Efficacy and safety of duloxetine in osteoarthritis or chronic low back pain? The tip of an iceberg!

Weng and colleagues must be commended for their attempts to clarify the benefit/harm ratio of duloxetine in osteoarthritis and chronic low back pain1. Indeed, the high number of therapeutic options available shows the state of affairs is a lottery while these frequent conditions “associated with substantial work disability, morbidity, costs, and increased mortality rates” deserve robust evidence2. However, their conclusion “Duloxetine had modest to moderate effects… with mild adverse events” claiming “future randomized controlled trials should focus on comparing duloxetine…” deserves scrutiny.
Source: Osteoarthritis and Cartilage - Category: Rheumatology Authors: Tags: Letter to the Editor Source Type: research

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Authors: Borisovskaya A, Chmelik E, Karnik A Abstract In this chapter, we describe the impact and etiology of chronic pain, the associated changes in the nervous system, and the mechanisms by which exercise may be able to affect and reverse these changes. Evidence for efficacy of exercise in different conditions associated with chronic pain is presented, with focus on chronic low back pain, fibromyalgia, osteoarthritis, rheumatoid arthritis, and migraines. While the efficacy of exercise and level of evidence supporting it vary in different diseases, exercise has direct and indirect benefits for most patients suffer...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Conclusions: Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion.IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates "high" and "moderate" quality evidence of the effectiveness of Tai Chi in improving importan...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Abstract Chronic musculoskeletal pain and disability dramatically reduce quality and quantity of life worldwide, disproportionately so in low- and middle-income countries. Complementary therapies not typically learned in conventional medical training have much to offer but are under-utilized. Prolotherapy is an injection-based complementary therapy supported by high-quality evidence for osteoarthritis, tendinopathy, and low back pain. Prolotherapy addresses causes of pain and disability at the tissue level, is straightforward to learn, and relies on common, inexpensive material, and requires no refrigeration. Not-...
Source: Health Physics - Category: Physics Authors: Tags: Phys Med Rehabil Clin N Am Source Type: research
Chronic musculoskeletal pain and disability dramatically reduce quality and quantity of life worldwide, disproportionately so in low- and middle-income countries. Complementary therapies not typically learned in conventional medical training have much to offer but are under-utilized. Prolotherapy is an injection-based complementary therapy supported by high-quality evidence for osteoarthritis, tendinopathy, and low back pain. Prolotherapy addresses causes of pain and disability at the tissue level, is straightforward to learn, and relies on common, inexpensive material, and requires no refrigeration. Not-for-profit organiz...
Source: Physical Medicine and Rehabilitation Clinics of North America - Category: Rehabilitation Authors: Source Type: research
Conclusion: In this study, the coastal areas of South Korea carry a higher burden than the national population. Additionally, chronic diseases compose the majority of the health burden in coastal areas. Despite the limitation of data, YLD was the best tool available for evaluating the health outcomes in specific areas, and has the advantage of simplicity and timely analysis.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Publication date: Available online 29 May 2019Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Rohini HandaAbstractLow Back Pain (LBP) is a common clinical problem in out patient practice. LBP, osteoarthritis, soft tissue rheumatism and inflammatory rheumatic diseases constitute the ‘Big 4′ of rheumatology-four musculoskeletal conditions most commonly encountered in the community (Fig. 1). The importance of LBP can also be gauged by the following facts: nearly 75% of the population will have back pain at some time in their life, back symptoms are the most common cause of disability in the young and...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
Clinical reasoning is a cornerstone of evidence-based healthcare, in fact some would argue it’s the cornerstone of all healthcare. While there are many different processes, the ultimate purpose of clinical reasoning is to ensure the person seeking help has their needs identified then met, and the clinician has a basis upon which to decide which treatment they should offer. The approach we use in clinical reasoning, including the information we prioritise and search for, and the way we synthesise the information to make sense of it will depend on the model we have to explain our treatment approach. For example, if...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Clinical reasoning Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice embodiment intersubjectivity making sense persistent pain Source Type: blogs
CONCLUSIONS:: Our findings show that the intervention did not cause a meaningful change in the hypothesized mediators, and these mediators were not associated with patient-reported outcomes. PMID: 30808203 [PubMed - as supplied by publisher]
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
Musculoskeletal pain disorders (MDs), such as osteoarthritis, low back pain and neck pain, are common health problems and a major cause of disease burden worldwide.10,13 MDs are the second most frequent cause of disability, accounting for 21.3% of the total years lived with disability, second only to mental health conditions.47,67 Psychological factors are strongly associated with MDs,6,13,24,48 and are thought to play a role in the development of chronic MDs (defined as pain lasting longer than three months).
Source: The Journal of Pain - Category: Materials Science Authors: Tags: Review Article Source Type: research
Over the past few years I’ve been pondering the presumed gap between people living with pain and the people who “treat” or work with them.  Most of my readers will know that I live with widespread pain (aka fibromyalgia) or pain that is present in many parts of my body, and the associated other symptoms like DOMS that last for weeks not a day or two, and increased sensitivity to heat, cold, pressure, chilli, sound and so on. I first “came out” with my pain about 15 years ago: that is, I first disclosed to people I worked with that I had this weird ongoing pain – and finally joined...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Professional topics Research Therapeutic approaches inclusion inequality Source Type: blogs
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