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Seyam O, Smith NL, Reid I, Gandhi J, Jiang W, Khan SA. Clinical utility of ozone therapy for musculoskeletal disorders. Med Gas Res 2018; 8:103-110. [PMID: 30319765 PMCID: PMC6178642 DOI: 10.4103/2045-9912.241075] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/09/2018] [Indexed: 01/03/2023] Open
Abstract
Oxygen-ozone (O3) therapy serves as an alternative medical technique that increases the oxygen in the body along with the introduction of O3. O3 therapy has finally reached a level where the biological mechanisms of action have been understood, showing that they are in the domain of physiology, biochemistry, and pharmacology. Few clinical applications have been reviewed here as well as exemplifying that O3 therapy is particularly useful in musculoskeletal disorders. In the therapeutic range, O3 can be used as a more effective and safe substitute of standard medications. O3 therapy has been used for many years for its ability to inactivate various viruses, cancer, and acquired immune deficiency syndrome but is now making strides in the treatment of musculoskeletal disorders such as rheumatoid arthritis, lumbar facet joint syndrome, subacromial bursitis, carpal tunnel syndrome, osteoarthritis, hip bursitis, shoulder adhesive capsulitis, herniated disc, and temporomandibular joint disorder.
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Affiliation(s)
- Omar Seyam
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | | | - Inefta Reid
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Jason Gandhi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Medical Student Research Institute, St. George's University School of Medicine, Grenada, West Indies
| | - Wendy Jiang
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Department of Urology, Stony Brook University School of Medicine, Stony Brook, NY, USA
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Lin WC, Shen CC, Tsai SJ, Yang AC. Increased Risk of Myofascial Pain Syndrome Among Patients with Insomnia. PAIN MEDICINE 2018; 18:1557-1565. [PMID: 28339643 DOI: 10.1093/pm/pnw300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective The aim of this study is to evaluate the risk of developing myofascial pain syndrome among patients diagnosed with insomnia. Methods We conducted a population-based longitudinal study of a matched cohort with 7,895 participants (1,579 patients with insomnia and 6,316 controls) who were selected from the Taiwan National Health Insurance Research Database. The patients were observed for a maximum of 10 years to determine the incidence of newly diagnosed myofascial pain syndrome. A Cox regression analysis was performed to identify the risk factors associated with myofascial pain syndrome in patients with insomnia. Results During the 10-year follow-up period, 182 insomnia patients (14.9 per 1,000 person-years) and 379 controls (7.5 per 1,000 person-years) were diagnosed with myofascial pain syndrome. The incidence risk ratio of myofascial pain syndrome between the insomnia and control patients was 2.00 (95% confidence interval [CI] = 1.67-2.38, P < 0.001). After adjusting for age, sex, monthly income, urbanization, and comorbidities, the insomnia patients were 1.93 times more likely to develop myofascial pain syndrome (95% CI = 1.62-2.31, P < .001) than the control patients. Malignant neoplasm (hazard ratio = 3.08) and living in urban areas (hazard ratio = 3.05) were identified as independent risk factors for myofascial pain syndrome in patients with insomnia. Conclusions Patients with insomnia had a higher risk of developing myofascial pain syndrome than controls. This study adds to the understanding of the complex relationship between sleep disturbance and pain.
