Study of musculoskeletal problems among long-term computer users in Ahmedabad City

Background: COVID-19 made many changes in life of persons and even after post COVID era these changes are integral to our life. Some of the changes were online classes, work from home, and online gaming. Computer work leads to static position of neck, shoulders, and upper limbs for extended hours. This leads to higher risk of developing visual, musculoskeletal and psychological problems. Aims and Objectives: The present study was carried out to determine prevalence of musculoskeletal health disorders, assess work distribution, and their probable interaction with musculoskeletal health problems in computer users of Ahmedabad city. Material(s) and Method(s): A cross-sectional study was carried out over a period of 1-year time among 800 participants to study the musculoskeletal problems among computer users. Result(s): Out of 800 participants, 76.75% of participants had any computer related musculoskeletal problem. If participants work more than 4 h in a single spell prevalence of musculoskeletal problems was 82.95%. Regular exercise has significant role in preventing computer-related musculoskeletal problems. Conclusion(s): Computer-related musculoskeletal problems have relation with number of hours spent in single spell, total daily working hours, and years of computer-related work.Copyright © 2023, Mr Bhawani Singh. All rights reserved.

Neuroimmune Mechanisms Underlying Post-acute Sequelae of SARS-CoV-2 (PASC) Pain, Predictions from a Ligand-Receptor Interactome.

PURPOSE OF REVIEW: Individuals with post-acute sequelae of SARS-CoV-2 (PASC) complain of persistent musculoskeletal pain. Determining how COVID-19 infection produces persistent pain would be valuable for the development of therapeutics aimed at alleviating these symptoms. RECENT FINDINGS: To generate hypotheses regarding neuroimmune interactions in PASC, we used a ligand-receptor interactome to make predictions about how ligands from PBMCs in individuals with COVID-19 communicate with dorsal root ganglia (DRG) neurons to induce persistent pain. In a structured literature review of -omics COVID-19 studies, we identified ligands capable of binding to receptors on DRG neurons, which stimulate signaling pathways including immune cell activation and chemotaxis, the complement system, and type I interferon signaling. The most consistent finding across immune cell types was an upregulation of genes encoding the alarmins S100A8/9 and MHC-I. This ligand-receptor interactome, from our hypothesis-generating literature review, can be used to guide future research surrounding mechanisms of PASC-induced pain.

Musculoskeletal pain among teleworkers: Frequency and associated factors

Teleworking, also known as remote working, has become the new norm for many workers since the coronavirus disease 2019 (COVID-19) pandemic. Studies show that during this time, the incidence of musculoskeletal pain is increasing among these workers. Despite this, few studies have addressed the possible correlates of musculoskeletal pasin in teleworkers, with several potential predictors receiving little or no attention in published studies. With this in mind, an online survey was conducted among organizations in the IT and communications sectors in Malta. Information was collected from 459 teleworkers on the frequency of telework, frequency of work during nonworking hours, exercise frequency, burnout, and ergonomic arrangements. Demographic data were also collected. Results revealed that 55.8% reported one or more musculoskeletal pain. Back pain was the most common, followed by neck and shoulder pain. The presence of pain, the number of painful body areas, and the presence of back, neck, and shoulder pain were each individually associated with work during nonworking hours, lower levels of exercise, and higher levels of burnout. It is argued that musculoskeletal pain appears to be common among teleworkers and may negatively impact the quality of life and organizational performance. Companies and occupational health practitioners should strive to identify the prevalence of these problems among their teleworkers, develop appropriate preventive measures, and support workers to obtain multidisciplinary care when needed.

