Evaluation of pain associated with chronic venous insufficiency in Spanish postmenopausal women

Assessment of lower extremity venous insufficiency and lipedema and their association with knee symptoms, functions, and quality of life in patients with knee osteoarthritis

OBJECTIVE

To evaluate the effects of the venous insufficiency (VI) or lipedema on the symptoms, functions, and quality of life (QoL) of patients with knee osteoarthritis (OA).

METHODS

96 patients with stage 3/4 knee OA were included in the study. Patients were grouped as OA (n = 35), VI + OA (n = 35), and lipedema + OA (n = 26). Range of motion (ROM), Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), short-form (SF-36), and 6-minute walking test (6MWT) were evaluated.

RESULTS

WOMAC stiffness score was significantly higher in the VI group than the other groups (p < .05). VAS resting, WOMAC pain, function, and total scores were significantly higher in the lipedema + OA and VI + OA groups than the OA group (p < .05). SF-36-physical role limitation was significantly lower in the lipedema and VI groups (p < .05).

CONCLUSION

VI or lipedema accompanying knee OA increases the existing disability due to OA by negatively affecting patients regarding pain, QoL, and physical functioning.

Management of Lower Extremity Pain from Chronic Venous Insufficiency: A Comprehensive Review

PURPOSE OF REVIEW

Chronic venous insufficiency is found to some extent in a large proportion of the world's population, especially in the elderly and obese. Despite its prevalence, little research has been pursued into this pathology when compared to similarly common conditions. Pain is often the presenting symptom of chronic venous insufficiency and has significant deleterious effects on quality of life. This manuscript will describe the development of pain in chronic venous insufficiency, and will also review both traditional methods of pain management and novel advances in both medical and surgical therapy for this disease.

RECENT FINDINGS

Pain in chronic venous insufficiency is a common complication which remains poorly correlated in recent studies with the clinically observable extent of disease. Although lifestyle modification remains the foundation of treatment for pain associated with chronic venous sufficiency, compression devices and various pharmacologic agents have emerged as safe and effective treatments for pain in these patients. In patients for whom these measures are insufficient, recently developed minimally invasive vascular surgical techniques have been shown to reduce postsurgical complications and recovery time, although additional research is necessary to characterize long-term outcomes of these procedures. This review discusses the latest findings concerning the pathophysiology of pain in chronic venous insufficiency, conservative and medical management, and surgical strategies for pain relief, including minimally invasive treatment strategies.

Pain Intensity, Pressure Pain Hypersensitivity, Central Sensitization, and Pain Catastrophizing Related to Vascular Alterations in Raynaud's Phenomenon: A Preliminary Case-Control Study

OBJECTIVE

To evaluate pain intensity, widespread pressure pain, central sensitization (CS), and catastrophizing between subjects with primary and secondary Raynaud's phenomenon (RP) and healthy controls and to compare the relationships between vascular impairment and pain perception.

METHODS

A preliminary case-control study was performed with a total sample of 57 participants (37 with RP). Sociodemographic data, clinical/vascular data, and pain variables (pain intensity, pressure pain sensitivity, pain magnitude and threshold, CS, and catastrophizing) were registered. Results were analyzed by analysis of covariance and Pearson correlation.

RESULTS

Participants with RP had a lower basal temperature (more vasoconstriction) in their hands (P ≤ 0.012), higher pain intensity (P ≤ 0.001), higher electrical pain magnitude (P < 0.001), and lower pressure pain (P ≤ 0.05) and electrical pain (P < 0.001) thresholds in comparison with healthy controls. Secondary RP participants showed a significantly higher level of CS compared with controls and primary RP participants (P = 0.001). Catastrophizing was higher in the primary and secondary RP (P ≤ 0.001) groups than in controls. No correlations were observed between severity of vasoconstriction and pain variables.

CONCLUSIONS

RP participants showed bilateral hypersensitivity to pressure pain. However, the severity of vascular alterations seems not to be related to central pain experiences. Additional mechanisms such as catastrophizing may influence pain in RP; nevertheless, central sensitization only appears to be involved in the secondary form of RP.

