Analgesic electrical currents associated with carboxytherapy in women with cellulite: A randomized controlled trial.

BACKGROUND: Pain is considered the main limiting factor in carboxytherapy. Electroanalgesia has gained recognition in the field of dermatology and to date, only transcutaneous electrical nerve stimulation (TENS) has proved to be effective at reducing pain associated with carboxytherapy; however, the effect of medium frequency currents has yet to be investigated. AIMS: Compare the effects of TENS, interferential current (IFC), and Aussie current on pain intensity associated with carboxytherapy and sensory comfort in the treatment of cellulite. PATIENTS/METHODS: Seventy-five women aged 18-49 years with moderate and/or severe gluteal cellulite were randomized into three groups: TENS (n = 25), IFC (n = 25), and Aussie current (n = 25), which underwent three sessions of carboxytherapy associated with an electrical current. Current amplitude was adjusted after each puncture, according to the maximum tolerance reported by participants, below the motor threshold. Pain intensity was measured using a numeric rating scale (0-10) and sensory comfort with the visual analogue scale (0-10). RESULTS: There was no significant intergroup difference in pain intensity (p > 0.05) and sensory comfort (p = 0.502) during the application of carboxytherapy throughout the three treatment sessions. CONCLUSION: TENS, IFC, and Aussie currents showed no difference in pain intensity reduction and no current was found to be more comfortable.

Traditional acupuncture and laser acupuncture in chronic nonspecific neck pain: study protocol for a randomized controlled trial.

BACKGROUND: Nonspecific neck pain is a multifactorial and very common condition in adult individuals, traditional acupuncture (TA) and laser acupuncture (LA) may be treatment options for certain individuals in such a condition. However, no reports were found in the literature comparing the effectiveness of TA and LA in cases of chronic nonspecific neck pain. Therefore, the aim of the present study is to investigate the effectiveness of TA and LA therapies in individuals with chronic nonspecific neck pain, noting which one is more efficient for this condition. The result of this research will have direct implications for pain management and, consequently, may benefit individuals suffering from nonspecific chronic neck pain. METHODS/DESIGN: This will be a controlled and randomized clinical trial. Eighty-four individuals will be recruited and distributed equally and randomly into 3 groups: TA (which will receive the acupuncture treatment with needles), LA (which will receive the laser acupuncture treatment), and Sham (who will receive the placebo intervention). The acupuncture points (Tianzhu, Fengchi, Jianjing, and Jianzhongshu) will be stimulated bilaterally. The primary outcome will be pain intensity, determined using the Numerical Rating Scale. The secondary outcomes will be pressure pain threshold, temporal summation of pain, conditioned pain modulation, use of analgesic medicines after treatment, and the global perceived effect scale. The assessments will be performed immediately before and after the treatment, which will be a single session, at the follow-up and 1 month after the end of the treatments; evaluation will be made of the pain intensity and the global perceived effect. Statistical analysis of the data obtained will consider a significance level of p < 0.05. DISCUSSION: This study will provide evidence concerning the effects of LA treatment, in comparison with TA and sham intervention, leading to benefits for individuals suffering from chronic nonspecific neck pain. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials - ReBEC RBR-7vbw5gd . Date of registration: August 06th, 2021.

Analgesic Effects of Interferential Current Therapy: A Narrative Review.

Background and Objectives: Transcutaneous electrical stimulation of low- and medium-frequency currents is commonly used in pain management. Interferential current (IFC) therapy, a medium frequency alternating current therapy that reportedly reduces skin impedance, can reach deeper tissues. IFC therapy can provide several different treatment possibilities by adjusting its parameters (carrier frequency, amplitudemodulated frequency, sweep frequency, sweep mode or swing pattern, type of application (bipolar or quadripolar), time of application and intensity). The objective of this review article is to discuss the literature findings on the analgesic efficacy of IFC therapy. Conclusions: According to the literature, IFC therapy shows significant analgesic effects in patients with neck pain, low back pain, knee osteoarthritis and post-operative knee pain. Most of the IFC parameters seem not to influence its analgesic effects. We encourage further studies to investigate the mechanism of action of IFC therapy.

