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Sharif S, Jazaib Ali MY, Kirazlı Y, Vlok I, Zygourakis C, Zileli M. Acute back pain: The role of medication, physical medicine and rehabilitation: WFNS spine committee recommendations. World Neurosurg X 2024; 23:100273. [PMID: 38807862 PMCID: PMC11130729 DOI: 10.1016/j.wnsx.2024.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/01/2024] [Indexed: 05/30/2024] Open
Abstract
Objectives To formulate the most current, evidence-based recommendations for the role of medication, physical medicine, and rehabilitation in the management of acute low back pain lasting <4 weeks. Methods A systematic literature search in PubMed and Google Scholar databases was performed from 2012 to 2022 using the search terms "acute low back pain," "drugs," "bed rest," "physical medicine," rehabilitation." Standardized screening criteria resulted in a total of 39 articles that were analyzed, including 16 RCTs, 8 prospective studies, 6 retrospective studies, and 9 systematic reviews. This up-to-date information was reviewed and presented at two separate meetings of the World Federation of Neurosurgical Societies (WFNS) Spine Committee. Two rounds of the Delphi method were utilized to vote on the statements and arrive at a positive or negative consensus. Results and conclusion The WFNS Spine Committee finalized twelve recommendation guidelines on the role of medication, physical medicine and rehabilitation in the management of acute LBP. We advocate for a uniform approach to the treatment of these patients, including proper patient education and utilizing drugs with proven efficacy and minimal side effects. First-line pharmacologic agents are acetaminophen and NSAIDs; muscle relaxants can be used for spasms and pain reduction, and opioids should be minimized. Continued activity, rather than bed rest, is recommended, and lumbar spine orthotics may be used to reduce pain and augment functional status. Thermotherapy, cryotherapy, TENs, spinal manipulative therapy, and acupuncture may all be used as adjuncts to improve acute LBP.
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Affiliation(s)
- Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital & Medical College, Karachi, Pakistan
| | | | - Yeşim Kirazlı
- Department of Physical Medicine and Rehabilitation, Ege University, Izmir, Turkey
| | - Ian Vlok
- Department of Neurosurgery, University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Corinna Zygourakis
- Department of Neurosurgery, Sanko University Faculty of Medicine, Gaziantep, Turkey
| | - Mehmet Zileli
- Department of Neurosurgery, Stanford University School of Medicine, California, USA
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Erdoğan P, Yardımcı H. Analgesic effects of LI4 acupuncture during intrauterine device insertion: a randomized controlled clinical trial. Arch Gynecol Obstet 2023; 308:1361-1368. [PMID: 37466690 DOI: 10.1007/s00404-023-07106-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/11/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Intrauterine device (IUD) is one the most effective contraceptive methods with reversible long-term effects. However, the major drawback of IUD use is pain perception during the insertion of the device. The aim of this study is to investigate the effects of bilateral LI4 acupuncture, administered before IUD insertion, on pain perception. METHODS This is a prospective randomized controlled study. It was held in Community Health Center in Niğde, Turkiye. Individuals enrolled in the study were randomized into the acupuncture group and non-intervention group. Acupuncture group received bilateral LI4 acupuncture prior to IUD insertion while others received no interventions. After IUD insertion, 10 cm visual analog scale (VAS) score was evaluated at 3rd minute and at 10th minute. Health care provider performing the IUD insertion and VAS evaluation was blind to randomization. RESULTS In total 72 participants were included in the study. The VAS scores were significantly lower in the acupuncture group both at 3rd minute and at 10th minute (1.93 ± 1.68; 3.81 ± 1.95; p < 0.001 and 0.53 ± 0.84; 1.64 ± 1.10; p < 0.001 respectively). Linear regression analysis showed that acupuncture was a significant predictor for lowering VAS both at 3rd minutes and 10th minutes following IUD insertion (p < 0.001). CONCLUSION This is the first randomized controlled clinical study investigating the effects of acupuncture on pain control during IUD insertion. The results demonstrated that bilateral LI4 acupuncture provides significant pain relief at both cervical and fundal components. Acupuncture prior to IUD insertion is a significant predictor of lowering overall VAS scores of individuals. TRIAL REGISTRATION NCT04963582.
