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Back & Joint Pain Trials

Trials for chronic back pain, arthritis, and other persistent pain conditions. 791 recruiting now nationwide.

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Close Chain and Open Chain Exercises With Blood Flow Restriction in Knee Osteoarthritis

Knee Osteoarthristis

The aim of this research is to find and compare the effect of close chain and open chain exercises with blood flow restriction in knee osteoarthritis on pain, range of motion, strength and functional performance in patients with knee osteoarthritis. Randomized controlled trials done at Railway General Hospital and Medistic Medical and Dental Center, Rawalpindi. The sample size was 40. The subjects were divided in two groups, 20 subjects in close chain exercises with blood flow restriction group and 20 in open chain exercises with blood flow restriction group. Study duration was of 4 weeks. Sampling technique applied was purposive non probability sampling technique. Only 45-75 years individual with grade 1 or 2 knee osteoarthritis were included. Tools used in the study are Numeric pain rating scale (NPRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), goniometer, crane scale (dynamometer), 30 s chair stand test. Data was analyzed through SPSS 21.

Multiple locations45–75 yrsAll genders
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IDENTIFICATION OF BIOMARKERS ASSOCIATED WITH THE SEVERITY AND RADIO-CLINICAL PROGRESSION OF KNEE OSTEOARTHRITIS

Knee Osteoarthritis · Chronic Inflammatory Rheumatism

Knee osteoarthritis (OA) is an heterogeneous disease, both symptomatically and structurally, with very different evolving profiles. Although several serum, urinary or synovial biomarkers have been developed in knee OA, their interest as potential predictive factors of clinical and structural progression remains poorly known. Similarly, to date, no biological predictive markers of response to OA treatments have been validated, particularly for intra-articular treatments \[corticosteroids (CTC), hyaluronic acid (HA), platelet-rich plasma (PRP)\]. Finally, although cohorts of OA patients have already been established in the past, none of them has made it possible to establish a biobank of serum and synovial fluid obtained from the same patient at inclusion but also during the follow-up of the OA disease, up to the joint replacement. The investigators hypothesize that some biomarkers in serum, PRP and synovial fluid in knee OA: * are be correlated with the clinical symptoms and radiological lesions, thus allowing to define distinct clusters of patients whose clinical and radiological evolving profile could be different * are correlated with the clinical evolution (pain and functional limitation) * can predict the radiographic progression but also in the long term the necessity of joint replacement * could constitute predictive factors of response to intra-articular treatments (CTC, HA and PRP). To validate theses hypothesis, investigators will conduct a longitudinal cohort study with long term follow-up until joint replacement in patients with knee OA. In parallel to this longitudinal study, a cross-sectional ancillary study will be conducted to compare the levels of different serum and synovial biomarkers between subjects with knee OA and subjects with chronic inflammatory rheumatism (rheumatoid arthritis, spondylarthritis) A/ Main objectives: \- Longitudinal study To study the correlations between changes in clinical symptoms (pain, function, quality of life, effusion, flare-up) / radiographic progression during the follow-up on the one hand, and the levels of biomarkers in serum, PRP and synovial fluid at inclusion / their variations at different times of the study on the other hand. B/ Secondary objectives * Longitudinal study 1. To study the correlations between clinical (pain, function, quality of life, effusion, congestive flare) / radiographic phenotype on the one hand, and serum, PRP, and synovial biomarker values at each follow-up visit. 2. To assess the prognostic value of clinical, biological or clinico-biological clusters on the ultimate outcome of OA defined by joint replacement. 3. To assess the prognostic value of different serum and synovial biomarkers on the structural progression during the follow-up. 4. To assess the prognostic value of different serum and synovial biomarkers on the efficacy of different intra-articular treatments (CTC, HA, PRP) 5. To assess changes of clinical symptoms, radiological grades and biological markers after different intra-articular treatments (CTC, HA, PRP) 6. To study the distribution of cellular populations in the joint fluid (synoviocytes, macrophages, lymphocytes, mesenchymal stem cells) according to the clinical and radiographic phenotype 7. To assess the correlations between the level of different biomarkers in serum, synovial fluid and their levels on tissue samples from OA joint obtained during joint replacement. 8. To study in vitro the effect of purified glycosamninoglycan (GAG) from synovial fluid and PRP on the metabolism of synoviocytes, macrophages and mesenchymal stem cells from autologous synovial fluid 9. To study in vitro the effect of purified GAGs from synovial fluid and PRP on the metabolism of synoviocytes, chondrocytes, mesenchymal stem cells obtained from human joint tissue samples (synovial membrane, cartilage) obtained during joint replacement. * Cross-sectional study 1. To assess the correlations between clinical symptoms (pain, function, quality of life, effusion, congestive flare) and radiographic phenotype and serum and synovial biomarkers at inclusion. 2. To compare serum and synovial biomarkers between subjects with knee OA and those with chronic inflammatory rheumatism (rheumatoid arthritis, spondyloarthritis) at inclusion. Method: 300 patients with knee pain related to knee OA (n=200) or chronic inflammatory rheumatism (spondylarthritis and rheumatoid arthritis) (n=100) requiring arthrocentesis and/or intra-articular injection will be enrolled in the Rheumatology department from Henri Mondor Hospital. A longitudinal follow-up will be proposed to patients with knee OA in addition to the participation in the cross-sectional study. The follow-up will include at least one visit each year or more in case of painful flare-up or new intra-articular injection. The follow-up will last a maximum of 10 years or less in case of joint replacement.

