COVID-19 pandemic: pain, quality of life and impact on public health in the confinement in Spain.

BACKGROUND: Given the uncontrolled increase of those affected by the SARS-CoV-2 Coronavirus, COVID-19, and the possibility of the health system collapsing in Spain, the Royal Decree 463/2020, of March 14th, declared a state of alarm for the management of this health crisis. The whole population, despite their social background, were confined inside their homes during this arduous situation. There are numerous articles that endorse the idea that their home conditions, the number of people with whom they coexist with, their employment, gender, amount of physical exercise, as well as their body mass index and their diagnosis in COVID-19 are characteristics that may represent an increased risk of suffering pain and changes in their quality of life. We proposed a study to determine the impact of the confinement on pain, quality of life and public health of the Spanish population due to the COVID-19 pandemic. METHODS: An observational study was carried out during April and May 2020 through an online survey. It was statistically analysed through descriptive analysis and inferential analysis by bivariate logistic regression, ordinal logistic and Pearson's chi square. RESULTS: A total of 225 questionnaires were obtained between April and May 2020. For subjects suffering pain before confinement, significant relationships were drawn between experiencing pain and work-related activities (P=0.006), as well as, physical activity or the absence of it (P=0.033). In addition, an important association between experiencing pain and gender was discovered, both for people suffering pain before and during confinement (P=0.007 and P=0.011). Furthermore, the confinement has affected the quality of life of those affected, particularly in relation with suffering pain before and during confinement (P=0.001 and P=0.000), Job type (P=0.016) and BMI (P=0.025) and affecting more Physical Role, Emotional Role and Mental Health, followed by Physical Function. CONCLUSIONS: The presence of pain in subjects undergoing confinement is persistent, with varying intensity and frequency based on age, gender, physical activity, and work status. In any of these conditions, the quality of life of the subjects in confinement has been severely affected, which to this day creates a severe public health problem.

Invasive and Non-Invasive Electrical Neuromodulation in Trigeminal Nerve Neuralgia: A Systematic Review and Meta-Analysis.

BACKGROUND: Trigeminal neuralgia is a chronic disease characterized by intense facial pain that is caused by trigeminal nerve affectation. It usually affects adults from 50 years of age, and is more frequent in women. Additionally, it presents serious psychological effects that often lead to depression, which is why it is considered highly disabling. The therapeutic approach is based on the modification of nerve activity through electrical, surgical or chemical stimulation in specific regions of the nervous system. OBJECTIVE: To perform a meta-analysis of the scientific literature related to invasive and non-invasive electrical neuromodulation of trigeminal neuralgia, in order to assess their effects over pain and adverse effects. METHODS: A literature search was conducted in 4 databases, followed by a manual search of articles on invasive or non-invasive electrical neuromodulation to control the pain of trigeminal neuralgia, including the last 15 years. RESULTS: Regarding non-invasive methods, clinical trials did not present enough results in order to perform a meta-analysis. Regarding invasive methods, clinical trials meta-analysis showed no statistical differences between different treatment methods. In all cases, improvements in patients' pain were reported, although results regarding adverse effects were variable. CONCLUSION: In the treatment of trigeminal neuralgia, the continuous radiofrequency provides better short and medium-term results, but pulsed radiofrequency shows less adverse effects after treatment, and has better results in the long-term.