Vibration anesthesia during carboxytherapy for cellulite: a study protocol.

Background: To date, there has been no investigation addressing the effects of vibration anesthesia during carboxytherapy. Aim: Investigate the analgesic effect of different vibratory devices during carboxytherapy for the treatment of cellulite. Materials & methods: A total of 78 women between 18 and 49 years of age with cellulite in the gluteal region will be randomly allocated to three groups: Group A (carboxytherapy and vibratory device A), Group B (carboxytherapy and vibratory device B) and control group. Pain intensity will be assessed using a numerical rating scale after each puncture. Expected outcome: Vibration anesthesia is expected to be effective at diminishing the pain intensity caused by carboxytherapy comparison with the control group, with no differences between the vibratory devices. Trial registry: Brazilian Registry of Clinical Trials: ReBEC (RBR-8jcqy7c).

Vibrating anesthesia involves applying vibrations to the skin to reduce discomfort and pain during injections. So far, we do not know much about the therapeutic action of vibrating anesthesia on pain associated with carboxytherapy, a cosmetic treatment that involves injecting carbon dioxide into the fatty layer just beneath the surface of the skin. This article describes a plan to investigate the effect of vibration devices on pain reduction during the application of carboxytherapy in the treatment of cellulite. A total of 78 women between 18 and 49 years old with cellulite in the gluteal region (around the buttocks) will participate in the study and will be divided into three study groups; two groups will receive carboxytherapy with two different vibrating devices, and the third group will receive carboxytherapy without vibrational anesthesia. Pain intensity will be assessed by asking participants to rate their pain using a numerical rating scale after each puncture of carboxytherapy. Vibrational anesthesia is expected to decrease pain caused by carboxytherapy compared with the control group, and it is expected that there will be no differences in pain intensity relief between the two vibrating devices.

Transcutaneous electrical stimulation in neck pain: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: The objective of this systematic review was to investigate the effectiveness of electrical stimulation (ES) for neck pain (NP). DATABASES AND DATA TREATMENT: The databases CINAHL, Embase, MEDLINE (via OVID), PEDro and Web of Science were searched, with no date restrictions. Two independent reviewers selected randomized controlled trials (RCTs) reporting pain, range of motion or psychosocial factors in people with NP, in which ES was applied. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence. Thirty studies met eligibility criteria. RESULTS: Main results showed evidence of moderate quality that ES combined with other intervention significantly decreases the pain intensity compared to other intervention immediately post-treatment and at short-term follow-up; evidence of low quality showed significant effects of ES combined with other intervention in decreasing neck disability compared to other intervention immediately post-treatment; evidence of very-low quality that ES increased the pressure pain threshold compared to placebo immediately post-treatment and that ES + other intervention also increased the pressure pain threshold compared to other intervention at short-term follow-up. CONCLUSIONS: ES combined with other intervention seems to be useful to relieve pain and to improve disability in people with NP, however, more studies are needed. SIGNIFICANCE: Electrical stimulation seems to be effective for improving pain intensity, immediately post-treatment in people with neck pain, mainly as an adjunct therapeutic modality. Nevertheless, high-quality RCTs are still needed to investigate the efficacy of electrical stimulation in neck pain.

Hypoalgesic effects of specific vs non-specific cervical manipulation in healthy subjects: a randomized crossover trial.

