The Analgesic Effect of Intraarticular Morphine in Osteoarthritis of Knee

OBJECTIVE: This study was conducted to assess the analgesic effect of intraarticular injection with morphine and hyaluronic acid in comparison with intraarticular injection with hyaluronic acid only in the patients with osteoarthritis of knee. METHOD: Twenty four patients with degenerative osteoarthritis of the knee were assigned randomly to a morphine group (morphine+hyaluronic acid) and a hyaluronic acid group. In the morphine group, intraarticular injection with morphine and hyaluronic acid at first was applied to the knee 2 times. Then intraarticular injection with hyaluronic acid without morphine was applied in the remaining 3times. In the hyaluronic acid group, intraarticular injection with hyaluronic acid was applied to the knee 5 times. Effects were assessed on the 1st week, 5th week after treatment, and on the last follow up day by pain rating score (PRS). RESULTS: Significant change of PRS improvement was noticed in the morphine group in the 1st week after treatment compared with the hyaluronic acid group. CONCLUSION: These results showed that intraarticular injection with morphine and hyaluronic acid was a more effective treatment method than intraarticular injection with hyaluronic acid only for pain control in patients with osteoarthritis of knee.

Effect of Percutaneous Vertebroplasty in Chronic Osteoporotic Compression Fracture of Thoracic and Lumbar Vertebra

OBJECTIVE: This study was conducted to assess the effect of percutaneous vertebroplasty in the patients with chronic osteoporotic compression fracture at the thoracic and the lumbar vertebra. METHOD: Twelve patients with chronic osteoporotic compression fracture of thoracic and lumbar vertebra were engaged in this study. Treated levels were from the ninth thoracic vertebra to the fifth lumbar vertebra. Effects were assessed on the first day, 1 month after treatment and the last follow up (average 164 days after vertebroplasty; range 60 days to 302 days) by visual analogue scale (VAS), McGill pain questionnaire (MPQ), and compression ratio of vertebral body. Complication rate was assessed. RESULTS: Significant improvement by VAS and MPQ was noticed on the first day, 1 month after treatment and the last follow up. Further vertebral height loss was not noticed on follow-up. CONCLUSION: Percutaneous vertebroplasty can be an effective treatment method in patients with chronic back pain due to osteoporotic compression fracture at the thoracic and the lumbar vertebra.

Effects of Intramuscular Stimulation in Myofascial Pain Syndrome of Upper Trapezius Muscle

objective: This study was conducted to assess effects of intramuscular stimulation (IMS) in comparison with that of dry needling and intramuscular electrical stimulation (IMES) in the patients with myofascial pain syndrome (MPS) of upper trapezius. METHOD: Thirty patients with MPS were assigned randomly to three groups, such as dry needling group (n=10), IMES group (n=10), and IMS group (n=10). In dry needling group, dry needling was applied to the trigger point of upper trapezius muscle. In IMES group, IMES was applied to the trigger point of upper trapezius muscle. In IMS group, IMS was applied to the trigger point of upper trapezius and parcervical muscles. Treatment were done three times a week for 2 weeks. Effects were assessed on 3rd day, 7th day and 14th day after treatment by visual analogue scale (VAS), McGill pain questionnaire (MPQ), and passive range of motion (PROM) of cervical spine. RESULTS: Significant changes of VAS and PROM were noticed in IMS group, compared with other groups. No significant difference of MPQ was noticed in IMS group, compared with other groups. CONCLUSION: IMS may be more effective treatment modality than dry needling and IMES in patients with MPS of upper trapezius muscle.

The Effect of Intramuscular Electrical Stimulation in Myofascial Pain Syndrome

OBJECTIVE: This study was conducted to assess the effect of intramuscular electrical stimulation (IMES) and compared it with that of transcutaneous electrical nerve stimulation (TENS) and dry needling in the patients with myofascial pain syndrome (MPS). METHOD: Forty five patients with MPS was assigned randomly to TENS group (n=15), dry needling group (n=15) and IMES group (n=15). In TENS group, TENS was applied to the trigger point. In dry needling group, dry needling was applied to the trigger point. In IMES group, IMES was applied to the trigger point. Duration of treatment was 2 weeks. Effects were assessed before treatment, 1 day, 3 days, 7 days and 14 days after treatment by visual analogue scale (VAS) and McGill pain questionnaire (MPQ). Thermography was performed before treatment, 7 days and 14 days after treatment. RESULTS: Significant change of VAS improvement ratio was noticed in IMES group from the 1 day after treatment compared with other groups. Significant change of MPQ improvement ratio was noticed in IMES group from the 3 days after treatment compared with other groups. The skin temperature difference was significantly improved in IMES group at 14 days after treatment. CONCLUSION: These results showed that IMES is effective treatment method for pain control in patients with MPS.