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Latest & greatest articles for chronic pain
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on chronic pain or other clinical topics then use Trip today.
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NSAIDs for Chronic Low Back Pain. Are nonsteroidal anti-inflammatory drugs (NSAIDs) associated with greater pain relief than placebo, other drugs, and nondrug treatments for patients with chronic low back pain?Compared with placebo, NSAIDs are associated with a small but significant improvement in pain and disability in patients with chronic low back pain, although this difference became nonsignificant when studies with high risk for bias were excluded. The associated benefits were smaller than
Topical analgesics for acute and chronicpain in adults - an overview of Cochrane Reviews. Topical analgesic drugs are used for a variety of painful conditions. Some are acute, typically strains or sprains, tendinopathy, or muscle aches. Others are chronic, typically osteoarthritis of hand or knee, or neuropathic pain.To provide an overview of the analgesic efficacy and associated adverse events of topical analgesics (primarily nonsteroidal anti-inflammatory drugs (NSAIDs), salicylate (...) rubefacients, capsaicin, and lidocaine) applied to intact skin for the treatment of acute and chronicpain in adults.We identified systematic reviews in acute and chronicpain published to February 2017 in the Cochrane Database of Systematic Reviews (the Cochrane Library). The primary outcome was at least 50% pain relief (participant-reported) at an appropriate duration. We extracted the number needed to treat for one additional beneficial outcome (NNT) for efficacy outcomes for each topical analgesic
Virtual Reality as an Adjunct Home Therapy in ChronicPain Management: An Exploratory Study Virtual reality (VR) therapy has been successfully used as an adjunct therapy for the management of acute pain in adults and children, and evidence of potential efficacy in other health applications is growing. However, minimal research exists on the value of VR as an intervention for chronic pain.This case series examined the value of VR to be used as an adjunctive therapy for chronicpain patients (...) in their own homes.An exploratory approach using a case series and personal interviews was used. Ten chronicpain patients received VR therapy for 30 min on alternate days for 1 month. Pre- and postexposure (immediately afterwards, 3 h, and at 24 h) pain assessment was recorded using the Numerical Rating Scale (NRS), and weekly using the Brief Pain Inventory (BPI) and Self-completed Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS). Terminal semistructured personal interviews
Radiofrequency ablation for sacroiliac joint denervation for chronic low back pain Radiofrequency ablation for sacroiliac joint denervation for chronic low back pain Radiofrequency ablation for sacroiliac joint denervation for chronic low back pain HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Radiofrequency ablation for sacroiliac joint (...) denervation for chronic low back pain. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Radiofrequency ablation (RFA) is a percutaneous treatment for chronic low back pain (LBP), including pain originating in the sacroiliac joint (SIJ), using radiowave-induced heat to create a lesion in a spinal sensory nerve. Following a diagnostic blockade to target the affected nerve(s), radiofrequency (RF) current is applied for several minutes via a needle electrode to denervate the targeted
Effectiveness of Models Used to Deliver Multimodal Care for Chronic Musculoskeletal Pain Management Briefs eBrief-no125 -- Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no125 -- Health Services Research & Development Management eBrief no. 125 » Issue 125 April 2017 The report is a product of the VA/HSR&D Evidence Synthesis Program. Effectiveness of Models Used to Deliver (...) Multimodal Care for Chronic Musculoskeletal PainChronic musculoskeletal pain is a growing burden on today's Veteran population. Studies of Veterans who served in Iraq and Afghanistan show that musculoskeletal system diseases are the most frequent diagnoses in inpatient and outpatient encounters, even surpassing mental health conditions. Pain is a complex condition involving dynamic interactions between biological, psychological, and social factors unique to each individual. For this reason, pain care
Management of chronicpain using complementary and integrative medicine. Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronicpain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronicpain, it remains inadequately (...) controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use. CIM offers a multimodality treatment approach that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. This review focuses on the use of CIM in three conditions with a high incidence of chronicpain: back pain, neck pain, and rheumatoid arthritis. It summarizes research on the mechanisms of action