Adaptive Immunity Dysregulation Is Associated to the Development of Long Covid

Background: The pathogenetic mechanisms behind the development of long- COVID (LC) are largely unknown. Because both plasma SARS-CoV-2 RNAemia and dysregulated immunity have been correlated with COVID-19 severity, we evaluated whether they are associated with LC. Method(s): We consecutively enrolled unvaccinated hospitalized COVID-19 patients during acute-COVID-19 (T0) in March-October 2020 who either developed LC at a follow-up visit 2-3 months from virologic clearance (T1) or did not. LC was defined as persistence >=2 months after recovery of >=1 symptom: anosmia, dysgeusia, fever, gastrointestinal symptoms, dyspnoea, fatigue, musculoskeletal pain, muscle weakness, brain fog. We measured: SARS-CoV-2 RNAemia (RT-qPCR, log10(copies/mL)), magnitude (ELISA, AUC) and functionality (pseudovirus neutralization, ID50;Fc-mediated functions, %ADCC) of SARS-CoV-2-specific antibodies, SARS-CoV-2-specific B and CD4-T-cells (Immunophenotype, AIM and ICS assays). Result(s): We enrolled 48 COVID-19 individuals, 38/48 (79.2%) developed LC (LC+) and 10 did not (LC-). LC+ and LC- had similar co-morbidities and symptoms in the acute phase (Fig.1A), and the majority showed a radiologically documented SARS-CoV-2 pneumonia. The SARS-CoV-2 RNAemia did not differ between groups at both time points. The levels of RBD-specific Abs, as well as their functionality, appeared to increase over time in the LC- group but not in the LC+ (Fig.1B-D). Similarly, a trend towards increased RBD-specific B-cells was observed over time in the LC- group but not in LC+ (Fig.1E). B-cell immunophenotyping showed a significant increase over time of classical memory B cells (MBCs) at the expenses of activated MBCs (Fig.1F-G) as well as an IgA class-switching in the LC- group compared to LC+ (Fig.1H-I). Furthermore, LC+ showed a faster decline of SARS-CoV-2-specific (CD69+CD137+) CD4- TEMRA and CD4-TEM (Fig.1L-M). Finally, IFN-gamma-producing TREG of LC- individuals increased over time (Fig.1N). Conclusion(s): Acutely ill, hospitalized COVID-19 patients developing LC feature a dysregulated SARS-CoV-2-specific humoral as well as B- and T-cell response, in both magnitude and functionality, suggesting a link between dysregulated SARS-CoV-2-specific adaptive immunity and LC development. The fine understanding of the factors contributing to such dysregulation in LC patients is strongly needed, that might further inform targeted therapeutic interventions. (Figure Presented).

Has the COVID 19 Pandemic Impacted the Management of Chronic Musculoskeletal Pain?

PURPOSE OF REVIEW: The COVID-19 pandemic has affected the management of chronic musculoskeletal pain; however, the extent of its impact has not been established. We conducted a comprehensive review of the pandemic's impact on clinical outcomes and healthcare accessibility for osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia (FM), lower back pain (LBP), and other musculoskeletal disorders and chronic pain syndromes to better inform clinical decision-making. RECENT FINDINGS: We examined 30 studies (n = 18,810) from 36 countries investigating the impact of the COVID-19 pandemic on chronic musculoskeletal pain outcomes. The available evidence suggests that the pandemic significantly impacted pain levels, mental health, quality of life and healthcare accessibility in patients with chronic musculoskeletal pain. Of 30 studies, 25 (83%) reported symptom worsening, and 20 (67%) reported reduced healthcare accessibility. Patients were unable to access necessary care services during the pandemic, including orthopedic surgeries, medications, and complementary therapies, leading to worsened pain, psychological health, and quality of life. Across conditions, vulnerable patients reported high pain catastrophizing, psychological stress, and low physical activity related to social isolation. Notably, positive coping strategies, regular physical activity, and social support were associated with positive health outcomes. Most patients with chronic musculoskeletal pain had greatly affected pain severity, physical function, and quality of life during the COVID-19 pandemic. Moreover, the pandemic significantly impacted treatment accessibility, preventing necessary therapies. These findings support further prioritization of chronic musculoskeletal pain patient care.

Impact of El-Poems study: the e-learning for postural education in music students: a randomized controlled trial protocol.

