Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis

Enke, Oliver; New, Heather A.; New, Charles H; Mathieson, Stephanie; McLachlan, Andrew J.; Latimer, Jane; Maher, Christopher G.; Lin, Chung‐Wei Christine

doi:10.1503/cmaj.171333

Cited by 147 publications

(118 citation statements)

References 32 publications

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“…This led to a marked increase in the use of pregabalin in many countries . Subsequently we have learnt that pregabalin is ineffective for sciatica and low back pain, but is associated with serious harms including death and dependence …”

Section: Overdefinitionmentioning

confidence: 99%

Musculoskeletal healthcare: Have we over‐egged the pudding?

et al. 2019

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The phrase "to over-egg the pudding" is a terrific analogy for what is now increasingly common in health care: medical overuse. Cooks would know that if you skimp with the eggs a pudding won't hold together and if you use too many eggs the pudding will go rubbery.And in musculoskeletal health care we also need to get the balance right. People's health can suffer when they receive too little health care and also if they receive too much health care.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Overdefinitionmentioning

confidence: 99%

Musculoskeletal healthcare: Have we over‐egged the pudding?

et al. 2019

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“…Nearly 80% of people will suffer from low back pain in their own life span [3]. Drug therapy (Non-steroidal anti-inflammatory drugs or pregabalin), vertebrectomy and decompression can alleviate the low back pain [4,5]. However, recurrent pain and disc degeneration of adjacent segments were the weakness of these two therapies [6].…”

Section: Introductionmentioning

confidence: 99%

Knockdown of miR-660 protects nucleus pulposus cells from TNF-a-induced apoptosis by targeting serum amyloid A1

et al. 2020

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Background: Intervertebral disc degeneration (IVDD) is a well-known cause of lower back pain, which is induced by multiple factors including increased apoptosis and decreased survival of nucleus pulposus cells. In this study, we evaluate the effect and potential mechanism of miR-660 on the nucleus pulposus cells apoptosis induced by TNF-α. Methods: First, we collected tissue of nucleus pulposus from IVDD and healthy controls. General characteristic of the IVDD and healthy control was also collected. And, we also collected nucleus pulposus cells that stimulated by TNF-α or control. miRNA microarray was performed to identify the differentially expressed miRNAs. Apoptosis rate and miR-660 relative expression was measured after stimulated with different concentration of TNF-α to identify the optimal concentration of TNF-α. Second, we successfully constructed antigomiR-660 to block the miR-660 expression in nucleus pulposus cells and then stimulated with TNF-α (100 ng/ml, 12 h). The apoptosis rates and relative protein expression were then measured again. The target association between miR-660 and SAA1 was confirmed by dual-luciferase reporter. Results: There was no significant difference between the age (IVDD: 39 ± 10 years, healthy controls: 36 ± 7 years), BMI and sex between IVDD and healthy controls. Microarray analysis found that miR-660 was significantly upregulated in IVDD and TNF-α treated groups, which was further identified by PCR. We found that the rate of apoptosis and miR-660 expression increased with TNF-α concentration increased. Finally, TNF-a with 100 ng/ml was used for further experiment. Compared with TNF-α group, TNF-α + antigomiR-660 could significantly downregulated the apoptosis rate and relative protein (c-Caspase3 and c-Caspase7). Dual-luciferase reporter revealed that miR-660 could directly binding to the SAA1 at 80-87 sites. Compared with TNF-α alone group, TNF-α + antigomiR-660 significantly up-regulated the SAA1 expression (P < 0.05). Conclusion: These results indicated that knockdown of miR-660 protected the nucleus pulposus from apoptosis that induced TNF-α via up-regulation of SAA1. Further studies should focus on the role of miR-660 in protecting IVDD in vivo.

