Latest & greatest articles for pain

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Top results for pain

41. Perioperative Pregabalin and Intraoperative Lidocaine Infusion to Reduce Persistent Neuropathic Pain After Breast Cancer Surgery: A Multicenter, Factorial, Randomized, Controlled Pilot Trial

Perioperative Pregabalin and Intraoperative Lidocaine Infusion to Reduce Persistent Neuropathic Pain After Breast Cancer Surgery: A Multicenter, Factorial, Randomized, Controlled Pilot Trial Persistent postsurgical pain is defined as pain localized to the area of surgery of a duration of ≥2 months and is, unfortunately, a common complication after breast cancer surgery. Although there is insufficient evidence to support any preventative strategy, prior literature suggests the possible efficacy (...) of intravenous lidocaine and perioperative pregabalin in preventing persistent pain after surgery. To determine feasibility of conducting a larger definitive trial, we conducted a multicenter 2 × 2 factorial, randomized, placebo-controlled pilot trial of 100 female patients undergoing breast cancer surgery. Patients were randomized to receive an intraoperative lidocaine infusion (1.5 mg/kg bolus followed by 2 mg/kg/h) or placebo and perioperative pregabalin (300 mg preoperatively, 75 mg twice daily for 9

2019 EvidenceUpdates

42. Effectiveness of Foot Orthoses Versus Corticosteroid Injection for Plantar Heel Pain: The SOOTHE Randomized Clinical Trial

Effectiveness of Foot Orthoses Versus Corticosteroid Injection for Plantar Heel Pain: The SOOTHE Randomized Clinical Trial Plantar heel pain is a common foot complaint that causes significant disability and poorer health-related quality of life. Foot orthoses and corticosteroid injection are effective treatments for plantar heel pain; however, it is unclear whether one is more effective than the other.The aim of this trial was to compare the effectiveness of foot orthoses and corticosteroid (...) injection for plantar heel pain.In this parallel-group, assessor-blinded, randomized clinical trial, participants received prefabricated, arch-contouring foot orthoses or a single ultrasound-guided corticosteroid injection. The primary outcome measure was the foot pain subscale of the Foot Health Status Questionnaire at 4 and 12 weeks.One hundred three participants aged 21 to 72 years (63 female) with plantar heel pain were recruited from the community and received an intervention. For the primary

2019 EvidenceUpdates

43. Perineural Platelet-Rich Plasma for Diabetic Neuropathic Pain, Could It Make a Difference?

Perineural Platelet-Rich Plasma for Diabetic Neuropathic Pain, Could It Make a Difference? To evaluate the clinical effect of perineural platelet-rich plasma (PRP) injection for pain and numbness alleviation in diabetic peripheral neuropathy (DPN).A randomized prospective clinical trial.Pain clinic and Rheumatology and Rehabilitation Departments, Assiut University Hospital.Sixty adult patients with type II DM accompanied by DPN of at least six months' duration were assessed by modified Toronto (...) Clinical Neuropathy Score (mTCNS) and randomly allocated into two groups. Group I underwent ultrasound-guided perineural PRP injection and medical treatment, and Group II received medical treatment only. Patients were followed up at months 1, 3, and 6 with regard to pain and numbness visual analog scale (VAS) and mTCNS scores.Significant improvement was recorded in pain and numbness VAS scale scores in group I vs group II (P ≤ 0.001 during the whole study period for both parameters); at the same time

2019 EvidenceUpdates

44. Beyond pain: can antidepressants improve depressive symptoms and quality of life in patients with neuropathic pain? A systematic review and meta-analysis

Beyond pain: can antidepressants improve depressive symptoms and quality of life in patients with neuropathic pain? A systematic review and meta-analysis Neuropathic pain can be a predictor of severe emotional distress, up to full-blown depressive states. In these patients, it is important to move beyond the sole treatment of pain, to recognize depressive symptoms, and to ultimately improve the quality of life. We systematically searched for published and unpublished clinical trials assessing (...) the efficacy and tolerability of antidepressants vs placebo on depression, anxiety and quality of life in patients with neuropathic pain, and pooled data in a meta-analysis. A total of 37 studies fulfilled eligibility criteria and 32 provided data for meta-analysis. Antidepressants were more effective than placebo in improving depressive symptoms (standardized mean difference -0.11; 95% confidence interval -0.20 to -0.02), although the magnitude of effect was small, with a number needed to treat of 24

