Background: Magnesium (Mg) is commonly used in clinical practice for acute and chronic pain and has been reported to reduce pain intensity and analgesics consumption in a number of studies. Results are, however, contested. Objectives: This review aims to investigate randomised clinical trials (RCTs) on the effectiveness of Mg treatment on pain and analgesics consumption in situations including post-operative pain, migraine, renal pain, chronic pain, neuropathic pain and fibromyalgia. Results: The literature search identified 81 RCTs (n = 5447 patients) on Mg treatment in pain (50 RCTs in post-operative pain, 18 RCTs in migraine, 5 RCTs in renal pain, 6 RCTs in chronic/neuropathic pain, 2 RCTs in fibromyalgia). Conclusion: The level of evidence for the efficacy of Mg in reducing pain and analgesics consumption is globally modest and studies are not very numerous in chronic pain. A number of gaps have been identified in the literature that need to be addressed especially in methodology, rheumatic disease, and cancer. Additional clinical trials are needed to achieve a sufficient level of evidence and to better optimize the use of Mg for pain and pain comorbidities in order to improve the quality of life of patients who are in pain.

Objective Pain evaluation scales often rely on the sense of sight. There is so far no pain assessment scale specifically designed for persons with visual impairment. Design This study aims to validate a tactile pain evaluation scale, Visiodol©, in blind/visually impaired persons, by correlation with a numeric pain scale (NPS). Setting The study took place in University Hospital Clermont-Fd, France Methods Pain intensity for a range of thermal stimuli (Pathway Medoc®) was evaluated with Visiodol© and NPS; secondary outcomes including pain thresholds, catastrophizing, emotion and quality of life were compared in blind/visually impaired and sighted persons. Lin’s concordance correlation coefficient was estimated; weighted Cohen κ accounted for degrees of disagreement between scales with 95% confidence interval (95%CI). Subjects 21 healthy sighted and 21 healthy non-sighted volunteers (n = 13 congenital, n = 8 acquired) were included. Results Lin’s correlation coefficient for repeated data was 0.967 (95%CI, 0.956; 0.978; P < 0.001) for visually impaired participants with a good agreement at each temperature plateau. Weighted Cohen κ of 0.90 (95% CI, 0.84–0.92) and 92.9% percentage of agreement for visually impaired participants was satisfactory. Pain perception, psychological components and quality of life were more impaired in blind/visually impaired persons than in sighted persons. Conclusions This study validates Visiodol©, a tactile scale for blind/visually impaired persons and addresses healthcare inequalities in the context of pain evaluation. It will now be tested on a larger population of patients in order to give the millions of blind/visually impaired persons worldwide, an option for pain intensity evaluation in clinical situations.

Background: Persons with severe intellectual disabilities often live in specialised care settings and suffer from comorbidities, some of them generating pain. The literature concerning pain assessment and management in this population is however limited. The main objective of this study was to determine the modalities of pain care in a sample of French institutions. Methods: This observational study focused on the modalities of pain assessment and management in six specialised care settings for persons with intellectual and/or psychomotor disabilities. Information about patients, pain evaluation, prevalence and how do healthcare professionals assess pain in noncommunicating intellectually disabled people was recorded. Results: The study included 218 residents and over the last month, 55% had pain, 87% suffered from acute pain and 16% from neuropathic pain. The use of pain scales for patients with communication impairment was unknown to the majority of healthcare professionals. Patients were prescribed 4 drugs a day, 68% had psychotropic drugs and over the last month, 98% of painful residents had received a non-opioid analgesic combined with a non-pharmacological technique in 78 % of them. Conclusion: Pain management must be carried out through accurate pain assessment and the limited knowledge of caregivers about pain assessment methods might contribute to insufficient pain care. It is necessary to train all caregivers about pain evaluation tools that must be adapted to the disability profile of the residents in order to provide the most effective assessment and treatment in these vulnerable patients.