Consumption of caffeine in the diet, both daily and occasional, has a significant biological effect on the nervous system. Caffeine, through various and not yet fully investigated mechanisms, affects headaches. This is especially noticeable in migraine. In other headaches such as hypnic headache, post-dural puncture headache and spontaneous intracranial hypotension, caffeine is an important therapeutic agent. In turn, abrupt discontinuation of chronically used caffeine can cause caffeine-withdrawal headache. Caffeine can both relieve and trigger headaches.
Background: Temporomandibular joint (TMJ) injections and arthrocentesis are commonly used minimally invasive methods for treating temporomandibular disorders (TMDs). Although considered safe, they can cause neurological complications. The aim of this systematic review was to synthesize all identified evidence for neurological adverse events following intra-articular TMJ interventions. Methods: This review was based on a systematic search with BASE, DOAJ, PubMed, SciELO, and Semantic Scholar on 28 May 2025. It included primary studies involving patients diagnosed with TMDs who underwent intra-articular injections into the TMJ or were treated with arthrocentesis, and in whom neurological adverse effects associated with the intra-articular intervention were reported. Studies reporting non-specific symptoms or unrelated systemic conditions were excluded. The risk of bias was assessed using the Joanna Briggs Institute’s critical appraisal tools. Results were presented in summary tables. Results: The search yielded five eligible studies comprising 319 patients, of whom 320 neurological adverse events were reported. Included studies comprised a randomized controlled trial, two retrospective studies, and two case reports. Four studies had a low risk of bias, and one had a moderate risk of bias according to the Joanna Briggs Institute appraisal tools. The proportion of patients affected ranged from 14% to 65% depending on the study design and intervention type. The most common adverse event was transient facial nerve (cranial nerve VII) paralysis, mainly involving the temporal and zygomatic branches. Less commonly reported complications involved the trigeminal nerve branches (V1, V3). There is also a single case of epidural hematoma with palsy of the oculomotor nerve (III). Most symptoms resolved spontaneously within a few hours to a few days. The use of local anesthesia and large volumes of irrigation (60 mL) during arthrocentesis increases the risk of complications. Attempts to explain the mechanisms of complications include local anesthetic diffusion, compression neuropraxia due to lavage fluid leakage, and corticosteroid neurotoxicity. One of the limitations of the study is the scarcity of data. Conclusions: Although most adverse events are mild and reversible, these findings highlight that precise, real-time guided injection and careful control of lavage volumes can minimize extra-articular spread of anesthetics or fluids, thereby reducing the likelihood of neurological complications. This study received no funding. PROSPERO ID number: CRD420251088170.
19 June 2015 in Ortopedia Traumatologia Rehabilitacja
Recent years have seen a noticeable increase in the number of people experiencing total damage to the anterior cruciate ligament in the knee joint. The causes are many, but increased sporting activity among people who generally lead a hypokinetic lifestyle is regarded as the most important factor. Researchers are seeking to optimize the surgical treatment and rehabilitation.
Introduction: In the majority of cases, anterior cruciate ligament (ACL) injuries require specialist surgical and physiotherapeutic treatment. The fact that the patient regains a full range of flexion and extension in the knee joint as well as the reduction or elimination of pain is a significant determinant of successful physiotherapy. Material and methods: The study included 72 randomly selected individuals with a complete ACL tear who were qualified for its surgical reconstruction. The research group included 37 patients aged 18-60 (mean age 37±10.3 years). All the participants from this group underwent physiotherapy based on recognised schemes of rehabilitation and performed for 4 weeks before the reconstruction surgery. The control group included 35 patients aged 18-60 (mean age 34±10.0 years) who did not undergo any presurgical physiotherapy programme. Results: Both in the research group and in the control group, subsequent measurements revealed a statistically significant improvement in the range of flexion and extension (p<0.05). Statistical analysis revealed a significantly better extension 1 week and 6 weeks after the ACL reconstruction (p<0.05) in the research group. Statistically significant differences in the level of pain in patients from both groups were noted in subsequent measurements (p<0.05). Also, a statistically significant difference concerning pain assessment 12 weeks after the reconstruction was noted in the research group (p<0.05). Conclusions: A quicker recovery of the range of extension in the operated knee joint and lower intensity of pain in the final measurement noted in the research group may indicate a certain therapeutic value of presurgical physiotherapy.
Alcohol is a widely consumed beverage worldwide, and headaches, including migraine, tension-type headache (TTH), and other primary headaches, are common in the general population. Although epidemiological studies have shown a correlation between alcohol consumption and headaches, the specific pathophysiological mechanism of this headache remains unknown. We reviewed articles deemed relevant to the issue of alcohol as a trigger for various headaches, those that discussed alcohol consumption in these patient groups, and those that addressed the pathophysiological and clinical aspects of alcohol and headache. The review concluded that alcohol affects both migraine and non-migraine headaches. Alcohol-induced headache, classified as a secondary headache, is a throbbing, bilateral headache that is exacerbated by physical activity and is precipitated by alcohol consumption. TTH can be precipitated by alcohol consumption, and patients with TTH have more alcohol-related problems than those with migraine. Cluster headaches (CH) are often triggered by alcohol, but surprisingly, many CH patients consume alcohol, even during attacks. The relationship between alcohol and migraine is complex. Numerous components of alcoholic beverages can influence pain triggering and are responsible for migraine attacks. Red wine is one of the most frequently cited triggers for migraine attacks, a finding not always confirmed by the few prospective studies. However, there is no safe dose of alcohol, and therefore avoidance should be recommended.
Objectives: To analyze the effect of whole-body cryotherapy on exercise tolerance in healthy, training men related to their profession based on the 6 min walk test (6MWT). Methods: The study group consisted of 30 individuals aged 24 to 59 years (mean age 39.2; median 38, SD 8.72). The subjects were soldiers from the Special Forces Unit (Military Unit GROM) and officers from the State Protection Service (SOP). All participants underwent a physical fitness assessment using the 6 min walk test: before the study, after two weeks of kinesiotherapy, and after 10 cryotherapy sessions combined with exercise on a stationary bicycle. Kinesiotherapy consisted of 20 min of cycling on a stationary bicycle (cycloergometer) under the supervision of trained personnel (with a load of 50–100 W) from Monday to Friday, from 11 a.m. to 12 noon. Whole-body cryostimulation treatments took place from Monday to Friday from 11 a.m. to 12 noon, entering the cryogenic chamber with a temperature of −130 °C for 2 min, then they went to the gym and rode a stationary bicycle (cycloergometer) for 20 min under the supervision of trained personnel (with a load of 50–100 W). Results: Both analyzed factors, i.e., 20 min of stationary cycle ergometer riding and whole-body cryostimulation treatments combined with kinesiotherapy, had a statistically significant effect on improving 6 min walk test results. The obtained results indicate that the impact of the exercise program was slightly greater than the impact of a series of 10 whole-body cryotherapy treatments followed by cycle ergometer riding. Conclusions: Both physical activity and cryostimulation had an impact on the physical performance of the subjects, but the obtained results indicate that the impact of exercise alone was slightly greater.