich MI, Chung MK, LaRiccia PJ. Resolving bulimia nervosa using an innovative neural therapy approach: two case reports. Clin Case Rep 2018; 6:278-282. [PMID: 29445463 PMCID: PMC5799634 DOI: 10.1002/ccr3.1326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/26/2017] [Accepted: 11/20/2017] [Indexed: 11/20/2022] Open
Abstract
Conventional treatment of Bulimia Nervosa is long term, expensive, and often ineffective. Neural therapy holds promise for treating Bulimia Nervosa in a shorter term, lower cost, and more effective manner. Much of neural therapy involves the superficial injection of local anesthetic injections. Implementation into current practice would be feasible.
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Affiliation(s)
- Michael I. Gurevich
- Psychiatry and Integrative Medicine; 997 Glen Cove Avenue Glen Head New York 11545
| | - Myung Kyu Chung
- Cooper Medical School of Rowan University; Chung Institute of Integrative Medicine; 110 Marter Avenue, Suite 507 Moorestown New Jersey 08057
| | - Patrick J. LaRiccia
- Center for Clinical Epidemiology and Biostatistics; Perlman School of Medicine; University of Pennsylvania; Philadelphia Pennsylvania
- Penn-Presbyterian Medical Center; Won Sook Chung Foundation; 51 N. 39th St. Philadelphia Pennsylvania 19104
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Ural FG, Öztürk GT, Nazlıkul H. Evaluation of Neural Therapy Effects in Patients with Lateral Epicondylitis: A Randomized Controlled Trial. ANKARA MEDICAL JOURNAL 2017. [DOI: 10.17098/amj.365851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Chenot JF, Greitemann B, Kladny B, Petzke F, Pfingsten M, Gabriele Schorr S. Non-Specific Low Back Pain. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:883-890. [PMID: 29321099 PMCID: PMC5769319 DOI: 10.3238/arztebl.2017.0883] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 07/28/2017] [Accepted: 10/26/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND For many years, low back pain has been both the leading cause of days lost from work and the leading indication for medical rehabilitation. The goal of the German Disease Management Guideline (NDMG) on nonspecific low back pain is to improve the treatment of patients with this condition. METHODS The current update of the NDMG on non-specific low back pain is based on articles retrieved by a systematic search of the literature for systematic reviews. Its recommendations for diagnosis and treatment were developed by a collaborative effort of 29 scientific medical societies and organizations and approved in a formal consensus process. RESULTS If the history and physical examination do not arouse any suspicion of a dangerous underlying cause, no further diagnostic evaluation is indicated for the time being. Passive, reactive measures should be taken only in combination with activating measures, or not at all. When drugs are used for symptomatic treatment, patients should be treated with the most suitable drug in the lowest possible dose and for as short a time as possible. CONCLUSION A physician should be in charge of the overall care process. The patient should be kept well informed over the entire course of his or her illness and should be encouraged to adopt a healthful lifestyle, including regular physical exercise.
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Affiliation(s)
- Jean-François Chenot
- Section Family Medicine, Institute for Community Medicine, University Hospital of Greifswald
| | | | - Bernd Kladny
- Department of Orthopedics, Fachklinik Herzogenaurach
| | - Frank Petzke
- ain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen
| | - Michael Pfingsten
- ain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen
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Local Anesthetics, Procaine, Lidocaine, and Mepivacaine Show Vasodilatation but No Type 1 Allergy: A Double-Blind, Placebo-Controlled Study. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9804693. [PMID: 30035116 PMCID: PMC6049527 DOI: 10.1155/2017/9804693] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/16/2017] [Accepted: 10/31/2017] [Indexed: 11/18/2022]
Abstract
Background Therapy with local anesthetics (LAs), also known as neural therapy, is used in integrative medicine because of its anti-inflammatory properties. Ester-linked LAs are often avoided because of their alleged high allergenicity. Little data supports this assumption and hence the importance of our investigation on type-1 allergies against ester- and amide-linked LAs. We performed a prospective, double-blinded, placebo-controlled observational study. Methods 177 patients received 340 intracutaneous injections with 1% procaine, 0.5% lidocaine, 1% mepivacaine, or saline solution. Every patient received two different tests on each forearm. Reactions were monitored for 15 minutes. Results No type-1 allergy was observed. The mean erythema diameter of the wheals after 10 minutes was procaine 8.0 ± 6.4 mm, mepivacaine 7.6 ± 6.3 mm, lidocaine 4.4 ± 4.8 mm, and NaCl 3.7 ± 3.2 mm. The wheal diameter of all substances showed a crescendo-decrescendo phenomenon. The procaine and mepivacaine wheals were significantly larger than those of lidocaine and NaCl. No general signs of hypersensitivity were observed. Diameter and intensity were independent of the injection site, order of injection, age, gender, and body mass index. Conclusion This study shows no higher type-1 allergenicity of the ester-linked LA procaine, compared to the amide-linked LAs lidocaine and mepivacaine, and supports its use in therapy and short-track surgery.