BACKGROUND: Joint manipulation is generally used to reduce musculoskeletal pain; however, evidence has emerged challenging the effects associated with the specificity of the manipulated vertebral segment. The aim of this study was to verify immediate hypoalgesic effects between specific and non-specific cervical manipulations in healthy subjects. METHOD: Twenty-one healthy subjects (18-30 years old; 11 males, 10 females) were selected to receive specific cervical manipulation at the C6-7 segment (SCM) and non-specific cervical manipulation (NSCM) in aleatory order. A 48h interval between manipulations was considered. Pressure pain threshold (PPT) was measured pre- and post-manipulation with a digital algometer on the dominant forearm. RESULTS: The SCM produced a significant increase in the PPT (P < 0.001) however no difference was observed in the PPT after the NCSM (P = 0.476). The difference between the two manipulation techniques was 37.26 kPa (95% CI: 14.69 to 59.83, p = 0.002) in favor of the SCM group CONCLUSION: Specific cervical manipulation at the C6-7 segment appears to increase PPT on the forearm compared to non-specific cervical manipulation in healthy subjects.

Interferential current and photobiomodulation in knee osteoarthritis: A randomized, placebo-controlled, double-blind clinical trial.

OBJECTIVES: To evaluate the effects of interferential current and photobiomodulation in patients with knee osteoarthritis. DESIGN: A randomized, placebo-controlled, double-blind clinical trial. SETTING: Physiotherapy Clinic of City University of São Paulo. SUBJECTS: A total of 184 patients with knee osteoarthritis were recruited and, of these, 168 were included and randomized into four groups with 42 each: interferential current, photobiomodulation, interferential current plus photobiomodulation or placebo groups. One hundred and sixty-four patients completed the study. INTERVENTION: Patients received 12 sessions (three times a week) of treatment: 30 minutes of interferential current (active or placebo) followed by photobiomodulation (active or placebo). MAIN MEASURES: Primary outcome: pain intensity at rest and during movement (numeric rating scale) after 12 sessions. Secondary outcomes: functional capacity (Timed Up & Go and Sit and Lift tests and Lequesne and WOMAC questionnaires), pressure pain threshold, conditioned pain modulation, and muscle strength production (isokinetic evaluation). Patients were assessed at baseline, after 12 sessions, and three and six months after the end of the treatment. RESULTS: Interferential current plus photobiomodulation reduced pain intensity at rest and during movement compared to placebo and interferential current at all time points (P < 0.05). Photobiomodulation reduced pain intensity at rest compared to placebo at all time points (P < 0.05) and compared to interferential current at six months follow-up (P < 0.05). Photobiomodulation reduced pain intensity during movement compared to placebo at six months follow-up (P < 0.05). CONCLUSION: Interferential current plus photobiomodulation or isolated photobiomodulation improve pain intensity in knee osteoarthritis.

Hypoalgesic Effects of Transcutaneous Electrical Nerve Stimulation Combined With Joint Manipulation: A Randomized Clinical Trial.

OBJECTIVE: The objective of this study was to compare the hypoalgesic effects of isolated or combined use of transcutaneous electrical nerve stimulation (TENS) and cervical joint manipulation (JM) in asymptomatic participants. METHODS: One hundred and forty-four healthy participants aged 18 to 30 years old were randomly assigned to 1 of 4 groups (n = 36 per group): active TENS + active JM, active TENS + placebo JM, placebo TENS + active JM, and placebo TENS + placebo JM. Active or placebo TENS was applied to the dominant forearm. JM was applied to the C6-7 segments. The pressure pain threshold was measured pre- and postintervention and after 20 minutes on the forearm and tibialis anterior of the dominant side. RESULTS: Segmental hypoalgesia was greater in the group active TENS + active JM compared with active TENS + placebo JM (P = .002), placebo TENS + active JM (P < .0001), and placebo TENS + placebo JM (P < .0001). For the extrasegmental hypoalgesia, active TENS + active JM had greater hypoalgesic effect compared with active TENS + placebo JM (P = .033), placebo TENS + active JM (P = .002), and placebo TENS + placebo JM (P < .0001). CONCLUSION: TENS and JM produced hypoalgesia when used alone and, when the treatments were combined, a higher segmental and extrasegmental hypoalgesic effect was obtained in asymptomatic participants.

