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Latest & greatest articles for chronic pain
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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
Radiofrequency ablation for facet joint denervation for chronic low back pain Radiofrequency ablation for facet joint denervation for chronic low back pain Radiofrequency ablation for facet 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 facet joint denervation (...) for chronic low back pain. Lansdale: HAYES, Inc. Directory Publication. 2016 Authors' objectives Radiofrequency ablation (RFA) is a percutaneous treatment for chronic low back pain (LBP) 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 in a pulsed or continuous manner for several minutes via a needle electrode to denervate the targeted nerve(s) under image guidance. The goal
Benefits and Harms of Cannabis in ChronicPain or PTSD Management Briefs eBrief-no122 -- Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no122 -- Health Services Research & Development Management eBrief no. 122 » Issue 122 February 2017 The report is a product of the VA/HSR&D Evidence Synthesis Program. Benefits and Harms of Cannabis in ChronicPain or PTSD: A Systematic (...) months) cannabis use. Thus, given the social, political, and legal changes surrounding cannabis use, physicians in both VA and non-VA settings will increasingly need to engage in evidence-informed discussions about the potential benefits and harms of cannabis use with their patients. This systematic review sought to assess the effectiveness of plant-based cannabis preparations in treating chronicpain or PTSD. In addition, investigators sought to: Assess the impact of short- and long-term cannabis
Distinguishing between nociceptive and neuropathic components in chronic low back pain using behavioural evaluation and sensory examination Diagnosis of chronic low back pain (CLBP) is traditionally predicated on identifying underlying pathological or anatomical causes, with treatment outcomes modest at best. Alternately, it is suggested that identification of underlying pain mechanisms with treatments targeted towards specific pain phenotypes may yield more success. Differentiation between (...) nociceptive and neuropathic components of CLBP is problematic; evidence suggests that clinicians fail to identify a significant neuropathic component in many CLBP patients. The painDETECT questionnaire (PDQ) was specifically developed to identify occult but significant neuropathic components in individuals thought to have predominantly nociceptive pain.Using the PDQ, we classified 50 CLBP patients into two distinct groups; those with predominantly nociceptive pain (Group 1) and those with a significant
Buprenorphine for ChronicPain: A Review of the Clinical Effectiveness Buprenorphine for ChronicPain: A Review of the Clinical Effectiveness | CADTH.ca Find the information you need Buprenorphine for ChronicPain: A Review of the Clinical Effectiveness Buprenorphine for ChronicPain: A Review of the Clinical Effectiveness Published on: January 6, 2017 Project Number: RC0837-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What (...) is the clinical effectiveness and safety of buprenorphine for the treatment of adults with chronicpain? What is the comparative clinical effectiveness of buprenorphine doses greater than 24 mg per day compared with daily doses of 24 mg or less? What is the clinical effectiveness of buprenorphine when tapering opioid doses for adults with chronicpain? Key Message Buprenorphine results in modest reductions in pain in adults with chronic non-cancer pain, relative to placebo. There is no evidence that other
High Prevalence of Undiagnosed Axial Spondyloarthritis in Patients with Chronic Low Back Pain Consulting Non-Rheumatologist Specialists in Belgium: SUSPECT Study Diagnosis of axial spondyloarthritis (SpA) can be delayed for several years mainly because of low awareness of axial SpA among non-rheumatologists who are the first interlocutors of potential SpA patients. One strategy to decrease the delay between appearance of first symptoms and diagnosis of axial SpA and to allow early management (...) of the disease is to provide the non-rheumatologists with tools to identify patients requiring prompt referral to rheumatologists. This study was designed to evaluate in a real-world setting whether screening patients with chronic low back pain who consult physical medicine and rehabilitation (PMR) physicians, orthopedists, and ophthalmologists is useful in detecting axial SpA.During this non-interventional cross-sectional study, data from 161 patients with chronic back pain, consulting an orthopedist, PMR
Managing Chronic Non-Terminal Pain in Adults Including Prescribing Controlled Substances 1 Quality Department Guidelines for Clinical Care Ambulatory ChronicPain Management Guideline Team Team Leads Daniel W Berland, MD General Medicine / Anesthesiology Phillip E Rodgers, MD Family Medicine Team Members Carmen R Green, MD Anesthesiology R Van Harrison, PhD Medical Education Randy S Roth, PhD Physical Medicine & Rehabilitation Consultants Daniel J. Clauw, MD Rheumatology Jennifer A. Meddings (...) acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific clinical procedure or treatment must be made by the physician in light of the circumstances presented by the patient. Managing Chronic Non-Terminal Pain in Adults Including Prescribing Controlled Substances Objective: To provide a systematic framework for providers to evaluate and manage patients with chronic, non-terminal pain with special attention to specific principles of opioid