Category Archives: Arthritis

Mucosal Breaks from Periodontal Disease Likely Promotes Rheumatoid Arthritis

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PainRelief.com Interview with:
Dana Orange MD
Associate Professor of Clinical Investigation
The Rockefeller Institute and
William H. Robinson, MD PhD
James W. Raitt, M.D., Professor Medicine
Immunology & Rheumatology
Stanford Health Care

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

Response: Periodontitis is more common in patients with rheumatoid arthritis than those without.  

Of patients with rheumatoid arthritis, those with current periodontitis are less likely to receive benefit from treatment with biologic agents than those without periodontitis.

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Knee OsteoArthritis: Study Finds Radiofrequency Nerve Ablation Provides Pain Relief

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PainRelief.com Interview with:
Kaitlin Carrato, M.D., Chief Resident in Interventional Radiology
MedStar Georgetown University Hospital, and
John B. Smirniotopoulos, M.D., Interventional Radiologist
MedStar Georgetown University Hospital

PainRelief.com: What is the background for this study? What is the main indication for the RFA procedure?

Response: Roughly one in four U.S. adults have knee pain due to arthritis that interferes with their everyday lives and activities. A treatment called genicular nerve radiofrequency ablation (RFA) is a safe and effective option for reducing pain from osteoarthritis of the knee, one of the most common joints affected by osteoarthritis. Interventional radiologists perform genicular nerve RFA using image guidance to place probe needles next to nerves around the knee that send pain signals to the brain. The primary indication for this procedure is chronic pain that has not been sufficiently managed by other treatments, prescription medications, physical therapy, or for patients with persistent pain even after knee replacement.

This study examined patient demographics, prior surgical history, degree of osteoarthritis and other clinical characteristics that may affect how well RFA reduces knee pain. We measured post-procedure pain in 36 patients using the visual analog scale (VAS) and the Western Ontario McMaster Universities Osteoarthritis (WOMAC) pain scale. We then evaluated whether pain reduction levels were influenced by demographics and clinical characteristics.

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Both High and Low Dose Exercise Beneficial for Knee Osteoarthritis

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PainRelief.com Interview with:
Tom Arild Torstensen
Department of Neurobiology, Care Sciences and Society
Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden, and
Holten Institute, Stockholm, Sweden 

Tom Arild Torstensen

PainRelief.com: What are the main findings?
Response: The results from our study (1) show that both high-dose and low-dose exercise therapy is beneficial for knee osteoarthritis. At a glance, it would be natural to think that I should choose a low-dose because it takes only 30 minutes and consists of 5 different exercises compared to the high-dose lasting 70 to 90 minutes consisting of 11 exercises. But because our study was designed as a superiority trial, meaning that even though we failed to show that high-dose treatment is superior to low-dose, our results do not imply that a low-dose exercise regimen is as beneficial as a high-dose regimen. 

Both groups improved over time, but there were no benefits of high-dose therapy in most comparisons. One exception was the KOOS score function in sports and recreation, where high-dose therapy was superior at the end of treatment and the 6-month follow-up. A small benefit in QoL at 6 months was also observed. Notably, most variables numerically favored the high-dose group, albeit not in a statistically or clinically meaningful way.

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Effect of Arthritis on Employment Varies Among Socioeconomic Groups

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PainRelief.com Interview with:
Adam Martin PhD
Academic Unit of Health Economics and
Edward Webb, PhD Economist
University of Leeds, UK

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

Response: We wanted to find out how arthritis affects people’s employment. We expected that some people with arthritis might experience poorer work outcomes than those without the condition, such as by losing their job or having a slower career progression.  This study set out to find out how large the differences in work outcomes were for people living with arthritis, and if particular age groups or genders doing specific jobs were especially at risk.

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CMAJ Study Finds Metformin Associated with Reduced Risk of Joint Replacement in Diabetic Patients

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PainRelief.com Interview with:
Zhaohua Zhu (Alex)
PhD, Associated Professor
Clinical Research Center
Zhujiang Hospital of Southern Medical University

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

Osteoarthritis is a leading cause of pain and disability in older adults, but there are no effective drugs in preventing or reversing osteoarthritis progression.

•Metformin is the first-line pharmacologic treatment and the most commonly prescribed drug worldwide for diabetes mellitus.

•Recent experimental studies have showed that both intragastric and intraarticular metformin use can attenuate cartilage degradation and modulated pain in osteoarthritis mouse models. However, it is unclear whether metformin use is associated with reduced risk of total joint replacement in patients with type 2 diabetes mellitus.

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Wake Forest Study Finds Diet and Exercise Can Lead to Pain Relief from Knee Arthritis

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PainRelief.com Interview with:
Stephen P. Messier, Ph.D.
Professor J.B. Snow Biomechanics Laboratory
Department of Health and Exercise Science
Worrell Professional Center
Wake Forest University
Winston Salem, NC 27109

Dr. Messier

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

Response: Some weight loss and exercise programs that have been successful in academic center-based trials have not been evaluated in community settings.  The results showed that among patients with knee osteoarthritis and overweight or obesity, diet and exercise compared with an attention control led to statistically significant differences in pain, function, mobility, body weight, waist circumference, and quality of life.

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

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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.

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

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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.

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

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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.

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Brain and Joints May Share Similar Inflammatory Mediators in Rheumatoid Arthritis

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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.

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