Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study

Koçak, Abdullah Osman; Ahişkalıoğlu, Ali; Sengun, Emre; Gür, Sultan Tuna Akgöl; Akbaş, İlker

doi:10.1016/j.ajem.2019.01.015

Cited by 31 publications

(21 citation statements)

References 27 publications

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“…Local preferred to saline alone. Kocak et al 440 RCT 54 VAS I-A Comparing NSAID and TPI for low back MPS; TPI was superior to NSAIDs when assessed with pain relief within the first hour of intervention. Mitidieri et al 50 RCT 35 VAS, NCS, MPQ I-A Comparing acupuncture to TPI for pelvic pain from abdominal MPS, no difference seen between outcomes when analyzed at 1 week, 1 month, 3 months, and 6 months out except for MPQ differences at 1 week.…”

Section: Injection Therapymentioning

confidence: 99%

The American Society of Pain and Neuroscience (ASPN) Evidence-Based Clinical Guideline of Interventional Treatments for Low Back Pain

Sayed¹,

Grider²,

Strand³

et al. 2022

JPR

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Introduction Painful lumbar spinal disorders represent a leading cause of disability in the US and worldwide. Interventional treatments for lumbar disorders are an effective treatment for the pain and disability from low back pain. Although many established and emerging interventional procedures are currently available, there exists a need for a defined guideline for their appropriateness, effectiveness, and safety. Objective The ASPN Back Guideline was developed to provide clinicians the most comprehensive review of interventional treatments for lower back disorders. Clinicians should utilize the ASPN Back Guideline to evaluate the quality of the literature, safety, and efficacy of interventional treatments for lower back disorders. Methods The American Society of Pain and Neuroscience (ASPN) identified an educational need for a comprehensive clinical guideline to provide evidence-based recommendations. Experts from the fields of Anesthesiology, Physiatry, Neurology, Neurosurgery, Radiology, and Pain Psychology developed the ASPN Back Guideline. The world literature in English was searched using Medline, EMBASE, Cochrane CENTRAL, BioMed Central, Web of Science, Google Scholar, PubMed, Current Contents Connect, Scopus, and meeting abstracts to identify and compile the evidence (per section) for back-related pain. Search words were selected based upon the section represented. Identified peer-reviewed literature was critiqued using United States Preventive Services Task Force (USPSTF) criteria and consensus points are presented. Results After a comprehensive review and analysis of the available evidence, the ASPN Back Guideline group was able to rate the literature and provide therapy grades to each of the most commonly available interventional treatments for low back pain. Conclusion The ASPN Back Guideline represents the first comprehensive analysis and grading of the existing and emerging interventional treatments available for low back pain. This will be a living document which will be periodically updated to the current standard of care based on the available evidence within peer-reviewed literature.

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Section: Injection Therapymentioning

confidence: 99%

The American Society of Pain and Neuroscience (ASPN) Evidence-Based Clinical Guideline of Interventional Treatments for Low Back Pain

Sayed¹,

Grider²,

Strand³

et al. 2022

JPR

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“… 31 We have clinical experience with mesotherapy and trigger point injection applications in patients with pain related to different health conditions. 12 , 14 , 38 Our mesotherapy treatment mixture can be intradermally injected without complication, based on our previous clinical experience. 12 , 14 …”

Section: Discussionmentioning

confidence: 99%

Intradermal mesotherapy versus intravenous dexketoprofen for the treatment of migraine headache without aura: a randomized controlled trial

Akbaş

Koçak²,

Koçak

et al. 2021

Ann Saudi Med

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BACKGROUND: Migraine is a prevalent disabling primary headache disorder that is classified into two major types: migraine without aura and migraine with aura. New therapeutic methods to reduce migraine headaches in the emergency department (ED) include intradermal mesotherapy. OBJECTIVE: Compare the efficacy of intradermal mesotherapy versus a systemic therapy in pain control in patients with headache related to migraine without aura. DESIGN: Prospective parallel-group randomized controlled trial. SETTING: University hospital in Turkey. PATIENTS AND METHODS: Patients 18 years of age and older who were admitted to the ED over a 15-month period with headache related to migraine without aura were eligible for inclusion if they had a VAS score of 4 or above. Patients were randomly allocated to one session of mesotherapy or intravenous dexketoprofen. Changes in pain intensity were measured by the score on a visual analog scale (VAS) at 30, 60, and 120 minutes and 24 hours after treatment. Efficacy was also assessed by the need for use of an analgesic drug within 24 hours, by readmission with the same complaint to the ED within 72 hours, and by adverse effect rates. MAIN OUTCOME MEASURE: Pain intensity on the VAS scale. SAMPLE SIZE: 148 patients (154 enrolled and treated; 1 patient in the mesotherapy and 5 patients in the systemic therapy group lost to follow up). RESULTS: Pain intensity on the VAS scale decreased from a median score of 8 to 4 in the mesotherapy group and from 8 to 5 in the systemic therapy group. These differences were statistically significant from baseline for all time intervals ( P =.001 to 30 minutes, P =.004 to 60 minutes, P =.005 to 120 minutes, and P =.002 to 24 hours). The need to use analgesics and the rate of readmission to the ED were higher in the systemic therapy group ( P =.013 and P =.030, respectively). Adverse effect rates were minimal and similar in the study groups during the one-week follow-up period. CONCLUSIONS: Mesotherapy is more efficacious than intravenous dexketoprofen in the management of acute attack of migraine without aura in the ED. LIMITATIONS: Unblinded. Valid for assessing short-term pain relief, but not sufficient to predict long-term efficacy. Not generalizable because single center and small sample size. CONFLICT OF INTEREST: None. REGISTRATION: ClinicalTrials.gov (NCT04519346)

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“…1 (These outcomes were based on earlier determinations of the minimal clinically important difference. 7,8 ) Additionally, capsaicin was more effective than piroxicam at each time interval. This difference was most pronounced at 72 hours, with a mean difference of delta VAS scores of 1.53 (95% CI, 0.85-2.221) and a mean percentage of the reduction in VAS scores of 19.7% (95% CI, 12.4%-27.2%) (P < .001).…”

Section: Topical Capsaicin Is An Effective Alternative To a Topical N...mentioning

confidence: 98%

Time to consider topical capsaicin for acute trauma pain?

Cleary¹

2022

The Journal of Family Practice

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Topical capsaicin is more effective than topical piroxicam at reducing pain in acute upper extremity injuries. PRACTICE CHANGERUse topical capsaicin gel 0.05% for pain reduction in patients with isolated blunt injuries of the upper extremity without fracture. STRENGTH OF RECOMMENDATIONB: Based on a single randomized controlled trial (RCT) 1 Kocak AO, Dogruyol S, Akbas I, et al. Comparison of topical capsaicin and topical piroxicam in the treatment of acute trauma-induced pain: a randomized double-blind trial.

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Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study

Cited by 31 publications

References 27 publications

The American Society of Pain and Neuroscience (ASPN) Evidence-Based Clinical Guideline of Interventional Treatments for Low Back Pain

The American Society of Pain and Neuroscience (ASPN) Evidence-Based Clinical Guideline of Interventional Treatments for Low Back Pain

Intradermal mesotherapy versus intravenous dexketoprofen for the treatment of migraine headache without aura: a randomized controlled trial

Time to consider topical capsaicin for acute trauma pain?

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