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Blind injections performed in the subacromial region by experienced individuals were reliably accurate and could therefore be given in daily routines. Corticosteroid injections in the subacromial region were very effective in improving the pain and functional status of patients with subacromial impingement syndrome during the short-term follow-up.

Viscosupplementation consists of injecting exagenous hyaluronan (HA) into the synovial joints to restore the normal rheological environment which deteriorates severely in osteoarthritic (OA) joints. Efficacy might be related to the rheological properties and molecular weight (MW) of the hyaluronan preparations. This prospective, controlled, double-blind, randomised clinical trial was aimed at comparing the elastoviscous properties of a high molecular weight viscosupplement, hylan G-F 20, with that of a lower molecular weight hyaluronan product in order to determine the relationship of elastoviscosity to efficacy, alongside placebo, in the treatment of patients with knee OA. The results were analysed as a "completers" analysis with 59 patients. Primary outcome measures included the Western Ontario and Mc Master Universities' Osteoarthritis Index (WOMAC) for pain, stiffness and function scores, and patient and physician global assessments (0-100 scale). For patient (PGA) and physician global assessments (PhGA), the 0-100 scale was used, with 100 being the worst. Follow-up assessments were made at intervals of 1, 3 and 6 months after the first injection. Local adverse events, such as transient pain at the injection site or warm knee lasting for one night, were recorded in two patients (3%). In all groups, the WOMAC pain score exhibited a significant difference from the baseline value; neither treatment group was significantly different from the placebo group, but total pain score was significantly better than baseline for both of the HA groups at the end of 6 months (p < 0.05). Improvement in WOMAC physical function score favoured both sodium hyaluronate and hylan G-F 20 after the first month, and remained significant until the end of 6 months (p < 0.01). In the placebo group, the physical function scores became worse after the end of the 1st month; the scores at the end of 6 months were no different from those at the beginning. The WOMAC stiffness scores of both of the hyaluronic acid groups improved with the first injection, and remained significantly better than the placebo group until the end of the survey (p < 0.001). All groups expressed improvement with PGA scores after the first injection. At the end of 6 months all three groups were similar, but the treatment groups were significantly better than the placebo group (p < 0.05), and all were significantly better than at the beginning (p < 0.05). The PhGA scores were similar in all groups until after the third injection. The second group was slightly better in the controls at 1 and 3 months, but all the groups were similar at the end of 6 months. Although the placebo group seemed worse, it was not statistically significant. Compared with lower molecular weight HA, the higher molecular weight HA might be more efficacious in treating knee OA, but heterogeneity of previous studies limited definitive conclusions. Patients treated by injection of either of two hyaluronan preparations showed clinical improvement for pain, though no different from the placebo group; W...

Dynamic lumbar stabilization exercises are an efficient and useful technique in the rehabilitation of patients who have undergone microdiscectomy. They relieve pain, improve functional parameters and strengthen trunk, abdominal and low back muscles.

Objective The clinical manifestations of COVID-19 range from mild symptoms to severe pneumonia and severe organ damage. When evaluated specifically for pain, the data so far have shown that myalgia, headache, and chest pain can be seen in patients at varying rates; myalgia and headache, especially, are among the initial symptoms. Design This retrospective chart review, followed by a descriptive survey design study, was carried out by examining patients afflicted with COVID-19. After discharge, patients were asked about the severity and the body region of their pain, their use of analgesics, their mood and mental health, and their overall quality of life. Results A total of 206 patients with a mean age of 56.24 ± 16.99 yrs were included in the study. Pain during COVID-19 was found to be higher compared with the preinfectious and postinfectious states. The most frequent painful areas were reported to be the neck and back before the infection, whereas the head and limbs during the infection. The most frequently used analgesic during infection was paracetamol. There was no relationship between the patients’ pain and anxiety and depression; the quality of life was found to be worse in patients with persistent pain. Conclusions This study showed that the head and limbs were the most common painful body regions during COVID-19. It was also found that pain can continue in the postinfection period.

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