2019 EvidenceUpdates

45. Duloxetine as treatment for knee osteoarthritis pain

Duloxetine as treatment for knee osteoarthritis pain Duloxetine as treatment for knee osteoarthritis pain – Morsels of Evidence \t\t\t\r\n\t\t\t \t\t\t\r\n\t\t\t Share this: Like this: Like Loading... ","author":{"@type":"Person","name":"Michael Tam"},"image":["https:\/\/evidencebasedmedicine.com.au\/wp-content\/uploads\/2019\/07\/mo_female-walking-cane-istock-1135067373.jpg"]} Toggle search form Toggle navigation Evidence-based medicine for general practitioners Jul 12 2019 Duloxetine (...) as treatment for knee osteoarthritis pain By in , , 12 July 2019 Journal reference: Osani MC, Bannuru RR. Efficacy and safety of duloxetine in osteoarthritis: a systematic review and meta-analysis. Korean J Intern Med 2019 Mar 15 Link: Published: March 2019 Evidence cookie says… Duloxetine (60-120 mg daily) appears to have a small to moderate beneficial effect on knee osteoarthritis pain and function at 3 months, compared to placebo. side-effects need to be considered – around a third experience

2019 Morsels of Evidence

46. Interventions for treating neuropathic pain in people with sickle cell disease. (PubMed)

Interventions for treating neuropathic pain in people with sickle cell disease. Pain is the hallmark of sickle cell disease (SCD) and it can be severe, frequent and unpredictable. Although nociceptive pain is more common, at times, people with SCD may have neuropathic pain. The latter can occur due to peripheral or central nerve injury. This review is focused on identifying treatment of only painful sensory neuropathy in people with SCD.To determine the effectiveness and safety of any (...) pharmacological or non-pharmacological therapies for treating neuropathic pain in people with SCD.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched trial registries, the reference lists of relevant articles and reviews and contacted experts in the field.Date of last search: 31 January 2019.Randomised controlled trials (RCTs

2019 Cochrane

47. Effect of Tanezumab on Joint Pain, Physical Function, and Patient Global Assessment of Osteoarthritis Among Patients With Osteoarthritis of the Hip or Knee: A Randomized Clinical Trial. (PubMed)

Effect of Tanezumab on Joint Pain, Physical Function, and Patient Global Assessment of Osteoarthritis Among Patients With Osteoarthritis of the Hip or Knee: A Randomized Clinical Trial. Patients with osteoarthritis (OA) may remain symptomatic with traditional OA treatments.To assess 2 subcutaneous tanezumab dosing regimens for OA.A randomized, double-blind, multicenter trial from January 2016 to May 14, 2018 (last patient visit). Patients enrolled were 18 years or older with hip or knee OA (...) , inadequate response to OA analgesics, and no radiographic evidence of prespecified joint safety conditions.Patients received by subcutaneous administration either tanezumab, 2.5 mg, at day 1 and week 8 (n = 231); tanezumab, 2.5 mg at day 1 and 5 mg at week 8 (ie, tanezumab, 2.5/5 mg; n = 233); or placebo at day 1 and week 8 (n = 232).Co-primary end points were change from baseline to week 16 in Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) Pain (0-10, no to extreme pain), WOMAC

2019 JAMA

48. Fentanyl (Actiq and other brands) and other opioids: risk of increased pain

Fentanyl (Actiq and other brands) and other opioids: risk of increased pain Prescrire IN ENGLISH - Spotlight ''Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain'', 1 July 2019 {1} {1} {1} | | > > > Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight (...) Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain Paradoxically, fentanyl, like other opioids, can exacerbate the pain it is intended to relieve. In 2018, the European Medicines Agency (EMA) reported 16 cases of hyperalgesia (severe pain) in patients taking transmucosal fentanyl. Hyperalgesia is a known adverse effect of opioids. The key symptom is an increase in the intensity of pain felt, an increase associated with the effects of the opioid. It is difficult to distinguish