Multiple locations18+ yrsAll genders
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geniculaR Artery eMBolization for Knee Osteoarthritis (RAMBO) Registry

Knee Osteoarthristis

The goal of this observational study (prospective registry) is to collect long-term real-world data on the effectiveness and safety of genicular artery embolization (GAE) for knee osteoarthritis in adults aged 18 years or older with symptomatic KOA that has not responded to medical therapy. The main questions it aims to answer are: 1. Does GAE lead to sustained improvement in pain (WOMAC, VAS) and quality-of-life scores over 12-36 months? 2. What patient or procedural factors are associated with better outcomes after GAE? Participants will: * Undergo GAE as part of their routine clinical care. * Complete clinical follow-up assessments at 1, 3, 6, 12, 18, 24, and 36 months after treatment, including symptom and quality-of-life questionnaires. * Have safety outcomes tracked according to Society of Interventional Radiology guidelines. There is no comparison group; results will be analyzed to identify predictors of success and inform best practices for patient selection and treatment.

Libertyville, IL18+ yrsAll genders
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McGill Versus Sahrmann's Exercises for Chronic Non-Specific Low Back Pain

Chronic Non-specific Low Back Pain

The goal of this clinical trial is to compare the effects of McGill stabilization exercises and Sahrmann's movement-based exercise protocol in adults with chronic non-specific low back pain. The study aims to determine which exercise program is more effective in reducing pain, improving lumbar range of motion, and decreasing functional disability. The main questions it aims to answer are: Do McGill stabilization exercises reduce pain, improve lumbar range of motion, and decrease disability in individuals with chronic non-specific low back pain? Are McGill stabilization exercises more effective than Sahrmann's movement-based exercise protocol in improving pain, lumbar range of motion, and functional disability? Researchers will compare the McGill stabilization exercise group with the Sahrmann exercise group to determine which intervention provides greater improvements in clinical outcomes. Participants will: Be randomly assigned to either the McGill stabilization exercise group or the Sahrmann exercise group. Receive baseline physiotherapy, including hot pack application, Transcutaneous Electrical Nerve Stimulation (TENS), lumbar isometric exercises, pelvic tilts, knee-to-chest exercises, and manual therapy. Attend supervised treatment sessions 2-3 times per week for 6 weeks. Complete outcome assessments before and after treatment using the Numeric Pain Rating Scale (NPRS) for pain, the Oswestry Disability Index (ODI) for disability, and a bubble inclinometer to measure lumbar range of motion. This study will provide evidence on the comparative effectiveness of two commonly used physiotherapy exercise protocols and help identify the most effective rehabilitation approach for managing chronic non-specific low back pain.

