A Psychosocial Perspective on Chronic Pain and Depression in the Elderly

Roy, Ranjan

doi:10.1300/j010v12n02_03

Cited by 46 publications

(30 citation statements)

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“…Many surveys have shown that depression in the elderly positively correlates with pain intensity. [14][15][16] In this study, both groups showed improvements of borderline significance (0.05<P<0.10). Further studies with more subjects would be needed to clarify whether acupuncture relieves depression in these cases.…”

Section: Discussionmentioning

confidence: 48%

Acupuncture Needling versus Lidocaine Injection of Trigger Points in Myofascial Pain Syndrome in Elderly Patients – a Randomised Trial

Choi

Park

et al. 2007

Acupunct Med

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IntroductionMyofascial pain syndrome (MPS) is a common cause of musculoskeletal pain characterised by trigger points (MTrPs), that is tender loci in taut bands of skeletal muscle, limited range of motion in joints, referred pain and local twitch responses (LTRs) during mechanical stimulation of the MTrPs. 1 Inactivation of MTrPs is essential in managing MPS and several methods have been recommended. The treatments most commonly used for this purpose are dry needling of the MTrPs, injection treatments with local anaesthetics or saline, sprays, and stretching. 2According to the results of several studies, injection continues to be the most effective choice for treatment. The superiority of local injection or dry needling for the inactivation of MTrPs is controversial, [2][3][4][5][6][7][8] and hollow needles were used for dry needling in these studies. 2;6 Gunn suggests that the 'hollow needle' induces more tissue injury and is more painful than a 'pointed-tip needle '. 9 In this single-blinded randomised trial, we compared the efficacies and adverse events of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome. Method ParticipantsWe obtained retrospective ethical approval from the institutional review board of Inha University Hospital. We selected 40 subjects with chronic MPS of the upper trapezius from volunteers at four communitybased facilities; one further subject proved unable to complete the necessary forms. Subjects were selected on the basis of physical examination and interview, and signed informed consent was obtained. Participants were randomised into two groups by coin-toss: 1) ACU (acupuncture needling) group and 2) TPI (trigger point injection with 0.5% lidocaine) group.Inclusion criteria for the trial were 1) aged more than 60 years old; 2) complaining of chronic shoulder AbstractAim To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients. Methods Thirty nine participants with myofascial pain syndrome of one or both upper trapezius muscles were randomised to treatment with either acupuncture needling (n=18) or 0.5% lidocaine injection (n=21) at all the trigger points on days 0, 7 and 14, in a single-blinded study. Pain scores, range of neck movement, pressure pain intensity and depression were measured up to four weeks from the first treatment. Results Local twitch responses were elicited at least once in 94.9% of all subjects. Both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point up to one month. Overall, the range of cervical movement improved in both groups, apart from extension in the acupuncture needling group. Changes in depression showed only trends. Conclusion There was no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating myofascial pain syndrome in elderly patients.

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Section: Discussionmentioning

confidence: 48%

Acupuncture Needling versus Lidocaine Injection of Trigger Points in Myofascial Pain Syndrome in Elderly Patients – a Randomised Trial

Choi

Park

et al. 2007

Acupunct Med

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“…Many surveys (18)(19)(20) have revealed that depression in the elderly group has a positive correlation with pain intensity, so this favourable change in depression rates in the IMS group is thought to be associated with pain relief. More than half of the participants in this study were isolated from their family members; it is the author's hypothesis that the fact that the greater time requirement for the IMS technique (when compared with the time needed for TPI) might have had a positive effect on pain and depression relief.…”

Section: Depressionmentioning

confidence: 99%

Intramuscular and nerve root stimulation vs lidocaine injection to trigger points in myofascial pain syndrome

Ga¹,

Koh²,

Choi³

et al. 2007

Acta Derm Venereol

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Objectives: To compare the efficacies of an intramuscular stimulation technique and 0.5% lidocaine injection to trigger points in myofascial pain syndrome. Participants: Forty-three people with myofascial pain syndrome of the upper trapezius muscle. Interventions: Twenty-two subjects were treated with intramuscular stimulation and another 21 with 0.5% lidocaine injection at all the trigger points on days 0, 7 and 14. Results: Intramuscular stimulation resulted in a significant reduction in Wong-Baker FACES pain scale scores at all visits and was more effective than trigger point injection. Intramuscular stimulation also resulted in significant improvement on the Geriatric Depression Scale -Short Form. Local twitch responses occurred in 97.7% (42/43) of patients. All the passive cervical ranges of motion were significantly increased. Post-treatment soreness was noted in 54.6% of patients in the intramuscular stimulation group and 38.1% in the trigger point injection group, respectively, and gross subcutaneous haemorrhage (> 4 cm 2 ) was seen in only one patient in the trigger point injection group. Conclusion: In managing myofascial pain syndrome, after one month intramuscular stimulation resulted in more significant improvements in pain intensity, cervical range of motion and depression scales than did 0.5% lidocaine injection of trigger points. Intramuscular stimulation is therefore recommended for myofascial pain syndrome.

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“…The elderly frequently suffer from a variety of chronic ailments (Roy, 1986), death of friends or a spouse (Rabasca, 1999), and social isolation to vaiying degrees (Delisle, 1988). Old age often brings a "realignment" of public and private selves (Larson, 1990).…”

Section: Introductionmentioning

confidence: 99%