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Non pharmacologic pain

Avneet K Mangat, Ju-Lee Oei, Kerry Chen, Im Quah-Smith, Georg M Schmölzer
Pain is a major problem in sick newborn infants, especially for those needing intensive care. Pharmacological pain relief is the most commonly used, but might be ineffective and has side effects, including long-term neurodevelopmental sequelae. The effectiveness and safety of alternative analgesic methods are ambiguous. The objective was to review the effectiveness and safety of non-pharmacological methods of pain relief in newborn infants and to identify those that are the most effective. PubMed and Google Scholar were searched using the terms: "infant", "premature", "pain", "acupuncture", "skin-to-skin contact", "sucrose", "massage", "musical therapy" and 'breastfeeding'...
September 20, 2018: Children
Jens Keßler, Marcus Geist, Hubert Bardenheuer
Pain therapy concepts should be based on a biopsychosocial model. A prerequisite for adequate pain therapy is the detailed medical history. The questions about the intensity of pain and especially about the quality of pain are crucial for the selection of drug therapy. In addition to the questioning, targeted physical examination is essential. This should be repeated in case of therapy-refractory pain in the course. The transfer of clinically relevant knowledge about the emergence and the development of pain occurs in the new cross-sectional area ​​14 "pain medicine" and has been anchored in the licensing regulations...
September 2018: Deutsche Medizinische Wochenschrift
Edward A Shipton
Globally, in 2016, low back pain (LBP) contributed 57.6 million of total years lived with disability. Low Back Pain Guidelines regularly recommend the use of physical exercise for non-specific LBP. Early non-pharmacological treatment is endorsed. This includes education and self-management, and the recommencement of normal activities and exercise, with the addition of psychological programs in those whose symptoms persist. The aim of physical treatments is to improve function and prevent disability from getting worse...
September 18, 2018: Pain and Therapy
Domenico A Restivo, Antonino Casabona, Lucia Frittitta, Antonino Belfiore, Rosario Le Moli, Damiano Gullo, Riccardo Vigneri
OBJECTIVE: Muscle cramps occur in over 50% of diabetic patients and reduce the quality of life. No effective treatment is available. We evaluated the clinical effectiveness of botulin toxin A (BTX-A) injections for treating cramps in diabetic patients with neuropathy. METHODS: This single-center, double-blind. placebo-controlled perspective study investigated the efficacy and safety of BTX-A intramuscular injection for treating calf or foot cramps refractory to common pharmacological drugs...
September 17, 2018: Annals of Neurology
Brian Chau, Bradley Chi, Thaddeus Wilson
PURPOSE: Recurrent botulinum toxin (BoNT) injections are used in the pediatric population for management of spasticity, but the procedure is often associated with significant pain and anxiety for patients. Non-pharmacologic treatment alternatives for procedural discomfort are limited. Immersive virtual reality (VR) has shown efficacy in treatment of procedural discomfort in pediatric patients. A retrospective chart review was performed to assess feasibility and use of treating BoNT procedure-related discomfort in pediatric patients with VR...
September 7, 2018: Journal of Pediatric Rehabilitation Medicine
Giovanni E Ferreira, Adrian C Traeger, Mary O'Keeffe, Chris G Maher
QUESTION: What are staff and patients' perceptions of physiotherapists working in the emergency department (ED)? DESIGN: Systematic review of qualitative studies. PARTICIPANTS: Staff working in EDs and patients presenting to the ED and managed by ED physiotherapists. OUTCOME MEASURES: Perceptions of ED staff and patients were synthesised using a three-stage thematic analysis consisting of extraction, grouping (codes), and abstraction of findings...
September 13, 2018: Journal of Physiotherapy
Alessandro Picelli, Andrea Santamato, Elena Chemello, Nicoletta Cinone, Carlo Cisari, Marialuisa Gandolfi, Maurizio Ranieri, Nicola Smania, Alessio Baricich
BACKGROUND AND OBJECTIVE: A wide range of adjunct therapies after botulinum toxin administration have been proposed. The aim of the present paper is to provide an overview of major writings dealing with adjuvant (non-pharmacological) treatments associated with botulinum toxin for managing spasticity in order to provide some up-to-date information about the usefulness of the most commonly used procedures. METHODS: The literature in PubMed was searched with the MeSH terms botulinum toxins, muscle spasticity, physical therapy modalities, and rehabilitation...
September 13, 2018: Annals of Physical and Rehabilitation Medicine
A Descazeaud, G Robert, A de La Taille
OBJECTIVE: To review the literature on the sexual adverse effects of pharmacological, instrumental and surgical treatments of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS/BPH). METHOD: A non-systematic review of the scientific literature was conducted from the PubMed database to retrieve the most relevant scientific publications. A first research was cross-referenced with the results of literature reviews already published and enriched by the authors of this review...
