Articles: chronic-pain.
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Randomized Controlled Trial
A randomized placebo-controlled clinical trial of phonophoresis for the treatment of chronic neck pain.
The aim of this trial was to investigate and compare the effects of phonophoresis (PP), placebo PP and exercise therapies on pain, disability, sleep quality, and depression in the patients with chronic neck pain (CNP). This is a randomized, single-blind, placebo-controlled study. A total of 61 patients with definite CNP were included in this study. ⋯ These differences were statistically significant in group 1 and 2 compared to group 3, and also in group 1 compared to group 2. We observed that PP treatment was effective in the treatment for patients with CNP. A combination of PP with exercises can be used to obtain optimal clinical results.
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Treatment for chronic non-cancer neuropathic pain can be complicated by side effects and drug interactions. Combining opioid analgesics and calcium channel modulators may overcome these and improve efficacy. The objective of the present study was to evaluate the efficacy and safety of OROS® hydromorphone combined with pregabalin in patients with chronic non-cancer neuropathic pain. ⋯ The OROS® hydromorphone and pregabalin combination was efficacious for chronic non-cancer neuropathic pain and well tolerated, providing significant pain reduction without the risk of addiction and with a good tolerability profile, regardless of age.
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Prescrire international · May 2014
Comparative StudyTapentadol. Acute or chronic pain: no therapeutic advance.
The standard opioids for relieving moderate to severe pain are: codeine as a step 2 analgesic and morphine for step 3. Tapentadol is an opioid similar to tramadol. An immediate-release form has been authorised in France for moderate to severe acute pain in adults and a sustained-release form for severe chronic pain in adults. ⋯ Gastrointestinal disorders appeared less common with tapentadol than with oxycodone, but the data could well be biased due to the use of a relative overdose of oxycodone in the trials. In practice, the evaluation of tapentadol was not designed to show whether this drug represents a therapeutic advance. Its analgesic efficacy remains unclear, and it provokes the adverse effects common to all opioids.
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To evaluate the effectiveness and safety of transdermal buprenorphine (BTDS) in the treatment of post-traumatic pain in a working population. ⋯ BTDS is an effective and safe alternative for the treatment of patients with severe post-traumatic pain, reducing the intensity of pain and improving functional capacity and quality of sleep.
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Patients with chronic pain often experience co-occurring depression and in some cases suicidal ideation. It is critical to discover risk factors for suicide in this vulnerable patient population. ⋯ Results of this study are consistent with the prevailing literature on pain and suicide demonstrating a high prevalence of suicidal ideation in the chronic pain population. Novel predictive variables were also identified that will provide the basis for developing a risk stratification model that can be further tested prospectively in chronic pain patients.