Latest & greatest articles for chronic pain

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Top results for chronic pain

41. Senza spinal cord stimulation system for delivering HF10 therapy to treat chronic neuropathic pain

Senza spinal cord stimulation system for delivering HF10 therapy to treat chronic neuropathic pain Senza spinal cord stimulation system for Senza spinal cord stimulation system for deliv delivering HF10 ther ering HF10 therap apy to treat chronic y to treat chronic neuropathic pain neuropathic pain Medical technologies guidance Published: 23 January 2019 nice.org.uk/guidance/mtg41 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice (...) and reduce the environmental impact of implementing NICE recommendations wherever possible. Senza spinal cord stimulation system for delivering HF10 therapy to treat chronic neuropathic pain (MTG41) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 17Contents Contents 1 Recommendations 4 2 The technology 6 Description of the technology 6 Current management 7 3 Evidence 8 Summary of clinical evidence 8 Main points from

2019 National Institute for Health and Clinical Excellence - Medical technologies

42. Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review

Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review Low back pain (LBP) and neck pain are major causes of pain and disability that are experienced across all ages. The primary goals of treatment are to improve patient function and facilitate a return to the patient's desired level of daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders, but there continues (...) demonstrated that the use of ultrasound was the cause of the statistically significant improvement in pain intensity.Therapeutic ultrasound is frequently used in the treatment of LBP and neck pain and is often combined with other physiotherapeutic modalities. However, given the paucity of trials and conflicting results, we cannot recommend the use of monotherapeutic ultrasound for chronic LBP or neck pain. It does seem that ultrasound may be considered as part of a physical modality treatment plan that may

2019 EvidenceUpdates

43. Physical functioning and mindfulness skills training in chronic pain: a systematic review

Physical functioning and mindfulness skills training in chronic pain: a systematic review The importance of improved physical function as a primary outcome in the treatment of chronic pain is widely accepted. There have been limited attempts to assess the effects mindfulness skills training (MST) has on objective outcomes in chronic pain care.This systematic review evaluated published reports of original randomized controlled trials that described physical function outcomes after MST (...) in the chronic pain population and met methodological quality according to a list of predefined criteria. PRISMA criteria were used to identify and select studies, and assess their eligibility for inclusion. The established guidelines for best practice of systematic reviews were followed to report the results.Of the 2,818 articles identified from the original search of four electronic databases, inclusionary criteria were met by 15 studies published as of August 10, 2015, totaling 1,199 patients. All

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2019 EvidenceUpdates

44. The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials Pregabalin is commonly used as an analgesic for neuropathic pain. But pregabalin as an adjunct to a multimodal analgesic regimen - although standard clinical protocol in some settings - has remained controversial. This meta-analysis was conducted to identify the efficacy of pregabalin for management of postoperative (...) pain in thoracotomy.Pubmed, Embase, Cochrane, Web of Science, Springer, and Clinical Trial Register database were searched for randomized controlled trials (RCTs) of pregabalin in preventing postoperative pain in thoracotomy. Review Manager 5.3 and STATA 12.0 were selected to conduct the meta-analysis. Trial sequential analysis was used to control random errors and calculate the required information size.Nine RCTs with 684 patients were included in our meta-analysis. Outcomes favoring pregabalin

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2019 EvidenceUpdates

45. Does Opioid Tapering in Chronic Pain Patients Result in Improved Pain or Same Pain vs Increased Pain at Taper Completion? A Structured Evidence-Based Systematic Review

Does Opioid Tapering in Chronic Pain Patients Result in Improved Pain or Same Pain vs Increased Pain at Taper Completion? A Structured Evidence-Based Systematic Review To support or refute the hypothesis that opioid tapering in chronic pain patients (CPPs) improves pain or maintains the same pain level by taper completion but does not increase pain.Of 364 references, 20 fulfilled inclusion/exclusion criteria. These studies were type 3 and 4 (not controlled) but reported pre/post-taper pain (...) levels. Characteristics of the studies were abstracted into tabular form for numerical analysis. Studies were rated independently by two reviewers for quality. The percentage of studies supporting the above hypothesis was determined.No studies had a rejection quality score. Combining all studies, 2,109 CPPs were tapered. Eighty percent of the studies reported that by taper completion pain had improved. Of these, 81.25% demonstrated this statistically. In 15% of the studies, pain was the same by taper