September 5, 2018: Progrès en Urologie
Samer Al-Dury, Hanns-Ulrich Marschall
Bile acids are synthesized from cholesterol in the liver, excreted with bile into the duodenum, almost completely taken up again in the distal ileum and finally returned to the liver with portal blood in a process termed enterohepatic circulation. Bile acid synthesis, excretion, and reuptake are tightly regulated. The apical sodium-dependent bile acid transporter [ASBT; also known as ileal bile acid transporter (IBAT) and SLC10A2] is pivotal for the almost complete reabsorption of conjugated bile acids in the ileum...
2018: Frontiers in Pharmacology
Shinya Ogawa, Takahiro Natsume, Hiroyuki Takamatsu
A number of promising compounds developed in rodent arthritis models lack efficacy in clinical osteoarthritis (OA) pain. To enhance successful translation of preclinical findings, a nonhuman primate (NHP) model of knee OA was developed and characterized using behavioral assessments designed for use in the NHP. A unilateral medial meniscectomy (MMx) was performed and animals underwent an exercise regimen. Decreased ipsilateral knee pressure threshold, pressure "hyperalgesia", and decreased ipsilateral weight bearing, suggestive of pain at rest were observed...
2018: Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
Melvin T Donaldson, Melissa A Polusny, Rich F MacLehose, Elizabeth S Goldsmith, Emily M Hagel Campbell, Lynsey R Miron, Paul D Thuras, Erin E Krebs
BACKGROUND: Non-pharmacological therapies and practices are commonly used for both health maintenance and management of chronic disease. Patterns and reasons for use of health practices may identify clinically meaningful subgroups of users. The objectives of this study were to identify classes of self-reported use of conventional and complementary non-pharmacological health practices using latent class analysis and estimate associations of participant characteristics with class membership...
September 5, 2018: BMC Complementary and Alternative Medicine
Jae Taek Hong, Jin-Hwan Kim, Keun-Su Kim, Chong-Suh Lee, Hyun-Chul Shin, Woo-Kyung Kim, Joo-Han Kim, Jung-Kil Lee, In-Soo Kim, Yoon Ha, Soo-Bin Im, Sang Woo Kim, In-Ho Han, Jun-Jae Shin, ByeongCheol Rim, Kyung-Soo Suk, Jin-Hyok Kim, Ye-Soo Park, Bong-Soon Chang, Deuk Soo Jun, Young-Hoon Kim, Jung-Hee Lee, Woo-Kie Min, Jung Sub Lee, Si-Young Park, In-Soo Oh, Jae-Young Hong, Bo-Jeong Seo, Young-Joo Kim, Juneyoung Lee
A number of studies have demonstrated an association of neuropathic pain and chronic low back pain (CLBP), but the outcome difference in each medical management is poorly understood. This study is aimed to investigate treatment patterns of neuropathic pain in CLBP patients and to explore patient-reported outcomes (PROs) including quality of life (QoL) and functional disability by treatment patterns.Data were extracted from the neuropathic low back pain (NLBP) outcomes research. It was a multicenter and cross-sectional study in which 1200 patients were enrolled at 27 general hospitals, from 2014 to 2015...
August 2018: Medicine (Baltimore)
Linde N Nijhof, Merel M Nap-van der Vlist, Elise M van de Putte, Annet van Royen-Kerkhof, Sanne L Nijhof
In patients with a pediatric rheumatic disease (PRD), chronic musculoskeletal pain (CMP) can have a major impact on functioning and social participation. Because CMP is not always alleviated solely by the use of pharmacological approaches, the aim was to systematically review the available evidence regarding non-pharmacological treatment options for reducing CMP in patients with PRD. PubMed, Embase, PsycINFO, and the Cochrane Library were systematically searched for (non-)randomized trials investigating non-pharmacological treatments for CMP in PRD published through October 25, 2017...
August 23, 2018: Rheumatology International
Margreet Kloppenburg, Féline Pb Kroon, Francisco J Blanco, Michael Doherty, Krysia S Dziedzic, Elsie Greibrokk, Ida K Haugen, Gabriel Herrero-Beaumont, Helgi Jonsson, Ingvild Kjeken, Emmanuel Maheu, Roberta Ramonda, Marco Jpf Ritt, Wilma Smeets, Josef S Smolen, Tanja A Stamm, Zoltan Szekanecz, Ruth Wittoek, Loreto Carmona
Since publication of the European League Against Rheumatism (EULAR) recommendations for management of hand osteoarthritis (OA) in 2007 new evidence has emerged. The aim was to update these recommendations. EULAR standardised operating procedures were followed. A systematic literature review was performed, collecting the evidence regarding all non-pharmacological, pharmacological and surgical treatment options for hand OA published to date. Based on the evidence and expert opinion from an international task force of 19 physicians, healthcare professionals and patients from 10 European countries formulated overarching principles and recommendations...