BACKGROUND: Musculoskeletal pain (MP) has today intensified in a large proportion of music students in Iran. Poor posture while playing an instrument is thus assumed as a very significant risk factor affecting such a condition in this population. The present study aims to evaluate the impact of electronic learning (e-learning) for postural education to music students on posture behavior and MP (abbreviated as an El-Poems study). METHODS: This study is a matched-pair, two-arm, parallel randomized controlled trial (RCT). The participants, as the 7th-to-12th-grade music students, will be accordingly assigned to intervention (n = 204) and control (n = 204) groups, based on the inclusion and exclusion criteria. The postural education will be also presented through the web-based Student Education Network (with the acronym, SHAD) at the Tehran Conservatory of Music, Tehran, Iran. The intervention program consists of four sessions, using the Integrated Change (I-Change) model. It will be also implemented by a trained physical education instructor and a health educator. The content of the program includes raising awareness, building motivation, and developing skills. Besides, its components are comprised of specific proper postures viz. standing, sitting, lifting, carrying, and hand position while playing a musical instrument. The primary outcome is the MP that will be assessed by the Nordic Body Map (NBM) questionnaire and a numerical rating scale (NRS), and the secondary outcome is the posture behavior that will be evaluated objectively, using the Rapid Entire Body Assessment (REBA) tool. The data will be also collected at baseline and after a six-month follow-up. CONCLUSION: This RCT is an innovative study as a pioneer to represent the first attempt for web-based postural education as well as an attractive intervention to prevent MP in Iranian music students. TRIAL REGISTRATION: Current Controlled Trials IRCT20180528039885N2 . Prospectively registered on 11 September 2021.

Quality of life and its health and occupational determinants among hospital-based nurses during the COVID-19 pandemic.

BACKGROUND: Nurses worldwide were exposed to increased levels of occupational stress during the COVID-19 pandemic which could have hindered their level of health-related quality of life (HRQoL). OBJECTIVES: This project investigated HRQoL level in nurses during the COVID-19 pandemic and its health and occupational predictors. METHODS: A cross-sectional design was adopted and targeted full-time nurses in Jordan. Study collected data included demographics, 12-item Short Form health survey (SF-12) to measure HRQoL, Nordic Musculoskeletal Questionnaire (NMQ), nurses' evaluation of work conditions during COVID-19, and Depression Anxiety Stress Scale (DASS21). Data was analyzed descriptively to summarize main outcome measures and using multiple linear regression model to identify factors significantly associated with HRQoL. RESULTS: In total 245 nurses successfully completed the survey, 39.6% were males with a mean age of 35±6 years. Participant SF-12 scores were 65.94±17.85 for physical component and 50.09±19.36 mental component. The statistical model significantly explained 53.2% of variance in HRQoL (r2 = 0.534, F = 57.849, p < 0.001). Better sleep quality self-evaluation was significantly associated with higher HRQoL levels, while increased levels of depression, musculoskeletal pain, and financial burden on family were significantly associated with worse HRQoL level. CONCLUSION: Jordanian nurses' HRQoL level was relatively low during COVID-19. Sleep quality, mental health status, musculoskeletal health status, and financial status were identified as factors possibly influenced HRQoL among nurses during the COVID-19 pandemic. Nurses' quality of life along with their mental and physical health should be considered by healthcare administrators in the remaining period of COVID-19 and in future similar emergencies.

comparative effectiveness of remotely delivered biopsychosocial interventions for the treatment of osteoarthritic pain. A network meta - analysis

