Latest & greatest articles for pain

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Top results for pain

1. Peripheral nerve ablation for limb pain

Peripheral nerve ablation for limb pain Final Peripheral nerve ablation for limb pain: findings and decision Page 1 of 9 Health Technology Clinical Committee Findings and Decision Topic: Peripheral nerve ablation for limb pain Meeting date: January 18, 2019 Final adoption: May 17, 2019 Meeting materials and transcript are available on the HTA website. Number and coverage topic: 20190118B – Peripheral nerve ablation for limb pain HTCC coverage determination: Peripheral nerve ablation, using any (...) technique, to treat limb pain including for knee, hip, foot, or shoulder due to osteoarthritis or other conditions, is not a covered benefit for adults and children. HTCC reimbursement determination: Limitations of coverage: N/A Non-covered indicators: N/A Agency contact information: Agency Phone Number Labor and Industries 1-800-547-8367 Public Employees Health Plan 1-800-200-1004 Washington State Medicaid 1-800-562-3022 WA - Health Technology Assessment May 17, 2019 Final Peripheral nerve ablation

2019 Washington Health Care Authority

2. Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain?

Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages e47–e49 Is Low-Dose Ketamine an Effective Alternative to Opioids for Acute Pain? x Jonathan M. Kirschner , MD (EBEM Commentator) , x Benton R. Hunter , MD (EBEM Commentator) Department (...) of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN DOI: | Publication History Published online: December 11, 2018 Expand all Collapse all Article Outline Take-Home Message In adult emergency department (ED) patients with acute pain, low-dose intravenous ketamine (0.3 to 0.5 mg/kg) may provide pain relief within 10 minutes that is similar to that of single-dose intravenous morphine (0.1 mg/kg). Methods Data Sources A medical librarian searched MEDLINE, EMBASE, Scopus, Cochrane

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2019 Annals of Emergency Medicine Systematic Review Snapshots

3. Using Public Cost Information During Low Back Pain Visits: A Qualitative Study. (PubMed)

Using Public Cost Information During Low Back Pain Visits: A Qualitative Study. Patients desire information about health care costs because they are increasingly responsible for these costs. Public Web sites that offer cost information could inform provider-patient discussions of costs at the point of care.To evaluate tools to facilitate the use of publicly available cost information during clinical visits for low back pain (LBP).Qualitative study using individual and group interviews

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2019 Annals of Internal Medicine

4. Are opioids effective in the treatment of chronic low back pain?

Are opioids effective in the treatment of chronic low back pain? Are Opioids Effective in the Treatment of Chronic Low Back Pain? – Clinical Correlations Search Are Opioids Effective in the Treatment of Chronic Low Back Pain? April 17, 2019 4 min read By Anna Hirsch Peer Reviewed The use of opioid medications for chronic low back pain, or for any chronic non-cancer pain complaint, is still a source of controversy in the medical community, with a large divide between the recommendations (...) of professional societies and actual physician prescribing data. In the , 1 the 2 and the 3 have all issued guidelines urging caution with the use of opioids for chronic back pain, specifically emphasizing the poor-to-moderate quality of the evidence demonstrating benefit from this therapeutic modality. All three organizations reinforce that opioids should only be used after failure of other non-opioid and non-pharmacologic treatment options and recommend that if physicians choose to prescribe opioids

2019 Clinical Correlations

5. Core im hoofbeats: a 66m w ruq pain, a 41m in afib w rvr and a 50m w syncope

Core im hoofbeats: a 66m w ruq pain, a 41m in afib w rvr and a 50m w syncope Core IM Hoofbeats: A 66M w RUQ pain, a 41M in Afib w RVR and a 50M w Syncope – Clinical Correlations Search Core IM Hoofbeats: A 66M w RUQ pain, a 41M in Afib w RVR and a 50M w Syncope April 10, 2019 1 min read Podcast: | Subscribe: | By Cindy Fang MD, David Kudlowitz MD, John Hwang MD || Illustration by Amy Ou MD || Audio Editing by Richard Chen, Harit Shah For a transcript of the podcast and show notes: Time Stamps (...) New features in this episode [0:30] Case one: 66M w RUQ pain [1:09] Case two: 41M w Afib in RVR [9:26] Case three: 50M w Syncope [14:33] Reveal [19:57] Retrieving illness scripts [22:29] Typical versus Atypical presentation of diseases [26:12] References Feinstein, A R. “An analysis of diagnostic reasoning. I. The domains and disorders of clinical macrobiology.” The Yale journal of biology and medicine vol. 46,3 (1973): 212-32. Nayar, et al. Venous Thromboembolism in Upper Extremity Fractures

2019 Clinical Correlations

6. Restrictive strategy versus usual care for cholecystectomy in patients with gallstones and abdominal pain (SECURE): a multicentre, randomised, parallel-arm, non-inferiority trial. (PubMed)