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Tamam Y, Özdemir HH, Gedik A, Tamam C, Nazlıkul H. Efficacy of peripheral lidocaine application (neural therapy) in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients. Neurourol Urodyn 2017; 36:1832-1838. [PMID: 28084625 DOI: 10.1002/nau.23191] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 11/15/2016] [Indexed: 12/28/2022]
Abstract
AIMS Many agents and treatments are used in the treatment of neurogenic detrusor overactivity (NDO) in MS patients, but no study has been conducted on the use of peripheric lidocaine (neural therapy-NT) on MS patients. We evaluated the effects of local administration of lidocaine on NDO in Multiple Sclerosis (MS) patients. METHODS For each patient local anesthetic lidocaine was injected at each session. Sessions were held once a week for 5 weeks. At each session, Th 10-L1, urogenital segment intradermal injections, Frankenhauser, and sacral epidural injections were given. The patients had clinical and urodynamic assessment 1 month before and 3, 9, and 12 months after NT. In addition, multiple sclerosis quality of life inventory (MSQL-54) and bladder control scale (BLCS) was performed for patients. RESULTS Twenty-eight patients were included in the study (8 males, 20 females). The patients' average age was 31.7 ± 8.1 years. The injection therapy significantly improved volume at first involuntary bladder contraction (FCV), maximal detrusor pression during filling (P det. max.), maximal cystometric bladder capacity (MCC) after 3 months. Also, the MSQL-54 and BLCS scores were improved with treatment. However, these improvements reached a maximum 3 months after treatment, but from the 9 month a regression was seen in the parameters, and after 12 months the findings were seen to be slightly above their basal levels. CONCLUSIONS These results suggest that NDO treatment in MS patients could be an effective treatment which is easy and has very few side effects, and is cost effective.
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Affiliation(s)
- Yusuf Tamam
- Department of Neurology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | | | - Abdullah Gedik
- Department of Urology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
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Successful Integrative Medicine Assessment and Treatment of Chronic Pain Associated With Breast Surgery: A Report of 3 Cases. Holist Nurs Pract 2016; 31:21-29. [PMID: 27782920 PMCID: PMC5134821 DOI: 10.1097/hnp.0000000000000188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Presented is the first reported case series of chronic neck and back pain associated with breast scars from breast surgery and successfully treated with an integrative medicine assessment and treatment approach, which included the assessment technique of autonomic response testing and the scar therapy technique of neural therapy. Implications for nursing practice are discussed.
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Rosén A, Tardast A, Shi TJ. How Far Have We Come in the Field of Nerve Regeneration After Trigeminal Nerve Injury? ACTA ACUST UNITED AC 2016; 3:309-313. [PMID: 27891301 PMCID: PMC5104765 DOI: 10.1007/s40496-016-0115-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patients suffering from nerve injury with sensory disturbances or orofacial pain have greatly reduced quality of life, and it is a big cost for the society. Abnormal sensations caused by trigeminal nerve injury often become chronic, severely debilitating, and extremely difficult to treat. In general, non-invasive treatment such as drug treatment has been insufficient, and there are currently few available effective treatments. Surgical interventions such as end-to-end connection or nerve grafting have disadvantages such as donor site morbidity or formation of neuroma. There is need for optimizing the technique for nerve repair, especially for the trigeminal nerve system, which has so far not yet been well explored. Recently, tissue engineering using biodegradable synthetic material and cell-based therapies represents a promising approach to nerve repair and it has been reported that mesenchymal stem cell (MSC) has an anti-inflammatory effect and seems to play an important role in nerve healing and regeneration.
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Affiliation(s)
- Annika Rosén
- Division of Oral and Maxillofacial Surgery, University of Bergen, Årstadveien 19, 5020 Bergen, Norway ; Department of Clinical Dentistry, University of Bergen, Årstadveien 19, 5020 Bergen, Norway
| | - Arezo Tardast
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, 501 82 Borås, Sweden
| | - Tie-Jun Shi
- Department of Clinical Dentistry, University of Bergen, Årstadveien 19, 5020 Bergen, Norway ; Department of Biomedicine, University of Bergen, Bergen, Norway
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Successful Treatment of Chronic Nausea and Vomiting Related to Body Piercing and Tattooing With Integrative Medicine Interventions. Holist Nurs Pract 2015; 29:33-6. [DOI: 10.1097/hnp.0000000000000059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chung MK, Chung D, LaRiccia PJ. Tongue piercing and chronic abdominal pain with nausea and vomiting--two cases. Explore (NY) 2014; 11:59-62. [PMID: 25457444 DOI: 10.1016/j.explore.2014.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Indexed: 11/27/2022]
Abstract
Chronic upper gastrointestinal (GI) symptoms of unclear etiology are frustrating to patients and physicians alike. The integrative medicine procedures of acupuncture and neural therapy may provide treatment options. Tongue piercing, which is prevalent in 5.6% of the adolescent population, may be a contributing factor in upper gastrointestinal symptoms. The objectives of the study were as follows: (1) To demonstrate the usefulness of an integrative medicine treatment approach in two cases of patients with chronic abdominal pain, nausea, and vomiting of unclear etiology who had failed standard medical management. (2) To identify scars from tongue piercings as a possible contributing factor in chronic upper GI symptoms of unclear etiology. Two retrospective case studies are presented of young adult females who were seen in a private multi-physician integrative medicine practice in the US. The patients were treated with neural therapy and acupuncture. The desired outcome was the cessation or reduction of the frequency of abdominal pain, nausea, and vomiting. Both patients had resolution of their symptoms. From this study, we have concluded the following: (1) Tongue scars from tongue rings may be causes of chronic upper gastrointestinal symptoms. (2) Neural therapy and acupuncture may be helpful in the treatment of chronic upper GI symptoms related to tongue scars.
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Affiliation(s)
- Myung Kyu Chung
- Cooper Medical School of Rowan University, Camden, New Jersey
| | | | - Patrick J LaRiccia
- Adjunct Scholar Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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