Opioids for chronic osteoarthritis pain: An updated systematic review and meta ‐analysis of efficacy, tolerability and safety in randomized placebo‐controlled studies of at least 4 weeks double‐blind duration

ConclusionsTolerability of opioids is low and efficacy is not clinically relevant in controlled studies from 4 to 24  weeks for osteoarthritis pain.SignificanceWithin the context of randomized controlled trials (4 –24 weeks), opioids provided no clinically relevant pain relief and no clinically relevant reduction in disability compared with placebo in chronic osteoarthritis pain (hip, knee). Number needed to treat for an additional dropout due to side effects was 5 (95% confidence interval 4–7). Two stud ies found no signals of abuse and addiction. The frequency of serious adverse events including deaths did not differ from placebo.
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: REVIEW ARTICLE Source Type: research

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ConclusionWhile these practices were implemented because of sound biologic plausibility or encouraging observational data, well-done RCTs have failed to show evidence of effectiveness. These examples raise caution in introducing new clinical interventions into widespread clinical practice without sufficient high quality evidence demonstrating efficacy.
Source: Current Therapeutic Research - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 22 February 2020Source: Neuroscience LettersAuthor(s): Yan Liu, Zhiwei Zhang, Xiaofen Lu, Jian Meng, Xuying Qin, Jie JiangAbstractEndometriosis of sciatic nerve is a common gynecological disease. Here we aimed to study the anti-inflammatory and anti-nociceptive role of sulforaphane on sciatic nerve endometriosis. The sciatic nerve endometriosis rat model was constructed by autologous implantation of uterine tissue. Sulforaphane was administered intraperitoneally at the dose of 5, 15, 30 and 60 mg/kg/day for 28 days. Behavioral testing was performed at day 7, 14, 21 and 28. At day 2...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
In this study, olfactory ensheathing cells (OECs) were cultured, chitosan (CS) was prepared, and the compatibility of CS and OECs was detected by MTT method. Animal model of chronic constrictive sciatic nerve injury (CCI) was made, OECs and OECs+CS were transplanted to the region surrounding the chronic sciatic nerve injury, and the difference between the two groups in the treatment of NPP was compared. The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured by using behavioral method. In situ hybridization and Western-blotting were used to detect the expression of P2X4R mRNA and protei...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
Authors: Guillaume GM, Vuylsteke ME, Dalcq V, Van der Borght L, Meeus P, de Maeseneer MG Abstract BACKGROUND: To date, it is unclear how treatment of patients with chronic venous disease (CVD) is influenced by national reimbursement systems. In Belgium, catheters or fibers used for endovenous thermal ablation (EVTA) are reimbursed only once in a lifetime. The potential impact of the Belgian public health insurance reimbursement policy on surgical practice in phlebology needs to be investigated. METHODS: Billing data available from the Belgian National Institute for Health and Disability Insurance (NIHDI) were u...
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
Conclusions: The proposed web-based deep learning approach can be very practical and accurate for spine segmentation as a diagnostic method. PMID: 32082701 [PubMed]
Source: Healthcare Informatics Research - Category: Information Technology Tags: Healthc Inform Res Source Type: research
Publication date: Available online 30 June 2018Source: Pharmacological ResearchAuthor(s): Jabeen Haleem DarakhshanAbstractChronic pain conditions such as low back pain and osteoarthritis are the most prominent causes of disability worldwide. Morphine and other opioid drugs are the gold standard treatment for severe pain, including surgical pain, but the use of these drugs for chronic pain is limited largely because long term use of these drugs is associated with drug abuse and hyperalgesia which produces a negative impact on the treatment. Non-addictive treatments for chronic pain are, therefore, highly needed. Commonly us...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
The United States is struggling to deal with an opioid epidemic that is damaging lives, resulting in overdoses, and yet not reducing chronic pain. National initiatives are underway to dramatically reduce access to prescription opioids, but these efforts lack a systematic approach to provide alternative treatments for these patients. Policy changes are urgently needed to provide better care for patients with chronic pain, and in this post, we outline three feasible policy initiatives. Innovative reimbursement initiatives by the Centers for Medicare and Medicaid Services (CMS) could frame and stimulate use of evidence-based ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Drugs and Medical Technology Health Professionals Public Health Quality chronic pain Opioid Addiction opioids Source Type: blogs
Over the last year, the general public has been inundated with a steady stream of reports about the dangers of opiates — pain medicines like codeine, Percocet, and OxyContin. The harm in terms of ruined lives and death from illicit drugs such as heroin is not news. But what is new, and concerning, are the risks of prescription pain medicines — those doctors prescribe for pain due to a range of causes, including musculoskeletal problems like low back pain. The history of using opiates for chronic pain Back pain isn’t a new problem either, but the history of how doctors have treated it is probably new to ma...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Addiction Back Pain Behavioral Health Pain Management Source Type: news
Osteoarthritis (OA) affects tens of millions of Americans and is a leading cause of disability and reduced quality of life across the globe. Other than joint replacement surgery, there is no known “cure” for OA, and most treatments focus on relief of symptoms such as pain. Often, the first step is non-medication-based approaches such as physical therapy, exercise, and weight loss. Most patients, however, will eventually use pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs). Other kinds of medication, such as opioids, have also been tested as treatments for OA, and there is ongoing debate abo...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Arthritis Drugs and Supplements Health Osteoarthritis Pain Management Source Type: news
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