2019 EvidenceUpdates

46. Evaluation of the Neuropathic Component of Chronic Low Back Pain

Evaluation of the Neuropathic Component of Chronic Low Back Pain Assessment of neuropathic pain in chronic low back syndromes is important. However, there is currently no gold standard for its diagnosis. The aim of this observational cross-sectional study was to assess the neuropathic component of pain in various chronic low back pain syndromes using a range of diagnostic tests.Included in this study were 63 patients with chronic axial low back pain (ALBP), 48 patients with chronic radicular (...) syndromes (CRS) comprising 23 with discogenic compression (CDRS) and 25 with lumbar spinal stenosis (LSS), and 74 controls. PainDETECT questionnaire (PDQ), quantitative sensory testing (QST), and skin biopsy with evaluation of intraepidermal nerve fiber density (IENFD) were used to assess the neuropathic pain component.Positive PDQ (≥19) was obtained more frequently in patients with CDRS and LSS (26.1% and 12.0%, respectively) compared with patients with ALBP (1.6%, P<0.001). The proportion of patients

2019 EvidenceUpdates

47. Effects of spinal manipulative therapy biomechanical parameters on clinical and biomechanical outcomes of participants with chronic thoracic pain: a randomized controlled experimental trial

Effects of spinal manipulative therapy biomechanical parameters on clinical and biomechanical outcomes of participants with chronic thoracic pain: a randomized controlled experimental trial Spinal manipulative therapy (SMT) includes biomechanical parameters that vary between clinicians, but for which the influence on the therapy clinical effects is unknown. This parallel-randomized controlled trial aimed to investigate the effect of SMT biomechanical parameters on the outcomes of participants (...) with chronic thoracic pain (CTP) following three treatment sessions (follow-up at one week).Adults reporting CTP (pain within the evaluated region [T6 to T8] for ≥3 months) were asked to participate in a four-session trial. At the first session, participants were randomly assigned to one of three experimental groups (different SMT doses) or the control group (no SMT). During the first three sessions, one SMT was executed at T7 for the experimental groups, while a 5-min rest was provided to the control

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2019 EvidenceUpdates

48. Efficacy of Internet-Delivered Mindfulness for Improving Depression in Caregivers of People With Spinal Cord Injuries and Chronic Neuropathic Pain: A Randomized Controlled Feasibility Trial

Efficacy of Internet-Delivered Mindfulness for Improving Depression in Caregivers of People With Spinal Cord Injuries and Chronic Neuropathic Pain: A Randomized Controlled Feasibility Trial To explore the feasibility and efficacy of web-based mindfulness training for carers of people with spinal cord injury (SCI).Randomized controlled feasibility study with 3-month follow-up.Community setting.Spouses or family caregivers (N=55) of people with SCI and chronic neuropathic pain were recruited via (...) the direct care team and advertisements. Participants were older than 18 years (no upper age limit), with Internet access for the duration of the study. Participants were randomly allocated to an 8-week online mindfulness training intervention (n=28), or to receive 8 weeks of psychoeducational materials on SCI and chronic pain (n=27).An established web-based, mindfulness training course was delivered over 8 weeks. Participants completed 10 minutes of mindfulness practices, twice per day, 6 days per week

2019 EvidenceUpdates

49. Effects of a Patient-Centered Graded Exposure Intervention Added to Manual Therapy for Women With Chronic Pelvic Pain: A Randomized Controlled Trial

Effects of a Patient-Centered Graded Exposure Intervention Added to Manual Therapy for Women With Chronic Pelvic Pain: A Randomized Controlled Trial To explore the effects of a 6-week patient-centered graded exposure intervention added to manual therapy in women with chronic pelvic pain (CPP) and fear of movement/(re)injury.Prospective 3-armed randomized controlled trial.Faculty of Health Sciences.A total of 49 women with CPP and substantial fear of movement were randomly allocated to 1 of 3 (...) groups: (1) patient-centered graded exposure intervention added to manual therapy; (2) manual therapy; (3) control group.The 6-week intervention consisted of 12 sessions in the group receiving manual therapy and 6 additional sessions of graded exposure therapy in the group receiving both interventions.Primary outcomes were fear-avoidance behavior assessed using the Fear-Avoidance Beliefs Questionnaire and pain interference and severity evaluated with the Brief Pain Inventory. The secondary outcome

2019 EvidenceUpdates

50. Safety of oral methylnaltrexone for opioid-induced constipation in patients with chronic noncancer pain

Safety of oral methylnaltrexone for opioid-induced constipation in patients with chronic noncancer pain Oral methylnaltrexone was shown to be effective in treating opioid-induced constipation (OIC) in patients with chronic noncancer pain in a Phase III randomized controlled trial. This report provides a detailed safety analysis from that study.Adults (n=803) with chronic noncancer pain for ≥2 months and confirmed OIC while receiving opioid doses ≥50 mg morphine equivalent per day for ≥14 days (...) generally small and similar across treatment groups. Rescue-laxative use was more common with placebo than methylnaltrexone 450 mg (6.20% vs 4.27% of study days, P=0.024). Changes in opioid dose, OOWS and SOWS scores, and pain-intensity scores during treatment were minimal.Oral methylnaltrexone had a safety profile comparable with placebo in the treatment of OIC in patients with chronic noncancer pain, with no evidence of cardiac toxicity or opioid withdrawal.