Magnesium as an Alternative or Adjunct to Opioids for ChronicPain: A Review of the Clinical Effectiveness and Guidelines Magnesium as an Alternative or Adjunct to Opioids for ChronicPain: A Review of the Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Magnesium as an Alternative or Adjunct to Opioids for ChronicPain: A Review of the Clinical Effectiveness and Guidelines Magnesium as an Alternative or Adjunct to Opioids for ChronicPain: A Review of the Clinical (...) Effectiveness and Guidelines Published on: April 20, 2017 Project Number: RC0873-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of magnesium as an analgesic for the treatment of adult patients with migraine or chronicpain? What are the evidence-based guidelines regarding the use of magnesium as an analgesic in adult patients with migraine or chronicpain? Key Message Definitive conclusions
Depicting individual responses to physical therapist led chronicpain self-management support with pain science education and exercise in primary health care: multiple case studies Previous evidence suggests self-management programs for people with chronicpain improve knowledge and self-efficacy, but result in small to negligible changes in function. The purpose of this multiple case studies design was to describe the unique responses of six participants to a new self-management program aimed (...) at improving function, to detail each component of the program, and to explore potential explanations for the varied trajectories of each of the participants.Six participants who had been experiencing chronicpain for at least 5 years were included. All participants were enrolled 6 weeks of ChrOnicpain self-ManageMent support with pain science EducatioN and exercise (COMMENCE). Participants completed an assessment at baseline, 7 weeks (1-week follow-up), and 18 weeks (12-week follow-up). Each participant
Translating Comprehensive Conservative Care for Chronic Knee Pain Into a Digital Care Pathway: 12-Week and 6-Month Outcomes for the Hinge Health Program Chronic knee pain (CKP) affects a large number of adults, many of whom do not receive best-practice care and are at high risk for unnecessary surgery.The aim of this study was to investigate the effect of the Hinge Health 12-week digital care program (DCP) for CKP on knee pain and function, with secondary outcomes of surgery interest (...) intention-to-treat statistics with last observation carried forward.The cohort consisted of 41 individuals (32 female, mean age 52 years, SD 9 years). Between baseline and week 12, participants reported clinically significant improvements in the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain and Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form (KOOS-PS) function scales of 16 points (95% CI 12-21, P<.001) and 10 points (95% CI 6-14, P<.001), respectively. Significant
Opioids Used in Conjunction With Benzodiazepines Produce Worse Outcomes in Patients Experiencing ChronicPain Compared To Sole Opioid Use UTCAT3169, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Opioids Used in Conjunction With Benzodiazepines Produce Worse Outcomes in Patients Experiencing ChronicPain Compared To Sole Opioid Use Clinical Question For a patient experiencing chronicpain, will the use (...) of benzodiazepines with opioids, compared to opioids alone, produce better outcomes? Clinical Bottom Line For patients with chronicpain, the use of opioids in conjunction with benzodiazepines produces worse outcomes than opioids alone. This is supported by a cross-sectional study where it was noted that the combination of opioids and benzodiazepines correlated with poor mood and decreased patient function. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient
Intradiscal Glucocorticoid Injection for Patients With Chronic Low Back Pain Associated With Active Discopathy: A Randomized Trial. Active discopathy is associated with a specific phenotype of chronic low back pain (LBP). Local inflammation has a role in active discopathy-associated symptoms.To assess the efficacy of a single glucocorticoid intradiscal injection (GC IDI) in patients with chronic LBP with active discopathy.Prospective, parallel-group, double-blind, randomized, controlled study (...) . (ClinicalTrials.gov: NCT00804531).3 tertiary care centers in France.135 patients with chronic LBP with active discopathy on magnetic resonance imaging (MRI).A single GC IDI (25 mg prednisolone acetate) during discography (n = 67) or discography alone (n = 68).The primary outcome was the percentage of patients with LBP intensity less than 40 on an 11-point numerical rating scale (0 [no pain] to 100 [maximum pain] in 10-point increments) in the previous 48 hours at 1 month after the intervention. The main secondary
Two-Year Follow-up of a Randomized Clinical Trial of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care for Chronic Low Back Pain. 28196244 2017 03 17 2018 12 02 1538-3598 317 6 2017 02 14 JAMA JAMA Two-Year Follow-up of a Randomized Clinical Trial of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care for Chronic Low Back Pain. 642-644 10.1001/jama.2016.17814 Cherkin Daniel C DC Group Health Research Institute, Seattle, Washington (...) United States Letter Randomized Controlled Trial United States JAMA 7501160 0098-7484 AIM IM Adult Aged ChronicPain therapy Cognitive Behavioral Therapy Disability Evaluation Follow-Up Studies Humans Low Back Pain therapy Middle Aged Mindfulness methods Mobility Limitation Outcome Assessment (Health Care) Regression Analysis Stress, Psychological therapy Surveys and Questionnaires Time Factors Treatment Outcome Young Adult 2017 2 15 6 0 2017 2 15 6 0 2017 3 18 6 0 ppublish 28196244 2601490 10.1001
