Continuous passive motion for osteoarthritis of the hip: a pilot study.

OBJECTIVE: To evaluate whether extended use of continuous passive motion (CPM) may allay the pain of walking, diminish disease effect, and increase the usual walking speed in patients with osteoarthritis (OA) of the hip. METHODS: This pilot study comprised 21 patients with Kellgren-Lawrence grade 2-4 OA of the hip who used CPM for periods of 1.2 to 7.6 h daily throughout a 12 week trial. RESULTS: Significant improvements were found in the patients' assessment of pain on visual analog scale, Sickness Impact Profile, self-selected walking speed, and the number of subjects who decreased their medication usage. None of these improvements was related to the radiographic grade of the patients' OA or the daily duration of CPM. CONCLUSION: Although regular exercise is now routinely recommended to patients with OA, there has been relatively little study of specific exercise programs. As such investigations are undertaken, we believe CPM should be included among the options that are studied.

Neuropathic pain in Charcot-Marie-Tooth disease.

OBJECTIVES: To determine the frequency and extent to which subjects with Charcot-Marie-Tooth (CMT) disease report pain and to compare qualities of pain in CMT to other painful neuropathic conditions. STUDY DESIGN: Descriptive, nonexperimental survey, using a previously validated measurement tool, the Neuropathic Pain Scale (NPS). PARTICIPANTS: Participants were recruited from the membership roster of a worldwide CMT support organization. MAIN OUTCOME MEASURES: NPS pain descriptors reported in CMT were compared with those reported by subjects with postherpetic neuralgia (PHN), complex regional pain syndrome, type 1 (CRPS-1), also known as reflex sympathetic dystrophy, diabetic neuropathy (DN), and peripheral nerve injury (PNI). RESULTS: Of 617 CMT subjects (40% response rate), 440 (71%) reported pain. with the most severe pain sites noted as low back (70%), knees (53%), ankles (50%), toes (46%), and feet (44%). Of this group, 171 (39%) reported interruption of activities of daily living by pain; 168 (38%) used non-narcotic pain medication and 113 (23%) used narcotics and/or benzodiazepines for pain. The use of pain description was similar for CMT, PHN, CRPS-1, DN, and PNI in terms of intensity and the descriptors hot, dull, and deep. CONCLUSIONS: Neuropathic pain is a significant problem for many people with CMT. The frequency and intensity of pain reported in CMT is comparable in many ways to PHN, CRPS-1, DN. and PNI. Further studies are needed to examine possible pain generators and pharmacologic and rehabilitative modalities to treat pain in CMT.