The Clinical journal of pain
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The current medical treatment of neuropathic pain (NP) is inadequate with more than two thirds of patients having no suitable solution for their morbid disease and deteriorating quality of life. Currently, medications for the treatment of NP are mostly systemic (affecting the central nervous system) and are dose limited because of serious and debilitating adverse effects. Scientific evidence suggests that localized cutaneous NP can be treated effectively and safely by topical medications; however, only a few topical medications are indicated for NP. This lack of topica medications stems from the limited resources that have been dedicated to exploring the role of the peripheral nervous system in NP or to the development of peripherally active topical analgesics. ⋯ This article discusses the role of topical medications in treating localized cutaneous NP and the role of the compounding pharmacists in applying this therapeutic approach (eg, the scientific considerations that the pharmacist should take into account).
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Review Meta Analysis
A Systematic Review and Meta-Analysis of Medical Leech Therapy for Osteoarthritis of the Knee.
Osteoarthritis of the knee is a common chronic disease among older adults. Therapeutic approaches mainly consist of physiotherapy or pharmacological therapy, but these approaches are limited over time by their cost and/or side effects. This paper presents a systematic review and meta-analysis of the effectiveness of medical leech therapy for osteoarthritis of the knee. ⋯ This systematic review found moderate to strong evidence for the reduction of pain, functional impairment, and joint stiffness after medical leech therapy in patients with osteoarthritis of the knee. Given the low number of reported adverse events, leech therapy may be a useful approach in treating this condition. Further high-quality RCTs are required for the conclusive judgment of its effectiveness and safety.