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Maier A, Wiedemann J, Rapp F, Papenfuß F, Rödel F, Hehlgans S, Gaipl US, Kraft G, Fournier C, Frey B. Radon Exposure-Therapeutic Effect and Cancer Risk. Int J Mol Sci 2020; 22:ijms22010316. [PMID: 33396815 PMCID: PMC7796069 DOI: 10.3390/ijms22010316] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 01/18/2023] Open
Abstract
Largely unnoticed, all life on earth is constantly exposed to low levels of ionizing radiation. Radon, an imperceptible natural occurring radioactive noble gas, contributes as the largest single fraction to radiation exposure from natural sources. For that reason, radon represents a major issue for radiation protection. Nevertheless, radon is also applied for the therapy of inflammatory and degenerative diseases in galleries and spas to many thousand patients a year. In either case, chronic environmental exposure or therapy, the effect of radon on the organism exposed is still under investigation at all levels of interaction. This includes the physical stage of diffusion and energy deposition by radioactive decay of radon and its progeny and the biological stage of initiating and propagating a physiologic response or inducing cancer after chronic exposure. The purpose of this manuscript is to comprehensively review the current knowledge of radon and its progeny on physical background, associated cancer risk and potential therapeutic effects.
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Affiliation(s)
- Andreas Maier
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Julia Wiedemann
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Felicitas Rapp
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Franziska Papenfuß
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Franz Rödel
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe-Universität Frankfurt am Main, 60590 Frankfurt am Main, Germany; (F.R.); (S.H.)
| | - Stephanie Hehlgans
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe-Universität Frankfurt am Main, 60590 Frankfurt am Main, Germany; (F.R.); (S.H.)
| | - Udo S. Gaipl
- Translational Radiation Biology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Gerhard Kraft
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Claudia Fournier
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Benjamin Frey
- Translational Radiation Biology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
- Correspondence:
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Rühle PF, Klein G, Rung T, Tiep Phan H, Fournier C, Fietkau R, Gaipl US, Frey B. Impact of radon and combinatory radon/carbon dioxide spa on pain and hypertension: Results from the explorative RAD-ON01 study. Mod Rheumatol 2018; 29:165-172. [DOI: 10.1080/14397595.2018.1442640] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Paul F. Rühle
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gerhart Klein
- Practice for Cardiology, Bad Steben, Germany
- Health Resort Research Association, Bad Steben, Germany
| | | | | | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Langevin P, Peloso PMJ, Lowcock J, Nolan M, Weber J, Gross A, Roberts J, Goldsmith CH, Graham N, Burnie SJ, Haines T. WITHDRAWN: Botulinum toxin for subacute/chronic neck pain. Cochrane Database Syst Rev 2015; 2015:CD008626. [PMID: 25994306 PMCID: PMC10637244 DOI: 10.1002/14651858.cd008626.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Withdrawn due to non‐compliance with The Cochrane Collaboration’s Commercial Sponsorship Policy The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- Pierre Langevin
- Département de réadaptation, Faculté de Médecine, Université LavalCliniques Physio Interactive3520 rue de l'HêtrièreSt‐Augustin‐de‐DesmauresQCCanadaG3A 2V4
| | - Paul Michael J Peloso
- MRL ‐ MerckDepartment of Clinical DevelopmentRY34‐B272126 E. Lincoln AveRahwayNJUSA07065
| | | | - May Nolan
- University of British ColumbiaSchool of Physiotherapy, Faculty of Medicine212‐2177 Westbrook MallVancouverBCCanadaV6T 1Z3
| | - Jeff Weber
- Family Physiotherapy Inc.G04, 7408 ‐ 139th AvenueEdmontonABCanadaT5C 3H7
| | - Anita Gross
- McMaster UniversitySchool of Rehabilitation Science & Department of Clinical Epidemiology and Biostatistics1400 Main Street WestHamiltonONCanadaL8S 1C7