Restrictive strategy versus usual care for cholecystectomy in patients with gallstones and abdominal pain (SECURE): a multicentre, randomised, parallel-arm, non-inferiority trial. International guidelines advise laparoscopic cholecystectomy to treat symptomatic, uncomplicated gallstones. Usual care regarding cholecystectomy is associated with practice variation and persistent post-cholecystectomy pain in 10-41% of patients. We aimed to compare the non-inferiority of a restrictive strategy (...) with stepwise selection with usual care to assess (in)efficient use of cholecystectomy.We did a multicentre, randomised, parallel-arm, non-inferiority study in 24 academic and non-academic hospitals in the Netherlands. We enrolled patients aged 18-95 years with abdominal pain and ultrasound-proven gallstones or sludge. Patients were randomly assigned (1:1) to either usual care in which selection for cholecystectomy was left to the discretion of the surgeon, or a restrictive strategy with stepwise selection

2019 Lancet

7. Effect of Doxepin Mouthwash or Diphenhydramine-Lidocaine-Antacid Mouthwash vs Placebo on Radiotherapy-Related Oral Mucositis Pain: The Alliance A221304 Randomized Clinical Trial. (PubMed)

Effect of Doxepin Mouthwash or Diphenhydramine-Lidocaine-Antacid Mouthwash vs Placebo on Radiotherapy-Related Oral Mucositis Pain: The Alliance A221304 Randomized Clinical Trial. Oral mucositis causes substantial morbidity during head and neck radiotherapy. In a randomized study, doxepin mouthwash was shown to reduce oral mucositis-related pain. A common mouthwash comprising diphenhydramine-lidocaine-antacid is also widely used.To evaluate the effect of doxepin mouthwash or diphenhydramine (...) -lidocaine-antacid mouthwash for the treatment of oral mucositis-related pain.A phase 3 randomized trial was conducted from November 1, 2014, to May 16, 2016, at 30 US institutions and included 275 patients who underwent definitive head and neck radiotherapy, had an oral mucositis pain score of 4 points or greater (scale, 0-10), and were followed up for a maximum of 28 days.Ninety-two patients were randomized to doxepin mouthwash (25 mg/5 mL water); 91 patients to diphenhydramine-lidocaine-antacid

2019 JAMA

8. Transition from acute to chronic pain after surgery. (PubMed)

Transition from acute to chronic pain after surgery. Over the past decade there has been an increasing reliance on strong opioids to treat acute and chronic pain, which has been associated with a rising epidemic of prescription opioid misuse, abuse, and overdose-related deaths. Deaths from prescription opioids have more than quadrupled in the USA since 1999, and this pattern is now occurring globally. Inappropriate opioid prescribing after surgery, particularly after discharge, is a major cause (...) of this problem. Chronic postsurgical pain, occurring in approximately 10% of patients who have surgery, typically begins as acute postoperative pain that is difficult to control, but soon transitions into a persistent pain condition with neuropathic features that are unresponsive to opioids. Research into how and why this transition occurs has led to a stronger appreciation of opioid-induced hyperalgesia, use of more effective and safer opioid-sparing analgesic regimens, and non-pharmacological interventions

2019 Lancet

9. Transcutaneous electrical nerve stimulation (TENS) for chronic pain - an overview of Cochrane Reviews. (PubMed)

Transcutaneous electrical nerve stimulation (TENS) for chronic pain - an overview of Cochrane Reviews. Chronic pain, considered to be pain lasting more than three months, is a common and often difficult to treat condition that can significantly impact upon function and quality of life. Treatment typically includes pharmacological and non-pharmacological approaches. Transcutaneous electrical nerve stimulation (TENS) is an adjunct non-pharmacological treatment commonly recommended by clinicians (...) and often used by people with pain.To provide an overview of evidence from Cochrane Reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine).To provide an overview of evidence from Cochrane Reviews of the safety of TENS when used to reduce pain in adults with chronic pain (excluding headache or migraine).To identify possible sources of inconsistency in the approaches taken to evaluating the evidence related to TENS for chronic pain (excluding

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2019 Cochrane

10. Herbal medicinal products or preparations for neuropathic pain. (PubMed)

Herbal medicinal products or preparations for neuropathic pain. Neuropathic pain is a consequence of damage to the central nervous system (CNS), for example, cerebrovascular accident, multiple sclerosis or spinal cord injury, or peripheral nervous system (PNS), for example, painful diabetic neuropathy (PDN), postherpetic neuralgia (PHN), or surgery. Evidence suggests that people suffering from neuropathic pain are likely to seek alternative modes of pain relief such as herbal medicinal products (...) due to adverse events brought about by current pharmacological agents used to treat neuropathic pain. This review includes studies in which participants were treated with herbal medicinal products (topically or ingested) who had experienced neuropathic pain for at least three months.To assess the analgesic efficacy and effectiveness of herbal medicinal products or preparations for neuropathic pain, and the adverse events associated with their use.We searched CENTRAL and the Cochrane Database