August 28, 2018: Annals of the Rheumatic Diseases
Daniela Pasero, Fabio Sangalli, Massimo Baiocchi, Ilaria Blangetti, Sergio Cattaneo, Gianluca Paternoster, Marco Moltrasio, Elisabetta Auci, Patrizia Murrino, Francesco Forfori, Ester Forastiere, Maria Giovanna De Cristofaro, Giorgio Deste, Paolo Feltracco, Flavia Petrini, Luigi Tritapepe, Massimo Girardis
Objective: Management of pain, agitation and delirium (PAD) remains to be a true challenge in critically ill patients. The pharmacological proprieties of dexmedetomidine (DEX) make it an ideal candidate drug for light and cooperative sedation, but many practical questions remain unanswered. This structured consensus from 17 intensivists well experienced on PAD management and DEX use provides indications for the appropriate use of DEX in clinical practice. Methods: A modified RAND/UCLA appropriateness method was used...
June 2018: Turkish Journal of Anaesthesiology and Reanimation
Eric S Schwenk, Edward R Mariano
Multimodal analgesia is defined as the use of more than one pharmacological class of analgesic medication targeting different receptors along the pain pathway with the goal of improving analgesia while reducing individual class-related side effects. Evidence today supports the routine use of multimodal analgesia in the perioperative period to eliminate the over-reliance on opioids for pain control and to reduce opioid-related adverse events. A multimodal analgesic protocol should be surgery-specific, functioning more like a checklist than a recipe, with options to tailor to the individual patient...
August 24, 2018: Korean Journal of Anesthesiology
Winnie W Chung, Crystle-Joie G Agbayani, Ariana Martinez, Vu Le, Haydee Cortes, Kim Har, Zeev N Kain, Michelle A Fortier
BACKGROUND AND METHODS: Despite advances in health care, the majority of children undergoing cancer treatment experience pain, particularly in the home setting. Mobile health tools provide a promising avenue to deliver pain management education and information to parents of children receiving cancer treatment. The current study describes the development and formative evaluation of a novel intervention, Cancer-Tailored Intervention for Pain and Symptoms (C-TIPS), which provides empirically-based pharmacological and non-pharmacological pain management information and coping skills training to parents of pediatric cancer patients...
August 16, 2018: Computers in Biology and Medicine
Rupert Jones, Herbert Muyinda, Grace Nyakoojo, Bruce Kirenga, Winceslaus Katagira, Jillian Pooler
Purpose: Chronic respiratory disease (CRD) including COPD carries high and rising morbidity and mortality in Africa, but there are few available treatments. Pulmonary rehabilitation (PR) is a non-pharmacological treatment with proven benefits in improving symptoms and exercise capacity, which has not been tested in Africa. We aimed to evaluate the lived experience of people with CRD, including physical and psychosocial impacts, and how these are addressed by PR. Patients and methods: A team of respiratory specialists, nurses, and physiotherapists implemented PR to meet the clinical and cultural setting...
2018: International Journal of Chronic Obstructive Pulmonary Disease
M M Wertli, J Steurer
Low back pain is common. In the acute (duration <6 weeks) and subacute pain phases (6-12 weeks) the main goal of pharmacological pain treatment is to enable patients to move and to stay as active as possible. In the chronic phase, pain medications can support non-pharmacological measures and improve physical function. Although almost every person will experience low back pain at least once in a lifetime, for many pain medications no clinical studies on their efficacy exist. Most data are available on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in acute and chronic low back pain; however, potential adverse effects and contraindications for NSAIDs need to be taken into account when the medication is prescribed...
August 16, 2018: Der Internist
Antonio Russo, Gianluca Coppola, Francesco Pierelli, Vincenzo Parisi, Marcello Silvestro, Alessandro Tessitore, Gioacchino Tedeschi
Background: It is well-known that both inter- and intra-individual differences exist in the perception of pain; this is especially true in migraine, an elusive pain disorder of the head. Although electrophysiology and neuroimaging techniques have greatly contributed to a better understanding of the mechanisms involved in migraine during recent decades, the exact characteristics of pain threshold and pain intensity perception remain to be determined, and continue to be a matter of debate. Objective: The aim of this review is to provide a comprehensive overview of clinical, electrophysiological, and functional neuroimaging studies investigating changes during various phases of the so-called "migraine cycle" and in different migraine phenotypes, using pain threshold and pain intensity perception assessments...
2018: Frontiers in Neurology
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