| | - John Roberts
- University of Calgary Sport Medicine CentrePhysiotherapy Department302 838 4th Ave NWCalgaryABCanadaT2N 0M8
| | - Charles H Goldsmith
- Simon Fraser UniversityFaculty of Health SciencesBlossom Hall, Room 95108888 University DriveBurnabyBCCanadaV5A 1S6
| | - Nadine Graham
- McMaster UniversitySchool of Rehabilitation Science1200 Main Street WestHamiltonONCanada
| | - Stephen J Burnie
- Canadian Memorial Chiropractic CollegeDepartment of Clinical Education6100 Leslie StreetTorontoONCanadaM2H 3J1
| | - Ted Haines
- McMaster UniversityDepartment of Clinical Epidemiology and Biostatistics1200 Main Street WestHSC 3H54HamiltonONCanadaL8N 3Z5
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Peloso PMJ, Gross A, Haines T, Trinh K, Goldsmith CH, Burnie SJ. WITHDRAWN: Medicinal and injection therapies for mechanical neck disorders. Cochrane Database Syst Rev 2015; 2015:CD000319. [PMID: 25994305 PMCID: PMC10798413 DOI: 10.1002/14651858.cd000319.pub5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Withdrawn due to non‐compliance with The Cochrane Collaboration’s Commercial Sponsorship Policy The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- Paul Michael J Peloso
- MRL ‐ MerckDepartment of Clinical DevelopmentRY34‐B272126 E. Lincoln AveRahwayNJUSA07065
| | - Anita Gross
- McMaster UniversitySchool of Rehabilitation Science & Department of Clinical Epidemiology and Biostatistics1400 Main Street WestHamiltonONCanadaL8S 1C7
| | - Ted Haines
- McMaster UniversityDepartment of Clinical Epidemiology and Biostatistics1200 Main Street WestHSC 3H54HamiltonONCanadaL8N 3Z5
| | - Kien Trinh
- McMaster UniversityDeGroote School of Medicine, Office of MD Admissions1200 Main Street WestMDCL‐3112HamiltonONCanadaL8N 3Z5
| | - Charles H Goldsmith
- Simon Fraser UniversityFaculty of Health SciencesBlossom Hall, Room 95108888 University DriveBurnabyBCCanadaV5A 1S6
| | - Stephen J Burnie
- Canadian Memorial Chiropractic CollegeDepartment of Clinical Education6100 Leslie StreetTorontoONCanadaM2H 3J1
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Annegret F, Thomas F. Long-term benefits of radon spa therapy in rheumatic diseases: results of the randomised, multi-centre IMuRa trial. Rheumatol Int 2013; 33:2839-50. [PMID: 23864139 DOI: 10.1007/s00296-013-2819-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 06/29/2013] [Indexed: 11/30/2022]
Abstract
In chronic rheumatic diseases, recent treatment regimens comprise multimodal concepts including pharmacologic, physical/exercise, occupational and psychological therapies. Rehabilitation programmes are used for long-term management of disease. Spa therapy is often integrated in various middle and south European and Asian countries. Here, we investigated radon spa therapy as applied in health resorts compared to a control intervention in rheumatic out-patients. Randomised, blinded trial enroling 681 patients [mean age 58.3 (standard deviation 11.1); female 59.7%] in 7 health resorts in Germany and Austria with chronic back pain (n 1 = 437), osteoarthritis (OA) (n 2 = 230), rheumatoid arthritis (n 3 = 98), and/or ankylosing spondylitis (n 4 = 39); multiple nominations in 146 cases). Outcomes were pain (primary), quality of life, functional capacity, and medication measured before start, after end of treatment, and 3 times thereafter in 3 monthly intervals. Adverse events were documented. To analyse between-group differences, repeated-measures analysis of covariance was performed in metric endpoints and Fisher's exact test in rates. Two-sided significance level of 5% was chosen. Until end of follow-up, superiority of radon therapy was found regarding pain relief (p = 0.032) and analgesic drug consumption (p = 0.007), but not regarding quality of life. Functional capacity was assessed specific to the underlying indication. Significant benefits were found in radon-treated OA patients until 6-month follow-up (p = 0.05), but not until end of study (p = 0.096). Neither the back pain sub-population nor the two smaller patient populations with inflammatory indications benefited significantly in functional capacity. Results suggest beneficial analgesic effects of radon spa therapy in rheumatic diseases until 9 months post-intervention.
