BACKGROUND AND OBJECTIVES: Most adults have several low back pain episodes during their lives. Ozone therapy is a minimally invasive method able to promote analgesia for most patients, with few reports of complications. This study aimed at reviewing the literature on the use of ozone therapy to treat low back pain and lumbosciatic pain. CONTENTS: Virtual Health Library was searched using the following keywords: ozone, therapy, pain, back, lumbodynia. Search sources included: LILACS, Medline, Cochrane, Pubmed, Ibecs and scientific journals, looking for articles originally published in English, Spanish and Portuguese in recent years. Fifty-four articles were selected. Two were randomized multicenter studies, four were systematic reviews, one was a meta-analysis with more than 8 thousand patients from different centers, one was a national Italian consensus, many were double-blind studies, some had control groups and many were observational studies. The level of evidence to support a stronger recommendation is still low (II-3 for intradiscal administration and II-1 for paravertebral or intraforaminal muscular administration), however this scenario seems to be dynamic with a trend toward the indication of ozone therapy. CONCLUSION: Ozone therapy was effective to treat low back pain with our without sciatic pain, being associated to few adverse events.
BACKGROUND AND OBJECTIVES:Ideal models should reproduce just sensory deficits, such as alodynia, hyperalgesia and spontaneous pain for short periods. There are different types of animal models to evaluate different neuropathic pain etiologies and manifestations. Some models study neuropathic pain peripheral mechanisms and other study its central mechanisms. This review focuses on animal models most commonly used for neuropathic pain research. CONTENTS: Animal models based on peripheral nerves ligation which are more commonly used are described. From all models described in this review, spared nerve injury is that producing more reproducible behavioral abnormalities for a longer period, while chronic sciatic nerve compression produces behavioral signs of less predictable painful neuropathies. Spinal hemisection and cytokines-induced spinal injury are the models of choice for the study of central pain mechanisms. Other specific models are used for the study of the specific etiology of pain. CONCLUSION: Since neuropathic pain is multifactorial, different neuropathic pain animal models were developed throughout the years, which have been critical for the study of neuropathic pain, since much of current knowledge comes from studies with rats and mice. Current animal models need to be further refined and more efforts should be made to determine which animal models may be more predictive, with less biases and more complex and objective analysis parameters. Keywords: Experimental models of neuropathic pain, Neuropathic pain. RESUMO JUSTIFICATIVA E OBJETIVOS:Os modelos ideais deveriam reproduzir apenas déficits sensitivos, como alodínea, hiperalgesia e dor espontânea por curtos períodos de tempo. Existem diversos tipos de modelos animais, que avaliam as diversas etiologias e manifestações da dor neuropática. Alguns modelos estudam os mecanismos periféricos e outros estudam mecanismos centrais da dor neuropática. Esta revisão enfoca os modelos animais mais comumente utilizados para pesquisa em dor neuropática. CONTEÚDO: São descritos modelos animais baseados em ligadura de nervos periféricos que são mais comumente empregados. De todos os modelos descritos nesta revisão, a lesão poupadora de nervo é aquela que produz anormalidades comportamentais mais reprodutíveis, por um período mais longo, ao passo que a constrição crônica do ciático produz sinais comportamentais de neuropatia dolorosas menos previsíveis. Hemisecção espinhal e lesão espinhal induzida por citocinas são os modelos de escolha para estudar mecanismos de dor central. Outros modelos específicos são utilizados para estudo da etiologia específica da condição dolorosa. CONCLUSÃO: Como a dor neuropática é multifatorial, diferentes modelos animais de dor neuropática foram desenvolvidos ao longo dos anos que têm sido fundamentais para o estudo da dor neuropática, uma vez que muito do conheci-© Sociedade Brasileira para o Estudo da Dor mento atual provém de estudos em ratos e camundongos. São necessários maiores refinamentos nos modelos animais atualmente empregados ...
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