Efficacy of motor imagery through mirror visual feedback therapy in complex regional pain syndrome: A comparative study

Background: Complex regional pain syndrome (CRPS) is characterized by disabling pain, swelling, vasomotor instability, sudomotor abnormality, and impairment of motor function. An integrated multimodal multidisciplinary treatment approach is recommended to treat CRPS including pharmacological treatment, interventional therapy, and physiotherapeutic management. As imaging studies indicate that CRPS is associated with manifestation of changes in brain, mirror visual feedback (MVF) therapy may also have effect in neuromodulation and cortical reorganization. Aims and Objectives: The aim and objective of this study are to compare the effectiveness of MVF therapy with other conventional treatment. Subjects and Methods: A total 30 patients were selected and randomly allocated into three groups. Group C was treated with pharmacological management with contrast bath, Group E was additionally treated with exercises, and Group M was additionally treated with MVF therapy. Prognosis of the patients was documented on the basis of pain at rest, on movement, and swelling. Statistical Analysis Used: Two-way (3 × 4) ANOVA test. Results: Patients with CRPS were benefited by pharmacological therapy, physical exercises, and mirror therapy as pain in rest and on movement improved over time. However, patients, additionally treated with mirror therapy, improved to a greater extent when compared to the other groups. Conclusion: MVF therapy has been established as a low-cost treatment technique for CRPS along with other conventional treatments

Intra-Articular hyaluronic acid injection versus RF ablation of genicular nerve for knee osteoarthritis pain: A randomized, open-label, clinical study

Background: Chronic knee osteoarthritis (OA) is one of the most common diseases of advanced age. Available therapies have insufficient evidence and adverse effects. Hyaluronic acid (HA) injection reduces knee pain in certain patients only for short duration. Radiofrequency (RF) neurotomy of genicular nerve branches has been tried recently. Comparison of these two modalities is lacking. The aim of this study was to compare pain relief and daily activities by visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between intra-articular HA injection and RF neurotomy of genicular nerves. Materials and Methods: Patients were treated with intra-articular HA injection and RF neurotomy of genicular nerves 12 in each group (n = 12). Pain relief and day-to-day activity were compared. Results: There was statistically significant difference and lower VAS and WOMAC scores in the RF group compared to HA group after treatment. Conclusion: As compared to intra-articular HA injection, RF neurotomy of genicular nerves appears to be a promising and more effective therapeutic procedure for patients with chronic knee OA