Articles: chronic-pain.
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Journal of neurosurgery · Dec 2022
Review Meta AnalysisIdiopathic Parkinson's disease and chronic pain in the era of deep brain stimulation: a systematic review and meta-analysis.
Pain is the most common nonmotor symptom of Parkinson's disease (PD) and is often undertreated. Deep brain stimulation (DBS) effectively mitigates the motor symptoms of this multisystem neurodegenerative disease; however, its therapeutic effect on nonmotor symptoms, especially pain, remains inconclusive. While there is a critical need to help this large PD patient population, guidelines for managing this significant disease burden are absent. Herein, the authors systematically reviewed the literature and conducted a meta-analysis to study the influence of traditional (subthalamic nucleus [STN] and globus pallidus internus [GPi]) DBS on chronic pain in patients with PD. ⋯ The results indicated that traditional STN and GPi DBS can have a favorable impact on pain control and improve pain scores by 40% from baseline in PD patients experiencing chronic pain. Further trials are needed to identify the subtype of PD patients whose pain benefits from DBS and to identify the mechanisms by which DBS improves pain in PD patients.
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Review Meta Analysis
Morphological changes of cervical musculature in relation to chronic nonspecific neck pain: a systematic review and meta-analysis.
Chronic neck pain is a common musculoskeletal disorder. Previous studies have found that chronic neck pain is associated with changes in neck muscle morphology and fat infiltration (FI). This systematic review summarizes and analyzes all studies on neck muscle morphology in patients with chronic nonspecific neck pain (CNNP). The main objective of this study was to review and analyze measurements of neck muscles in all patients with CNNP, including morphologic changes in the multifidus muscle (MF), longus colli muscle (LC), and semis-spinalis capitis muscle (SCa) in patients with CNNP compared with controls. ⋯ LC and SCa sizes were slightly smaller in patients with CNNP; there was no difference in MF muscle size between the 2 groups. In addition, no conclusions could be drawn in fat infiltration due to insufficient evidence. In summary, CNNP has influence on neck muscle morphology but the evidence is limited.
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Review Meta Analysis
Interventions for promoting evidence-based guideline-consistent surgery in low back pain: a systematic review and meta-analysis of randomised controlled trials.
Examine the effectiveness of interventions to approach guideline-adherent surgical referrals for low back pain assessed via systematic review and meta-analysis. ⋯ CRD42020215137.
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This systematic review, meta-analysis and meta-regression investigated the effects of individualized interventions, based on exercise alone or combined with psychological treatment, on pain intensity and disability in patients with chronic non-specific low-back-pain. Databases were searched up to January 31, 2022 to retrieve respective randomized controlled trials of individualized and/or personalized and/or stratified exercise interventions with or without psychological treatment compared to any control. Fifty-eight studies (n = 10084) were included. ⋯ Still, sustainability of effects (> 12 months) is doubtable. As individualization in exercise therapies is easy to implement, its use should be considered. PROSPERO REGISTRATION: CRD42021247331.
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This study examined the efficacy of internet-delivered cognitive and behavioural interventions for adults with chronic pain AND explored the role of clinical and study characteristics as moderators of treatment effects. PubMed, Embase, PsycINFO, CENTRAL and CINAHL were searched to identify randomized controlled trials published up to October 2021. A meta-analysis of 36 studies (5778 participants) was conducted, which found small effect sizes for interference/disability (Hedges' g = 0.28; 95% confidence interval [CI] 0.21-0.35), depression ( g = 0.43; 95% CI 0.33-0.54), anxiety ( g = 0.32; 95% CI 0.24-0.40), pain intensity ( g = 0.27; 95% CI 0.21-0.33), self-efficacy ( g = 0.39; 95% CI 0.27-0.52) and pain catastrophizing ( g = 0.31; 95% CI 0.22-0.39). ⋯ No differences were found between treatments based on traditional cognitive behaviour therapy vs acceptance and commitment therapy. Sample size, study year, and overall risk of bias (Cochrane rating) did not consistently moderate treatment effects. Overall, the results support the use of internet-delivered cognitive and behavioural interventions as efficacious and suggest guided interventions are associated with greater clinical gains for several key pain management outcomes.