Joint Pain

Occlusal interventions for managing temporomandibular disorders.

Singh BP, Singh N, Jayaraman S, Kirubakaran R, Joseph S, Muthu MS · The Cochrane database of systematic reviews · 2024 · n=2846

Temporomandibular disorders (TMD) are conditions related to the musculoskeletal structure of the temporomandibular joint, which may lead to muscle or joint pain and other health issues. TMD may present in muscles only (myogenous), joints only (arthrogenous), or both (mixed), and may affect one side or both sides of the face. Myogenous TMD may present with or without limited mouth opening. Arthrogenous TMD may present as disc displacement with or without reduction ('reduction' meaning the articular disc resumes its normal position when the jaw is moving). Occlusal interventions change the occlusal relationship of maxillary and mandibular teeth to improve the alignment of the tooth contact, with the aim of relieving pain, and improving psychosocial functioning and quality of life. Occlusal interventions include splints and adjustments. Occlusal splints are specially designed mouth guards; they are generally classified as stabilisation, reflex or repositioning splints. Occlusal adjustment

Effects of transcranial direct current stimulation on pain and physical function in patients with knee osteoarthritis: a systematic review and meta-analysis.

Wu YL, Luo Y, Yang JM, Wu YQ, Zhu Q, Li Y · BMC musculoskeletal disorders · 2024 · n=503

Keen Osteoarthritis (KOA) is a common chronic disabling disease characterized by joint pain and dysfunction, which seriously affects patients' quality of life. Recent studies have shown that transcranial direct current stimulation (tDCS) was a promising treatment for KOA. Investigate the effects of tDCS on pain and physical function in patients with KOA. Randomized controlled trials related to tDCS and KOA were systematically searched in the PubMed, Embase, Medline, Cochrane Library, CINHL, and Web of Science databases from inception to July 23, 2024. The pain intensity was evaluated using the visual analog scale or the numeric rating scale, and the pain sensitivity was assessed using conditioned pain modulation, pressure pain threshold, heat pain threshold, or heat pain tolerance. The physical function outcome was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index or the Knee injury and Osteoarthritis Outcome Score. Statistical analysis was performed

Injective Treatments for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis.

Ruffilli A, Cerasoli T, Barile F, Manzetti M, Viroli G, Traversari M · Indian journal of orthopaedics · 2024 · n=2431

The most effective injective treatment approach for sacroiliac joint (SIJ) pain remains unclear. Aim of this study was to quantify the safety and effectiveness of the available injective strategies to address SIJ pain. A systematic review and meta-analysis of the literature was conducted on PubMed, Scopus, and Embase databases from inception until January 2023. Inclusion criteria were studies written in English, comparative and non-comparative studies regardless of the minimum follow-up, and case series on SIJ injections. Safety and efficacy of the different injection therapies for the SIJ were quantified. A meta-analysis was conducted on the available data of the documented injective therapies. The "Checklist for Measuring Quality" by Downs and Black was used to assess the risk of bias and the quality of papers. The literature search retrieved 43 papers (2431 patients): 16 retrospective case series, 2 retrospective comparative studies, 17 prospective case series, 3 prospective compa

The Safety and Efficacy of Glucosamine and/or Chondroitin in Humans: A Systematic Review.

Baden KER, Hoeksema SL, Gibson N, Gadi DN, Craig E, Draime JA · Nutrients · 2025

Glucosamine and chondroitin are natural substances often used alone or in combination for conditions affecting the joints. Our objective was to evaluate the efficacy and safety of glucosamine and/or chondroitin supplementation in humans as well as to determine the common dosages used. A systematic review was conducted using PRISMA methodology. Searches were performed in PubMed and Web of Science and uploaded into Covidence where two independent researchers reviewed articles according to inclusion and exclusion criteria. Quality assessment was performed using the Mixed Methods Appraisal Tool (MMAT). Of the 2013 articles screened, 146 studies were included in our review, with nearly 60% being randomized controlled trials and most conducted in Europe, Asia, or the U.S. Most studies focused on osteoarthritis and joint pain, with over 90% of efficacy studies reporting positive outcomes and most safety studies indicating minimal or no adverse effects. Glucosamine and chondroitin were most

A comprehensive review on the co-occurrence of scurvy and anorexia nervosa.

Cui S · Frontiers in nutrition · 2024

Scurvy, a rare disease resulting from vitamin C deficiency, can occur in individuals with restrictive eating disorders like anorexia nervosa (AN), leading to severe health complications. This review explores the complex relationship between scurvy and AN, highlighting the overlapping symptoms and challenges in diagnosis and treatment. Vitamin C is essential for collagen synthesis, immune function, and neurotransmitter production, and its deficiency manifests as fatigue, gingival bleeding, joint pain, and perifollicular hemorrhages. AN exacerbates these symptoms through extreme food restriction, causing severe nutritional deficiencies. Analyzing nine case reports, this review reveals that patients with co-occurring AN and scurvy often present with gastrointestinal, psychiatric, and dermatological symptoms. Treatment with vitamin C supplementation typically results in rapid symptom improvement. However, the malnutrition inherent in AN complicates the clinical picture, making timely diagn

Circadian pain patterns in human pain conditions - A systematic review.