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Affiliation(s)
- Pınar Erdoğan
- Midwifery Department, Niğde Ömer Halisdemir University Zübeyde Hanım School of Health, Atatürk Bulvarı, Derbent Campus Merkez, Niğde, Turkey.
| | - Harun Yardımcı
- Director of Health Services Department, Niğde Provincial Directorate of Health, Yenice mah, Süleyman Fethi Cad. Merkez, Niğde, Turkey
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Arnstein P, Shade M, Herr KA, Young HM, Fishman SM. Managing Older Adults' Chronic Pain: Lower-Risk Interventions. Am J Nurs 2023; 123:46-52. [PMID: 36698362 DOI: 10.1097/01.naj.0000919740.00088.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. This new group of articles provides practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
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Affiliation(s)
- Paul Arnstein
- Paul Arnstein is a professor in the School of Nursing at the MGH Institute of Health Professions in Boston. Marcia Shade is an assistant professor in the College of Nursing at the University of Nebraska Medical Center in Omaha. Keela A. Herr is the Kelting Professor in Nursing, associate dean for faculty, and codirector of the Csomay Center for Gerontological Excellence in the College of Nursing at the University of Iowa in Iowa City. Heather M. Young is a professor and founding dean emerita in the Betty Irene Moore School of Nursing at the University of California Davis in Sacramento, and national director of the Betty Irene Moore Fellowship for Nurse Leaders and Innovators. Scott M. Fishman is a professor, the Fullerton Endowed Chair in Pain Medicine, and executive vice chair in the Department of Anesthesiology and Pain Medicine at the University of California Davis School of Medicine in Sacramento, where he is also director of the Center for Advancing Pain Relief. This work was funded by the Mayday Fund and the Ralph C. Wilson, Jr. Foundation. Contact author: Paul Arnstein, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Zhou Z, Xu G, Huang L, Shu Y, Tian H, Huang F, Liu Y, Liang F, Sun M. Effectiveness and Safety of Acupuncture-Related Therapies for Chronic Musculoskeletal Pain: A Protocol for Systematic Review and Network Meta-Analysis. J Pain Res 2022; 15:3959-3969. [PMID: 36561644 PMCID: PMC9767024 DOI: 10.2147/jpr.s387756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Chronic pain is one of the major health problems worldwide in recent years, and acupuncture-related therapies have been reported to have definite analgesic effects. However, it is still unclear which treatment is the most effective. Our systematic review and network meta-analysis protocol aims to summarize the evidence and determine the most effective method to treat the chronic musculoskeletal pain. Methods and Analysis Our literature search will be performed in five electronic databases-the Cochrane Library, EMBASE, and PubMed, AMED, CINAHL, until May 20, 2022. All randomized controlled trials of acupuncture-related therapies for chronic musculoskeletal pain will be included. The primary outcomes will be common pain-related scales, and the secondary outcomes will include quality of life and incidence of adverse events. Excel 2019 will be used for data extraction, RoB2 will be used for bias risk assessment. R 3.6.2 and WinBUGS V.1.4.3 software will be used for network data synthesis and to produce related plots. During the study, literature selection, data extraction, quality assessment and bias risk assessment will be independently completed by two reviewers, and differences will be judged by the third reviewer. Finally, the risk of bias and sources of heterogeneity in the study will be analyzed and explained in order to obtain reliable results. Results Our study will evaluate the effectiveness and safety of acupuncture-related therapies for the treatment of chronic musculoskeletal pain, and we will rank all methods to recommend the best appropriate treatment option. Conclusion This study will provide a good foundation for complementary and alternative medicine to treat chronic musculoskeletal pain. It will be also helpful to promote the clinical practice by providing evidence-based medical evidence.
