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Latest & greatest articles for 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 pain or other clinical topics then use Trip today.
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Palliative cancer care - pain: What issues should I consider before prescribing hyoscine butylbromide? Hyoscine butylbromide | Prescribing information | Palliative cancer care - pain | CKS | NICE Search CKS… Menu Hyoscine butylbromide Palliative cancer care - pain: What issues should I consider before prescribing hyoscine butylbromide? Last revised in October 2016 What issues should I consider before prescribing hyoscine butylbromide? Hyoscine butylbromide should not be administered to people
Palliative care - oral: Scenario: Oral pain Scenario: Oral pain | Management | Palliative care - oral | CKS | NICE Search CKS… Menu Scenario: Oral pain Palliative care - oral: Scenario: Oral pain Last revised in October 2018 Scenario: Oral pain From age 16 years onwards. Topical pain relief Treat the underlying cause of oral pain where possible. If this is not possible or not fully effective, treat pain symptomatically. For mild to moderate oral pain, use topical non-opioid analgesia (...) . For localized pain: Choline salicylate gel — short-lived effect. Excessive use should be avoided because it can lead to ulceration, particularly if the gel is trapped under dentures. Benzydamine spray — relatively short duration of action, and numbness and stinging are sometimes a problem. Lidocaine 5% ointment or 10% spray — duration of action of topical local anaesthetics, such as lidocaine, is relatively short, and these agents will not provide continuous pain relief throughout the day. Care should also
Scrotal pain and swelling: Scenario: Hydrocele Scenario: Hydrocele | Management | Scrotal pain and swelling | CKS | NICE Search CKS… Menu Scenario: Hydrocele Scrotal pain and swelling: Scenario: Hydrocele Last revised in August 2019 Scenario: Hydrocele How should I manage a boy with a congenital hydrocele? For an infant or toddler with a hydrocele since birth: Reassure the parents that the hydrocele is likely to resolve without treatment by 2 years of age. Progression to hernia is rare
Scrotal pain and swelling: Scenario: Haematocele Scenario: Haematocele | Management | Scrotal pain and swelling | CKS | NICE Search CKS… Menu Scenario: Haematocele Scrotal pain and swelling: Scenario: Haematocele Last revised in August 2019 Scenario: Haematocele How should I manage a man or boy with haematocele? If the haematocele follows acute trauma, admit immediately. If the haematocele does not follow trauma or is chronic, refer for urgent ultrasound of the scrotum. Small haematoceles
Scrotal pain and swelling: Scenario: Epididymal cyst/spermatocele Scenario: Epididymal cyst/spermatocele | Management | Scrotal pain and swelling | CKS | NICE Search CKS… Menu Scenario: Epididymal cyst/spermatocele Scrotal pain and swelling: Scenario: Epididymal cyst/spermatocele Last revised in August 2019 Scenario: Epididymal cyst/spermatocele How should I manage a man with epididymal cysts/spermatoceles? If confident of the diagnosis: Reassure the man that epididymal cysts/spermatoceles
Transcutaneous electrical nerve stimulation (TENS) for chronic neck pain. Chronic neck pain is a highly prevalent condition, affecting 10% to 24% of the general population. Transcutaneous electrical nerve stimulation (TENS) is the noninvasive, transcutaneous use of electrical stimulation to produce analgesia. It is a simple, low-cost and safe intervention used in clinical practice as an adjunct treatment for painful musculoskeletal conditions that have a considerable impact on daily activities (...) , such as chronic neck pain. This review is a split from a Cochrane Review on electrotherapy for neck pain, published in 2013, and focuses specifically on TENS for chronic neck pain.To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) (alone or in association with other interventions) compared with sham and other clinical interventions for the treatment of chronic neck pain.We searched Cochrane Back and Neck Trials Register, CENTRAL, MEDLINE, Embase, five other databases and two
Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial This randomized clinical trial investigated the effects of adding cervico-mandibular manual therapies into an exercise and educational program on clinical outcomes in individuals with tinnitus associated with temporomandibular disorders (TMDs).Sixty-one patients with tinnitus attributed to TMD were randomized into the physiotherapy (...) and manual therapy group or physiotherapy alone group. All patients received six sessions of physiotherapy treatment including cranio-cervical and temporomandibular joint (TMJ) exercises, self-massage, and patient education for a period of one month. Patients allocated to the manual therapy group also received cervico-mandibular manual therapies targeting the TMJ and cervical and masticatory muscles. Primary outcomes included TMD pain intensity and tinnitus severity. Secondary outcomes included tinnitus
