Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress

BMC Medicine, Год журнала: 2023, Номер 21(1)

Опубликована: Сен. 29, 2023

Abstract Background Chronic pain conditions impose significant burdens worldwide. Pharmacological treatments like opioids have limitations. Non-invasive non-pharmacological therapies (NINPT) encompass diverse interventions including physical, psychological, complementary and alternative approaches, other innovative techniques that provide analgesic options for chronic without medications. Main body This review elucidates the mechanisms of major NINPT modalities synthesizes evidence their clinical potential across populations. leverages peripheral, spinal, supraspinal to restore normal processing limit central sensitization. However, heterogeneity in treatment protocols individual responses warrants optimization through precision medicine approaches. Conclusion Future adoption requires addressing limitations standardization accessibility as well synergistic combination with emerging therapies. Overall, this highlights promise a valuable option ready integration into contemporary paradigms improve patient care outcomes.

Язык: Английский

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Neuropathic pain: From actual pharmacological treatments to new therapeutic horizons

Pharmacology & Therapeutics, Год журнала: 2023, Номер 251, С. 108546 - 108546

Опубликована: Окт. 11, 2023

Язык: Английский

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Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: a 20-year perspective

Frontiers in Psychology, Год журнала: 2024, Номер 14

Опубликована: Янв. 8, 2024

Introduction Documented use and investigation of hypnosis spans centuries its therapeutic has received endorsement by multiple medical associations. We conducted a comprehensive overview meta-analyses examining the efficacy to provide foundational understanding in evidence-based healthcare, insight into safety interventions, identification gaps current research literature. Methods In our systematic review, randomized controlled trials on patients with mental or somatic health problems compared any control condition published after year 2000 were included. A literature search using Medline, Scopus, PsycINFO, The Cochrane Library, HTA Database, Web Science manual was identify eligible reviews. Methodological quality included rated AMSTAR 2 tool. Effect estimates various outcomes including at least three comparisons ( k ≥ 3) extracted transformed common effect size metric (Cohen’s d ). If available, information certainty evidence for these (GRADE assessment) obtained. Results 49 261 distinct primary studies. Most robust reported undergoing procedures (12 reviews, 79 studies) pain (4 65 studies). There considerable overlap studies across meta-analyses. Only nine have high methodological quality. Reported sizes comparing against conditions ranged from = −0.04 2.72. Of effects, 25.4% medium 0.5), 28.8% large 0.8). Discussion Our findings underline potential positively impact treatment outcomes, largest effects found experiencing pain, procedures, populations children/adolescents. Future should focus moderators efficacy, established children adolescents, identifying who do not benefit hypnosis. Clinical Trial Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023395514 , identifier CRD42023395514

Язык: Английский

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Impact of different types of pain on organizational decisions in palliative medicine

Medicine Today and Tomorrow, Год журнала: 2024, Номер 93(1), С. 47 - 55

Опубликована: Март 31, 2024

In press This short scientific report reveals important aspects of palliative medicine use narcotic and non-narcotic analgesics, antidepressants, anticonvulsants. Specific indications restrictions on their use, routes drug administration (oral, intravenous, intramuscular, subcutaneous, transdermal, intrarectal) are defined. The issues monitoring the dosage painkillers by medical personnel patients themselves, bolus doses, equipment necessary for this were discussed. Special attention is paid to such pharmaceuticals as morphine, oxycodone, buprenorphine, butorphanol, morphine. study pathogenesis, clinical manifestations, diagnostic methods arsenal therapeutic agents overcoming acute chronic pain in organization hospice care (HPC). Different types described depending nosological forms, individual sensitivity pain, sensitization ways transmitting signal from peripheral central part nervous system, humoral mechanisms increasing decreasing sensation assessment Visual Analogue Scale. need organizational solutions improve situation with analgesia Ukrainian institutions, particular increase availability effective patients, was identified. Improving relief corresponds national strategy Ukraine development HPC system. makes a comparison system Great Britain way one best systems basis futuristic models literature, it assumed that similar path. Keywords: nociception, somatic visceral neuropathic analgesics.

Язык: Английский

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The overlooked burden of persistent physical symptoms: a call for action in European healthcare

The Lancet Regional Health - Europe, Год журнала: 2024, Номер 48, С. 101140 - 101140

Опубликована: Ноя. 26, 2024

Язык: Английский

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Integrative Medicine for Cancer-Related Pain: A Narrative Review

Healthcare, Год журнала: 2024, Номер 12(3), С. 403 - 403

Опубликована: Фев. 4, 2024

Cancer-related pain (C-RP) is a prevalent and debilitating concern among patients with cancer, conventional treatments limited in their ability to provide adequate relief, by the adverse effects associated use. Complementary integrative medicine (CIM) modalities have been shown be potentially effective safe for treatment of related symptoms, when used conjunction medications under medical supervision. An increasing number oncology centers CIM within supportive palliative care service, an "Integrative Oncology" (IO) setting. A large body clinical research, including systematic reviews guidelines such as those published 2022 Society Integrative Oncology (SIO), collaboration American Clinical (ASCO), support use some C-RP concerns. These include acupuncture general peri-operative/procedural pain, well aromatase inhibitor-associated arthralgia (AIA); reflexology or acupressure during systemic therapy cancer; hypnosis procedural due diagnostic workup; massage experienced hospice care. Further research needed, both randomized control trials pragmatic non-controlled studies which are more reflective real-life IO This review summarizes evidence supporting C-RP; analgesic mechanism presented; challenges facing researchers, implementation SIO-ASCO guideline recommendations.

