Acute Pain Medicine: Show Me the Data

Dietary Ingredients as an Alternative Approach for Mitigating Chronic Musculoskeletal Pain: Evidence-Based Recommendations for Practice and Research in the Military

“…Alternative approaches are needed. In 2014, a Pain Medicine supplement [9] detailing the current evidence on what the authors termed active self-care complementary and integrative (ACT-CIM) modalities was published in response to the Army’s 2010 Pain Management Task Force Report recommendations [3] and the 2011 Institute of Medicine’s report “Relieving Pain in America” [2]. Additional recommendations for use of such therapies (e.g., yoga, tai chi, music therapy) and future research considerations were made for the military that are also generalizable to the general population.…”

“…In fact, although approximately 70–74% of the general adult population and 55–76% of Service members use dietary supplements [11,12], most individuals typically decide which supplements to use based on advice from both reliable and unreliable sources. The evidence supporting the outweighing of benefits over any potential harms across dietary supplements for pain management is unclear [1, 9,10,13]. Though supplements may be perceived to have fewer adverse events than conventional treatments, the safety of many products is unknown, and many have not been assessed for safety or efficacy, or prepared according to Good Manufacturing Processes [14].…”

“…A large number of dietary and herbal supplements may even contain various toxins because they do not undergo standard regulatory and quality control [15,16]. Because dietary ingredients could potentially be a promising self-care intervention [9,10], it is important to clearly determine their safety and efficacy for pain management and how ingredients might impact not only pain, but also other related (e.g., psychological health, quality of life) outcomes. If such products are going to be used for mitigating MSK pain, evidence-based research is required to inform appropriate and safe decisions about the available ingredients.…”

Conditional Recommendations for Specific Dietary Ingredients as an Approach to Chronic Musculoskeletal Pain: Evidence-Based Decision Aid for Health Care Providers, Participants, and Policy Makers

“…Dietary supplement use for a wide range of conditions, including pain, has become increasingly popular, with about 70–74% of the general adult population and 55–76% of Service members using dietary supplements for various reasons [5,6]. Despite their popularity, evidence for their use is unclear [7–10], and decisions to use these supplements may be driven by information that is not evidence-based (e.g., advice from peers, family members, and other sources). It is imperative that evidence-based research be used to inform decisions regarding such use to ensure safe and effective management of MSK pain.…”