Pain practice : the official journal of World Institute of Pain
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Review Meta Analysis
Hyperbaric Oxygen Therapy: A New Treatment for Chronic Pain?
Hyperbaric oxygen therapy (HBOT) is a treatment providing 100% oxygen at a pressure greater than that at sea level. HBOT is becoming increasingly recognized as a potential treatment modality for a broad range of ailments, including chronic pain. In this narrative review, we discuss the current understanding of pathophysiology of nociceptive, inflammatory and neuropathic pain, and the body of animal studies addressing mechanisms by which HBOT may ameliorate these different types of pain. Finally, we review clinical studies suggesting that HBOT may be useful in treating chronic pain syndromes, including chronic headache, fibromyalgia, complex regional pain syndrome, and trigeminal neuralgia. ⋯ HBOT has been shown to reduce pain using animal models. Early clinical research indicates HBOT may also be useful in modulating human pain; however, further studies are required to determine whether HBOT is a safe and efficacious treatment modality for chronic pain conditions.
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Review Meta Analysis
Interventional Procedures for Chronic Pain in Children and Adolescents: A Review of the Current Evidence.
This review discusses the role of interventional procedures in the treatment of chronic pain in children and adolescents. Due to lack of scientific evidence, significant controversy surrounds the utility of invasive techniques for managing pediatric chronic pain states. ⋯ The use of such techniques in children is supported only by case reports, case series, and very few randomized controlled studies. In addition, the potential for severe complications leaves open a debate on the safety of these invasive procedures, which must be confirmed by more extensive and accurate prospective studies.
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Review Meta Analysis
Repetitive Transcranial Magnetic Stimulation for Fibromyalgia: Systematic Review and Meta-Analysis.
Fibromyalgia (FM) is a prevalent chronic pain syndrome with few effective therapeutic options available. Repetitive transcranial magnetic stimulation (rTMS) is an emerging therapeutic alternative for this condition; however, results have been mixed. ⋯ In comparison with sham stimulation, rTMS demonstrated superior effect on the QoL of patients with FM 1 month after starting therapy. However, further studies are needed to determine optimal treatment protocols and to elucidate the mechanisms involved with this effect, which does not seem to be mediated by changes in depression, but that may involve pain modulation. Level of evidence 1b.
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Review Meta Analysis Guideline
Dutch Multidisciplinary Guideline for Invasive Treatment of Pain Syndromes of the Lumbosacral Spine.
When conservative therapies such as pain medication or exercise therapy fail, invasive treatment may be indicated for patients with lumbosacral spinal pain. The Dutch Society of Anesthesiologists, in collaboration with the Dutch Orthopedic Association and the Dutch Neurosurgical Society, has taken the initiative to develop the guideline "Spinal low back pain," which describes the evidence regarding diagnostics and invasive treatment of the most common spinal low back pain syndromes, that is, facet joint pain, sacroiliac joint pain, coccygodynia, pain originating from the intervertebral disk, and failed back surgery syndrome. ⋯ The guideline committee concluded that the categorization of low back pain into merely specific or nonspecific gives insufficient insight into the low back pain problem and does not adequately reflect which therapy is effective for the underlying disorder of a pain syndrome. Based on the guideline "Spinal low back pain," facet joint pain, pain of the sacroiliac joint, and disk pain will be part of a planned nationwide cost-effectiveness study.
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Review Meta Analysis
Acupuncture for Acute Postoperative Pain after Back Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Acupuncture is commonly used as a complimentary treatment for pain management. However, there has been no systematic review summarizing the current evidence concerning the effectiveness of acupuncture for acute postoperative pain after back surgery. This systematic review aimed at evaluating the effectiveness of acupuncture treatment for acute postoperative pain (≤1 week) after back surgery. ⋯ Our systematic review finds encouraging but limited evidence for the effectiveness of acupuncture treatment for acute postoperative pain after back surgery. Further rigorously designed clinical trials are required.