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Affiliation(s)
- Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Che Shen
- Division of Psychiatry, Faculty of Medicine.,Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan.,Department of Information Management, National Chung-Cheng University, Chiayi, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine
| | - Albert C Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine.,Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan
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Activity Limitations and Participation Restrictions in Patients with Chronic Fatigue Syndrom—Construction of a Disease Specific Questionnaire. ACTA ACUST UNITED AC 2011. [DOI: 10.1300/j092v10n03_02] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Upper Quarter Myofascial Pain Syndrome in Singapore: Characteristics and Treatment. ACTA ACUST UNITED AC 2010. [DOI: 10.1300/j094v08n04_07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nutritional Supplementation withChlorella pyrenoidosafor Fibromyalgia Syndrome: A Double-Blind, Placebo-Controlled, Crossover Study. ACTA ACUST UNITED AC 2010. [DOI: 10.1300/j094v09n04_05] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Comorbidity of fibromyalgia and cervical myofascial pain syndrome. Clin Rheumatol 2010; 29:405-11. [DOI: 10.1007/s10067-009-1342-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 12/08/2009] [Accepted: 12/09/2009] [Indexed: 10/20/2022]
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Kamanli A, Kaya A, Ardicoglu O, Ozgocmen S, Zengin FO, Bayik Y. Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome. Rheumatol Int 2004; 25:604-11. [PMID: 15372199 DOI: 10.1007/s00296-004-0485-6] [Citation(s) in RCA: 183] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2003] [Accepted: 05/03/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. Several methods have been recommended for the inactivation of trigger points (TrP). OBJECTIVES This prospective, single-blind study was proposed to compare TrP injection with botulinum toxin type A (BTX-A) to dry needling and lidocaine injection in MPS. METHODS Eighty-seven trigger points (cervical and/or periscapular regions) in 23 female and six male patients with MPS were treated and randomly assigned to three groups: lidocaine injection (n=10, 32 TrP), dry needling (n=10, 33 TrP), and BTX-A injection (n=9, 22 TrP). OUTCOME MEASURES Clinical assessment including cervical range of motion, TrP pain pressure threshold (PPT), pain scores (PS), and visual analog scales for pain, fatigue, and work disability were evaluated at entry and the end of the 4th week. Additionally, depression and anxiety were evaluated with the Hamilton depression and anxiety rating scales, and quality of life was assessed using the Nottingham health profile (NHP). The subjects were also asked to describe side effects. INJECTION PROCEDURE: One milliliter of 0.5% lidocaine was administered to each TrP in the lidocaine injection group, 10-20 IU of BTX-A to each TrP in the BTX-A group, and dry needling to each TrP in the last group, followed by stretching of the muscle groups involved. The patients were instructed to continue their home exercise programs. RESULTS Pain pressure thresholds and PS significantly improved in all three groups. In the lidocaine group, PPT values were significantly higher than in the dry needle group, and PS were significantly lower than in both the BTX-A and dry needle groups. In all, visual analog scores significantly decreased in the lidocaine injection and BTX-A groups and did not significantly change in the dry needle group. Disturbance during the injection procedure was lowest in the lidocaine injection group. Quality of life scores assessed by NHP significantly improved in the lidocaine and BTX-A groups but not in the dry needle group. Depression and anxiety scores significantly improved only in the BTX-A-injected group. CONCLUSIONS Injection is more practical and rapid, since it causes less disturbance than dry needling and is more cost effective than BTX-A injection, and seems the treatment of choice in MPS. On the other hand, BTX-A could be selectively used in MPS patients resistant to conventional treatments.
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Affiliation(s)
- A Kamanli
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Firat University, Elazig, Turkey.
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Kashikar-Zuck S, Graham TB, Huenefeld MD, Powers SW. A review of biobehavioral research in juvenile primary fibromyalgia syndrome. ACTA ACUST UNITED AC 2003; 13:388-97. [PMID: 14635315 DOI: 10.1002/1529-0131(200012)13:6<388::aid-art9>3.0.co;2-p] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- S Kashikar-Zuck
- Division of Psychology, Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
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Abstract
Primary fibromyalgia is regarded as disorder with a complex symptomatology, and no morphological alterations. Findings increasingly point to a dysfunction of the central nervous pain processing. The study aims to discuss vulnerability for fibromyalgia from a developmental psychopathological perspective. We investigated the presence of psychosocial adversities affecting the childhood of adult fibromyalgia patients (FM) and compared them to those of patients with somatoform pain disorders (SOM) and a control group (CG) with medically explained chronic pain. Using the structured biographical interview for pain patients (SBI-P), 38 FM patients, 71 SOM patients, and 44 CG patients were compared on the basis of 14 childhood adversities verified as relevant regarding longterm effects for adult health by prospective studies. The FM patients show the highest score of childhood adversities. In addition to sexual and physical maltreatment, the FM patients more frequently reported a poor emotional relationship with both parents, a lack of physical affection, experiences of the parents' physical quarrels, as well as alcohol or other problems of addiction in the mother, separation, and a poor financial situation before the age of 7. These experiences were found to a similar extent in the SOM patients, but distinctly less frequently in the CG. The results point to early psychosocial adversities as holding a similar etiological meaning in fibromyalgia as well as in somatoform pain disorders. The potential role of these factors as increasing the vulnerability for fibromyalgia is discussed.
