Ultrasound Guided Dry Needling Boosts Pain Relief for Patients with Knee Osteoarthritis

PainRelief.com Interview with:
Dr PANG Chun Yiu Johnson
Assistant Professor
School of Health Sciences
Caritas Institute of Higher Education
Hong Kong

Mr PANG

PainRelief.com: What is the background for this study?

Response: As a practicing physiotherapist for over 20 years in an outpatient setting at a government-based hospital, I had encountered difficult situations where patients were suffered with long-term pain that pervious treatments were ineffective or wasn’t long lasting.

Dry needling is a treatment technique that I had always been interested and practicing even during my college times. With years of practice, it has become a skill that I specialized in and received promising results from most of my patients.

However, like most techniques, it has its limitations. Microtrauma inducted by the puncturing of the needles elicit inflammatory response that activate mast cells proliferation to promote tissues healing. As a result, the effectiveness of dry needling depends on the expertise and skill of the practitioners to accurately locate the problematic structure for the insertion of needles.

The inconsistency results of studies with dry needling can be attributed to the absence of a standardized approach and inaccuracies related to needle targeting and advancement.

With that in mind, I wanted to investigate and validate a method that can enhance the accuracy of needle advancement and improve the effectiveness of dry needling. Through constantly researching evidence-based publications, coincidently I came across an article that incorporated ultrasound guidance into dry needling on treating shoulder impairments. The results were promising, both in patient’s feedback and ultrasound imaging, since the practitioner was able to clearly identify the problematic structure under ultrasound guidance. This had inspired me to further investigate the effectiveness of ultrasound-guided dry needling on different musculoskeletal conditions.

Pain Relief from Osteoarthritis Achieved Through Digital and Face-to-Face Interventions

PainRelief.com Interview with:
Thérése Jönsson, PT, PhD
Research group, Sport Sciences
Department of Health Sciences
Lund University

Dr. Jönsson

PainRelief.com: What is the background for this study?

Response: Osteoarthritis (OA) is the most common joint disease and affects more than 300 million people worldwide. Exercise combined with patient education and weight control, if needed is the first-line treatment for OA. Traditionally, first-line treatment has been provided as a face-to-face intervention, requiring the patient to physically visit a primary care clinic or similar.

To increase access to healthcare for the wider community, digital health care interventions are recommended by the World Health Organization to complement traditional care. Digital care platforms have been introduced, but there is limited evidence for their efficacy compared with traditional face-to-face treatment modalities.

Chronic Pain Linked to Later Life Pessimism and Joblessness

PainRelief.com Interview with:
Alex Bryson PhD
Professor of Quantitative Social Science
UCL Social Research Institute
University College London  London

Prof. Bryson

PainRelief.com: What is the background for this study?

Response: The authors were concerned to know more about both the incidence of chronic pain and its implications for health, wellbeing and labour market prospects later in life.  So we turned to a birth cohort study (The National Child Development Study) tracking all those born in Britain in a single week in 1958 through to age 62 to take a life-course approach.

Yoga for Knee Arthritis: Some Improvement in Function but No Pain Reduction

PainRelief.com Interview with:
Professor Kim Bennell FAHM
Barry Distinguished Professor | NHMRC Leadership Fellow
Dame Kate Campbell Fellow
Centre for Health Exercise and Sports Medicine
Department of Physiotherapy
Melbourne School of Health Sciences
The University of Melbourne, Victoria Australia

PainRelief.com: What is the background for this study?

Response: Osteoarthritis is very common, and a major contributor to disability and decreased function. Exercise is a key treatment for osteoarthritis, but many people admit to not undertaking exercise. We investigated whether a free, online 12-week unsupervised yoga program (“My Joint Yoga”) could improve pain and function in people with knee osteoarthritis. Our team worked with yoga therapists, physiotherapists and people with lived experience of osteoarthritis to design an online yoga program tailored specifically to those with knee osteoarthritis.

Pain Stimulates Protective Mucus Secretion in GI Tract

PainRelief.com Interview with:
Isaac M. Chiu PhD
Associate Professor, Department of Immunology
Harvard Medical School
Boston, MA 02115

PainRelief.com: What is the background for this study?

Response: The gut is densely innervated by pain fibers and we know that pain is associated with gut-related diseases. However, it is not so clear how pain fibers talk to the gut lining and barrier. We were interested to see that pain fibers were very close by the epithelial cells that line the gut, and in particular the goblet cells that produce mucus. We were wondering if mucus could be regulated by pain. Mucus is a key protective barrier that keeps our gut healthy by keeping harmful substances as well as bacteria away from the gut wall.

