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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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An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronicpain patients with fibromyalgia In this experimental randomized placebo-controlled 4-way crossover trial, we explored the analgesic effects of inhaled pharmaceutical-grade cannabis in 20 chronicpain patients with fibromyalgia. We tested 4 different cannabis varieties with exact knowledge on their [INCREMENT]-tetrahydrocannabinol (THC) and cannabidiol (CBD) content: Bedrocan (22.4-mg THC, <1-mg (...) analgesic effects, indicative of synergistic pharmacokinetic but antagonistic pharmacodynamic interactions of THC and CBD. This experimental trial shows the complex behavior of inhaled cannabinoids in chronicpain patients with just small analgesic responses after a single inhalation. Further studies are needed to determine long-term treatment effects on spontaneous pain scores, THC-CBD interactions, and the role of psychotropic symptoms on pain relief.
Subarachnoid block with continuous TAP catheter analgesia produces less chronicpain and better functional outcome after inguinal hernioplasty: a randomized controlled observer-blinded study The major concern after inguinal hernioplasty is chronic postsurgical pain and impaired quality of life due to central sensitization. Preoperative, intraoperative, and postoperative pre-emptive analgesia using regional techniques may help prevent the development of central sensitization. This study (...) evaluated the effect of regional anesthesia followed by continuous regional analgesia on postoperative pain and functional outcome following inguinal hernioplasty.Seventy-two consecutive patients scheduled to undergo open mesh inguinal hernioplasty were randomly allocated to one of three groups: subarachnoid block alone (group SAB), general anesthesia alone (group GA), or subarachnoid block combined with a continuous transverse abdominis plane block (group TAP). Pain and functional outcome was assessed
Transcutaneous electrical nerve stimulation (TENS) for chronicpain - an overview of Cochrane Reviews. Chronicpain, 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 chronicpain (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 chronicpain (excluding headache or migraine).To identify possible sources of inconsistency in the approaches taken to evaluating the evidence related to TENS for chronicpain (excluding
Compounded Topical Pain Creams to Treat Localized ChronicPain: A Randomized Controlled Trial. The use of compounded topical pain creams has increased dramatically, yet their effectiveness has not been well evaluated.To determine the efficacy of compounded creams for chronic pain.Randomized controlled trials of 3 interventions. (ClinicalTrials.gov: NCT02497066).Military treatment facility.399 patients with localized pain classified by each patient's treating physician as neuropathic (n = 133 (...) ), nociceptive (n = 133), or mixed (n = 133).Pain creams compounded for neuropathic pain (ketamine, gabapentin, clonidine, and lidocaine), nociceptive pain (ketoprofen, baclofen, cyclobenzaprine, and lidocaine), or mixed pain (ketamine, gabapentin, diclofenac, baclofen, cyclobenzaprine, and lidocaine), or placebo.The primary outcome measure was average pain score 1 month after treatment. A positive categorical response was a reduction in pain score of 2 or more points coupled with a score above 3 on a 5
Video-Game-Based Exercises for Older People With Chronic Low Back Pain: A Randomized Controlledtable Trial (GAMEBACK) Video game technology increases adherence to home exercise and could support self-management for older people with chronic low back pain (LBP).The objective was to investigate the effects of home-based video game exercises on pain self-efficacy and care-seeking in older people with chronic LBP.The study was a randomized controlled trial.The setting was a community and waiting (...) list.Sixty participants, aged > 55 years with chronic LBP, were randomized (1:1) to Wii Fit U exercises or to continue their usual activities for 8 weeks.The intervention was home-based Wii Fit U flexibility, strengthening, and aerobic exercises for 60 minutes, 3 times per week, with fortnightly calls from a physical therapist.Measurements included pain self-efficacy and care-seeking (primary outcomes), and physical activity, pain, function, disability, fear of movement/reinjury, falls efficacy
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
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.
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
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
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 chronicpain (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
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
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. firstname.lastname@example.org. eng Letter 2019 08 09 Germany
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 chronicpain management. Much evidence exists empirically to support the benefits of activity / exercise in the management of chronicpain. However many patients struggle to exercise / increase activity
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
Clinical meaningfulness of duloxetine's effect in Chinese patients with chronicpain 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
Ropivacaine versus placebo on postoperative analgesia and chronicpain 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, chronicpain (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
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
Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronicpain: 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 chronicpain: 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 chronicpain: A systematic review and network meta