![]() While surgical interventions are recommended in more advanced stages, first-line treatment for COA (< 6 weeks) often involves non-steroidal anti-inflammatory drugs (NSAIDS) and physical therapy ( ). Similar logic would imply that central sensitization may be a contributing factor in individuals suffering with COA-related chronic pain. In KOA, hypersensitivity in the surrounding tissues arising through central sensitization is understood to be an important factor in pain generation. A similar weak association between the severity of joint degeneration and intensity of pain has been previously reported for knee osteoarthritis (KOA). However, these degenerative changes are only weakly associated with clinical symptoms of chronic pain and stiffness in patients diagnosed with COA by radiographic imaging. COA is highly age dependent and is present in all adults over 40 years of age ( ). (NCT03542955).Ĭervical osteoarthritis (COA), or cervical spondylosis, refers to the degeneration of the joints in the cervical region of the neck commonly arising from dehydrated/herniated vertebrae, bone spurs, and/or stiff ligaments. However, the PSWT intervention showed superior improvements in all outcome measures when compared to the NSAID arm with no adverse effects. Both NSAID and PSWT treatments resulted in statistically significant improvements in quality of life (NDI) and reduction in pain (VAS) resulting from cervical osteoarthritis. Eleven adverse effects were reported in the NSAID arm and zero in the PSWT arm. The PSWT arm used 50% less rescue pain medication. Similarly, the reductions from baseline in VAS rest and VAS activity were significantly greater in the PSWT arm than NSAID arm (10.89 mm 95% CI 6.90 to 14.87 p < 0.0001 and 12.05 mm 95% CI 7.76 to 16.33 p < 0.0001, respectively). The absolute reduction from baseline in NDI was significantly greater in the PSWT arm than NSAID arm (3.66 points 95% CI 2.3 to 5.02 p < 0.0001). After 4 weeks of treatment, subjects in both study arms reported statistically significant ( p < 0.0001) reductions in NDI, with final scores of 11.24-NSAID and 9.34-PSWT, VAS rest, with final scores of 30.08-NSAID 22.76-PSWT, and VAS activity, with final scores of 36.40-NSAID 27.42-PSWT. ![]() These 4-week scores were compared across the two arms to assess superiority. Secondary outcome measures included pain (at rest and during activity) measured on a visual analog scale (VAS) of 0–100 mm, dose count of rescue pain medication (paracetamol) use, and a treatment satisfaction rating. The primary outcome measure was the 4-week score on the Neck Disability Index (NDI), a 10-question assessment on a 50-point scale. Two hundred chronic pain suffers (average pain duration about 2 years) diagnosed with cervical osteoarthritis by radiological imaging were randomized into one of two treatment arms: COX-2 NSAID treatment etoricoxib 60 mg/day for 4 weeks or PSWT treatment worn 24 h/day for 4 weeks. Assess treatment superiority of pulsed shortwave therapy (PSWT) against COX-2 NSAID therapy, in reducing disability and pain due to cervical osteoarthritis.
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