Knee pain – and central sensitisation
Conclusion People living with OA in their knees often spend many years having difficulty managing their pain before they are able to have surgery. From recent research in New Zealand, I don’t think many people are offered a pain “education” approach, and indeed, I’d bet there are a lot of people who don’t get referred for movement-based therapy either. Misunderstanding is rife in OA, with some people uncertain of the difference between osteoarthritis and rheumatoid arthritis, and others very worried that they’re going to “wear the joint out” if they exercise. While OA isn’t as sexy as low back pain, doesn’t have the economic cost of low back pain, and has a reasonable surgical option – it is still a significant problem for many people. Helping those people be more confident to move, helping reduce their uncertainty about the effect of movement on their joints, and giving them an opportunity to think differently about their knee pain would be a real step forward. Surgery, while helpful for many, is either not available or unsuccessful for others, and it’s time we attended to their needs as well. Courtney CA, Kavchak AE, Lowry CD, et al. (2010). Interpreting joint pain: quantitative sensory testing in musculoskeletal management. Journal of Orthopaedic Sports Physical Therapy. 40:818–825. Lluch Girbes E, Meeus M, Baert I, et al. (2015) Balancing “hands-on” with “hands-off&rdquo...
Conclusions: High-dual and high-disabled ACOs had similar or higher spending than other ACOs at baseline, but achieved greater savings and were equally or more likely to earn shared savings, suggesting that alternative payment models can have positive financial outcomes for providers who serve vulnerable populations.
RHEUMATOID arthritis is a type of joint pain condition that affects about 400,000 people in the UK. What is the condition, and what are the signs to look out for? This Morning ’s Dr Chris reveals the symptoms of the autoimmune condition.
Conclusion: Although use of RA techniques in geriatric trauma patients with multiple rib fractures was associated with higher MED, opioid use decreased after RA initiation and Acute Pain Service consultation, and the risk of delirium was lower.
Research shows young black men experience more anxiety in whiter neighborhoods.
Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic chest pain, fever, fatigue, and loss of appetite. Children and the elderly have different presenting features of pneumonia, which include headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms. Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia.
Angela Tuffnell, 57, from Cheshire, spent years battling varicose veins hidden inside her pelvis, leaving her in pain so excruciating she could barely stand and would even pass out.
Publication date: Available online 13 August 2018Source: The LancetAuthor(s): Peter Kranke, Stephanie Weibel
This study is registered with the ISRCTN registry, number ISRCTN29654603.FindingsBetween May 13, 2014, and Sept 2, 2016, 201 women were randomly assigned to the remifentanil PCA group and 200 to the pethidine group. One participant in the pethidine group withdrew consent, leaving 199 for analyses. The proportions of epidural conversion were 19% (39 of 201) in the remifentanil PCA group and 41% (81 of 199) in the pethidine group (risk ratio 0·48, 95% CI 0·34–0·66; p
Publication date: Available online 13 August 2018Source: Journal of Critical CareAuthor(s): Carol L. Hodgson, Kimberley J. Haines, Michael Bailey, Jonathan Barrett, Rinaldo Bellomo, Tracey Bucknall, Belinda J. Gabbe, Alisa M. Higgins, Theodore J. Iwashyna, Julian Hunt-Smith, Lynne J. Murray, Paul S. Myles, Jennie Ponsford, David Pilcher, Andrew A. Udy, Craig Walker, Meredith Young, D.J. (Jamie) Cooper, ICU-Recovery InvestigatorsAbstractPurposeTo determine predictors of inability to return to work due to health six-months after intensive care admission; and compare functional recovery between patients who had not returned t...
CONCLUSIONS: The quality of the evidence examining physical activity and exercise for chronic pain is low. This is largely due to small sample sizes and potentially underpowered studies. A number of studies had adequately long interventions, but planned follow-up was limited to less than one year in all but six reviews.There were some favourable effects in reduction in pain severity and improved physical function, though these were mostly of small-to-moderate effect, and were not consistent across the reviews. There were variable effects for psychological function and quality of life.The available evidence suggests physica...
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