Moderators of Internet-Delivered Cognitive-Behavioral Therapy for Adolescents With Chronic Pain: Who Benefits From Treatment at Long-Term Follow-Up? Cognitive behavioral therapy (CBT) is effective for pediatric chronic pain, but little is understood about which youth are most likely to benefit. The current study aimed to identify individual characteristics for which CBT yielded the greatest (and least) clinical benefit among adolescents with chronic pain participating in a multicenter (...) randomized controlled trial of Internet-delivered CBT (WebMAP2). A total of 273 adolescents ages 11 to 17 with chronic pain (M age = 14.7; 75.1% female) were randomly assigned to Internet-delivered CBT or Internet-delivered pain education and evaluated at pretreatment, post-treatment, and 2 longer term follow-up periods (6 and 12 months). Multilevel growth models tested several adolescent- and parent-level moderators of change in pain-related disability including 1) adolescent age, sex, pain
Subacromial decompression surgery for adults with shoulder pain Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline | The BMJ Intended for healthcare professionals Username * Password * Edition: Search form Search Search Subacromial... Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline (Published 06 February 2019) Cite this as: BMJ 2019;364:l294 Visual summary of recommendation or Subacromial decompression (...) surgery Nonoperative management only Arthroscopic subacromial decompression plus nonoperative management Including guided physical therapy, exercise programmes, NSAIDs, and steroid injections Interventions compared Recommendation Population Adults with shoulder pain for more than 3 months Does not apply to patients with: Including: Traumatic shoulder pain Subacromial pain syndrome (SAPS) Rotator cuff disease (RCD) Other differential diagnoses We recommend against subacromial decompression surgery More
Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments The objective of the InMEDIATE study was to evaluate the change in intensity of traumatic pain over the first 20 min in adult patients treated with methoxyflurane versus standard analgesic treatment in Spain. This the first randomized, active-controlled, multicenter trial of methoxyflurane (...) in the emergency setting in Europe.This was a randomized, controlled study that enrolled adult patients with acute moderate to severe (score ≥4 on the 11-point Numeric Rating Scale) trauma-associated pain in 14 Spanish emergency departments. Patients were randomized 1:1 to methoxyflurane (up to 2×3 mL) or standard analgesic treatment. Coprimary endpoints were the change from baseline in Numeric Rating Scale pain intensity score during the first 20 minutes of treatment and time to first pain relief.Three
Effects of open-label placebo on pain, functional disability, and spine mobility in patients with chronic back pain: a randomized controlled trial Chronic back pain (CBP) is a major global health problem, while its treatment is hampered by a lack of efficacy and restricted safety profile of common frontline therapies. The present trial aims to determine whether a 3-week open-label placebo treatment reduces pain intensity and subjective and objective functional disability in patients with CBP (...) . This randomized controlled trial, following a pretest-posttest design, enrolled 127 patients with CBP (pain duration >12 weeks) from the Back Pain Center, Neurology, University Hospital Essen, Germany. Patients randomized to the open-label placebo group received a 3-week open-label placebo treatment. Patients in the treatment as usual (TAU) group received no intervention. Both groups continued TAU. Primary outcome was the change in pain intensity. Secondary outcomes included patient-reported functional
Effect of Ubrogepant vs Placebo on Pain and the Most Bothersome Associated Symptom in the Acute Treatment of Migraine: The ACHIEVE II Randomized Clinical Trial. Ubrogepant is an oral calcitonin gene-related peptide receptor antagonist under investigation for acute treatment of migraine.To evaluate the efficacy and tolerability of ubrogepant compared with placebo for acute treatment of a single migraine attack.Phase 3, multicenter, randomized, double-blind, placebo-controlled, single-attack (...) , clinical trial (ACHIEVE II) conducted in the United States (99 primary care and research clinics; August 26, 2016-February 26, 2018). Participants were adults with migraine with or without aura experiencing 2 to 8 migraine attacks per month.Ubrogepant 50 mg (n = 562), ubrogepant 25 mg (n = 561), or placebo (n = 563) for a migraine attack of moderate or severe pain intensity.Co-primary efficacy outcomes were pain freedom and absence of the participant-designated most bothersome migraine-associated
Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures Common medical procedures to assess and treat patients can cause significant pain and distress. Clinicians should have a basic approach for minimizing pain and distress in children, particularly for frequently used diagnostic and therapeutic procedures. This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical (...) procedures. Simple, evidence-based strategies for managing pain and distress are reviewed, with guidance for integrating them into clinical practice as an essential part of health care. Health professionals are encouraged to use minimally invasive approaches and, when painful procedures are unavoidable, to combine simple pain and distress-minimizing strategies to improve the patient, parent, and health care provider experience. Health administrators are encouraged to create institutional policies