Язык: Английский

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The controllability of pain in palliative medicine as a factor in the medical and social impact on the patients’ quality of life at the end-of-life

Experimental and Clinical Medicine, Год журнала: 2024, Номер 93(1), С. 69 - 86

Опубликована: Март 31, 2024

Availability and adequacy of analgesia is one the factors that significantly influence quality life palliative patients. At current stage development, system hospice care in Ukraine will not provide clear pain relief for majority We conducted a study PubMed Google Scholar’s sources legal acts at list content management patients, which should be considered their work by medical social workers providing care, as well health managers. proposed to expand scientific discussion about types corresponding analgesia. The regulatory documentation on protocol treatment chronic patients revealed compliance with modern protocols rules systems developed care. However, we also found practical implementation existing varies direction non-enforcement. came conclusion need use narcotic non-narcotic relievers Ukrainian medicine, strengthen material technical base hospices eliminate staff shortage. article covers number issues pathophysiology pain. determined both causes its perception, can evaluated several scales points, are important issue perception an adequate reaction simplifies diagnosis appointment treatment, excessive "stoic" complicates them. noted involves drug therapy, hypnosis, cognitive-behavioral physical exercises, physio­therapeutic procedures. Keywords: pain, nociception, pharmacotherapy, analgesics, analgesics.

Язык: Английский

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Management of post-traumatic stress disorder symptoms by yoga: an overview

BMC Complementary Medicine and Therapies, Год журнала: 2023, Номер 23(1)

Опубликована: Июль 21, 2023

Posttraumatic stress disorder (PTSD) can occur after trauma. While PTSD management strategies include first-line pharmacotherapy and psychotherapy, mind-body therapies, such as yoga, are applied in the population. This overview aimed to summarize effectiveness of yoga interventions on symptoms adults a systematic review (SR) including randomized controlled trials (RCTs).We searched for SR with or without meta-analysis RCTs involving diagnosis trauma history. The search was conducted until April 2022, through six databases (Cochrane Database, MEDLINE (Pubmed), Scopus, Embase, CINHAL PEDro). primary outcome evolution throughout intervention. Secondary outcomes included follow-up, safety, adherence, cost Two authors independently performed selection, data extraction risk bias assessment AMSTAR 2 tool overlap calculation. is qualitative summary results obtained selected studies.Eleven SRs were analyzed, which 8 meta-analyses. between studies considered very high (corrected covered area 21%). Fifty-nine 4434 participants included. Yoga had significant small-to-moderate effect-size symptom decrease 7 non-significant effects 1 meta-analysis. All found beneficial PTSD. not sufficiently assessed provide clear evidence. Results should be interpreted caution rated at moderate bias, 3 low critically low.While therapy seems promising decreasing symptoms, future research standardize duration/frequency/type consider long-term efficacy better delineate patients.

Язык: Английский

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Adjunctive use of hypnosis for clinical pain: a systematic review and meta-analysis

PAIN Reports, Год журнала: 2024, Номер 9(5), С. e1185 - e1185

Опубликована: Сен. 10, 2024

Abstract Systematic reviews suggest that stand-alone hypnotic suggestions may improve pain outcomes compared with no treatment, waitlist, or usual care. However, in clinical practice, hypnosis is often provided adjunctively other interventions, which might have different effects than those reported previous reviews. This systematic review aimed to summarize the analgesic of adjunctive adults pain. Seven databases (MEDLINE, Embase, PsycINFO, Emcare, SCOPUS, CENTRAL, Cochrane) were searched up January 2024. Randomised controlled trials comparing (hypnosis + primary intervention) intervention alone included. Meta-analyses (random-effects model) calculated mean differences (MD, [95% confidence intervals]) for intensity (0–100). Seventy studies pooled meta-analyses (n = 6078). Hypnosis care had a small additional effect (chronic pain: −8.2 [−11.8, −1.9]; medical procedures/surgical −6.9 [−10.4, −3.3]; burn wound care: −8.8 [−13.8, −3.9]). education medium chronic (−11.5 [−19.7, 3.3]) but not postsurgery (−2.0 [−7.8, 3.7]). When paired psychological slightly increased analgesia only at three-month follow-up (−2 [−3.7, −0.3]). medicines (−13.2, [−22.5, −3.8]). The overall evidence certainty very low; therefore, there still uncertainty about hypnosis. adjunct reduce Clarification proposed therapeutic targets evaluate underlying mechanisms warranted.

Язык: Английский

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Effects of non‐pharmacological interventions on pain in wound patients during dressing change: A systematic review

Nursing Open, Год журнала: 2024, Номер 11(2)

Опубликована: Янв. 31, 2024

Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may problems or even impede healing. There is no systematic study non-pharmacologic therapies for during changes, despite gradual promotion reduction methods.

Язык: Английский

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