Journal of Back and Musculoskeletal Rehabilitation - Volume 11, issue 3
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: The treatment of pain in children, the elderly, and intensive care unit patients presents some unique problems. Here a unifying theme is emphasized: the difficulty in adequately assessing pain in patients who are often unable to communicate. Also addressed are the differences in pharmacokinetics and pharmacodynamics from neonates to the elderly. Finally, common pain syndromes in each group, the associated treatments, and recent controversies are discussed. Because of changing demographics, pain treatment for these groups will become increasingly important. Only in the past 10 years has pediatric pain been treated with the same energy as adult pain; application of the…newest techniques still lags far behind these patients' adult counterparts. Pain treatment in the elderly will inevitably become a larger problem as our population ages. Finally, recent advances in technology enable us to sustain patients with increasingly severe illnesses. Thus, pain management in these special populations will take on progressively greater importance.
Keywords: Pain, pediatric, geriatric, intensive care unit
Abstract: Myofascial pain syndrome (MPS) and fibromyalgia (FM) are common muscular pain syndromes. They are both characterized by tenderness, but MPS is further characterized by the myofascial trigger point that has a taut band and causes referred pain. FM can be either primary (idiopathic) or secondary. MPS is always secondary to some muscle stressor. The diagnosis of these conditions is generally made by physical examination. Algometry can quantify the tenderness. EMG of the trigger point and diagnostic ultrasound can provide objective evidence of the trigger point. Biochemical markers and other phenomena associated with FM have not yet been shown to be…either specific or sensitive enough to use as clinical indicators of the condition. Tryptophane is low in the serum and spinal fluid of FM patients, whereas substance P is elevated in the spinal fluid. Treatment of MPS is effective when the trigger point is inactivated and underlying mechanical or medical perpetuating factors are corrected. Treatment of fibromyalgia is more difficult as the drugs commonly used, such as the tricyclic antidepressants, which have uncertain benefits; and exercise, which clearly shows a short-term benefit, fail to provide long-lasting relief at 4 years.
Keywords: Myofascial pain syndrome, Fibromyalgia, Trigger point, Tender point, Myalgia, Referred pain, Algometry, Muscle disorder