Lahore20–50 yrsAll genders
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Evaluating the Effectiveness of Using a Home Laser Device to Treat Patients With Knee Osteoarthritis

Osteoarthritis Of Knee

Osteoarthritis is a degenerative disease affecting joint cartilage and its surrounding tissue. It is the leading cause of disability in the elderly. Photobiomodulation (PBM), has been used widely for alleviation of pain, reduction of inflammation, and acceleration of wound healing, and particularly to treat knee osteoarthritis (KOA). The purpose of the current study is to determine if a near-infrared PBM device (B-Cure Laser), applied at home, by the patient or personal caregiver in a real-life situation, can reduce pain and improve functionality in patients with KOA.

Ashkelon50–90 yrsAll genders
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Ligament Balancing in Total Knee Arthroplasty

Ligament; Laxity, Knee · Knee Osteoarthritis

The goal of this interventional pilot study is to evaluate if performing ligament balancing on the medial collateral ligament (MCL) in a more systematical manner with a novel instrument can produce more objective and repeatable ligament lengthening in Total Knee Arthroplasty. The main questions it aim to answer are: 1. Is it feasible to perform systematic ligament balancing on the MCL using a novel instrument? 2. Can a novel instrument for ligament balancing acquire more objective and repeatable results, without risk of injury? Participants must consent prior to the surgery, but inclusion is only done once ligament balancing is indicated during surgery. Patients will be follow-up as standard protocol for Total Knee Arthroplasty patients at the hospital.

Bærums verk40+ yrsAll genders
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Effect of VR-MBCT in Chronic Nonspecific Low Back Pain

Chronic Non-specific Low Back Pain

This is a multi-center, prospective, open-label randomized controlled trial evaluating the efficacy and safety of virtual reality-based mindfulness-based cognitive therapy (VR-MBCT) as an adjunct to usual care in adults with chronic nonspecific low back pain (CNLBP). A total of 214 participants aged 20-70 years with pain duration ≥3 months and average back pain bothersomeness ≥4 (0-10 scale) will be enrolled from three hospitals in China and randomized 1:1 to an 8-week VR-MBCT intervention group or a waitlist usual care control group. The co-primary outcomes are the proportions of patients achieving ≥30% improvement from baseline in Oswestry Disability Index (ODI) and self-rated back pain bothersomeness at week 8. Secondary outcomes include pain intensity (NRS), global improvement, anxiety (GAD-7), depression (PHQ-9), physical activity (IPAQ-SF), sleep quality (SQS), fear-avoidance beliefs (FABQ-PA), pain catastrophizing (PCS), work productivity (WPAI-GH), treatment use, system usability (SUS), and patient satisfaction. Safety will be monitored for VR-related adverse events. Assessments will be performed at baseline (T0), week 4 (T1), week 8 (T2), and week 26 (T3). Data will be analyzed following the intention-to-treat principle using mixed-effects models and per-protocol analyses.

Suzhou20–70 yrsAll genders
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Integrative Mindfulness-Based Predictive Approach for Chronic Low Back Pain Treatment

Chronic Low-back Pain

This study will identify unique signatures that people have which can cause pain by evaluating biological, psychological, and social markers using artificial intelligence. These markers can be used to accurately predict the response of diverse individuals with chronic low back pain (cLBP) to Mindfulness-Based Stress Reduction. This will help enhance clinician decision-making and the targeted treatment of chronic pain. The overall objective is to use a unique machine learning (ML) approach to determine the biomarker signature of persons undergoing mindfulness based stress reduction (MBSR) treatment for their chronic low back pain (cLBP). This signature will facilitate clinical prediction and monitoring of patient response to MBSR treatment. The design of the study is a single-arm clinical trial of the evidence-based MBSR program for patients with cLBP.