2019 Prescrire

49. Stimulation of the Gasserian Ganglion for Trigeminal Neuropathic Pain Refractory to Medical Management

Stimulation of the Gasserian Ganglion for Trigeminal Neuropathic Pain Refractory to Medical Management "Stimulation of the Gasserian Ganglion for Trigeminal Neuropathic Pain " by Jessica Smedley < > > > > > Title Author Date of Graduation Summer 8-10-2019 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Trigeminal neuropathic pain (TNP) is an often debilitating facial pain syndrome for which there is no known cure (...) using Clinical Key, MEDLINE-Ovid and Web of Science and the following search terms: trigeminal neuropathic pain, neuromodulation and stimulation. Articles were assessed for quality using GRADE criteria. Results: Two case series studies fit all eligibility criteria. Each utilized a temporary electrode placed for a trial period to assess efficacy and determine candidacy for permanent implantation. One study found that in those with a positive trial, 96.3% at 6 months and 46.7% of patients at 24 months

2019 Pacific University EBM Capstone Project

50. The Effect of Acupuncture on Pain in Inpatient Medicine

The Effect of Acupuncture on Pain in Inpatient Medicine "The Effect of Acupuncture on Pain in Inpatient Medicine" by Jessica Kolahi < > > > > > Title Author Date of Graduation Summer 8-9-2019 Degree Type Thesis Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background : Pain management has become a controversial topic. Opioids, which once held the promise of improving quality of life for millions of Americans, have resulted in an epidemic of addiction (...) . As a result, national organizations are investigating alternative methods to treat pain, including acupuncture. The purpose of this review is to investigate the effect of acupuncture on the general symptom of pain, within the context of the controlled environment of inpatient medicine. Methods : An exhaustive search of MEDLINE-Ovid, CINAHL, and Web of Science was conducted using the search terms acupuncture , inpatient , and pain . Included studies measured pain scores before and after acupuncture

2019 Pacific University EBM Capstone Project

51. Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain

Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain UTCAT3387, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain. Clinical Question In patients experiencing pain from orthodontic tooth movement, what is the drug of choice to relieve pain without the inhibition of orthodontic tooth movement? Clinical Bottom Line (...) Acetaminophen is comparable to systemic NSAIDs in terms of relieving orthodontic pain without the side effects of NSAIDs that could inhibit orthodontic tooth movement. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Fang et al/2016 128 patients undergoing orthodontic treatment Meta-Analysis Key results Throughout five different studies included, celecoxib, acetaminophen, and aspirin were used to determine

2019 UTHSCSA Dental School CAT Library

52. Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review

Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review Acetyl-L-carnitine (ALC) has shown a neuroprotective effect in patients with peripheral neuropathies of different etiologies. Preclinical studies demonstrated a central anti-nociceptive action, both in neuropathic and nociceptive pain models. The present review aims to provide the knowledge on the efficacy of ALC in patients with painful peripheral neuropathy, based on the evidence. Consistent with the PRISMA statement (...) in painful peripheral neuropathy, a meta-analysis of four randomized controlled trials was performed. Mean difference in pain reduction as measured on a 10-cm VAS, and 95% CIs were used for pooling continuous data from each trial. Four randomized controlled trials tested ALC in patients with neuropathy secondary to diabetes and to antiretroviral therapy for HIV. Compared to placebo, ALC produced a significant pain reduction equal to 20.2% (95% CI: 8.3%-32.1%, P<0.0001) with respect to baseline. Clinical