Purpose: Osteoarthritis (OA) can cause pain, discomfort, stiffness and progressively limit your ability to perform everyday tasks. Currently, there is no cure for OA, hence most patients experience chronic pain. Evidence suggests a shared mechanism between chronic pain and mental disorders. Patients living with OA- related chronic pain and depression have complex needs due to high rates of persistent physical and mental health symptoms, issues around inadequate pain relief, risks with opioid use, frequent lack of access to primary care, 80% unemployment rates, and complicated family/social relationships. Thus, they require physical, cognitive, and social treatments delivered by a multidisciplinary team that integrates physical and mental health approaches. The pandemic posed a major challenge for patients with osteoarthritis. Public health measures postponed non-emergency in-person treatment programs. People suffering from osteoarthritis are typically older which makes them more vulnerable to SARS-COV-2 infection. Telemedicine is a method that enables remote or virtual appointments between patients and health care practitioner. While remote care offers a wide range of benefits it is unclear if these interventions can provide similar effects with face-to-face care. In this study, we aimed to evaluate the effectiveness of remote biopsychosocial interventions in comparison to sham, traditional, or alternative remote treatments in patients with osteoarthritic pain and mental health symptoms using a network meta-analysis approach. Method(s): Eligible studies were randomized trials of remote biopsychosocial interventions that included at least one treatment arm provided remotely/virtually and compared to an alternative (sham, non-intervention, face-to-face treatment or alternative virtual/remote intervention). Patients had OA-related chronic musculoskeletal pain and at least 60% of participants had a mental health comorbidity or the analysis was disaggregated by mental health comorbidity. The primary outcome of interest was pain intensity at 12-weeks follow-up. Secondary outcomes were depression levels, dropouts/withdrawals and any adverse or serious adverse events reported. Potential mediators extracted were patient characteristics such as mean age, sex/gender and duration of symptoms/follow-up. We extracted data from the closest timepoint to 12-weeks follow-up for all outcomes. We critically appraised the included trials with the Cochrane risk of bias tool. Effect estimates were presented as standardized mean differences (SMD) and were comparisons between remote interventions and wait-list control. For all estimates, we reported the medians with corresponding 95% credibility intervals (CrIs) from the 2.5th and 97.5th percentile of the posterior distribution. The prespecified minimal clinically important between-group difference was -0.37 SD units. We estimated the probability of the effect of remote interventions of being superior to facilitate the interpretation of estimated treatment effects. We used a Bayesian random-effects network meta-analysis model. Analysis was conducted with OpenBUGS and STATA 16.0. Result(s): Overall, 21 trials with 4,426 patients with OA were included in this network meta-analysis. We identified 11 different interventions (combination or alone) such as usual care, exercise, education, cognitive behavioural therapy (CBT) guided or unguided delivered in different remote formats (internet, tele, mobile application or face-to-face). At 12-weeks follow-up, internet-delivered exercise (SMD -0.25, 95%Crl -0.59 to -0.09), Tele-CBT (SMD -0.22, 95%Crl -0.56 to 0.12) and a combination of Tele-CBT with education plus exercise (SMD -0.25, 95%Crl -0.66 to 0.15) had more pronounced treatment effects on pain reduction compared to wait-list control and 94%, 92% and 90% probability of being superior (respectively). For depression outcomes, a combination of tele-CBT with education plus exercise, had more pronounced treatment effects (SMD -0.31 95%Crl -1.16 to 0.53) when compared to wait-list-control and 86% pr bability of being superior. Conclusion(s): Internet-delivered exercise, Tele-CBT, and a combination of Tele-CBT with education plus exercise displayed higher probability of being superior than the other interventions, and had more pronounced effects in reducing pain intensity and depression levels when compared to wait-list control. However, none of these interventions excluded the null threshold.Copyright © 2023

Effects of pulmonary rehabilitation on major symptoms of long COVID (post-COVID-19 syndrome)

Several months after COVID-19 infection, a high proportion of patients complains of persistent symptoms (long COVID). Regardless of acute disease severity, dyspnea and fatigue are part of major symptoms. Spontaneous recovery is unlikely without any intervention. Thus, our aim was to assess the feasibility and efficacy of a pulmonary rehabilitation (PR) program to relieve these symptoms. 39 patients with a documented COVID-19 infection and suffering from persistent symptoms were included. They took part in PR program between Feb.-Dec. 2021. The program comprised, at the very least, 18 endurance and 10 resistance training sessions and 6 educational sessions (dyspnea management, psychological support and counselling). Exercise tolerance (ET), dyspnea (D-12), fatigue (MFI-20) and quality of life (QoL) were assessed by questionnaires before (T1) and after (T2) PR. Main delay between first symptoms and PR enrolment was 297+/-131 days. Main symptoms were dyspnea (n=34), fatigue (n=29), concentration disorders (n=16) and musculoskeletal pain (n=15). After PR, D-12 and MFI-20 decreased significantly (T1:15.5+/-8;T2: 8.3+/-5.6;p<.05 and T1: 65.6+/-14.3;T2:53.2+/-12.8;p<.05, respectively). In addition, QoL, through physical (PCS) and mental (MCS) dimensions, and ET significantly improved (PCS (T1): 34.8+/-9.7;PCS (T2): 42.7+/-8.3;p<.01;MCS (T1): 40.3+/-9.3;MCS (T2): 48.8+/-8.5;p<.01 and T1: 516.6+/-131.6 m;T2: 602.6+/-118.8 m;p<.05, respectively). PR appears to be a safe, feasible and efficient therapy to relieve dyspnea and fatigue in patients with residual symptoms of COVID-19 several months after initial infection. In addition, PR allows a significant improvement in ET and QoL for these patients.