Boston, MA18+ yrsAll genders
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Total Periarticular Infiltration Vs Posterior Periarticular Infiltration Plus PENG Block for Hip Analgesia

Hip Osteoarthritis · Postoperative Pain

In a recent study, direct periarticular local anesthetic infiltration (PAI) showed a greater incidence of early quadriceps weakness (33% at 3 hours and 13% at 6 hours) than pericapsular nerve group block (PENGB) in total hip arthroplasty (THA) but, in turn, demonstrated a statistically significant better pain control. Additionally, PENGB could not completely circumvent motor compromise either, particularly at 3 hours (20% incidence), probably secondary to an injectate migration towards the femoral nerve. Posteriorly to this publication, a cadaveric trial looking into the maximum effective volume that spared the femoral nerve resulted in 13.2 mL. This newer evidence led to the design of a strategy that combines both interventions, aiming to obtain the best of them and have a solid alternative for those cases where very early mobilization is pursued. Thus, it is hypothesized that posterior PAI added to a low-volume PENGB (10mL) represents a superior alternative to PAI in terms of strength preservation and provides effective analgesia during the first 24 postoperative hours after THA.

Santiago18–80 yrsAll genders
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Autologous BMA vs Saline and LAM + LP-PRP vs Saline Evaluations in Knee OA

Osteoarthritis, Knee

ABLE OA is a Health Canada authorized (phase II/III) trial \[Parent Control #: 263591\]. A multi-center, prospective, double-blinded, randomized, placebo-controlled adaptive trial to evaluate the efficacy of two minimally manipulated autologous cellular preparations i) bone marrow aspirate (BMA) injection; and, ii) combined lipoaspirate micronized (LAM) and leukocyte poor (LP) platelet-rich plasma (PRP) injections for the treatment of knee osteoarthritis (OA). BMA, LAM from lipoaspirate (LA), and LP-PRP from whole blood will be prepared using the Cervos Marrow Cellution™ Bone Marrow Aspiration System, Cervos LIPO-PRO™ Adipose Transfer System, and Cervos KEYPRP Platelet Separator System, respectively. Patient-reported outcome (PRO) measures will be collected using web- or paper-based questionnaires administered at baseline (pre-injection) as well as at 3, 6 and 12 months (post-injection). Blood, synovial fluid, and urine samples will be collected at baseline pre-injection and 6 months post-injection only.

Toronto30+ yrsAll genders
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Dexamethasone vs Dexmedetomidine for iPACK + ACB in TKA

Knee Osteoarthritis

This randomized, double-blind, controlled trial is designed to compare the analgesic efficacy and safety of perineural dexamethasone versus perineural dexmedetomidine as adjuvants to ropivacaine for ultrasound-guided interspace between the popliteal artery and the capsule of the posterior knee (iPACK) and adductor canal blocks in patients undergoing primary unilateral total knee arthroplasty (TKA). Elderly participants scheduled for elective TKA will be randomized into three parallel groups: ropivacaine alone (control), ropivacaine combined with perineural dexamethasone, or ropivacaine combined with perineural dexmedetomidine. The primary objective is to determine whether the addition of either adjuvant reduces postoperative opioid consumption compared with ropivacaine alone and to assess potential differences in analgesic efficacy between the two adjuvants. Secondary outcomes include pain intensity at rest and during mobilization, time to first rescue analgesia, quality of early functional recovery, and the incidence of adverse events, including postoperative nausea and vomiting, motor impairment, and hemodynamic instability.