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Affiliation(s)
- Franke Annegret
- Centre of Biomedical Statistics, Untere Reuth 20, 08645, Bad Elster, Germany,
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Langevin P, Peloso PMJ, Lowcock J, Nolan M, Weber J, Gross A, Roberts J, Goldsmith CH, Graham N, Burnie SJ, Haines T. Botulinum toxin for subacute/chronic neck pain. Cochrane Database Syst Rev 2011:CD008626. [PMID: 21735434 DOI: 10.1002/14651858.cd008626.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Neck disorders are common, disabling and costly. Botulinum toxin (BoNT) intramuscular injections are often used with the intention of treating neck pain. OBJECTIVES To systematically evaluate the literature on the treatment effectiveness of BoNT for neck pain, disability, global perceived effect and quality of life in adults with neck pain with or without associated cervicogenic headache, but excluding cervical radiculopathy and whiplash associated disorder. SEARCH STRATEGY We searched CENTRAL, MEDLINE, AMED, Index to Chiropractic Literature, CINAHL, LILACS, and EMBASE from their origin to 20 September 2010. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials in which BoNT injections were used to treat subacute or chronic neck pain. DATA COLLECTION AND ANALYSIS A minimum of two review authors independently selected articles, abstracted data, and assessed risk of bias, using the Cochrane Back Review Group criteria. In the absence of clinical heterogeneity, we calculated standardized mean differences (SMD) and relative risks, and performed meta-analyses using a random-effects model. The quality of the evidence and the strength of recommendations were assigned an overall grade for each outcome. MAIN RESULTS We included nine trials (503 participants). Only BoNT type A (BoNT-A) was used in these studies.High quality evidence suggests there was little or no difference in pain between BoNT-A and saline injections at four weeks (five trials; 252 participants; SMD pooled -0.07 (95% confidence intervals (CI) -0.36 to 0.21)) and six months for chronic neck pain. Very low quality evidence indicated little or no difference in pain between BoNT-A combined with physiotherapeutic exercise and analgesics and saline injection with physiotherapeutic exercise and analgesics for patients with chronic neck pain at four weeks (two trials; 95 participants; SMD pooled 0.09 (95% CI -0.55 to 0.73)) and six months (one trial; 24 participants; SMD -0.56 (95% CI -1.39 to 0.27)). Very low quality evidence from one trial (32 participants) showed little or no difference between BoNT-A and placebo at four weeks (SMD 0.16 (95% CI -0.53 to 0.86)) and six months (SMD 0.00 (95% CI -0.69 to 0.69)) for chronic cervicogenic headache. Very low quality evidence from one trial (31 participants), showed a difference in global perceived effect favouring BoNT-A in chronic neck pain at four weeks (SMD -1.12 (95% CI: -1.89 to -0.36)). AUTHORS' CONCLUSIONS Current evidence fails to confirm either a clinically important or a statistically significant benefit of BoNT-A injection for chronic neck pain associated with or without associated cervicogenic headache. Likewise, there was no benefit seen for disability and quality of life at four week and six months.