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Affiliation(s)
- Katrin Imbierowicz
- Department of Psychotherapy and Psychosomatics, University Hospital Bonn, Bonn, Germany
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Nijs J, De Becker P, De Meirleir K, Demanet C, Vincken W, Schuermans D, McGregor N. Associations between bronchial hyperresponsiveness and immune cell parameters in patients with chronic fatigue syndrome. Chest 2003; 123:998-1007. [PMID: 12684286 DOI: 10.1378/chest.123.4.998] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVE To examine whether bronchial hyperresponsiveness (BHR) in patients with chronic fatigue syndrome (CFS) is caused by immune system abnormalities. DESIGN Prospective comparative study. SETTING A university-based outpatient clinic (Vrije Universiteit; Brussels, Belgium). PARTICIPANTS One hundred thirty-seven CFS patients and 27 healthy volunteers. MEASUREMENTS Pulmonary function testing, histamine bronchoprovocation test, immunophenotyping, and ribonuclease (RNase) latent determination. RESULTS Seventy-three of 137 patients presented with BHR, of whom 64 had normal results of the histamine bronchoprovocation test. No significant differences were found in age or sex characteristics between the groups. There were no differences in the RNase L ratio, total lung capacity, or FEV(1)/FVC ratio between CFS patients with or without BHR. The group of patients in whom BHR was present (BHR+) differs most significantly from the control group with eight differences in the immunophenotype profile in the cell count analysis and seven differences in the percentage distribution profile. The group of patients in whom no BHR was detected (BHR-) only differed from the control subjects in CD25+ count and in the percentage of CD25+ cells. We observed a significant increase in cytotoxic T-cell count and in the percentage of BHR+ patients compared to BHR- patients, which is consistent with the significant reduction in percentage naïve T cells. CONCLUSIONS These results refute any association between the cleaving of 80 kd RNase L and BHR. Immunophenotyping of our sample confirmed earlier reports on (chronic) immune activation in patients with CFS, compared to healthy control subjects. BHR+ CFS patients have more evidence of immune activation compared to BHR- patients. Inflammation and the consequent IgE-mediated activation of mast cells and eosinophils, as seen in asthma patients, is unlikely to be responsible for the presence of BHR in patients with CFS.
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Affiliation(s)
- Jo Nijs
- Department of Human Physiology, Faculty of Physical Education and Physical Therapy, Academic Hospital, Vrije Universiteit Brussel, Belgium.
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Patarca-Montero R, Antoni M, Fletcher MA, Klimas NG. Cytokine and other immunologic markers in chronic fatigue syndrome and their relation to neuropsychological factors. APPLIED NEUROPSYCHOLOGY 2001; 8:51-64. [PMID: 11388124 DOI: 10.1207/s15324826an0801_7] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The literature is reviewed and data are presented that relate to a model we have developed to account for the perpetuation of the perplexing disorder currently termed chronic fatigue syndrome (CFS). In patients with CFS there is chronic lymphocyte overactivation with cytokine abnormalities that include perturbations in plasma levels of proinflammatory cytokines and decrease in the ratio of Type 1 to Type 2 cytokines produced by lymphocytes in vitro following mitogen stimulation. The initiation of the syndrome is frequently sudden and often follows an acute viral illness. Our model for the subsequent chronicity of this disorder holds that the interaction of psychological factors (distress associated with either CFS-related symptoms or other stressful life events) and the immunologic dysfunction contribute to (a) CFS-related physical symptoms (e.g., perception of fatigue and cognitive difficulties, fever, muscle and joint pain) and increases in illness burden and (b) impaired immune surveillance associated with cytotoxic lymphocytes with resulting activation of latent herpes viruses.
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Affiliation(s)
- R Patarca-Montero
- E. M. Papper Laboratory of Clinical Immunology, Center for Behavioral Medicine Research, Miami Veterans Administration Medical Center, University of Miami School of Medicine, P.O. Box 016960, Miami, FL 33101, USA
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Winfield JB. Psychological determinants of fibromyalgia and related syndromes. CURRENT REVIEW OF PAIN 2001; 4:276-86. [PMID: 10953275 DOI: 10.1007/s11916-000-0104-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Fibromyalgia and other chronic pain and fatigue syndromes constitute an increasingly greater societal burden that currently is not being approached effectively by traditional Western medicine. Although the hallmarks of fibromyalgia--chronic widespread pain, fatigue, and multiple other somatic symptoms--have neurophysiologic and endocrinologic underpinnings, these biological aspects derive primarily from psychological variables. Female gender, adverse experiences during childhood, psychological vulnerability to stress, and a stressful, often frightening environment and culture are important antecedents of fibromyalgia. To understand fibromyalgia and related syndromes and to provide optimum care requires a biopsychosocial, not a biomedical, viewpoint.
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Affiliation(s)
- J B Winfield
- Thurston Arthritis Research Center, 3330 C Thurston Building, Campus box # 7280, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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