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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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The effect of a lay-led, group-based self-management program for patients with chronicpain: a randomized controlled trial of the Danish version of the ChronicPain Self-Management Programme The Stanford ChronicPain Self-Management Programme (CPSMP) consists of 6 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by 2 workshop leaders of whom at least 1 must suffer from a long-term pain condition. The program is highly structured and manualized (...) is not recommended as treatment for chronicpain-related disability. This heterogeneous group of patients with pain did not benefit from the CPSMP except for a small, but clinically insignificant improvement in psychological well-being.
Treatment Options for Failed Back Surgery Syndrome Patients With Refractory ChronicPain: An Evidence Based Approach A significant number of lumbar postsurgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients.Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS (...) such as adhesiolysis. The strongest evidence for long-term treatment is for spinal cord stimulation (SCS), showing favorable Level I RCT results compared with conventional medical management and reoperation. In addition, high-frequency SCS at 10 kHz has demonstrated superiority over traditional, low-frequency SCS for treating low back and leg pain in a recent Level I RCT.Clinicians may increasingly utilize levels of evidence during their evaluation of each FBSS patient to render the best therapeutic plan, likely
Coronary artery disease presenting with left upper quadrant pain in a patient with chronic cervical tetraplegia This single-subject case report aims to describe and discuss a case of a patient with established C5 tetraplegia with acute coronary syndrome presenting with left upper quadrant pain and tenderness.A 65-year-old male with chronic C5 American Spinal Injury Association Impairment Scale (AIS) A tetraplegia presented to the emergency department with severe left upper quadrant pain (...) radiating across the chest to the right upper limb with associated dyspnoea and diaphoresis. Prior to his emergency department admission, he had experienced progressive worsening of left upper quadrant pain and tenderness over several months. He was a non-smoker and swam regularly. He underwent coronary angiography and was found to have significant coronary artery disease. Drug-eluting stents were placed to critical coronary artery lesions followed by an uneventful hospital course with complete symptom
Opioids for chronic non-cancer pain in children and adolescents. Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views (...) on children's pain have changed over time, and relief of pain is now seen as importantWe designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol as priority areas) in order to review the evidence for children's pain utilising pharmacological interventions in children and adolescents.As the leading cause of morbidity in children and adolescents in the world today, chronic
Impact of Needle Diameter on Long-Term Dry Needling Treatment of Chronic Lumbar Myofascial Pain Syndrome. To investigate the impact of diameter of needles on the effect of dry needling treatment of chronic lumbar myofascial pain syndrome.Forty-eight patients with chronic lumbar myofascial pain syndrome were randomly allocated to 3 groups. They received dry needling with needles of diameter 0.25 (group A), 0.5 (group B), and 0.9 mm (group C). Visual analog scale evaluation and health survey were
Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials. Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking.To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain.Three pragmatic multicenter, nonblinded randomized clinical trials (...) on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints
The pain course: a randomised controlled trial comparing a remote-delivered chronicpain management program when provided in online and workbook formats This study compared a remote-delivered pain management program, the Pain Course, when delivered in online and workbook formats. Participants (n = 178) were randomised into 2 groups: (1) an Internet Group (n = 84) who were provided with secure accounts to the program in an online format; or (2) a Workbook Group (n = 94) who were mailed workbook (...) a similarly small amount of clinician contact per participant (M = 74.85 minutes; SD = 41.03). These results highlight the public health potential of remote-delivered pain management programs, delivered in either workbook or online formats, as methods of increasing access to pain management.
[Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] [Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] [Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] Rey-Ares L, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A, López A Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been (...) made for the HTA database. Citation Rey-Ares L, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A, López A. [Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Documentos de Evaluación de Tecnologías Sanitarias, Informe de Respuesta Rapida No 514. 2017 Authors' conclusions Scarce evidence of moderate methodological quality suggests that the use of intrathecal opioids
Multidisciplinary Treatment Programs for Patients with Chronic Non-Malignant Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Multidisciplinary Treatment Programs for Patients with Chronic Non-Malignant Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Multidisciplinary Treatment Programs for Patients with Chronic Non-Malignant Pain: A Review of Clinical Effectiveness, Cost-Effectiveness (...) , and Guidelines Multidisciplinary Treatment Programs for Patients with Chronic Non-Malignant Pain: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Published on: June 22, 2017 Project Number: RC0894-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of multidisciplinary treatment programs for patients with chronic, non-malignant pain in outpatient settings? What is the cost
Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial. Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) is unknown. Moreover, little is known about yoga's effectiveness in underserved patients with more severe functional disability and pain.To determine whether yoga is noninferior to PT for cLBP.12-week, single-blind, 3-group randomized noninferiority trial and subsequent (...) Disability Questionnaire (RMDQ), and pain, measured by an 11-point scale, at 12 weeks. Prespecified noninferiority margins were 1.5 (RMDQ) and 1.0 (pain). Secondary outcomes included pain medication use, global improvement, satisfaction with intervention, and health-related quality of life.One-sided 95% lower confidence limits were 0.83 (RMDQ) and 0.97 (pain), demonstrating noninferiority of yoga to PT. However, yoga was not superior to education for either outcome. Yoga and PT were similar for most
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