RESUMEN
Aim: To investigate the analyze the relationship between concentration platelet-dose in platelet-rich plasma (PRP) injections and improvements in pain when treating lateral epicondylitis. Methods: A systematic review was conducted into five medical databases, exploring the difference in pain outcomes based on concentration of PRP. Results: Initial querying of the databases yielded 1408 articles with 20 articles ultimately included. There was no statistical significance between effect sizes of the two treatment groups (high and low platelet concentration; p = 0.976). Conclusion: Both large and small concentrations of platelets depict significant reduction in pain, however, between subgroups there was no significance. It can thus be concluded that concentration of platelets in PRP does not impact overall pain relief.
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Asunto(s)
Plasma Rico en Plaquetas , Codo de Tenista , Codo de Tenista/terapia , Codo de Tenista/sangre , Humanos , Resultado del Tratamiento , Manejo del Dolor/métodos , Plaquetas/metabolismoRESUMEN
Aim: To investigate the potential benefit of topical capsaicin formulations. Materials & methods: A narrative systematic review was employed. Results: About 8% capsaicin patches were found to significantly reduce symptoms of diabetic peripheral neuropathy. Capsaicin was found to improve sleep quality (p = 0.02). Capsaicin patch exposure for 60 min showed significant reduction in symptoms (-32.8%). Capsaicin cream significantly reduced pain at weeks two and six (p = 0.003 and p = 0.03, respectively), but not at week eight in comparative studies. 0.025% capsaicin gel had an insignificant reduction in pain compared with placebo (p = 0.53), however 0.075% was found to be significant (p = 0.038). Capsaicin cream did not have superior improvement of pain as compared with clonidine gel (p = 0.931). The most common adverse events included application site discomfort, erythema and burning. Conclusion: Topical capsaicin treatments are a potentially beneficial peripherally acting medication. Further research is needed to determine the best means of ameliorating the side effects of treatments.
Painful diabetic neuropathy (DPN) is a serious and common problem affecting those suffering from diabetes. Current treatments of DPN include medications that act on the CNS, rather than the distally affected nerves. Topical capsaicin patches and creams offer potential as alternative treatments to centrally acting neuropathy medications. Topical capsaicin depletes the neurotransmitter for pain signaling at the distally affected nerves. Topical capsaicin in all formulations has been shown to be beneficial in reduction of DPN. However, capsaicin treatments are often irritating to the skin, causing burning and redness at the application site.
Asunto(s)
Diabetes Mellitus , Neuropatías Diabéticas , Neuralgia , Humanos , Capsaicina/efectos adversos , Diabetes Mellitus/inducido químicamente , Diabetes Mellitus/tratamiento farmacológico , Neuropatías Diabéticas/tratamiento farmacológico , Neuropatías Diabéticas/inducido químicamente , Neuralgia/tratamiento farmacológicoRESUMEN
Aim: We aimed to expound upon previous research examining the effect of platelet rich plasma in the treatment of sacroiliac joint (SIJ) dysfunction and pain. Materials & methods: A systematic review was employed in conjunction with a pooled analysis of the efficacy of platelet-rich plasma (PRP) in SIJ dysfunction and pain. Results: A total of 259 articles were retrieved following database systematic review. As a result, four clinical trials and two case studies were subjected to full text appraisal. The dates of publication ranged from 2015 to 2022. Conclusion: Although a unique modality, there is not enough evidence to support the employment of PRP injections over current steroid standard of care. Further double-blinded, randomized control trials are required to elucidate PRP role in SIJ dysfunction.
Platelet rich plasma is an injection derived from separating blood components in a centrifuge. Injection of platelet rich plasma into the sacroiliac joint has often been touted as highly beneficial for pain and disability, and superior to other modalities. Our systematic review and pooled analysis show that platelet rich plasma injections are beneficial, albeit not to the degree previously reported.