Multiple locations65–100 yrsAll genders
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Prehabilitation Effect on Function and Patient Satisfaction Following Total Knee Arthroplasty

Prehabilitation · Knee Osteoarthritis

Knee arthrosis has a high prevalence. Non-surgical treatment, such as exercise, is the first choice of treatment. However, most patients end up having a surgical procedure such as total knee arthroplasty. Following surgery with total knee replacement as much as 20% of patients report to not be satisfied with the results. It is noteworthy that this level of dissatisfaction has persisted over the last decades despite formidable progress in surgical methods and technology. Leg strength prior to surgery is associated with faster recovery post operatively, which may influence satisfaction. The investigators aim is to implement a period of strength training prior to surgery to evaluate if training prior to surgery may reduce the level of dissatisfaction post operatively.

Molde50–80 yrsAll genders
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Chronic Low Back Pain and Osteopathic Manipulation Treatment

Chronic Low Back Pain (CLBP) · Low Back Pain

The goal of this clinical trial is to learn if adding Osteopathic Manipulative Therapy (OMT) to the usual medical care provided at the VA (usual VA care) improves treatment outcomes in individuals with chronic low back pain (CLBP). OMT is a set of hands-on techniques a doctor uses to move a patient's muscles and joints which include stretching, gentle pressure, resistance and applying forces to specific areas of the body. This feasibility clinical trial aims to learn about the treatment effects (e.g., effect sizes) of adding OMT to the usual medical care provided at the VA (Usual VA Care) in individuals with LBP.

Hines, IL18+ yrsAll genders
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Combined Use of PRP and Hyaluronic Acid for Infiltrative Treatment of Patients With Knee Osteoarthritis

Osteo Arthritis Knee

"PRP+HA-23" is a double-blind randomized controlled clinical trial with 1:1:1 allocation. The objective of the study is to evaluate by a randomized controlled, double-blind clinical trial the efficacy and safety of viscosupplementation-associated PRP infiltration compared with PRP-only or HA-only infiltration for the treatment of patients with knee osteoarthritis.

Multiple locations40–75 yrsAll genders
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Comparative Effects Of Dynamic And Static Stretching In Postmenopausal Females With Knee Osteoarthritis

Postmenopausal · Knee Osteoarthritis

As the aging population continues to grow, there is a pressing need to explore effective interventions to alleviate the symptoms of osteoarthritis, particularly in postmenopausal women who may experience unique challenges. Osteoarthritis (OA) is progressive joint disease characterized by joint inflammation and a reparative bone response and is one of the top five most disabling conditions that affects more than one-third of persons \>65 years of age, commonly affecting hands, feet, spine, hips, and knees. Among the various therapeutic modalities, stretching exercises, both dynamic and static, have gained attention for their potential to enhance joint flexibility, reduce pain, and improve functional outcomes.

Lahore50–65 yrsWomen
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Telerehabilitation Program to Improve Function in People With Chronic Low Back Pain Compared With Conventional Care

Chronic Low Back Pain (Non-specific, Uncomplicated)

The goal of this clinical trial is to evaluate whether an additional telerehabilitation program, combined with conventional care, can improve functional recovery in adults with chronic low back pain treated in primary care clinics of the Mexican Institute of Social Security (IMSS). The main questions it aims to answer are: * Does the telerehabilitation program lead to greater functional improvement, measured by the Oswestry Disability Index (ODI), compared with conventional care alone? * Does the program reduce pain intensity and improve adherence and satisfaction among participants? Researchers will compare patients receiving conventional care plus telerehabilitation with those receiving conventional care only to determine whether the digital intervention provides additional clinical benefits. Participants will: * Continue their usual medical care for chronic low back pain at IMSS clinics. * Follow a 6-week telerehabilitation program delivered through an online platform, including educational videos, stretching and strengthening exercises, and weekly virtual check-ins. * Complete baseline and post-intervention assessments of pain, disability, and satisfaction.

México18–60 yrsAll genders
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Back & Joint Pain trials by state

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