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2019 EvidenceUpdates

53. Intravenous lidocaine in the management of chronic peripheral neuropathic pain: a randomized-controlled trial

Intravenous lidocaine in the management of chronic peripheral neuropathic pain: a randomized-controlled trial Neuropathic pain, resulting from injury to the peripheral or central nervous system, is due to upregulation of aberrant sodium channels with neuronal hyperexcitability. Lidocaine blocks these channels and several studies show that intravenous (IV) lidocaine infusion provides significant relief in patients with chronic peripheral neuropathic pain in the short term (for up to six hours (...) ). Our objective was to determine if IV lidocaine provides significant pain relief and overall improvement in quality of life in the longer term (for up to four weeks).This single site randomized double-blind, crossover trial compared IV lidocaine infusion (5 mg·kg-1) with active placebo infusion containing diphenhydramine (50 mg) in patients with chronic neuropathic pain of peripheral nerve origin of at least six months duration. The primary outcome was average pain intensity reduction from IV

2019 EvidenceUpdates

54. Paravertebral Dexmedetomidine in Video-Assisted Thoracic Surgeries for Acute and Chronic Pain Prevention

Paravertebral Dexmedetomidine in Video-Assisted Thoracic Surgeries for Acute and Chronic Pain Prevention Video-assisted thoracoscopic surgery (VATS) is considered as one of the minimally invasive surgeries. Early postoperative pain alleviation is very important to avoid complications, at the same time, proper early pain control is an established fact to decrease the incidence of chronic pain.To evaluate the efficacy of thoracic paravertebral block (PVB) by a bupivacaine/ dexmedetomidine mixture (...) on acute and chronic post-thoracoscopic surgery pain in patients undergoing VATS.A randomized prospective double-blinded trial.Assiut University Hospitals, Orman Cardiology Hospital.Sixty adult patients underwent elective VATS surgery under general anesthesia randomly allocated into 2 groups; Group I received thoracic PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and Group II received PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and dexmedetomidine (1 mcg/kg). Postoperative pain (at rest, with cough

2019 EvidenceUpdates

55. Multicolumn spinal cord stimulation for predominant back pain in failed back surgery syndrome patients: a multicenter randomized controlled trial

Multicolumn spinal cord stimulation for predominant back pain in failed back surgery syndrome patients: a multicenter randomized controlled trial Despite optimal medical management (OMM), low back pain (LBP) can be disabling, particularly after spinal surgery. Spinal cord stimulation (SCS) is effective in reducing neuropathic leg pain; however, evidence is limited for LBP. This prospective, open-label, parallel-group trial randomized (1:1) failed back surgery syndrome (FBSS) patients (...) with predominant LBP to SCS plus OMM (SCS group) or OMM alone (OMM group) at 28 sites in Europe and the Americas. If trial stimulation was successful, a multicolumn SCS system was implanted. Outcomes were assessed at baseline (before randomization) and at 1, 3, 6, and 12 months after randomization. Patients could change treatment groups at 6 months. The primary outcome was the proportion of patients with ≥50% reduction in LBP (responder) at 6 months. Secondary outcomes included change in pain intensity

2019 EvidenceUpdates

56. Virtual Reality for Pediatric Needle Procedural Pain: Two Randomized Clinical Trials

Virtual Reality for Pediatric Needle Procedural Pain: Two Randomized Clinical Trials To assess the efficacy and safety of a virtual reality distraction for needle pain in 2 common hospital settings: the emergency department (ED) and outpatient pathology (ie, outpatient laboratory). The control was standard of care (SOC) practice.In 2 clinical trials, we randomized children aged 4-11 years undergoing venous needle procedures to virtual reality or SOC at 2 tertiary Australian hospitals (...) . In the first study, we enrolled children in the ED requiring intravenous cannulation or venipuncture. In the second, we enrolled children in outpatient pathology requiring venipuncture. In the ED, 64 children were assigned to virtual reality and 59 to SOC. In pathology, 63 children were assigned to virtual reality and 68 to SOC; 2 children withdrew assent in the SOC arm, leaving 66. The primary endpoint was change from baseline pain between virtual reality and SOC on child-rated Faces Pain Scale-Revised.In

2019 EvidenceUpdates

57. Can a brief psychological expectancy intervention improve postoperative pain? A randomized, controlled trial in patients with breast cancer