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Affiliation(s)
- Zhuo Zhou
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Guixing Xu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Liuyang Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yunjie Shu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Hao Tian
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fengyuan Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yilin Liu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fanrong Liang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China,Correspondence: Fanrong Liang, Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-28-87683962, Email
| | - Mingsheng Sun
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
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Ha G, Tian Z, Chen J, Wang S, Luo A, Liu Y, Tang J, Lai N, Zeng F, Lan L. Coordinate-based (ALE) meta-analysis of acupuncture for musculoskeletal pain. Front Neurosci 2022; 16:906875. [PMID: 35937886 PMCID: PMC9354890 DOI: 10.3389/fnins.2022.906875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022] Open
Abstract
Background Neuroimaging studies have been widely used to investigate brain regions' alterations in musculoskeletal pain patients. However, inconsistent results have hindered our understanding of the central modulatory effects of acupuncture for musculoskeletal pain. The main objective of our investigation has been to obtain comprehensive evidence of acupuncture for musculoskeletal pain diseases. Methods The PubMed, Web of Science, Google Scholar, Embase, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine disc Database, Clinical Trial Registration Platform, and Wanfang Database were searched for neuroimaging studies on musculoskeletal pain diseases published from inception up to November 2021. Then, the relevant literature was screened to extract the coordinates that meet the criteria. Finally, the coordinate-based meta-analysis was performed using the activation likelihood estimation algorithm. Results A total of 15 neuroimaging studies with 183 foci of activation were included in this study. The ALE meta-analysis revealed activated clusters in multiple cortical and sub-cortical brain structures in response to acupuncture across studies, including the thalamus, insula, caudate, claustrum, and lentiform nucleus. Conclusions The studies showed that acupuncture could modulate different brain regions, including the thalamus, insula, caudate, claustrum, and lentiform nucleus. The findings offer several insights into the potential mechanisms of acupuncture for musculoskeletal pain and provide a possible explanation for the observed clinical benefit of this therapy. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227850, identifier: CRD42021227850.
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Affiliation(s)
- Guodong Ha
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zilei Tian
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiyao Chen
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuo Wang
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Aga Luo
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yunyu Liu
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Tang
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ningyuan Lai
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fang Zeng
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Key Laboratory of Sichuan Province for Acupuncture and Chronobiology, Chengdu, China
| | - Lei Lan
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Liu X, Xie X, Li Y, Li M, Wang Y, Wang N, Zhuang L, Liao M. Efficacy of manual acupuncture versus placebo acupuncture for generalized anxiety disorder (GAD) in perimenopause women: study protocol for a randomized controlled trial. Trials 2021; 22:833. [PMID: 34819129 PMCID: PMC8612005 DOI: 10.1186/s13063-021-05756-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is common among perimenopausal women. Acupuncture may be an effective treatment for GAD, but evidence is limited. The pathogenesis of GAD is not yet clear, but it is related to the hypothalamic-pituitary-adrenal axis and its excretion, cortisol (CORT), and adrenocorticotropic hormone (ACTH). The object of this study is to evaluate the efficacy of manual acupuncture (MA) versus placebo acupuncture (PA) for perimenopausal women with GAD. METHODS This study is a single-center, randomized, single-blind clinical trial that will be conducted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 112 eligible GAD patients will be randomly assigned (1:1) to receive MA (n=56) or PA (n=56) three times per week for 4 weeks. The primary outcome measure will be the HAMA score. The secondary outcome measures will be the GAD-7 and PSQI scores and the levels of CORT and ACTH. The evaluation will be executed at baseline, 2 weeks, the end of the treatment, and a follow-up 3-month period. All main analyses will be carried out based on the intention-to-treat (ITT) principle. DISCUSSION This study intends to compare the efficacy between MA and PA in the treatment of perimenopausal women with GAD and to further study the mechanisms underlying the effect. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100046604 . Registered on 22 May 2021.
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Affiliation(s)
- Xin Liu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Xiaoyan Xie
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Yingjia Li
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Meichen Li
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Yuting Wang
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Nanbu Wang
- Department of Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Lixing Zhuang
- Department of Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China.
| | - Muxi Liao
- Department of Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China.
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Sudhakaran P. Acupuncture for Low-Back Pain. Med Acupunct 2021; 33:219-225. [PMID: 34239663 DOI: 10.1089/acu.2020.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Low-back pain affects 84% of the world's population. At present, no method of treatment can be considered as the method of choice. Acupuncture is effective, scientific, cost-effective, and free from major side-effects. Three illustrative cases, showing the beneficial effects of acupuncture are presented. Attention is drawn to the possible presence of underlying sacroiliac-joint dysfunction, which could masquerade as sciatica, hip pain, and/or groin pain.
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Jones C, Abdel Shaheed C, Maher C. Letter to the Editor of the Clinical Journal of Pain. Clin J Pain 2020; 36:567-568. [DOI: 10.1097/ajp.0000000000000840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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