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Background: Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Acupuncture is a traditional medicine that is effective on pain. This study aimed to evaluate the effect of acupuncture treatment on pain, function, range of motion (ROM) and quality of life compared to sham acupuncture in patients diagnosed with SIS. Methods: A randomized, prospective, double-blinded, sham-controlled trial was conducted. In acupuncture group 40 participants received acupuncture treatment plus exercise therapy while in control group 40 participants received sham acupuncture plus exercise therapy. Primary outcomes included pain-rest, activity and night pain. Secondary outcomes included function [Shoulder Pain and Disability Index (SPADI) and The Disabilities of the Arm, Shoulder and Hand Score (Quick DASH)], ROM, and quality of life [The Western Ontario Rotator Cuff Index (WORC)] in patients with SIS. Results: Both groups had significant improvements for pain-rest, activity night pain scores, SPADI, Quick DASH and WORC after treatment and at the first month follow-up. Significant improvements were recorded in the acupuncture group for all ROM after treatment and at the first month follow-up while in control group only in passive internal rotation. Acupuncture group had better improvements for Quick DASH, WORC and all ROM parameters after the treatment, as well as for all parameters except pain-night and passive flexion at the first month follow-up. Conclusion: This study suggest that acupuncture treatment is a safe, effective and non-invasive treatment option in patients with SIS. Trial registration: The study protocol is registered at clinicaltrials.gov (NCT05794633).

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OBJECTIVES: This study aimed to investigate the effects of duloxetine and pregabalin primarily on pain and functional status in patients with knee osteoarthritis and secondarily on quality of life, depression, anxiety, and sleep disturbance. METHODS: A total of 66 patients with knee osteoarthritis were randomized to use duloxetine or pregabalin. Patients were evaluated by Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36, Beck Depression Inventory, Beck Anxiety Inventory, and Pittsburg Sleep Quality Index before the treatment and after 4 and 12 weeks of treatment. RESULTS: Improvements occurred in Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36 (with an exception of the mental health subgroup scores in duloxetine-treated group), Beck Depression Inventory, and Beck Anxiety Inventory scores in both groups from 4 weeks after baseline. Pittsburg Sleep Quality Index total scores and SF-36 mental health subgroup scores started to improve on the 4th and 12th weeks in pregabalin- and duloxetine-treated groups, respectively. CONCLUSION: Osteoarthritis pain, a complex outcome with nociceptive and neuropathic components, leads to central sensitization in a chronic phase. Using centrally acting drugs in the control of pain and associated symptoms would increase the probability of treatment success.

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SUMMARY OBJECTIVES: This study aimed to investigate the effects of duloxetine and pregabalin primarily on pain and functional status in patients with knee osteoarthritis and secondarily on quality of life, depression, anxiety, and sleep disturbance. METHODS: A total of 66 patients with knee osteoarthritis were randomized to use duloxetine or pregabalin. Patients were evaluated by Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36, Beck Depression Inventory, Beck Anxiety Inventory, and Pittsburg Sleep Quality Index before the treatment and after 4 and 12 weeks of treatment. RESULTS: Improvements occurred in Visual Analog Scale, Neuropathic Pain Diagnostic Questionnaire, Western Ontario and McMaster University Osteoarthritis Index, Short Form-36 (with an exception of the mental health subgroup scores in duloxetine-treated group), Beck Depression Inventory, and Beck Anxiety Inventory scores in both groups from 4 weeks after baseline. Pittsburg Sleep Quality Index total scores and SF-36 mental health subgroup scores started to improve on the 4th and 12th weeks in pregabalin- and duloxetine-treated groups, respectively. CONCLUSION: Osteoarthritis pain, a complex outcome with nociceptive and neuropathic components, leads to central sensitization in a chronic phase. Using centrally acting drugs in the control of pain and associated symptoms would increase the probability of treatment success.

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OBJECTIVES: Hallux valgus (HV) is a progressive foot deformity in which the first metatarsophalangeal (MTP) joint is affected. The relationship between the dome height of the first metatarsal head and the HV deformity has not been studied previously. This study aimed to investigate a possible relation of the dome height of the first metatarsal head with articular alignment and the hallux valgus angle (HVA), which is frequently used to evaluate HV. METHODS: A total of 129 feet of 68 patients were included in the study. Anteroposterior digital radiographic images of the foot taken in a weightbearing, standing position were used to assess the HVA, dome height, and shape of the first metatarsal head and the alignment of the MTP joint. The dome height of the first metatarsal head is the vertical distance from the base to the highest point of the articular surface doming. The alignment was categorized into three groups: aligned, deviated, and subluxated. Patients were assigned into three groups based on the HVA: Normal, Mild HV and Moderate HV. RESULTS: A statistically significant, positive correlation was found between the HVA and the dome height of the first metatarsal head (r = 0.293, P = 0.001 and P < 0.05). The dome height was significantly lower in the patients with a normal HVA than those with a high HVA (P1 = 0.042, P2 = 0.039 and P < 0.05, respectively). The dome height of the first metatarsal head was found significantly higher in feet with subluxation, compared to feet aligned and deviated (P1 = 0.001; P2 = 0.0089 and P < 0.05, respectively). CONCLUSIONS: Our study results suggest that HV deformity may be related to an increased dome height and the measurement of the dome height of the first metatarsal head might be used to evaluate an anatomic tendency toward HV development.

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OBJECTIVE: The aim of this study was to determine the effects of platelet-rich plasma (PRP) treatment on pain, functionality, quality of life, and cartilage thickness in patients with knee osteoarthritis (OA). METHODS: Sixty patients with chronic knee pain were randomly separated into two groups. The first group was administered 4-ml PRP intra-articularly (IA) in three doses at one-week intervals, and the second group had only one dose of a 4-ml saline solution IA. The patients' pain was measured using the Visual Analogue Scale (VAS); functionality was measured using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The distal femur cartilage thickness was assessed using ultrasonography (USG). RESULTS: All baseline parameters were similar (p> 0.05). In the first and sixth months after the treatment, the VAS scores of the PRP group were significantly low (p< 0.001). In the same group, only the pain sub-score was low in the WOMAC assessment in the first month after treatment. However, in the sixth month, all parameters of the WOMAC score were lower than those of the placebo group (p< 0.05). Cartilage thickness measurements were similar in the two groups (p< 0.05). CONCLUSION: PRP treatment had positive effects on the pain, physical function, and quality of life of patients with knee OA, but it did not increase cartilage thickness.

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