Latest & greatest articles for chronic pain

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Top results for chronic pain

81. Evaluation of the Neuropathic Component of Chronic Low Back Pain (Abstract)

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

82. Safety of oral methylnaltrexone for opioid-induced constipation in patients with chronic noncancer pain Full Text available with Trip Pro

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

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

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

84. Patient-delivered tDCS on chronic neuropathic pain in prior responders to TMS (a randomized controlled pilot study) Full Text available with Trip Pro

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

85. 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 Full Text available with Trip Pro

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

86. Effects of spinal manipulative therapy biomechanical parameters on clinical and biomechanical outcomes of participants with chronic thoracic pain: a randomized controlled experimental trial Full Text available with Trip Pro

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

2019 EvidenceUpdates

87. Answer to the letter to the editor of Y. Li et al. concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Sp Full Text available with Trip Pro

Answer to the letter to the editor of Y. Li et al. concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Sp 31399848 2019 08 30 1432-0932 28 9 2019 Sep European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J Answer (...) to the letter to the editor of Y. Li et al. concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156]. 2224 10.1007/s00586-019-06063-5 Fischgrund Jeffrey S JS Oakland University William Beaumont School of Medicine, 3535 West 13 Mile Road, Suite 744, Royal Oak, MI, 48073, USA. jsfischgrund37@gmail.com. eng Letter 2019 08 09 Germany

2019 European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Controlled trial quality: predicted high

88. Is graded exercise beneficial in improving function, mobility and quality of life in adult patients with chronic musculoskeletal pain?

Is graded exercise beneficial in improving function, mobility and quality of life in adult patients with chronic musculoskeletal pain? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: June 2017 CAT Lead: Laura Freeman / Treena Larkin (South Staffs Group) Date CAT completed: June 2017 Date to be reviewed June 2022 Specific Question: Is graded exercise beneficial in improving function, mobility, quality of life in adult patients with chronic (...) musculoskeletal pain? Clinical bottom line There is limited evidence of poor quality to answer this question with confidence. The studies that were identified were of poor quality and therefore results should be viewed with caution. Why is this important? Exercise is generally considered an important part of chronic pain management. Much evidence exists empirically to support the benefits of activity / exercise in the management of chronic pain. However many patients struggle to exercise / increase activity

2019 Public Health England

89. Compounded creams no better than placebo creams for localised chronic pain. (Abstract)

Compounded creams no better than placebo creams for localised chronic pain. 31311799 2019 07 17 1468-9618 2019 Jul 16 Evidence-based nursing Evid Based Nurs Compounded creams no better than placebo creams for localised chronic pain. ebnurs-2019-103128 10.1136/ebnurs-2019-103128 Hu Jiale J http://orcid.org/0000-0003-1993-8704 Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, Virginia, USA. eng Journal Article 2019 07 16 England Evid Based Nurs 9815947 1367-6539 (...) neurological pain pain management Competing interests: None declared. 2019 07 10 2019 7 18 6 0 2019 7 18 6 0 2019 7 18 6 0 aheadofprint 31311799 ebnurs-2019-103128 10.1136/ebnurs-2019-103128

2019 Evidence-Based Nursing Controlled trial quality: predicted high

90. Effects of motor control exercise and patient education program in the management of chronic low back pain among community-dwelling adults in rural Nigeria: a study protocol for a randomized clinical trial. Full Text available with Trip Pro

Effects of motor control exercise and patient education program in the management of chronic low back pain among community-dwelling adults in rural Nigeria: a study protocol for a randomized clinical trial. The impact of chronic low back pain (CLBP) is disproportionally higher in rural Nigeria than in urban areas but lack access to rehabilitation. While exercise and education are commonly advocated interventions for the rehabilitation of CLBP, there is a paucity of community-based randomized (...) to one of three intervention arms; MCE plus PE, MCE, or PE groups. The MCE will be administered twice a week for 8 weeks while the PE will be provided once a week for 8 weeks. Participants will be assessed pre-intervention, immediately post-intervention and at 3-month post-intervention. Primary outcomes will be pain intensity and functional disability. Secondary outcomes will be quality of life, fear-avoidance beliefs, pain catastrophizing, back beliefs, global perceived recovery, and physical

2019 Integrative medicine research Controlled trial quality: uncertain

91. Clinical meaningfulness of duloxetine's effect in Chinese patients with chronic pain due to osteoarthritis: post hoc analyses of a phase 3 randomized trial. Full Text available with Trip Pro

Clinical meaningfulness of duloxetine's effect in Chinese patients with chronic pain due to osteoarthritis: post hoc analyses of a phase 3 randomized trial. To evaluate the analgesic effect of duloxetine in Chinese patients with osteoarthritis (OA) of the knee/hip at individual patient level and report the relationship between pain intensity reduction, overall improvement, and physical functioning.Post hoc analysis of 13-week, phase 3, parallel-group, randomized, placebo-controlled study (...) of duloxetine in Chinese patients with OA pain. Patients were randomized (1:1, computer-generated, interactive web-response system) to duloxetine (60 mg once daily, n=202) or placebo (n=207). Patients, investigators, and study staff were blinded throughout the study. Duloxetine's efficacy was evaluated using the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) and the Osteoarthritis Research Society International and Outcome Measures in Rheumatology (OARSI-OMERACT

