Effects of diflunisal on cutaneous sensory and pain thresholds.

The analgesic activity of diflunisal was evaluated through the measurement of cutaneous sensory and pain thresholds after electrical stimulation. Twelve healthy volunteers were examined at baseline and five hourly intervals after oral administration of 500 mg and 1 gm of diflunisal. The results showed that the sensory threshold was not modified by diflunisal, but that the pain threshold was significantly increased two and three hours after 500 mg of diflunisal and one, two, and three hours after 1 gm of diflunisal. At two hours the pain threshold was significantly higher after 1 gm than after 500 mg of diflunisal. It is concluded that diflunisal produces an actual increase of the pain threshold in healthy human subjects and that the amplitude, latency, and duration of its effect are dose related.

Comparison of electromotive drug administration with ketorolac or with placebo in patients with pain from rheumatic disease: a double-masked study.

This study was undertaken to assess the efficacy of ketorolac compared with placebo when delivered by electromotive drug administration (EMDA) in patients with pain from rheumatic disease. In EMDA, or iontophoresis, a low-intensity electric current is applied over the skin to deliver medication into body tissues. Although EMDA has been used to treat patients with various diseases, controlled studies are lacking in patients with rheumatic disease. This double-masked study included 60 patients (43 women and 17 men) aged 31 to 80 years with the following conditions: 12, epicondylitis; 30, scapulohumeral periarthritis; 10, gonalgia; and 8, metatarsalgia. They were divided randomly by a physician into 2 groups of 30 patients each for 5 sessions of active treatment (30 mg of ketorolac) or placebo (5 mL of normal saline). Treatment took place every other day for 20 minutes. Immediately before and after the five treatment sessions and 7 days after treatment ended, both patient and physician measured the degree of pain using a categoric scale (no pain, slight pain, intermediate pain, strong pain, and very strong pain) and evaluated pain intensity using the Scott and Huskisson Visual Analogue Scale (VAS). Seven days after treatment ended, both physician and patient judged the result of treatment using a second categoric scale (no improvement or intermediate, good, or very good result). Both ketorolac and placebo provided immediate, significant pain relief when delivered by EMDA, but only those patients receiving ketorolac experienced a further reduction in pain 7 days after treatment; those receiving placebo experienced a slight increase in pain. VAS values differed significantly between the two groups. Poor results (no improvement) were significantly higher in the placebo-treated group, while good results were significantly higher in the ketorolac-treated group. No patient reported any adverse effects during treatment. This study demonstrates that ketorolac relieves pain when delivered by EMDA and offers longer-lasting pain relief than does placebo.

Muscle pain after exercise is linked with an inorganic phosphate increase as shown by 31P NMR.

31P nuclear magnetic resonance (NMR) spectra were obtained from the forearm muscles of 5 subjects before and after performing a muscle stretching (eccentric) exercise routine. Spectra collected before and immediately after exercise showed normal resting phosphorylated metabolite levels and unchanged intracellular pH (pHi). Measurements made on the day following exercise, when muscular pain was apparent, revealed an elevated inorganic phosphate level. No significant changes in other metabolites or pHi were detected. This study gives the first indication of biochemical change following a form of exercise that is associated with considerable muscle pain and damage. The findings may help in understanding pathological processes resulting in pain and damage in muscle.

[A heparin-glucuronylglucosaminoglycan combination for topical use. An evaluation of the therapeutic effects in induced experimental muscle damage and in minor sports injuries]. / L'associazione eparina-glucoronilglucosaminoglicano per uso topico. Valutazione degli effetti terapeutici nel danno muscolare sperimentale indotto e nella traumatologia minore da sport.

The aim of the study was to evaluate the clinical efficacy of the association of heparin and sulodexide on experimental pain and on "small sport traumatology". In the experimental part of the study, cutaneous pain threshold and subcutaneous tissue ticking were measured after the induction of an algogenic focus in deep somatic side. In the clinical part of the study, pain intensity (by A.V. scale), athletic performance and therapy duration, in athletes from muscular or articular posttraumatic injuries, were also assessed. After the therapy with the examined drug, a less significant lowering of cutaneous pain threshold and a less subcutaneous tissue thickening were found in the experimental study; in the clinical study a significant reduction of pain intensity and a quick restore of athletic performance were revealed. These results allow to conclude that the drug in effective to reduce painful symptomatology in both experimental and clinical conditions, by the limitation of some aspects of inflammation.