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Affiliation(s)
- Pierre Langevin
- Cliniques Physio Interactive, Département de réadaptation, Faculté de Médecine, Université Laval, 1100 boul Chaudière, CP 75217, Quebec City, PQ, Canada, G1Y 3C7
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8
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Application of Pressure Algometry In Balneology for Evaluation of Physical Therapeutic Modalities and Drag Effects. ACTA ACUST UNITED AC 2010. [DOI: 10.1300/j094v06n01_08] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Peloso P, Gross A, Haines T, Trinh K, Goldsmith CH, Burnie S. Medicinal and injection therapies for mechanical neck disorders. Cochrane Database Syst Rev 2007:CD000319. [PMID: 17636629 DOI: 10.1002/14651858.cd000319.pub4] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Controversy persists regarding medicinal therapies and injections. OBJECTIVES To determine the effects of medication and injections on primary outcomes (e.g. pain) for adults with mechanical neck disorders and whiplash. SEARCH STRATEGY We searched CENTRAL, MANTIS, CINAHL from their start to May 2006; MEDLINE and EMBASE to December 2006. We scrutinised reference lists for other trials. SELECTION CRITERIA We included randomised controlled trials with adults with neck disorders, with or without associated headache or radicular findings. We considered medicinal and injection therapies, regardless of route of administration. DATA COLLECTION AND ANALYSIS Two authors independently selected articles, abstracted data and assessed methodological quality. When clinical heterogeneity was absent, we combined studies using random-effects models. MAIN RESULTS We found 36 trials that examined the effects of oral NSAIDs, psychotropic agents, steroid injections, and anaesthetic agents. Trials had a mean of 3.1 on the Jadad Scale for methodological quality; 70% were high quality. For acute whiplash, administering intravenous methylprednisolone within eight hours of injury reduced pain at one week (SMD -0.90, 95% CI -1.57 to -0.24), and sick leave but not pain at six months compared to placebo in one trial. For chronic neck disorders at short-term follow-up, intramuscular injection of lidocaine was superior to placebo (SMD -1.36, 95% CI -1.93 to -0.80); NNT 3, treatment advantage 45% and dry needling, but similar to ultrasound in one trial each. In chronic neck disorders with radicular findings, epidural methylprednisolone and lidocaine reduced neck pain and improved function more than when given by intramuscular route at one-year follow-up, in one trial. In subacute and chronic neck disorders, muscle relaxants, analgesics and NSAIDs had limited evidence and unclear benefits. In participants with chronic neck disorders with or without radicular findings or headache, there was moderate evidence from five high quality trials that Botulinum toxin A intramuscular injections had similar effects to saline in improving pain (pooled SMD: -0.39, 95%CI -1.25 to 0.47), disability or global perceived effect. AUTHORS' CONCLUSIONS The major limitations are the lack of replication of the findings and sufficiently large trials. There is moderate evidence for the benefit of intravenous methylprednisolone given within eight hours of acute whiplash, from a single trial. Lidocaine injection into myofascial trigger points appears effective in two trials. There is moderate evidence that Botulinum toxin A is not superior to saline injection for chronic MND. Muscle relaxants, analgesics and NSAIDs had limited evidence and unclear benefits.
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Affiliation(s)
- P Peloso
- Amgen, Inc, One Amgen Center Drive, MS 38-2-C, Thousand Oaks, California 91320, USA.