2019 Open access rheumatology : research and reviews Controlled trial quality: uncertain

92. Ropivacaine versus placebo on postoperative analgesia and chronic pain following third molar extraction: A Prospective Randomized Controlled Study. (Abstract)

Ropivacaine versus placebo on postoperative analgesia and chronic pain following third molar extraction: A Prospective Randomized Controlled Study. The present study aimed at assessing the efficiency of ropivacaine on post-operative pain for extraction of third molars.In a single centre, prospective, parallel, double blind randomised trial, patients scheduled for removal of all four third molars, ASA I-III patients<65 year-old patients were included. After intubation under general anesthesia (...) when VAS>3/10, followed by oral tramadol 50mg after discharge), patient satisfaction, chronic pain (1-3 month), time in PACU and total hospitalization time were also recorded.A total of 50 patients were analysed in each group with similar characteristics (ropivacaine vs. control, for age (years) 18 [17-21] vs. 18 [17-21], for sex (female) 33 (66%) vs. 25 (50%), and BMI (kg/m2): 20 [19-23] vs. 21 [19-23]). Area Under the Curve for VAS pain (0 to 4h) was lower for Ropivacaine group: 0.43 [0.19-0.66

2019 Journal of stomatology, oral and maxillofacial surgery Controlled trial quality: predicted high

93. Letter to the Editor concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156 Full Text available with Trip Pro

Letter to the Editor concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156 31309332 2019 08 30 1432-0932 28 9 2019 Sep European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J Letter (...) to the Editor concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156]. 2223 10.1007/s00586-019-06061-7 Li Yongchao Y Department of Orthopaedics, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China. Feng Xiaofei X Department of Orthopaedics, Shanghai East Hospital, Tongji University

2019 European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Controlled trial quality: predicted high

94. Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis Full Text available with Trip Pro

Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis | Evidence-Based Mental Health Log in using your username and password For personal accounts (...) OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta

2019 Evidence-Based Mental Health

95. 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. (Abstract)

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 Controlled trial quality: uncertain

96. 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

97. Effects of an anteroposterior mobilization of the glenohumeral joint in overhead athletes with chronic shoulder pain: A randomized controlled trial. (Abstract)

Effects of an anteroposterior mobilization of the glenohumeral joint in overhead athletes with chronic shoulder pain: A randomized controlled trial. Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations.To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead (...) athletes with chronic shoulder pain.Double-blind, controlled, within-subject, repeated-measures design.Thirty-one overhead athletes with chronic shoulder pain participated. The effects of a 9-min, AP mobilization of the glenohumeral joint were compared with manual contact and no-contact interventions. Self-reported pain, pressure pain threshold (PPT), range of movement (ROM), muscle strength, and disability were measured immediately before and after each intervention.No significant differences were

2018 Musculoskeletal science & practice Controlled trial quality: uncertain

98. Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham-Controlled Pilot Study Full Text available with Trip Pro

Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham-Controlled Pilot Study Chronic pain is associated with maladaptive reorganization of the central nervous system. Recent studies have suggested that disorganization of large-scale electrical brain activity patterns, such as neuronal network oscillations in the thalamocortical system, plays a key role (...) in the pathophysiology of chronic pain. Yet, little is known about whether and how such network pathologies can be targeted with noninvasive brain stimulation as a nonpharmacological treatment option. We hypothesized that alpha oscillations, a prominent thalamocortical activity pattern in the human brain, are impaired in chronic pain and can be modulated with transcranial alternating current stimulation (tACS). We performed a randomized, crossover, double-blind, sham-controlled study in patients with chronic low

2018 EvidenceUpdates

99. Cannabinoids for Chronic Pain

Cannabinoids for Chronic Pain Cannabinoids for Chronic Pain November 2018 Mailing Address: Therapeutics Initiative The University of British Columbia Department of Anesthesiology, Pharmacology & Therapeutics 2176 Health Sciences Mall Vancouver, BC Canada V6T 1Z3 Tel.: 604 822 0700 Fax: 604 822 0701 E-mail: info@ti.ubc.ca www.ti.ubc.ca 115 C anada’s parliament legalized the recreational use of herbal cannabis (marijuana) in October 2018. The well-publicized limitations of clinical re- search (...) and well-recognized side effects such as canna- bis intoxication have not deterred people from seeking out and using herbal cannabis for chronic pain in in- creasing numbers. This is occurring with or without a physician’s authorization. 1 In fact, half of Canadians reporting a medical use of herbal cannabis used it for pain relief. 2 Adult patients in Canada still require a physician’s ‘au- thorization’ to legally access cannabis from a licensed producer of cannabis for medical purposes. Facilitating

2018 Therapeutics Letter

100. Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial Full Text available with Trip Pro

Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial Antidepressants at low dose are commonly prescribed for the management of chronic low back pain and their use is recommended in international clinical guidelines. However, there is no evidence for their efficacy.To examine the efficacy of a low-dose antidepressant compared with an active comparator in reducing pain, disability, and work absence and hindrance in individuals with chronic low back pain.A (...) double-blind, randomized clinical trial with a 6-month follow-up of adults with chronic, nonspecific, low back pain who were recruited through hospital/medical clinics and advertising was carried out.Low-dose amitriptyline (25 mg/d) or an active comparator (benztropine mesylate, 1 mg/d) for 6 months.The primary outcome was pain intensity measured at 3 and 6 months using the visual analog scale and Descriptor Differential Scale. Secondary outcomes included disability assessed using the Roland Morris

2018 EvidenceUpdates