2019 EvidenceUpdates

51. Patient-delivered tDCS on chronic neuropathic pain in prior responders to TMS (a randomized controlled pilot study)

Patient-delivered tDCS on chronic neuropathic pain in prior responders to TMS (a randomized controlled pilot study) Successful response to repetitive transcranial magnetic stimulation (rTMS) of the motor cortex requires continued maintenance treatments. Transcranial Direct Current Stimulation (tDCS) may provide a more convenient alternative.This pilot study aimed to examine the feasibility of a randomized, double-blind, double-crossover pilot study for patients to self-administer tDCS motor (...) cortex stimulation for 20 minutes/day over five consecutive days. Primary outcomes were as follows: usability of patient-administered tDCS, compliance with device, recruitment, and retention rates. Secondary outcomes were as follows: effect on overall pain levels and quality of life via Short Form-36 anxiety and depression via Hospital Anxiety and Depression Scale, and Mini-Mental State scores.A total of 24 subjects with neuropathic pain, who had previously experienced rTMS motor cortex stimulation

2019 EvidenceUpdates

52. A commonly used treatment does not improve chronic low back pain

A commonly used treatment does not improve chronic low back pain A commonly used treatment does not improve chronic low back pain Discover Portal Discover Portal A commonly used treatment does not improve chronic low back pain Published on 7 November 2017 doi: This trial found that destroying nerves that take pain signals to the brain using heat (radiofrequency denervation) did not improve pain, function or a sense of “recovery”. The treatment was used alongside exercise and was a variation (...) of no specific source is the single biggest cause of disability worldwide. Exact UK figures are lacking as it is recorded alongside other musculoskeletal conditions. However, an estimated 30.6 million working days were lost in 2013 due to these conditions. In most cases, back pain resolves quickly. However, chronic back pain can interfere with everyday life, lead to time off work or education and affect the quality of life. Chronic back pain can be difficult to treat if it does not respond to initial

2019 NIHR Dissemination Centre

53. Acupuncture shown to have benefits for treatment of some chronic pain

Acupuncture shown to have benefits for treatment of some chronic pain Acupuncture shown to have benefits for treatment of some chronic pain Discover Portal Discover Portal Acupuncture shown to have benefits for treatment of some chronic pain Published on 20 June 2017 doi: Acupuncture is not a placebo for treatment of chronic pain. This NIHR-funded systematic review shows that acupuncture is better than usual care and sham acupuncture for pain from musculoskeletal conditions, knee osteoarthritis (...) and chronic headache. This NIHR review was large with over 140 trials overall, and the direct comparison with sham acupuncture helps to address uncertainty around whether acupuncture gives clinical benefit above a “placebo effect.” Acupuncture had a smaller effect on pain when compared with sham acupuncture than when compared with no acupuncture, but both comparisons showed statistically significant differences. Acupuncture also improved quality of life compared with standard care and was assessed

2019 NIHR Dissemination Centre

54. Effects of kinesiotape on pain and disability in individuals with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials

Effects of kinesiotape on pain and disability in individuals with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials To explore the effects of kinesiotape on pain and disability in individuals with chronic low back pain.PubMed, Embase and the Cochrane Central Register of Controlled Trials were searched for English language publications from inception to 13 February 2018.This study was registered in PROSPERO (CRD42018089831). Our key search terms were (...) involved, with 317 in the kinesiotape group and 310 in the control group. The effects of kinesiotape on pain and disability were explored. While kinesiotape was not superior to placebo taping in pain reduction, either alone ( P = 0.07) or in conjunction with physical therapy ( P = 0.08), it could significantly improve disability when compared to the placebo taping ( P < 0.05).Since kinesiotape is convenient for application, it could be used for individuals with chronic low back pain in some cases