Knezevic NN, Nader A, Pirvulescu I, Pynadath A, Rahavard BB, Candido KD · Pain practice : the official journal of World Institute of Pain · 2023

Chronobiology is the science of how physiological processes in the body follow a pattern of time. Pain has been shown to follow a circadian rhythm, with different types of pain having variable expression along this rhythm. This article reviews the nature of diurnal variations in pain along with a discussion of the mechanisms of circadian rhythm of pain. We conducted a literature search on the PubMed and Google Scholar electronic databases, through April 2022. Publications were screened for English language, full-text availability, and human subjects. Randomized controlled trials and observational trials were included. Data were extracted from studies on patients with acute or chronic pain phenotypes, which provide pain severity data and corresponding diurnal time points. The literature search led to the inclusion of 39 studies. A circadian pattern of pain was found to be present in nociceptive, neuropathic, central, and mixed pain states. Postoperative pain, fibromyalgia, trigeminal

Osteoarthritis: care and management

NICE

This guideline covers diagnosing and managing osteoarthritis in adults. It aims to improve care by providing recommendations on non-pharmacological and pharmacological interventions.

Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults with overweight or obesity: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.

Ji L, Gao L, Xue H, Tian J, Wang K, Jiang H · The lancet. Diabetes & endocrinology · 2025 · n=166

Ecnoglutide is a novel cyclic adenosine monophosphate (cAMP)-biased GLP-1 receptor agonist currently in development for weight management. We aimed to assess the efficacy and safety of once weekly ecnoglutide versus placebo for the treatment of overweight or obesity in Chinese adults. This randomised, double-blind, placebo-controlled, phase 3 trial was done at 36 medical centres across China. Eligible adults were aged 18-75 years with overweight or obesity (defined as BMI ≥28 kg/m2 or ≥24 kg/m2 with at least one weight-related comorbidity [prediabetes, hypertension, hyperlipidaemia, metabolic dysfunction-associated steatotic liver disease, obstructive sleep apnoea syndrome, or weight-bearing joint pain]), without diabetes (type 1 or 2). Participants were randomly assigned (3:3:3:1:1:1) via computer-generated random sequencing to receive subcutaneous ecnoglutide (1·2, 1·8, or 2·4 mg) or volume-matched placebo (1·2, 1·8, or 2·4 mg), once weekl

A Standardized Boswellia serrata Extract Improves Knee Joint Function and Cartilage Morphology in Human Volunteers with Mild to Moderate Osteoarthritis in a Randomized Placebo-Controlled Study.

Kumar B, Ghaytidak AB, Pandey AK, Somepalli RR, Sarda P, Raychaudhuri SP · Journal of the American Nutrition Association · 2025

Boswellia serrata Roxb. ex Colebr. (Family: Burseraceae; Genus: Boswellia) gum resin (Salai guggul) has profound therapeutic value in Ayurvedic and Unani medicines in alleviating several chronic inflammatory illnesses, including arthritis, asthma, skin and blood diseases, fever, etc. SN13108F (Aflapin®) is a proprietary, standardized Boswellia serrata gum resin extract. This 180-day randomized, placebo-controlled clinical study aimed to evaluate cartilage morphology using magnetic resonance imaging (MRI), pain and joint function and long-term safety in the SN13108F-supplemented volunteers with knee osteoarthritis (KOA). Eighty adult male and female subjects with the Kellgren-Lawrence grade II - III KOA were supplemented with SN13108F (100 mg/day) or a matched placebo for 180 consecutive days. SN13108F reduced (p < 0.001; vs. baseline and placebo) Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale, Lequesne's Functional I

Effectiveness and safety of steamed ginger extract on mild osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial.

Baek HI, Shen L, Ha KC, Park YK, Kim CS, Kwon JE · Food & function · 2024 · n=100

The purpose of this study was to evaluate the efficacy and safety of steamed ginger extract (GGE03) in subjects with mild knee osteoarthritis (OA). In total, 100 subjects were randomly assigned (1 : 1) to the GGE03 (0.48 g day-1 as GGE03) or placebo (0 g day-1 as GGE03) group and administered 1.6 g of the product for 12 weeks. Biomarkers were measured before and after intervention. At the efficacy endpoint, pain visual analog scale (VAS) Korean-Western Ontario and McMaster University Osteoarthritis Index (K-WOMAC; total scores, sub-scores) and patient global assessment (PGA) were found to be decreased in a statistically significantly manner in the GGE03 group compared to the placebo group. No significant changes were observed in any safety endpoint. These results suggest that GGE03 intake is useful as a functional food because it has beneficial effects in terms of improving joint pain as well as managing or preventing knee OA without side effects.