Post-COVID-19 fibromyalgia syndrome: A report of two case

COVID-19 is a viral infection caused by SARS-CoV-2 that primarily targets the respiratory system. COVID-19 may be followed in some patients by post-COV-ID-19 syndrome, fatigue, anxiety, and musculoskeletal pain. These symptoms may be associated with other symptoms, resulting in a constellation of symptoms consistent with fibromyalgia syndrome (FMS). Two patients were evaluated at the rheumatology outpatient clinic for diffuse persistent musculoskeletal pain after COVID-19 infection. Patients presented with generalized musculoskeletal pain, fatigue, anxiety, depression, headache, hand paresthesia, and non-restorative sleep. General examination and various laboratory investigations, including autoimmune profile and radiological investigation, were normal. After examining eighteen tender points, both patients fulfilled the 1990 ACR classification criteria for FMS. Post-COVID-19 FMS should be considered during the management of post-COVID-19 syndrome to alleviate pain and prevent worsening of symptoms during the COVID-19 pandemic.Copyright © 2022, Derman Medical Publishing. All rights reserved.

The Effect of Strengthening and Relaxation Exercises on Pain, Anxiety and Sleep Quality in People with Covid-19

Musculoskeletal pain, anxiety and sleep problems may continue after COVID-19. In our study, it was aimed to examine the effects of strengthening and relaxation exercises on musculoskeletal pain, anxiety and sleep quality in people with ongoing COVID-19 symptoms. The study, which was carried out at XXX Hospital between 18 January 2021 and 31 March 2021, included 76 patients aged between 18-65 who were diagnosed with COVID-19 in last 3 months. While strengthening and relaxation exercises were applied to 38 of the patients included in the study (experimental group), no exercise was applied to 38 of them (control group). Personal information form, McGill pain scale short form (SFMPQ), short form 36 (SF-36), Pittsburgh sleep quality scale (PUKI) were administered to all patients before and after the study. There was no significant difference between the experimental and control groups for the demographic characteristics and baseline results (p>0.05). After the study, a significant difference was found in the experimental group in terms of SF-36, Mcgill, Beck Anxiety Scale and PUKI (p<0.05). In the control group after the study, statistically significant difference was found in all evaluations except, SF-36's Physical Role Difficulty, Social Functioning and Pain sub-dimension scores (p<0.05). The changes before and after the study for Mcgill, Beck Anxiety scale, PUKI, SF-36 (except emotional) scores were significantly higher in the experimental group than the control group (p<0.05). In conclusion, it was determined that strengthening and relaxation exercises had a significantly positive effect on post-COVID-19 musculoskeletal pain, anxiety and sleep quality in our study.