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“…Bununla birlikte bel ağrısı veya radiküler bel ağrısında etkinlik ve güvenlik açısında yeterli kanıt yoktur. Son 10 yılda bel ve boyun ağrılarının tedavisinde antikonvulzan ilaç kullanımı yüksek oranda bir artış gözlenmiştir [21]. Çalışmamızda takip ettiğimiz hastaların %90'ı kronik bel ağrısı olmasına rağmen literatürden farklı olarak mekanik bel ağrısı nedeniyle takip ettiğimiz hastaların sadece %10.4'üne nöropatik komponent varlığı nedeniyle pregabalin/gabapentin grubu ilaç tedavisi başlandığı gözlenmiştir.…”

Section: Discussionunclassified

Bel Ağrılı Hastalarımızın Değerlendirilmesi

Özgen¹

2019

Osmangazi̇ Journal of Medicine

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Özet: Bel ağrısı toplumda en sık poliklinik başvuru nedenlerinden birisidir. Bel ağrılarının büyük kısmını mekanik bel ağrıları oluşturur. Çalışmamızın amacı; kliniğimize bel ağrısı nedeniyle başvuran hastaların sıklığının, mekanik/inflamatuvar bel ağrısı yönünden dağılımının ve tedavi yaklaşımının değerlendirilmesidir. Polikliniğimize 2016-2017 yılları arasında bel ağrısı nedeniyle başvuran hastalar geriye dönük tarandı. Hastaların demografik ve klinik bilgileri dosya kayıtlarından elde edildi. Polikliniğimize 1398 (%7.5) hastanın bel ağrısı nedeniyle başvurduğu, hastaların 67 (%4.79)'sinde inflamatuvar bel ağrısı, 1331 (%95.27)'inde mekanik bel ağrısı olduğu saptandı. Hastaların yaş ortalaması mekanik bel ağrısı grubunda 50.2 ± 16.09, inflamatuvar bel ağrısı grubunda 41.8 ± 11.1'di. Hastaların 841(%60.1)'i kadın, 557 (%39.8)'si erkekti. Mekanik bel ağrısı olanların 829 (%62.3)'u kadın ve 502 (%37.7)'si erkek, inflamatuvar bel ağrısı olanların 12 (%17.9)'si kadın ve 55 (%82.1)'ü erkekti. Hastaların 136 (%10.2)'sı akut/subakut, 1195 (%89,9)'i kronik bel ağrısına sahipti. Nöropatik ağrı varlığı nedeniyle hastaların 138 (%10.4)'i tedavi alıyordu. Bel ağrıları toplumda sık görülür. Bel ağrısı nedenlerinin büyük kısmını mekanik bel ağrıları oluşturur. Üçüncü basamak sağlık kuruluşlarına kronik bel ağrılı hastalar daha fazla başvurur. Bel ağrısı yaşam kalitesi ve iş gücü kaybına neden olur. Bu nedenle ayrıcı tanısının yapılması, tedavisinin planlanmasının ve koruyucu önlemlerinin alınmasının önemli olduğu sonucuna varılmıştır.Anahtar Kelimeler: bel ağrısı, sıklık Abstract: One of the most common complaints in clinics is low back pain. These pain is usually caused by mechanical disorders. The aim of this study is to determine the prevalence of patients with low back pain and to evaluate the distribution and treatment of mechanical / inflammatory back pain. Patients who applied to our outpatient clinic with low back pain between Ocak 2016-Aralık 2017 were screened retrospectively. The demographic and clinical information of the patients were obtained from the file records. In our polyclinic, 1398 (7.5%) patients presented with low back pain. Inflamatuar back pain was seen 67 (4.79%) of the patients and mechanical back pain was seen 1331 (95.27%) of the patients. The mean age of the mechanical back pain patients was 50.2 ± 16.09 and 41.8 ± 11.1 of the inflammatory back pain patients. All the patients who presented to polyclinic, 841 (60.1%) were female and 557 (39.8%) were male. Patients who had mechanical back pain, 829 (62.3%) were female and 502 (37.7%) were male; patients who had inflamatuar back pain, 12 (17.9%) were female and 55 (82.1%) were male .Acute / subacute and chronic low back pain rates respectevely 136 (10.2%) and 1195 (89.9%). Because of the neuropathic pain presence, 138 (10.4%) of the patients were receiving pregabalin /gabapentin treatment. Low back pain is common in the community. Although acute low back pain is more common, tertiary health care institutions mostly are got application by patients wi...

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Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis

Cited by 147 publications

References 32 publications

Musculoskeletal healthcare: Have we over‐egged the pudding?

Musculoskeletal healthcare: Have we over‐egged the pudding?

Knockdown of miR-660 protects nucleus pulposus cells from TNF-a-induced apoptosis by targeting serum amyloid A1

Bel Ağrılı Hastalarımızın Değerlendirilmesi

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