Differences in pain, fatigue, and quality of life in patients with chronic venous insufficiency based on physical activity level

Background

This study aims to compare the effect of different physical activity levels on pain, fatigue, and quality of life in patients with chronic venous insufficiency.

Methods

Between October 2018 and February 2019, a total of 69 patients (4 males, 65 females; mean age 50 years; range, 19 to 73 years) who were diagnosed with chronic venous insufficiency and consulted for physiotherapy were included in the study. The physical activity level of the patients was determined using the International Physical Activity Questionnaire in three groups as light, moderate, or vigorous. Fatigue, pain, and QoL were assessed using the Fatigue Severity Scale, visual analog scale (during the night, activity, and rest), and Venous Insufficiency Epidemiological and Economic Study Quality/Symptom Scale, respectively.

Results

Of a total of 69 patients, 17 were in the light-intensity physical activity group, 32 in the moderate-intensity physical activity group, and 20 in the vigorous-intensity physical activity group. Perceived pain during activity and fatigue were significantly different between the light- and moderate-intensity physical activity groups (p<0.05). There was no significant difference in pain, fatigue, and quality of life scores between the vigorous-intensity physical activity group and the other two groups (p>0.05).

Conclusion

Our study results suggest that a moderate level of physical activity may be helpful to overcome symptoms such as pain and fatigue in patients with chronic venous insufficiency and to improve quality of life.

Dancing: More than a therapy for patients with venous insufficiency

Objective

This study aims to figure out the effects of dance therapy on patients with chronic venous insufficiency disease.

Methods

Forty subjects with chronic venous insufficiency were recruited to either the control group or the dance therapy group. As the severity of chronic venous insufficiency was defined with the Venous Clinical Severity Scores (VCSS), patients in control group received only medical treatment. Twenty patients with chronic venous insufficiency in dance therapy group received three times a week, for five weeks, totally 15 sessions of dance therapy in addition to medical treatment.

Results

There was no significant difference in pre- and post-treatment results of Rivermead Index, VCSS parameters constipation complaint, assistive breath muscle activity, lower limb circumference, strength and range of motion between groups ( p > 0.05). The remarkable result of this study was obtaining that the post-treatment quality of life scale’s bodily pain score was significantly higher in the dance therapy group than the control group ( p < 0.05).

Conclusions

It was concluded that dance therapy has positive effects on quality of life. There were no barriers to chronic venous insufficiency patients in this form of gentle exercise, showing that it is to meliorate the cardiovascular, physical and psychological benefits of an activity that is enhancing of the self-esteem in addition to the quality of life. Treatment of chronic venous insufficiency should consist of methods that support the patient mentally, physically and psychologically, in addition to the medical treatment. Dance therapy might be a potential exercise intervention for improvements in chronic venous insufficiency patients, so clinicians focusing on them could recommend this form of gentle exercise in addition to the medical treatment.

Nociceptive Alteration by High Sucrose Diet in Hypoestrogenic Wistar Rats

Preclinical Research Obesity is a risk factor associated with alterations in pain perception. The aim of this study was to analyse a time-course of nociceptive responses (plantar test) in hypoestrogenic rats after the induction of obesity. Animals (hypoestrogenic and naïve) received either a hypercaloric or regular diet for 24 weeks. Thermal nociception and body weight were measured during this period. At the 4th and 17th weeks after treatment, oral glucose tolerance, blood insulin levels, abdominal fat weight, and uric acid levels were measured. The hypoestrogenic rats on a high sucrose diet had higher body weight and abdominal fat weight than control rats. A biphasic response was observed in the ovariectomized group fed with sucrose with thermal latency being decreased in the fourth week. During weeks 12-18, thermal latency increased compared to that of the hypoestrogenic control. There were no differences in basal blood glucose levels at the 4th and 17th weeks; however, oral glucose tolerance, insulin, and uric acid levels were altered. This indicated that increased body weight and fat as well as alteration sin glucose tolerance, hyperinsulinemia and hyperuricemia, may be associated with the biphasic nociceptive response. Drug Dev Res 77 : 258-266, 2016. © 2016 Wiley Periodicals, Inc.