Home Sensors Developed for Overnight Monitoring in Opioid Use Disorder

PainRelief.com Interview with:
Marian Wilson, PhD, MPH, RN, PMGT-BC 
Associate Professor
Assistant Editor, Pain Management Nursing
Washington State University College of Nursing

Dr. Wilson

PainRelief.com: What is the background for this study?

Response: People with opioid use disorder often experience withdrawal symptoms that can interfere with recovery success. Our team was interested in whether noninvasive home sensors could provide accurate information to detect overnight restlessness and sleep problems that could indicate opioid withdrawal for adults prescribed methadone for opioid use disorder.

Brain and Joints May Share Similar Inflammatory Mediators in Rheumatoid Arthritis

PainRelief.com Interview with:
Dr. Woojin Won
KU-KIST Graduate School of Converging Science and Technology
Korea University, Seoul
Center for Cognition and Sociality, Institute for Basic Science (IBS), Daejeon
Republic of Korea

PainRelief.com: What is the background for this study?

Response: Rheumatoid arthritis is a chronic systemic autoimmune disease that mainly affects the joint, and 30-70% of patients have complained of psychiatric disorders such as depression and cognitive impairment. It was suggested that inflammation of the brain was the cause, but the detailed mechanism was unknown. Based on the previous studies, I hypothesized that neuroinflammation will affect astrocytes (star-shaped brain cells) and induce psychiatric disorders.

In addition, there have been clinical reports that inhibition of monoamine oxidases (MAOs), enzymes that catalyze the oxidation of monoamine, relieves pain and mood disorder symptoms of rheumatoid arthritis. However, it is difficult to find a study on MAO inhibitors and rheumatoid arthritis. The reason may be that although MAO consists of two types (MAO-A and MAO-B), several studies have used them without distinction.

Novel Protocol Reduced Use of Opioid Pain Relievers After Knee and Shoulder Surgeries

PainRelief.com Interview with:
Nicole Simunovic, MSc
On behalf of the NO PAin Principal Investigators

PainRelief.com: What is the background for this study?

Response: Orthopaedic surgeons prescribe more opioids than any other type of surgeon in North America. Opioids have the potential to be highly addictive and can cause serious harm or even death if taken in excess. The goal of our clinical study was to determine if an opioid sparing approach to postoperative pain management was safe and effective in patients undergoing arthroscopic knee and shoulder surgery.

iovera° Cryoneurolysis Treatment is Drug-Free Option for Knee Pain

PainRelief.com Interview with:
Vinod Dasa MD
Professor of Clinical Orthopaedics
Director of Research
Louisiana State University Health

PainRelief.com:  Would you describe cryoneurolysis?

Response: Cryoneurolysis is a specialized intense cold therapy technique that provides long-term pain relief without the use of any system drugs. The iovera° system has revolutionized the delivery of long term, drug-free pain relief by delivering a concentrated, targeted cold therapy through a handheld device. The iovera° treatment blocks targeted sensory nerves from sending pain signals. Small closed-end needles are inserted into the treatment region and a treatment cycle is performed until the nerve is blocked, providing pain relief until the nerve regenerates. The localized nerve blocks and targets peripheral nerves to temporarily stop pain signals for up to 90 days and provide immediate, long-lasting pain relief without the need for opioids. The iovera° treatment is used to treat specific nerves so the pain relief is focused only on the part of the body that is being treated.

Nitrous Oxide “Cracking” Can Reduce Greenhouse Gas From Pain Killer Used During Childbirth

PainRelief.com Interview with:
Dr Clifford L Shelton
Consultant Anaesthetist, Wythenshawe Hospital
Senior Clinical Lecturer, Lancaster Medical School (Director of Simulation and Skills)
Executive Editor, Anaesthesia Reports
Deputy Chair of PCPIE, National Institute of Academic Anaesthesia Health Services Research Centre

Dr. Annie Pinder
North West School of Anaesthesia,
Health Education England North West, Manchester, UK

PainRelief.com: What is the background for this study?

Response: Inhaled nitrous oxide is the most commonly-used pain relief for labour in the UK – used by an estimated 77% of women in labour. However, it has a high ‘carbon footprint’ and depletes the ozone layer so healthcare organisations must take steps to reduce its release. Previous works have also noted high levels of nitrous oxide in the work environment of midwives working on labour ward, which can have health implications.

In Scandinavia, nitrous oxide ‘cracking’ technology has been used for several years to address these concerns and this has recently become available in the UK – however, there is little available effectiveness of the technology in the clinical workplace. We previously conducted a bench experiment to assess the ability of cracking technology to reduce ambient nitrous oxide concentrations under ideal circumstances and found a substantial improvement when the technology was in place. However, controlled experimental situations are not representative of real-life.

In this study we therefore aimed to assess whether ambient nitrous oxide levels would be reduced when the technology was implemented on the low-risk birth centre of a typical UK maternity hospital.