Photobiomodulation therapy and transcutaneous electrical nerve stimulation on chronic neck pain patients: Study protocol clinical trial (SPIRIT Compliant).

INTRODUCTION: Chronic neck pain is a common musculoskeletal disorder that is associated with functional disability and decreased of quality of life. Electrophysical agents are commonly used to relieve pain, however the effects of combined use of these agents are little studied. The objective is to investigate the efficacy of photobiomodulation and electrical stimulation to relieve pain, both in isolation and combined. MATERIALS AND METHODS: This a 4-arm randomized placebo-controlled trial with patient and evaluator blinded. This study will be performed in Department of Physical Therapy at Federal University of São Carlos, São Carlos/SP, Brazil. One hundred and forty-four patients with chronic neck pain will be randomized into 4 groups: active photobiomodulation therapy with active electrical stimulation, active photobiomodulation therapy, active electrical stimulation, or placebo treatment. They will receive 10 sessions of treatment. PRIMARY OUTCOME: pain intensity (measured by pain numerical rating scale) posttreatment. SECONDARY OUTCOMES: pain during movement, neck disability, range of motion, pressure pain threshold, temporal summation, conditioned pain modulation, depressive symptoms, pain catastrophizing, quality of life, analgesic intake, and global perceived effect at posttreatment (10 sessions). Pain intensity and global perceived effect will also be measured after 6 weeks randomization. DISCUSSION: The findings of this study might clarify the importance of using the photobiomodulation therapy and transcutaneous electrical nerve stimulation for patients with chronic neck pain. TRIAL REGISTRATION: NCT04020861. https://clinicaltrials.gov/ct2/show/NCT04020861?term=NCT04020861&draw=2&rank=1.

Effects of thermotherapy and transcutaneous electrical nerve stimulation on patients with primary dysmenorrhea: A randomized, placebo-controlled, double-blind clinical trial.

OBJECTIVES: To evaluate the effects of thermotherapy and transcutaneous electrical nerve stimulation (TENS) on pain intensity, pressure pain threshold (PPT) and conditioned pain modulation (CPM) in patients with primary dysmenorrhea (PD). DESIGN: A randomized, placebo-controlled, double-blind clinical trial. SETTING: Physiotherapy Department of the Universidade Cidade de São Paulo, São Paulo (Brazil). INTERVENTIONS: Eighty-eight dysmenorrheic women were randomly allocated into four groups: Thermotherapy + TENS(n = 22), Thermotherapy(n = 22), TENS(n = 22) and Placebo(n = 22). Thermotherapy was applied by microwave diathermy (20 min), and TENS (200 µs, 100 Hz, 30 min), into the lower abdomen both. MAIN OUTCOME MEASURES: Pain intensity was measured using the numeric rating scale (NRS) and the McGill Pain Questionnaire (Br-MPQ). PPT and CPM were recorded from women's abdominal and lumbar. The evaluation was done in 5 times: baseline, after 20, 50, 110 min and 24 h from intervention. RESULTS: There was a significant decrease in the NRS for Thermotherapy + TENS vs. TENS, for Thermotherapy vs. TENS and for Placebo, after 20 min; for Thermotherapy vs. TENS and for Placebo, after 110 min and 24 h. Abdome PPT increased in the Thermotherapy + TENS vs. TENS and Placebo, after 50 min; for Thermotherapy + TENS vs. Placebo and for Thermotherapy vs. Placebo, after 110 min. No changes in lumbar PPT and CPM were observed. CONCLUSIONS: The use of thermotherapy reduced NRS compared to the TENS and Placebo after 20, 110 min and 24 h. Thermotherapy demonstrated an increase in the PPT in the abdomen after 50 and 110 min and decreased the Br-MPQ scores after 110 min in patients with PD.