Tag: musculoskeletal pain

Categories : Injury & TraumaTags :

Icing Injuries May Slow Recovery and Prolong Pain, Study Finds

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New research challenges long-held views about how to treat injuries

Photo by Andrea Piacquadio from Pexels

Icing a sprained ankle or sore muscle, long used to reduce pain and swelling, may in the longer run delay recovery and prolong pain, new research suggests.

In a preclinical study published in Anesthesiology, McGill University researchers found that even though cryotherapy (icing) eased pain in the short term, recovery time was more than doubled in some cases.

“These results highlight a paradox: treatments that reduce inflammation and relieve pain in the short term may, in some cases, interfere with the biological processes required for full recovery,” said lead author Lucas Lima, a research associate at the Alan Edwards Centre for Research on Pain.

The findings add to a growing body of research questioning the long-term benefits of common anti-inflammatory strategies, said Lima. Previous studies have shown that medications such as acetylsalicylic acid (Aspirin) can also extend the duration of pain, and animal research has suggested icing may delay tissue repair.

The new study provides, for the first time, direct evidence that icing can also affect the duration of pain itself, based on experiments with mice mimicking inflammatory and exercise-related injuries.

Icing is commonly used as part of the RICE protocol, a standard approach to managing injuries that includes rest, ice, compression and elevation. It is widely used by athletes, clinicians and in everyday injury care, but there is limited evidence for its long-term benefits, said the researchers.

“Our results suggest we need to better understand when anti-inflammatory strategies are helpful and when they are not,” said senior author Jeffrey Mogil, James McGill Distinguished Professor and E. P. Taylor Chair in Pain Studies.

He emphasized the results are not yet directly applicable to humans. A clinical trial is underway to test whether the same effect appears in patients recovering from procedures such as wisdom tooth removal.

About the study

“Cryotherapy and Duration of Inflammatory Pain in Mice” by Lucas Lima and Jeffrey Mogil et al. was published in Anesthesiology. The study was supported by the Canadian Institutes of Health Research Foundation and the Louise and Alan Edwards Foundation.

Source: McGill University

Categories : Skeletal SystemTags :

Sustained Device Use Alters the Spine And Muscles, Causing Pain

On By ModernMedia
Source: CC0

Learning new languages, sending emails, attending a virtual class, or speaking to loved ones halfway around the world are just some of the tasks accomplished by touching a button on a smartphone. Unfortunately, the ease and convenience of modern devices have also come with a painful crick in the neck. The sedentary nature of work and prolonged use of hand-held devices and computers have contributed to a sharp increase in neck pain.

While fatigue in neck muscles has long been suspected of causing pain, the actual mechanical changes in the spine and muscles that precede weakness remain an outstanding question.

Now, using high-precision X-ray imaging to track spine movements during neck exertion tasks, Texas A&M University researchers have discovered that sustained neck exertions cause muscle fatigue that then exaggerate the cervical spine curvature. This leads to neck pain.

Their results are published in the Proceedings of the National Academy of Sciences.

“We are talking about subtle movements of the neck in statically held positions, which are hard to capture. They are also highly complex because there are so many individual pieces in the neck, or as we call, motion segments,” said Dr Xudong Zhang, professor in the Department of Industrial and Systems Engineering. “With this study, we have, for the first time, provided unequivocal evidence that fatigue causes mechanical changes that increase the risk.”

Zhang said this understanding can help to make informed decisions about how we work and the design of products (e.g., head-mounted wearables) that can potentially reduce the risk of neck pain.

Neck pain is prevalent

Neck pain is one of the most common musculoskeletal disorders, and globally, around 2500 people out of 100 000 have some form of neck pain. In fact, by 2050, the estimated global number of neck pain cases is projected to increase by 32.5%. An important risk factor for neck pain is bad posture sustained over long periods. Consequently, working long hours on the computer in a stooped position or prolonged use of smart devices are important contributors to neck pain.

Neck posture is maintained dynamically by the bones of the spine pulled into position by the muscles that attach to them.  Although the neck is highly flexible, it is also very unstable.

“The muscle drives movements by producing force,” said Zhang. “We hypothesised that when different muscles’ force production abilities diminish, the bone positions change and that can be captured.”

Measuring fatigue

To test their idea, they recruited healthy volunteers in a “sustained-till-exhaustion” neck exertion task. The subjects maintained their necks in the neutral, 40° extended (bent backwards) and 40° bent forward for a certain duration. The investigators used electromyography (EMG) to measure muscle electrical activity. In particular, they objectively measured muscle fatigue through changes in the frequency of the EMG signal. In addition, they used high-precision, dynamic X-ray technology to track small-amplitude cervical spine movements that were of the order of a few degrees.

“We imagined the cervical spine as a cantilever bridge,” said Zhang. “If there is excessive and/or repeated stress on the bridge, it might sag or buckle; similarly, if the muscles get fatigued, the cervical spine may deflect.”

The researchers’ experimental paradigm validated that sustained exertions indeed lead to EMG signals of fatigue. Biomechanically, the muscular fatigue modified the spine’s mechanics, which then increases the propensity for injury.

Further investigations

As a next step, the researchers will develop dynamic biomechanical models, a novel approach that promises to provide a more realistic understanding of the muscular events that precede fatigue. Unlike the model in this study that assumes static neck exertions, the dynamic model will capture subtle but consequential changes in the muscles and bones over time.

Source: Texas A&M University

Categories : Ageing Pain ManagementTags :

Earlier Retirement for People with Chronic Musculoskeletal Pain

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Photo by Towfiqu barbhuiya

Frequent musculoskeletal pain is linked with an increased risk of exiting work and retiring earlier, according to a new study published this week in the open-access journal PLOS ONE by Nils Niederstrasser of the University of Portsmouth, UK, and colleagues.

Previous studies have shown higher rates of absenteeism, reduced working capacity and reduced income for people with chronic musculoskeletal pain. The prevalence of people living with musculoskeletal pain increases with age, but few studies have specifically focused on the effects of chronic pain on the employment status of older populations.

In the new study, Niederstrasser and colleagues used data on 1156 individuals aged 50+ living in England and taking part in the English Longitudinal Study of Ageing. Over the course of the 14-year data collection period, 1073 of the individuals retired.

The researchers found that people with more musculoskeletal pain complaints tended to retire earlier compared to pain-free participants (HR = 1.30, CI = 1.12–1.49). Participants suffering from musculoskeletal pain were also 1.25 times more likely to cease work sooner (CI = 1.10–1.43), whether or not they described themselves as retired. Other factors associated with earlier retirement age included higher work dissatisfaction and higher self-perceived social status. Frequent musculoskeletal pain remained a significant predictor of earlier retirement and risk of work cessation at earlier ages even when controlling for the influence of job satisfaction, depressive symptoms, self-perceived social status, sex, and working conditions.

The authors conclude that pain experiences can lead to poor work outcomes and point out that further research should establish the mechanisms and decision making involved in leaving the workforce for people with frequent musculoskeletal pain.  

The authors add: “It is remarkable that pain predicts earlier retirement and work cessation to a similar extent or even more strongly than other variables, such as job satisfaction or specific job demands. It shows just how much impact pain can have on all aspects of people’s lives.”