Management of sacroiliac joint pain: current concepts.

Migliorini F, Lucenti L, Bardazzi T, Bell A, Cocconi F, Maffulli N · European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025 · n=2666

Managing sacroiliac joint (SIJ) pain is challenging and unpredictable. There are no internationally accepted recommendations. In light of the lack of global consensus and guidelines and the ongoing advancements in management options, a widely accepted treatment algorithm remains absent. This systematic review updates and evaluates the existing evidence on strategies for managing SIJ pain. This study followed the guidelines defined in the 2020 PRISMA statement. All clinical studies concerning the clinical management of SIJ pain were considered. Web of Science, PubMed, and Embase were accessed in January 2025 without additional filters or temporal constraints. The risk of bias evaluation and statistical analysis followed the guidelines described in the Cochrane Handbook for Systematic Reviews of Interventions. Fifteen randomised controlled trials, 13 clinical trials, and 10 retrospective studies were included. Data from 2666 patients (1429 women) were retrieved. The mean length of foll

Current and future advances in practice: aromatase inhibitor-induced arthralgia.

Kim S, Chen N, Reid P · Rheumatology advances in practice · 2024

Aromatase inhibitors (AIs) have shown great success as adjuvant therapy for post-menopausal women with hormone receptor-positive breast cancers. AI-induced arthralgia (AIA) is a frequent AI toxicity contributing to non-adherence and discontinuation. This review aims to understand current knowledge of AIA. The mean incidence of AIA was 39.1% and the mean discontinuation of AI therapy due to AIA was 9.3%. Most of the AIAs were non-inflammatory. A shorter time since the last menstrual period and pre-existing joint pain were risk factors. Vitamin D3 supplementation may be a preventative measure and treatment with duloxetine, acupuncture and/or exercise is supported by large randomized controlled trials. There was consistent improvement in AIAs with switching to an alternate AI, and this could additionally allow continuation of cancer treatment with AI. Further research is needed to identify predictive biomarkers, better characterize AIA subcategories and study more reliable therapeutic opt

Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline.

Mao JJ, Ismaila N, Bao T, Barton D, Ben-Arye E, Garland EL · Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022

The aim of this joint guideline is to provide evidence-based recommendations to practicing physicians and other health care providers on integrative approaches to managing pain in patients with cancer. The Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, and patient advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2021. Outcomes of interest included pain intensity, symptom relief, and adverse events. Expert panel members used this evidence and informal consensus to develop evidence-based guideline recommendations. The literature search identified 227 relevant studies to inform the evidence base for this guideline. Among adult patients, acupuncture should be recommended for aromatase inhibitor-related joint pain. Acup

Turmeric

NCCIH

This NCCIH page provides an overview of turmeric, including its uses, potential side effects, and scientific evidence related to its efficacy for various conditions, including joint pain.

NHS website

NHS

The NHS website provides information on various health conditions and treatments, often including advice on complementary and alternative medicines, which might include information relevant to boswellia.

An Observational Follow-up Study to Investigate the Duration of Treatment Effect With Subcutaneous Injections of Pentosan Polysulfate Sodium Compared With Placebo in Adult Participants With Knee Osteoarthritis Pain

n=133 · NCT04814719 · COMPLETED · COMPLETED

The purpose of this study is to measure the duration of treatment effect with subcutaneous injections of pentosan polysulfate sodium (PPS) compared with placebo in adult participants with knee osteoarthritis (OA) pain. The study duration will be up to 34 weeks. Participants who completed pDay 162 of Study PARA\_OA\_002 (i.e. did not discontinue/withdraw prematurely from the parent study) will be invited to participate.

Corticosteroid Injections Administered Under Ultrasound Guidance to Diabetic Patients and the Effect on Blood Glucose

n=38 · NCT05048264 · TERMINATED · TERMINATED

The purpose of this study is to measure the effect of various corticosteroids administered to the shoulder, knee and hip joints in diabetic patients on resultant blood glucose readings.

GREAT Knee Pain Reduction Trial, Genicular Radiofrequency Ablation Efficacy in Achieving Total Knee Pain Reduction Trial

n=60 · NCT02947321 · COMPLETED · COMPLETED

Given the benefits of genicular nerve radiofrequency ablation (RFA) in improving pain and functional status in non-surgical patients with knee osteoarthritis as well as the high prevalence of postoperative pain from total knee arthroplasty (TKA), this study is designed to determine the efficacy of preoperative genicular nerve RFA in improving acute and chronic postoperative pain as well as functional status in patients undergoing TKA. Patients will be randomized to one of two study arms: RFA group (genicular nerve thermal RFA) or control group (RFA needles placed in proper location without effective neurotomy).

Joint Pain

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice. Searching for 'joint pain' yields a wide array of evidence-based medical literature.

Cochrane Library: Joint pain

Cochrane

The Cochrane Library provides systematic reviews and meta-analyses of healthcare interventions related to joint pain. These reviews synthesize the best available evidence to inform treatment decisions.