Articles: pain-management.
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Arthritis and rheumatism · Jun 2009
Review Meta AnalysisThe effectiveness of Tai Chi for chronic musculoskeletal pain conditions: a systematic review and meta-analysis.
To determine whether Tai Chi improves pain, disability, physical performance, and/or health-related quality of life (HRQOL) in people with chronic musculoskeletal pain. ⋯ The available data on the effect of Tai Chi are sparse and derived principally from low-quality studies. These data suggest that Tai Chi has a small positive effect on pain and disability in people with arthritis. The extent to which it benefits other forms of musculoskeletal pain is unclear.
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Review Meta Analysis
How effective are patient-based educational interventions in the management of cancer pain? Systematic review and meta-analysis.
This review aimed to quantify the benefit of patient-based educational interventions in the management of cancer pain. We undertook a systematic review and meta-analysis of experimentally randomised and non-randomised controlled clinical trials identified from six databases from inception to November 2007. Two reviewers independently selected trials comparing intervention (formal instruction on cancer pain and analgesia on an individual basis using any medium) to usual care or other control in adults with cancer pain. ⋯ Compared to usual care or control, educational interventions improved knowledge and attitudes by half a point on 0-5 rating scale (weighted mean difference 0.52, 95% confidence interval 0.04-1.0), reduced average pain intensity by over one point on 0-10 rating scale (WMD -1.1, -1.8 to -0.41) and reduced worst pain intensity by just under one point (WMD -0.78, -1.21 to -0.35). We found equivocal evidence for the effect of education on self-efficacy, but no significant benefit on medication adherence or on reducing interference with daily activities. Patient-based educational interventions can result in modest but significant benefits in the management of cancer pain, and are probably underused alongside more traditional analgesic approaches.
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J Pain Symptom Manage · Apr 2009
Review Meta AnalysisAcupuncture: what does the most reliable evidence tell us?
Many trials of acupuncture and numerous systematic reviews have recently become available. Their conclusions are far from uniform. In an attempt to find the most reliable type of evidence, this article provides an overview of Cochrane reviews of acupuncture. ⋯ Five reviews arrived at positive or tentatively positive conclusions and two were inconclusive. The conditions that are most solidly backed up by evidence are chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache. It is concluded that Cochrane reviews of acupuncture do not suggest that this treatment is effective for a wide range of conditions.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisPsychological therapies for the management of chronic pain (excluding headache) in adults.
Psychological treatments are designed to treat pain, distress and disability, and are in common practice. No comprehensive systematic review has been published since 1999. ⋯ CBT and BT have weak effects in improving pain. CBT and BT have minimal effects on disability associated with chronic pain. CBT and BT are effective in altering mood outcomes, and there is some evidence that these changes are maintained at six months.
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Review Meta Analysis
Summary measures of number needed to treat: how much clinical guidance do they provide in neuropathic pain?
Several systematic reviews of randomized controlled trials (RCTs) of drugs to treat neuropathic pain have reported summary estimates of efficacy - specifically, the number needed to treat (NNT). ⋯ Summary NNT estimates may have limited clinical relevance, due to problems of heterogeneity. The most that can be extracted from systematic reviews published to date is the identity of drugs that have demonstrated efficacy for specific types of neuropathic pain, and the strength of such evidence.