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Forestier R, Françon A, Saint-Arromand F, Bertolino C, Guillemot A, Graber-Duvernay B, Slikh M, Duplan B. Y a-t-il un effet des soins thermaux et des champs électromagnétiques pulsés sur la cervicalgie chronique? Essai clinique randomisé Première partie: étude clinique. ACTA ACUST UNITED AC 2007; 50:140-7. [PMID: 17229483 DOI: 10.1016/j.annrmp.2006.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Accepted: 12/04/2006] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The purpose of this study was to compare SPA therapy (ST) with pulsed electromagnetic field (PEMF) therapy in chronic neck pain. MATERIALS AND METHODS Inclusion criteria were age between 18 and 80 years, neck pain of more than 3 months' duration and pain score>30 mm on a visual analog scale (VAS). Exclusion criteria were contraindication to ST or PEMF. The protocol was approved by the ethics committee of Grenoble Hospital. Randomisation to the ST (n=44) and PEMF groups (n=42) was blinded. The main outcome measure was number of improved patients at 6 months in each group. A patient was considered improved if pain score decreased by more than 20%. Secondary measures were score on the Copenhagen and MOS SF-36 scales. Evaluation and intent-to-treat analysis were also blinded. RESULTS Patients' preferences were for PEMF. At 6 months, in the PEMF group, 33 patients were improved, 5 not improved and 4 lost to follow-up. In the ST group, 24 patients were improved, 14 not improved and 6 lost to follow-up, for significantly greater improvement in the PEMF than ST group (p=0.02). Significant improvement was seen in both groups in terms of pain score, Copenhagen scale score and score on some dimensions of the MOS SF-36 survey. CONCLUSION PEMF seems to be superior to standard ST without massage in control of neck pain. The difference between groups, although perhaps biased, seem to suggest the importance of our conclusions.
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Affiliation(s)
- R Forestier
- Centre de recherche rhumatologique et thermal, BP 234, 73102 Aix-les-Bains cedex, France.
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Franke A, Reiner L, Resch KL. Long-term benefit of radon spa therapy in the rehabilitation of rheumatoid arthritis: a randomised, double-blinded trial. Rheumatol Int 2007; 27:703-13. [PMID: 17203297 DOI: 10.1007/s00296-006-0293-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Accepted: 12/02/2006] [Indexed: 10/23/2022]
Abstract
This study investigates the effects of radon (plus CO2) baths on RA in contrast to artificial CO2 baths in RA rehabilitation using a double-blinded trial enrolling 134 randomised patients of an in-patient rehabilitative programme (further 73 consecutive non-randomised patients are not reported here). The outcomes were limitations in occupational context/daily living (main outcome), pain, medication and further quantities. These were measured before the start, after the end of treatment and quarterly in the year thereafter. Repeated-measures analysis of covariance (RM-ANCOVA) of the intent-to-treat population was performed with group main effects (GME) and group x course interactions (G x C) reported. Hierarchically ordered hypotheses ensured the adherence of the nominal significance level. The superiority of the radon treatment was found regarding the main outcome (RM-ANCOVA until 12 months: p(GME) = 0.15, p(G x C) = 0.033). Consumption of steroids (p(GME) = 0.064, p(G x C) = 0.025) and NSAIDs (p(GME) = 0.035, p(G x C) = 0.008) were significantly reduced. The results suggest beneficial long-term effects of radon baths as adjunct to a multimodal rehabilitative treatment of RA.
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Affiliation(s)
- Annegret Franke
- FBK Spa Medicine Research Institute, Lindenstr.5, 08645 Bad Elster, Germany.