Can a brief psychological expectancy intervention improve postoperative pain? A randomized, controlled trial in patients with breast cancer Pain after surgery remains a major health problem, calling for optimized treatment regimens to maximize the efficacy of pharmacological interventions. In this randomized controlled trial, we tested in a routine surgical treatment setting whether postoperative pain can be reduced by a brief preoperative intervention, ie, positive verbal suggestions (...) in combination with sham acupuncture, designed to optimize treatment expectations. We hypothesized that the expectancy intervention as add-on to patient-controlled intravenous analgesia with morphine reduces patient-reported postoperative pain and improves satisfaction with analgesia. Ninety-six women undergoing breast cancer surgery were randomized at 2 stages: Before surgery, anesthesiologists delivered either positive or neutral verbal suggestions regarding the benefits of acupuncture needling

2019 EvidenceUpdates

58. Efficacy and safety of loxoprofen sodium topical patch for the treatment of pain in patients with minor acute traumatic limb injuries in Brazil: a randomized, double-blind, noninferiority trial

Efficacy and safety of loxoprofen sodium topical patch for the treatment of pain in patients with minor acute traumatic limb injuries in Brazil: a randomized, double-blind, noninferiority trial Posttraumatic injury pain is commonly treated with oral nonsteroidal anti-inflammatory drugs. However, oral nonsteroidal anti-inflammatory drugs cause several adverse events, with topical formulations arising as an important alternative. Therefore, we aimed at evaluating the efficacy and safety (...) of loxoprofen patch (LX-P) in the treatment of patients with posttraumatic pain. This phase III, randomized, double-blind, noninferiority study enrolled Brazilian patients aged 18 to 65 years diagnosed with lower and upper limb posttraumatic injury who were experiencing moderate or severe pain. Patients were assigned to active LX-P or to loxoprofen tablet (LX-T), and pain intensity was measured based on a visual analog scale score variation after 7 days of treatment. Data on clinical symptoms, rescue

2019 EvidenceUpdates

59. The Efficacy of a Lateral Wedge Insole for Painful Medial Knee Osteoarthritis After Prescreening: A Randomized Clinical Trial

The Efficacy of a Lateral Wedge Insole for Painful Medial Knee Osteoarthritis After Prescreening: A Randomized Clinical Trial Lateral wedge shoe insoles decrease medial knee loading, but trials have shown no effect on pain in medial knee osteoarthritis (OA). However, loading effects of insoles are inconsistent, and they can increase patellofemoral loading. We undertook this study to investigate the hypothesis that insoles would reduce pain in preselected patients.Among patients with painful (...) medial knee OA, we excluded those with patellofemoral OA and those with a pain rating of <4 of a possible 10. We further excluded participants who, in a gait analysis using lateral wedges, did not show at least a 2% reduction in knee adduction moment (KAM), compared to wearing their shoes and a neutral insole. We then randomized subjects to lateral wedge versus neutral insole for 8-week periods, separated by an 8-week washout. The primary outcome measure was knee pain (0-10 scale) during the past

2019 EvidenceUpdates

60. Analgesic Efficacy and Safety of Intravenous Meloxicam in Subjects With Moderate-to-Severe Pain After Open Abdominal Hysterectomy: A Phase 2 Randomized Clinical Trial

Analgesic Efficacy and Safety of Intravenous Meloxicam in Subjects With Moderate-to-Severe Pain After Open Abdominal Hysterectomy: A Phase 2 Randomized Clinical Trial An intravenous (IV) formulation of meloxicam was developed for moderate-to-severe pain management. This study evaluated the safety and efficacy of meloxicam IV after open abdominal hysterectomy. Meloxicam IV is an investigational product not yet approved by the US Food and Drug Administration.Women (N = 486) with moderate (...) -to-severe pain after open abdominal hysterectomy were enrolled in this multicenter, randomized, double-blind, placebo- and active-controlled trial. Subjects were randomized to receive a single dose of meloxicam IV (5-60 mg), placebo, or morphine (0.15 mg/kg) in ≤6 hours after morphine dosing on postoperative day 1 and were evaluated for 24 hours. Rescue morphine (≈0.15 mg/kg IV) was available if needed for pain not relieved by the study medication. In an open-label extension (N = 295), meloxicam IV

2019 EvidenceUpdates