2019 Cochrane

11. Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents. (PubMed)

Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents. This is the first update of a review published in 2015, Issue 1. Chronic pain is common during childhood and adolescence and is associated with negative outcomes, such as increased severity of pain, reduced function, and low mood. Psychological therapies, traditionally delivered face-to-face with a therapist, are efficacious at reducing pain intensity and disability (...) , for the management of chronic pain in children and adolescents.We searched four databases (CENTRAL, MEDLINE, Embase, and PsycINFO) from inception to May 2018 for randomised controlled trials (RCTs) of remotely-delivered psychological interventions for children and adolescents with chronic pain. We searched for chronic pain conditions including, but not exclusive to, headache, recurrent abdominal pain, musculoskeletal pain, and neuropathic pain. We also searched online trial registries, reference sections

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2019 Cochrane

12. Elagolix (Orilissa) - for the treatment of moderate to severe pain associated with endometriosis

Elagolix (Orilissa) - for the treatment of moderate to severe pain associated with endometriosis Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product. The for is located below. Recent Activity for SBDs

2019 Health Canada - Drug and Health Product Register

13. Chronic Pelvic Pain

Chronic Pelvic Pain Chronic Pelvic Pain | Uroweb › Chronic Pelvic Pain Chronic Pelvic Pain To access the pdfs & translations of individual guidelines, please as EAU member. Non-EAU members can view the web versions. To become an EAU member, click . D. Engeler (Chair), A.P. Baranowski, B. Berghmans, J. Borovicka, A.M. Cottrell, P.S. Elneil, J. Hughes, E. Messelink (Vice-chair), A.C. de C Williams Guidelines Associates: L. Pacheco-Figueiredo, B. Parsons, S. Goonewardene TABLE OF CONTENTS (...) REFERENCES 1. Fall, M., et al., EAU Guidelines on Chronic Pelvic Pain., In: EAU Guidelines on Chronic Pelvic Pain. Presented at the 18th EAU Annual Congress Madrid 2003. 2003, European Association of Urology: Arnhem. 2. Fall, M., et al. EAU guidelines on chronic pelvic pain. Eur Urol, 2004. 46: 681. 3. Fall, M., et al., EAU Guidelines on Chronic Pelvic Pain, In: EAU Guidelines on Chronic Pelvic Pain. Presented at the 18th EAU Annual Congress Barcelona 2010. 2010, EAU: Arnhem. 4. Fall, M., et al. EAU

2019 European Association of Urology

14. 5 pearls on pain management

5 pearls on pain management Core IM: 5 Pearls on Pain Management – Clinical Correlations Search Core IM: 5 Pearls on Pain Management March 22, 2019 3 min read Podcast: | Subscribe: | For a transcript of the podcast and show notes: Time Stamps How effective are non-opioids? ( 3:17) Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51) What are the best practices for patients who require opioid analgesia? (19:00) When prescribing (...) and opioid-related adverse events in nonsurgical patients in US hospitals. J Hosp Med. 2014 Feb;9(2):73-81. Sriperumbuduri et al. The case for cautious consumption: NSAIDs in chronic kidney disease. Curr Opin Nephrol Hypertens. 2018 Dec 5. Herzig et al. Safe opioid prescribing for acute noncancer pain in hospitalized adults: A systematic review of existing guidelines. J Hosp Med. 2018 Apr; 13(4) 256-262. Grennan et al. Dose response study with ibuprofen in rheumatoid arthritis: Clinical

2019 Clinical Correlations

15. Naldemedine (Rizmoic) - treating constipation caused by opioid pain relief medicines

Naldemedine (Rizmoic) - treating constipation caused by opioid pain relief medicines 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2019. Reproduction is authorised provided the source is acknowledged. EMA/21684/2019 EMEA/H/C/004256 Rizmoic An overview of Rizmoic and why it is authorised in the EU (...) What is Rizmoic and what is it used for? Rizmoic is a medicine for treating constipation caused by opioid pain relief medicines in patients who have previously been treated with a laxative (a medicine that triggers bowel movements). It contains the active substance naldemedine. How is Rizmoic used? Rizmoic is available as 200 microgram tablets. The recommended dose is one tablet once daily, which the patient can take with or without a laxative. The patient must stop taking Rizmoic when