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Peloso P, Gross A, Haines T, Trinh K, Goldsmith CH, Aker P. Medicinal and injection therapies for mechanical neck disorders. Cochrane Database Syst Rev 2005:CD000319. [PMID: 15846603 DOI: 10.1002/14651858.cd000319.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Medicinal therapies and injections are commonly recommended for neck pain, yet controversy persists over their effectiveness. OBJECTIVES To determine the effect of medicines and injections on pain, function/disability, patient satisfaction and range of motion in participants with mechanical neck disorders (MND). SEARCH STRATEGY We searched CENTRAL (Issue 4, 2002), and MEDLINE, EMBASE, MANTIS, CINHAL from their start to March 2003. We scrutinized reference lists for other trials. SELECTION CRITERIA We included randomized controlled trials with adults with MND, with or without associated headache or radicular findings. We considered medicinal and injection therapies, regardless of route of administration. DATA COLLECTION AND ANALYSIS Two authors independently selected articles, abstracted data and assessed methodological quality using the Jadad criteria. Consensus was used to resolve disagreements. When clinical heterogeneity was absent, we combined studies using random-effects meta-analysis models. MAIN RESULTS We found 32 trials that examined the effects of oral NSAIDs, psychotropic agents, injections of steroids, and anaesthetic agents. Overall, methodological quality had a mean of 3.2/5 on the Jadad Scale. For acute whiplash, administering intravenous methylprednisolone within eight hours reduced pain at one week, and sick leave but not pain at six months compared to placebo. For chronic MND at short-term follow-up, intramuscular injection of lidocaine was superior to placebo or dry needling, but similar to ultrasound. In chronic MND with radicular findings, epidural methylprednisolone and lidocaine reduced neck pain and improved function at one-year follow-up compared to the intramuscular route. In subacute/chronic MND, we found conflicting evidence of pain reduction for oral psychotropic agents compared to placebo or control. Single trials of eperison hydrochloride and tetrazepam showed positive results. Results for cyclobenzaprine were mixed. Diazepam did not show benefit. Other treatments including NSAIDS and nerve blocks had unclear or limited evidence of benefit. In participants with chronic MND with or without radicular findings or headache, there was moderate evidence from five high quality trials showing that Botox A intramuscular injections were not better than saline in improving pain (pooled SMD: -0.39 (95%CI: -1.25 to 0.47), disability or global perceived effect. AUTHORS' CONCLUSIONS Intra-muscular injection of lidocaine for chronic MND and intravenous injection of methylprednisolone for acute whiplash were effective treatments. There was limited evidence of effectiveness of epidural injection of methylprednisolone and lidocaine for chronic MND with radicular findings. Oral psychotropic agents had mixed results. There was moderate evidence that Botox A intramuscular injections for chronic MND were no better than saline. Other medications, including NSAIDs, had contradictory or limited evidence of effectiveness.
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Yamaoka K, Mitsunobu F, Hanamoto K, Mori S, Tanizaki Y, Sugita K. Study on biologic effects of radon and thermal therapy on osteoarthritis. THE JOURNAL OF PAIN 2004; 5:20-5. [PMID: 14975375 DOI: 10.1016/j.jpain.2003.09.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2003] [Revised: 08/25/2003] [Accepted: 09/11/2003] [Indexed: 10/26/2022]
Abstract
UNLABELLED Radon therapy uses radon (222Rn) gas, which mainly emits alpha-rays and induces a small amount of active oxygen in the body. We first examined the temporal changes in antioxidants, immune, vasoactive, and pain-associated substances in human blood by therapy to elucidate the mechanism of osteoarthritis in which radon therapy is used as a treatment. Results showed that radon inhalation enhanced the antioxidation and immune function, and the findings suggest that radon therapy contributes to the prevention of osteoarthritis related to peroxidation reactions and immune depression. Moreover, the changes in vasoactive and pain-associated substances indicated increases in tissue perfusion brought about by radon therapy, suggesting that radon inhalation plays a role in alleviating pain. PERSPECTIVE The findings suggest that an appropriate amount of active oxygen is produced in the body after radon inhalation, and this contributes to the alleviation of the symptoms of active oxygen diseases such as osteoarthritis.
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Affiliation(s)
- Kiyonori Yamaoka
- Department of Medical Radioscience, Okayama University Medical School, Okayama, Japan.