Additional Effect of Static Ultrasound and Diadynamic Currents on Myofascial Trigger Points in a Manual Therapy Program for Patients With Chronic Neck Pain: A Randomized Clinical Trial. To assess the additional effect of static ultrasound and diadynamic currents on myofascial trigger points in a manual therapy program to treat individuals with chronic neck pain.A single-blind randomized trial was conducted. Both men and women, between ages 18 and 45, with chronic neck pain and active myofascial (...) was no group-versus-time interaction for Numeric Rating Scale, Neck Disability Index, Pain-Related Self-Statement Scale, pressure pain threshold, cervical range of motion, and skin temperature (F-value range, 0.089-1.961; P-value range, 0.106-0.977). Moreover, we found no differences between groups regarding electromyographic activity (P > 0.05).The use of static ultrasound or diadynamic currents on myofascial trigger points in upper trapezius associated with a manual therapy program did not generate
Evidence Brief: Effectiveness of Models Used to Deliver Multimodal Care for Chronic Musculoskeletal Pain 4 Department of Veterans Affairs Health Services Research & Development Service Evidence-based Synthesis Program Evidence Brief: Effectiveness of Models Used to Deliver Multimodal Care for Chronic Musculoskeletal Pain January 2017 Prepared for: Department of Veterans Affairs Veterans Health Administration Quality Enhancement Research Initiative Health Services Research & Development Service (...) Washington, DC 20420 Prepared by: Evidence-based Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Investigators: Kim Peterson, MS Johanna Anderson, MPH Donald Bourne, BS Katherine Mackey, MD Mark Helfand, MD, MS, MPH Evidence Brief: Models of Multimodal ChronicPain Care Evidence-based Synthesis Program i PREFACE The VA Evidence-based Synthesis Program (ESP) was established in 2007 to provide timely and accurate syntheses
A technology ecosystem for chronicpain: promises, challenges, and future research 28300227 2019 01 09 2306-9740 3 2017 mHealth Mhealth A technology ecosystem for chronicpain: promises, challenges, and future research. 6 10.21037/mhealth.2017.02.03 Marceglia Sara S Department of Engineering and Architecture, University of Trieste, Trieste, Italy;; Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Hospital (...) 27724911 Hemoglobin. 2015;39(3):162-8 25831427 JMIR Res Protoc. 2014 Dec 12;3(4):e76 25500281 Stud Health Technol Inform. 2016;226:225-8 27350511 Pain Res Manag. 2014 Sep-Oct;19(5):257-65 25000507 J Pain. 2014 Oct;15(10):1001-7 24854065 J R Soc Med. 2012 Jun;105(6):233-41 22722967 J Med Internet Res. 2013 Dec 30;15(12):e277 24449711 Clin J Pain. 2016 Nov 24;:null 27898460 J Telemed Telecare. 2016 Nov 9;:null 27831496 J Med Internet Res. 2013 Apr 24;15(4):e89 23615332 Br J Pain. 2016 Aug;10(3):135-40
Effectiveness of an Internet-Delivered Exercise and Pain-Coping Skills Training Intervention for Persons With Chronic Knee Pain: A Randomized Trial. Effective, accessible biopsychosocial treatments are needed to manage chronic knee pain on a population level.To evaluate the effectiveness of Internet-delivered, physiotherapist-prescribed home exercise and pain-coping skills training (PCST).Pragmatic parallel-group randomized, controlled trial. (Australian New Zealand Clinical Trials Registry (...) : ACTRN12614000243617).Community (Australia).148 persons aged 50 years or older with chronic knee pain.The intervention was delivered via the Internet and included educational material, 7 videoconferencing (Skype [Microsoft]) sessions with a physiotherapist for home exercise, and a PCST program over 3 months. The control was Internet-based educational material.Primary outcomes were pain during walking (11-point numerical rating scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on noninvasive treatment of low back pain.Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials and systematic reviews published through April 2015 (...) for this guideline includes all clinicians, and the target patient population includes adults with acute, subacute, or chronic low back pain.Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence). If pharmacologic treatment is desired, clinicians and patients should select
Sacroiliac joint injections with corticosteroids for treatment of chronic low back pain Sacroiliac joint injections with corticosteroids for treatment of chronic low back pain Sacroiliac joint injections with corticosteroids for treatment of chronic low back pain HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Sacroiliac joint injections (...) with corticosteroids for treatment of chronic low back pain. Lansdale: HAYES, Inc. Healthcare Technology Brief Publication. 2016 Authors' objectives The sacroiliac joint (SIJ) has been implicated as the primary source of pain in 10% to 30% of patients with chronic low back pain. Description of Technology: This health technology assessment focuses on therapeutic injections of corticosteroid and local anesthetic into the SIJ to treat SIJ pain that is refractory to noninvasive therapies. These injections are usually