2019 European Medicines Agency - EPARs

16. WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents

WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents ISBN 978 92 4 155039 0 20 Avenue Appia CH-1211 Geneva 27 Switzerland www.who.int/ 9 789241 548397 WHO GUIDELINES FOR THE PHARMACOLOGICAL AND RADIOTHERAPEUTIC MANAGEMENT OF CANCER PAIN IN ADULTS AND ADOLESCENTS WHO GUIDELINES FOR THE PHARMACOLOGICAL AND RADIOTHERAPEUTIC MANAGEMENT OF CANCER PAIN IN ADULTS AND ADOLESCENTS WHO GUIDELINES FOR THE PHARMACOLOGICAL AND RADIOTHERAPEUTIC (...) MANAGEMENT OF CANCER PAIN IN ADULTS AND ADOLESCENTSWHO GUIDELINES FOR THE PHARMACOLOGICAL AND RADIOTHERAPEUTIC MANAGEMENT OF CANCER PAIN IN ADULTS AND ADOLESCENTSWHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents ISBN 978-92-4-155039-0 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org

2019 World Health Organisation Guidelines

17. Interstitial cystitis/bladder pain syndrome

Interstitial cystitis/bladder pain syndrome Interstitial cystitis/bladder pain syndrome - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Interstitial cystitis/bladder pain syndrome Last reviewed: February 2019 Last updated: March 2019 Summary Chronic, often debilitating clinical syndrome of urinary frequency, urgency, and pelvic pain. Symptoms vary with bladder filling. Typified by periods of remission (...) and exacerbations. Diagnosis is one of exclusion, and physicians must carefully consider all patients with chronic pelvic pain as potential candidates. Associated with several other comorbidities, including irritable bowel syndrome and systemic lupus erythematosus. Treatment approach is aimed at symptom relief and pain management, with minimally invasive options tried before progressing to more complex, invasive therapies. On average, a patient experiences symptoms for 5 years prior to diagnosis. Definition

2019 BMJ Best Practice

18. Psychosocial interventions for pain management in older adults with dementia: A systematic review of randomized controlled trials

Psychosocial interventions for pain management in older adults with dementia: A systematic review of randomized controlled trials To assess the effectiveness of psychosocial interventions on pain in older adults living with dementia.A systematic review with meta-analysis of randomized controlled trials.Scopus, ProQuest, EBSCO (CINAHL and MEDLINE), PubMed, OVID (PsycINFO), Web of Science, and Cochrane Library were searched from their inception up to 2 May 2018.Risk of bias assessment and meta (...) -analysis were conducted according to the Cochrane methods using RevMan 5.3 and findings were generated using the GRADE profiler software.Eight studies met the inclusion criteria, but the quality of the current evidence was low to moderate. Results showed that psychosocial interventions significantly reduced the observational pain score and pain medication. Subgroup analyses indicated that sensory stimulation and individual interventions showed a reduction in observational pain in people

2019 EvidenceUpdates

19. Transcutaneous electrical nerve stimulation (TENS) for chronic pain - an overview of Cochrane Reviews. (PubMed)

Transcutaneous electrical nerve stimulation (TENS) for chronic pain - an overview of Cochrane Reviews. Chronic pain, considered to be pain lasting more than three months, is a common and often difficult to treat condition that can significantly impact upon function and quality of life. Treatment typically includes pharmacological and non-pharmacological approaches. Transcutaneous electrical nerve stimulation (TENS) is an adjunct non-pharmacological treatment commonly recommended by clinicians (...) and often used by people with pain.To provide an overview of evidence from Cochrane Reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine).To provide an overview of evidence from Cochrane Reviews of the safety of TENS when used to reduce pain in adults with chronic pain (excluding headache or migraine).To identify possible sources of inconsistency in the approaches taken to evaluating the evidence related to TENS for chronic pain (excluding

2019 Cochrane

20. Does a Rehabilitation Program of Aerobic and Progressive Resisted Exercises Influence HIV-Induced Distal Neuropathic Pain? (PubMed)

Does a Rehabilitation Program of Aerobic and Progressive Resisted Exercises Influence HIV-Induced Distal Neuropathic Pain? Distal symmetrical polyneuropathy is a common neurological sequela after HIV, which leads to neuropathic pain and functional limitations. Rehabilitation programs with exercises are used to augment pharmacological therapy to relieve pain but appropriate and effective exercises are unknown. This study explored the safety and effect of moderate-intensity aerobic exercises (...) and progressive resisted exercises for HIV-induced distal symmetrical polyneuropathy neuropathic pain.A randomized pretest, posttest of 12 wks of aerobic exercise or progressive resisted exercise compared with a control. Outcome measures were assessed using the subjective periphery neuropathy, brief peripheral neuropathy screening, and numeric pain rating scale. Pain was assessed at baseline, 6 and 12 wks. Data between groups were compared using Kruskal-Wallis, Mann-Whitney U test, and within-groups Friedman

2019 American journal of physical medicine & rehabilitation