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Falkenbach A, Kovacs J, Franke A, Jörgens K, Ammer K. Radon therapy for the treatment of rheumatic diseases--review and meta-analysis of controlled clinical trials. Rheumatol Int 2003; 25:205-10. [PMID: 14673618 DOI: 10.1007/s00296-003-0419-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2003] [Accepted: 10/18/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the effect of radon therapy on pain in rheumatic diseases. METHODS MEDLINE and MedKur databases were searched for the terms radon plus therapy, rheum, arthritis, and osteo. Radon therapy centers and experts in the field were contacted, proceedings hand-searched, and bibliographies checked for references of potential importance. Included were all prospective randomized controlled clinical trials that compared clinical effects of radon therapy with other interventions in patients with rheumatic diseases and studied pain intensity. Information concerning patients, interventions, results, and methodology were extracted in a standardized manner by all authors independently and summarized descriptively. Reports on pain reduction were pooled for meta-analysis. RESULTS Five clinical trials with a total of 338 patients and comparing the effect on pain of radon baths (three trials) or radon speleotherapy (two trials) with control intervention in degenerative spinal disease (two trials), rheumatoid arthritis (one trial) and ankylosing spondylitis (two trials) met the inclusion criteria. In meta-analysis, the pooled data showed no difference immediately after treatment (P=0.13) but significantly better pain reduction in the radon group than the control group at 3 months (P=0.02) and 6 months (P=0.002) after treatment. CONCLUSIONS The existing trials suggest a positive effect of radon therapy on pain in rheumatic diseases. With respect to the potential clinical effect and given the increasing public interest in radon therapy, there is an urgent need for further randomized controlled clinical investigations with long-term follow-up.
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Falkenbach A. Speleotherapeutic radon exposure of a child suffering from juvenile chronic arthritis. J Altern Complement Med 2000; 6:551-2. [PMID: 11152060 DOI: 10.1089/acm.2000.6.551] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Should a child be exposed to radon for therapeutic purposes? CASE REPORT We report on a 7-year-old boy with juvenile chronic arthritis who experienced good pain relief after therapeutic radon exposure. DISCUSSION Controversy exists whether children should be exposed to radon for therapeutic purposes. Benefit and risk of therapeutic radon exposure should be discussed more objectively and not emotionally.
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Affiliation(s)
- A Falkenbach
- Research Institute Gastein, and Gasteiner Heilstollen Hospital, Bad Gastein, Austria
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Franke A, Reiner L, Pratzel HG, Franke T, Resch KL. Long-term efficacy of radon spa therapy in rheumatoid arthritis--a randomized, sham-controlled study and follow-up. Rheumatology (Oxford) 2000; 39:894-902. [PMID: 10952746 DOI: 10.1093/rheumatology/39.8.894] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To quantify the efficacy of a series of baths containing natural radon and carbon dioxide (1.3 kBq/l, 1.6 g carbon dioxide/l on average) versus artificial carbon dioxide baths alone in patients with rheumatoid arthritis. SUBJECTS Sixty patients participating in an in-patient rehabilitation programme including a series of 15 baths were randomly assigned to two groups. DESIGN Pain intensity (100 mm visual analogue scale) and functional restrictions [Keitel functional test, Arthritis Impact Measurement Scales (AIMS questionnaire)] were measured at baseline, after completion of treatment and 3 and 6 months thereafter. To investigate whether the overall value of the outcomes was the same in both groups, the overall mean was analysed by Student's t-test for independent samples. RESULTS The two groups showed a similar baseline situation. After completion of treatment, relevant clinical improvements were observed in both groups, with no notable group differences. However, the follow-up revealed sustained effects in the radon arm, and a return to baseline levels in the sham arm. After 6 months, marked between-group differences were found for both end-points (pain intensity: -16.9%, 95% confidence interval -27.6 to -6.2%; AIMS score: 0.57, 95% confidence interval 0.16 to 0.98). The between-group differences were statistically significant for both overall means (pain intensity, P: = 0.04; AIMS, P: = 0.01). CONCLUSION Marked short-term improvements in both groups at the end of treatment may have masked potential specific therapeutic effects of radon baths. However, after 6 months of follow-up the effects were lasting only in patients of the radon arm. This suggests that this component of the rehabilitative intervention can induce beneficial long-term effects.
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Affiliation(s)
- A Franke
- Balneology and Rehabilitation Sciences Research Institute (FBK), Bad Elster, Maximilians University, Munich, Germany
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Becker K. How dangerous is radon in buildings?--some reflections from Europe. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 1994; 14:1-2. [PMID: 8146395 DOI: 10.1111/j.1539-6924.1994.tb00020.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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