European journal of pain : EJP
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Review Meta Analysis
Effectiveness of Percutaneous Electrical Nerve Stimulation for Musculoskeletal Pain: A Systematic Review and Meta-analysis.
To evaluate the effects of percutaneous electrical stimulation (PENS) alone or as an adjunct with other interventions on pain and related disability in musculoskeletal pain conditions. ⋯ This meta-analysis investigating the effectiveness of PENS for the management of pain and related disability in musculoskeletal pain conditions found that PENS could decrease level of pain intensity but not relateddisability in musculoskeletal pain disorders.
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Clinical guidelines recommend physical activity to manage neck pain (NP) and low back pain (LBP). However, studies used to support these guidelines are based on self-reports of physical behaviour, which are prone to bias and misclassification. This systematic review aimed to investigate associations between objectively measured physical behaviour and the risk or prognosis of NP and/or LBP. ⋯ Based on prospective cohort studies with objectively measured physical behaviour, this review questions the common notion that increased physical activity is associated with reduced risk or better prognosis of NP and/or LBP. We found that, among blue-collar workers, increased sitting time at work reduces the risk of NP and LBP, whereas physical activity somewhat increases the risk. Despite methodological shortcomings, there was consistency in the direction of the results, although high-quality articles reported the weakest associations. Systematic review registration: PROSPERO CRD42018100765.
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There are various approaches to the psychological management of chronic pain and it is difficult to know which components of psychological therapies are necessary or desirable for the effective management of chronic pain. ⋯ The expert consensus indicated that psycho-education, strategies to increase activity and cognitive therapy strategies were necessary for effective psychological treatment of patients with chronic pain. While other strategies were deemed desirable, psychological treatments should include at least those three components.