Effect of Arthritis on Employment Varies Among Socioeconomic Groups

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.

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

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.

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

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.

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.

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.

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.

Over Half of Older Adults Use OTC Pain Relievers for Joint Pain Relief

PainRelief.com Interview with:
Beth Wallace, M.D. M.Sc
Associate Investigator, Center for Clinical Management Research
Staff Physician, Rheumatology
VA Ann Arbor Healthcare System
Assistant Professor, Division of Rheumatology
University of Michigan

Dr. Wallace

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

Response: Arthritis and joint pain are common among older adults. We used data from the University of Michigan National Poll on Healthy Aging to understand how a national sample of older adults experiences and manages joint pain.

PainRelief.com: What are the main findings?

Response: Seventy percent of adults aged 50-80 report that they have joint pain. Three in five have a diagnosis of arthritis, including 30% who have a diagnosis of osteoarthritis (also called “wear and tear” or “bone on bone” arthritis).

Of those with joint pain, half said that it limited their usual activities, but about three in four said that they saw arthritis and joint pain as a normal part of aging that they could manage on their own.

More than half of all adults use over-the-counter pain relievers like non-steroidal anti-inflammatory drugs (Advil, Motrin, Aleve) for joint pain. One in ten used a prescription oral steroid, like prednisone. This is important because these medications can cause or worsen health conditions common in older people, such as high blood pressure and heart disease. More than a quarter of adults who used oral steroids for joint pain did not remember discussing the risks of these medications with their health care provider.

Ninety percent of those with joint pain used non-medication treatments, like exercise, massage, and splints and braces, to manage their symptoms. Most people who used these treatments found them to be very helpful.

University of Pittsburgh Study Finds Durable Pain Relief in Obese Patients Following Bariatric Surgery

PainRelief.com Interview with:
Wendy C. King, PhD
Epidemiology Data Center
School of Public Health
University of Pittsburgh
Pittsburgh, PA

Dr. King

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

Response: Previous studies had provided evidence that bariatric surgical procedures are associated with improvements in pain, physical function and work productivity. However, most prior studies only followed participants 1-2 years, at which point participants were at the peak of their weight loss. 

Among a large cohort of US adults, we wanted to evaluate how much initial improvements in pain, physical function and work productivity declined during long-term follow-up, when some degree of weight regain is not uncommon. We limited our study to adults who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), the two most common bariatric surgical procedures done today.

Experimental Hydrogel Improved Chronic Pain from Degenerative Disc Disease

PainRelief.com Interview with:
Douglas P. Beall, MD, FSIR
Chief of Radiology Services
Clinical Radiology of Oklahoma

Dr. Bealll

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

Response: Degenerative disc disease (DDD) is the leading cause of chronic low back pain and one of the world’s most common medical conditions contributing to high medical and disability costs. Healthy spinal discs act aids spine movement and distributes force which allows for spine flexibility and even distribution of the load that is placed on the spine. Each has a firm outer layer and a soft, jelly-like core. With normal aging, discs tend to become dry, thin, cracked or torn, which can cause pain and abnormal motion.

Substances called hydrogels, with biochemical similarities to the intervertebral disc designed to augment both the core and outer layer, have been used for years to help repair degenerated discs. First-generation hydrogels are placed as a soft solid, through a surgical incision, but were not simple to place and had a tendency to migrate from where they were originally placed.

For a first-in-human trial, our team conducted a prospective, single-arm feasibility study to evaluate an experimental, injectable hydrogel for safety and performance in relieving chronic low back pain caused by DDD. We used a second-generation hydrogel (Hydrafil™) developed by ReGelTec, Inc.. Unlike earlier hydrogels, it can be temporarily modified into a liquid and injected rather than placed through a small incision. In 2020, this product received FDA’s breakthrough device designation, allowing expedited review based on promising early evidence.

We recruited 20 patients, aged 22 to 69, who each described their pain as four or higher on a zero to 10 scale. None had found more than mild relief from non-surgical management, which includes rest, analgesics, physical therapy, and back braces. Patients were sedated for the procedure, and the gel was heated to become a thick liquid. Guided by fluoroscopic imaging, an interventional radiologist used a 17-gauge needle to inject the gel directly into the affected disc(s). The gel filled in cracks and tears and adhered to the disc’s core and outer layer.