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Titolo:
Pharmacologic pain treatment of musculoskeletal disorders: Current perspectives and future prospects
Autore:
Curatolo, M; Bogduk, N;
Indirizzi:
Univ Hosp Bern, Dept Anesthesiol, Div Pain Therapy, CH-3010 Bern, Switzerland Univ Hosp Bern Bern Switzerland CH-3010 erapy, CH-3010 Bern, Switzerland Univ Newcastle, Bone & Joint Inst, Newcastle, NSW 2308, Australia Univ Newcastle Newcastle NSW Australia 2308 ewcastle, NSW 2308, Australia
Titolo Testata:
CLINICAL JOURNAL OF PAIN
fascicolo: 1, volume: 17, anno: 2001,
pagine: 25 - 32
SICI:
0749-8047(200103)17:1<25:PPTOMD>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-BACK-PAIN; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RANDOMIZED CLINICAL-TRIALS; PLACEBO-CONTROLLED TRIAL; HEALTH-CARE UTILIZATION; DIRECT SEARCH PROCEDURE; DOUBLE-BLIND; CORTICOSTEROID INJECTIONS; LATERAL EPICONDYLITIS; EPIDURAL INJECTIONS;
Keywords:
drug therapy; musculoskeletal pain;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
86
Recensione:
Indirizzi per estratti:
Indirizzo: Curatolo, M Inselspital Bern, Dept Anesthesiol, Div Pain Therapy, CH-3010 Bern, Switzerland Inselspital Bern Bern Switzerland CH-3010 Bern, Switzerland
Citazione:
M. Curatolo e N. Bogduk, "Pharmacologic pain treatment of musculoskeletal disorders: Current perspectives and future prospects", CLIN J PAIN, 17(1), 2001, pp. 25-32

Abstract

Objective: The authors aimed to provide an educational update on the current evidence of the effectiveness of drug therapy in the treatment of musculoskeletal pain and to offer a perspective of possible future developments. Design: The authors used a pragmatic review of data provided by available systematic reviews and seminal controlled studies pertaining to the treatment of regional musculoskeletal pain problems. Results: Epidural steroids may offer limited, short-term benefit for sciatica. Local injections of steroids are either ineffective or provide short-lasting benefits. Nonsteroidal anti-inflammatory drugs and opioids reduce pain, but the effect size is modest. The literature does not support convincingly the use of antidepressants. Certain muscle relaxants may be useful in the treatment of back pain. Hyaluronic acid, neutraceutical agents, avocado-soybean unsaponifiable agents, oxaceprol and diacerein may be effective inthe treatment of osteoarthritis, but the information regarding these new agents does not allow wholesale endorsement of these substances. Selective epidural injection of steroids at a target nerve root approached through theintervertebral foramin has the potential to replace the traditional epidural approach. Long-acting, C-fiber-specific local anesthetics are under investigation and could provide long-lasting pain relief without motor or sensory impairment. In the future, central hypersensitivity in chronic musculoskeletal pain might be treated using antagonists of the N-methyl-D-aspartate receptor. Cannabinoid agents produce antinociception and prevent experimentally induced hyperalgesia in animals, and they may find a role in pain management. Methods to optimize drug combinations are available. Conclusions: The effectiveness of the currently available drugs in the treatment of musculoskeletal pain conditions is disappointing. Recent developments may open new perspectives in this area of pain medicine.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/04/20 alle ore 15:59:51