Top 20 Research Studies of 2021 for Primary Care Physicians

This article summarizes the top 20 research studies of 2021 identified as POEMs (patient-oriented evidence that matters) that did not address the COVID-19 pandemic. Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists prevent adverse cardiovascular and renal outcomes in patients with type 2 diabetes mellitus and also reduce all-cause and cardiovascular mortality. Most older adults (mean age, 75 years) with prediabetes do not progress to diabetes. Among patients in this age group with type 2 diabetes treated with medication, an A1C level of less than 7% is associated with increased risk of hospitalization for hypoglycemia, especially when using a sulfonylurea or insulin. For patients with chronic low back pain, exercise, nonsteroidal anti-inflammatory drugs, duloxetine, and opioids were shown to be more effective than control in achieving a 30% reduction in pain, but self-discontinuation of duloxetine and opioids was common. There is no clinically important difference between muscle relaxants and placebo in the treatment of nonspecific low back pain. In patients with chronic pain, low- to moderate-quality evidence supports exercise, yoga, massage, and mindfulness-based stress reduction. For acute musculoskeletal pain, acetaminophen, 1,000 mg, plus ibuprofen, 400 mg, without an opioid is a good option. Regarding screening for colorectal cancer, trial evidence supports performing fecal immunochemical testing every other year. For chronic constipation, evidence supports polyethylene glycol, senna, fiber supplements, magnesium-based products, and fruit-based products. The following abdominal symptoms carry a greater than 3% risk of cancer or inflammatory bowel disease: dysphagia or change in bowel habits in men;rectal bleeding in women;and abdominal pain, change in bowel habits, or dyspepsia in men and women older than 60 years. For secondary prevention in those with established arteriosclerotic cardiovascular disease, 81 mg of aspirin daily appears to be effective. The Framingham Risk Score and the Pooled Cohort Equations both overestimate the risk of cardiovascular events. Over 12 years, no association between egg consumption and cardiovascular events was demonstrated. Gabapentin, pregabalin, duloxetine, and venlafaxine provide clinically meaningful improvements in chronic neuropathic pain. In patients with moderate to severe depression, initial titration above the minimum starting dose of antidepressants in the first eight weeks of treatment is not more likely to increase response. In adults with iron deficiency anemia, adding vitamin C to oral iron has no effect. In children with pharyngitis, rhinosinusitis, acute bronchitis, or acute otitis media, providing education combined with a take-and-hold antibiotic prescription results in 1 in 4 of those children eventually taking an antibiotic.Copyright © 2022 American Academy of Family Physicians.

Co-Occurring Physical Health Challenges in Neurodivergent Children and Young People: A Topical Review and Recommendation

Background: Neurodivergence has been established as associated with a significant number of co-occurring physical conditions, particularly for autistic individuals who are at risk for increased pain, hypermobility (including Ehlers-Danlos Syndrome) and gastrointestinal problems. However, data, so far, has been focused on adults and generally limited to discussions of condition prevalence alone. Method(s): The following article will present a topical review of the literature considering evidence for increased physical health concerns within neurodivergent populations, particularly autistic individuals, with a focus on the impact that these physical health concerns may have in an educational setting. Results and discussion: The impact of physical health concerns within neurodivergent populations in an educational setting may be concerning. Such populations may face a range of challenges in obtaining appropriate support for physical conditions. We discuss a number of said challenges including;communication challenges, misattributing physical health symptoms as a part of neurodivergence, and a history of not being believed, which limits symptomatic reporting. We further consider the potential impact these physical health concerns may have on scholastic and social development, such as impacts for attainment and attendance. Furthermore, we provide recommendations for teachers, parents/carers and other allied professionals in young people's lives, on supporting young neurodivergent people with physical health concerns.Copyright © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Effects of basic body awareness therapy on pain, sleep, quality of life during COVID-19 pandemic -a randomized controlled study