2019 EvidenceUpdates

55. Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review

Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review Neck pain is a major health issue with high rates of recurrence. It presents with a variety of altered sensorimotor functions. Exercise is a cornerstone of rehabilitation and many training methods are used. Exercise is evaluated in most randomized controlled trials on its pain relieving effects. No review has assessed the effect of exercise on the altered (...) physiological functions or determined if there are differential effects of particular training methods. This review investigated the effects of deep cervical flexor (DCF) training, a training method commonly used for patients with neck pain, and compared it to other training methods or no training on outcomes of cervical neuromuscular function, muscle size, kinematics and kinetics.Web of Science, Scopus, CINAHL, PubMed were searched from inception until January 2018. Twelve randomized controlled trials were

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2019 EvidenceUpdates

56. Do Regenerative Medicine Therapies Provide Long-Term Relief in Chronic Low Back Pain: A Systematic Review and Metaanalysis

Do Regenerative Medicine Therapies Provide Long-Term Relief in Chronic Low Back Pain: A Systematic Review and Metaanalysis Several cell-based therapies have been proposed in recent years the management of low back pain, including the injection of medicinal signaling cells or mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP). However, there is only emerging clinical evidence to support their use at this time.To assess the effectiveness of MSCs or PRP injections in the treatment of low (...) and methodological quality assessment were performed utilizing Cochrane review methodologic quality assessment and Interventional Pain Management Techniques - Quality Appraisal of Reliability and Risk of Bias Assessment (IPM-QRB) and Interventional Pain Management Techniques - Quality Appraisal of Reliability and Risk of Bias Assessment for Nonrandomized Studies (IPM-QRBNR). The evidence was summarized utilizing principles of best evidence synthesis on a scale of 1 to 5.Twenty-one injection studies met inclusion

2019 EvidenceUpdates

57. The effect of lumbosacral orthosis on the thickness of deep trunk muscles using ultrasound imaging: A randomized controlled trial in patients with chronic low back pain. (PubMed)

The effect of lumbosacral orthosis on the thickness of deep trunk muscles using ultrasound imaging: A randomized controlled trial in patients with chronic low back pain. This study was conducted to evaluate the changes occurring in the thickness of deep trunk muscles, measured using ultrasound imaging, after four weeks of lumbosacral orthosis (LSO) use in conjunction with routine physical therapy.This parallel-group, randomized, controlled trial was conducted on 44 patients with nonspecific (...) chronic low back pain (CLBP), randomly allocated to the experimental and control groups. Both groups received eight sessions of physical therapy twice per week for four weeks. The experimental group wore non-extensible LSO in addition to undergoing routine physical therapy. The thickness of the transversus abdominis (TrA), obliquus internus (IO) and lumbar multifidus (LM) was measured by ultrasound before and after the four-week intervention.The deep trunk muscles differed in thickness in various test

2019 American journal of physical medicine & rehabilitation

58. Ketamine for chronic pain

Ketamine for chronic pain Ketamine for chronic pain We use cookies on this website. By using this site, you agree that we may store and access cookies on your device. Swedish Agency for Health Technology Assessment and Assessment of Social Services Ketamine for chronic pain Share: Reading time approx. 12 minutes Patients with complex and chronic pain conditions may experience that conventional pain management with for example opioids is insufficient for pain relief. Ketamine is mainly used (...) in anaesthesia, but in lower doses may also be used for pain management in the acute setting. Question What clinical evidence exists for the treatment of low-dose intravenous ketamine for chronic pain conditions? Table with identified studies Table 1. Overviews over systematic reviews Included studies Population Outcome Bell and Kalso 2018 [1] 18 systematic reviews Several populations: chronic noncancer pain, refractory cancer pain, opioid-resistant pain in palliative care, postoperative pain (chronic

2019 Swedish Council on Technology Assessement

59. Effectiveness of Kinesio Taping in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review With Meta-analysis

Effectiveness of Kinesio Taping in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review With Meta-analysis Systematic review.To investigate the effects of Kinesio Taping (KT) in patients with nonspecific low back pain.KT is widely used in patients with low back pain.We conducted searches on PubMed, EMBASE, PEDro, SciELO, and LILACS up to February 26, 2018. We included only randomized controlled trials (RCTs) in adults with chronic nonspecific low back pain that compared KT (...) was no better than any other intervention for most the outcomes assessed in patients with chronic nonspecific low back pain. We found no evidence to support the use of KT in clinical practice for patients with chronic nonspecific low back pain.1.

2019 EvidenceUpdates

60. A machine learning aided systematic review and meta-analysis of attentional bias to somatosensory stimuli in chronic pain patients

A machine learning aided systematic review and meta-analysis of attentional bias to somatosensory stimuli in chronic pain patients Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record

2019 PROSPERO