Aim: In this study, we aimed to investigate the effects of the telerehabilitation-based BBAT (Basic Body Awareness Therapy) approach on body awareness, musculoskeletal pain, sleep, and quality of life (QoL) in university students during the COVID-19 social isolation and home quarantine period. Material(s) and Method(s): The study was designed as a randomized controlled trial. A total of 40 university students participated in the study. Patients were divided into two groups: the treatment group who received the BBAT (n=20) and the control group who refused to receive treatment (n=20). BBAT was applied to the treatment group on an online platform for three days a week (60 minutes per session) for six weeks. Pre-and post-treatment self-reported questionnaire data were used. Pain severity was assessed using the McGill Pain Questionnaire (MPQ), sleep quality using the Pittsburg Sleep Quality Index (PSQI), body awareness using the Body Awareness Questionnaire (BAQ), and QoL using the World Health Organization Quality of Life (WHOQoL) questionnaire. Result(s): In the treatment group, there was a statistically significant difference between the participants' pre-treatment and post-treatment scores in MPQ, PSQI and BAQ, as well as in the psychological health, social relationships and environment domains and general health facet of the WHOQoL questionnaire (p<0.05). In the control group, no statistically significant difference was observed between the participants' pre-treatment and post-treatment scores in MPQ, PSQI, BAQ and the psychological health, social relationships and environment domains of the WHOQoL questionnaire (p>0.05). Discussion(s): The telerehabilitation-based BBAT approach is effective for university students' body awareness, musculoskeletal pain, sleep, and quality of life during the ongoing COVID-19 pandemic period.Copyright © 2023, Derman Medical Publishing. All rights reserved.

Evaluation of the pain in COVID-19 patients with musculoskeletal pain: A cross-sectional study

Aim: There is no study that have assessed face-to-face using the multidimensional pain scale in COVID-19 patients with musculoskeletal pain. This study aimed to reveal the pain region, character and severity in COVID-19 patients with musculoskeletal pain. Material(s) and Method(s): This cross-sectional study was carried out in 214 patients who had a positive result of the polymerase chain reaction test within the last five days and at least one musculoskeletal pain symptom, such as fatigue, myalgia, and arthralgia/polyarthralgia. The cases were divided into groups as clinically severe and non-severe. Evaluations were made on the first day of admission. Myalgia symptoms were classified as diffuse and local. The McGill Pain Questionnaire was used for pain regions and caharacters while the Visual Analog Scale (VAS) was for pain intensity. Result(s): The frequency of involvement was myalgia (96.3%), fatigue (77.6%) and polyarthralgia (62.6%), respectively. The diffuse myalgia was (53.3%) in all patients. The mean myalgia VAS score in the non-severe group was 5.88+/-1.83 and 6.25+/-1.24 in the severe group (p=0.192). The most common pain areas were the back, feet, and knees respectively, and throbbing (40.7%), aching (30.8%), and pricking (26.1%) were the most common characteristics. The suffocating character of the pain was significantly higher in the severe group (p<0.05). Discussion(s): Defining disease-specific pain regions, character and severity in COVID-19 patients with musculoskeletal pain is important in managing possible chronic pain.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Post-COVID-19 syndrome and fibromyalgia

A growing body of evidence is suggesting the possible subacute and long-term effects in patients suffering from COVID-19, affecting multiple organ systems. During acute COVID-19, musculoskeletal pain is reported in one-third of patients and it may be also part of the spectrum of post-COVID-19 syndrome, along with other manifestations. Musculoskeletal pain is the cardinal symptoms of fibromyalgia. In this context, the role of viral infection as a triggering factor for the development of fibromyalgia has been postulated since many years. Thus, the occurrence of post-COVID-19 fibromyalgia may be postulated. Several COVID-19-specific mechanisms may contribute to the pathophysiology of the subsequent musculoskeletal syndrome, such as a small fiber neuropathy, an autonomic dysfunction, and an immunological derangement. Finally, the possible multiple components of the pathogenesis and maintenance of post-COVID-19 fibromyalgia may necessitate a multimodal treatment approach. © 2023 Elsevier Inc. All rights reserved.

Physiotherapy in Musculoskeletal and Sports conditions: AB No: 70: Association of Musculoskeletal Pain, Body Part and Posture with Use of Various Electronic Devices in Students of Age 14–18 Years-A Cross Sectional Study

Purpose: To determine association of musculoskeletal pain, body part and posture due to the use of various electronic devices in higher secondary school students. Relevance: The present situation of COVID-19 has show increased use of electronic devices for studies in students' life. Children using gadgets for long duration attain improper posture which are associated with musculoskeletal disorders. Participants: High school students of age between 14–18 years with a minimum use of electronic devices for 6 months. Methods: An observational study design was conducted at various schools in Belagavi city for a sample of 388 students. Data collection was based on an E-form (Google form) which included informed consents, informed assents and assessment tool Adolescent pediatric pain tool (APPT). Analysis: Standard descriptive statistics were used for the data, frequency tables and percentage analysis for categorical variables. Pearson Correlation test were used. Result: The results of study showed that pain in the right and left knee was associated with use of television and significantly corelated to assumption of certain positions. Neck pain was associated with the use of laptops and assuming particular positions. The duration of time spent using an electronic device and the severity of pain were found to have a strong positive correlation. Conclusion: There is significant association present between pain, body part and posture due to the use of electronic device in students of age 14–18 years. Implications: The knowledge about the improper posture and its musculoskeletal consequences can help minimize and prevent further complications associated with it by ergonomic advice.

[Updated S1 guideline on long/post-COVID: relevant aspects for pain medicine]. / Aktualisierte S1-Leitlinie Long/Post-COVID: Relevante Aspekte für die Schmerzmedizin.

BACKGROUND: The S1 guideline on long/post-COVID of the AWMF [German Association of the Medical Scientific Societies] registration number 020-027) was updated in August 2022. METHODS: Under the coordination of the German Society of Pneumology, the guideline was updated by 21 scientific associations, two professional associations and clinical centers each and one institute and statutory accident insurance each. Each scientific association was responsible for its own chapter. The German Pain Society prepared the chapter "Pain". The coordinators of each chapter performed a selective literature search and also received approval for the chapter within their scientific association. During an internal period of comments, all representatives of the participating institutions could comment on all chapters. The AWMF task force commented on the draft of the guideline, which was then finally approved by the boards of all participating institutions. RESULTS: Coronavirus disease 2019 (COVID-19) increases the risk of persistent headache and musculoskeletal pain. Long/Post-COVID pain is frequently associated with fatigue and cognitive problems. A specialist assessment might be considered if symptoms with limitations of daily activities persist 3 months after the infection. The diagnostic workup of long/post-COVID-associated pain should be performed according to the standards of pain medicine. Management should follow the pain guidelines of the AWMF. CONCLUSIONS: The updated S1 guideline on long/post-COVID is a clinical manual which offers orientation for diagnostics and treatment despite limited data.

Pain Management in the Post-COVID Era-An Update: A Narrative Review.

An extensive computer search (from January 2020 to January 2023) was conducted including literature from the PubMed, Scopus, MEDLINE, Web of Science, and EMBASE databases. According to preset criteria, a total of 58 articles were included in this review article. Generally, any patient who becomes infected with COVID-19 can develop post-COVID-19 conditions. The course of COVID-19 is divided into three main stages: acute COVID-19 (up to 4 weeks), post-acute COVID-19 (from 4 to 12 weeks), and post-COVID (from 12 weeks to 6 months). If a more protracted course of COVID (over 6 months) is demonstrated, the term "long-COVID" is used. Although the acute stage of COVID-19 infection most commonly manifests with acute respiratory symptoms, one very common symptom of the disease is pain, while the most common symptoms of post-COVID syndrome are shortness of breath, dry cough, fatigue, loss of olfactory and gustatory function, tightness and chest pain, sleep and mood disturbances, body aches, muscle and joint pain, sore throat, fever, and persistent headaches. All observations demonstrated a high incidence of chronic pain syndromes of various localization in the post- and long-COVID period. Post-COVID chronic pain might include a newly developed chronic pain as a part of post-viral syndrome; worsening of preexisting chronic pain due to the associated changes in the medical services, or a de novo chronic pain in healthy individuals who are not infected with COVID. Chronic pain during and post-COVID-19 pandemic is an important health issue due to the significant impacts of pain on the patients, health care systems, and society as well. Therefore, it is important that patients with chronic pain receive effective treatment according to their specific needs. Accordingly, the main goal of this review article is to provide a broad description about the post-COVID pain and to explore the impact of long COVID-19 on chronic pain patients, and also to give brief reports about the prevalence, risk factors, possible mechanisms, different presentations, and the management tools through a systematic approach.