Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON Project

Peloso, Paul M.; Khan, Mahweesh; Gross, Anita; Carlesso, Lisa C.; Santaguida, Lina; Lowcock, Janet; MacDermid, Joy C.; Walton, Dave; Goldsmith, Charlie H.; Langevin, Pierre; Shi, Qiyun

doi:10.2174/1874325001307010473

Cited by 16 publications

(14 citation statements)

References 97 publications

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“…In the ICON review [16] the authors found low quality evidence to support the use of IM-lidocaine for chronic MND, and epidural methylprednisolone with lidocaine injection for radiculopathy. There was a lack of evidence for the effectiveness of different types of corticosteroids and local anaesthetics.…”

Section: Discussionmentioning

confidence: 99%

“…A 2011 systematic review on botolinum toxin (BoNT) for subacute/chronic neck pain was updated [15] (search end date 2010) and the conclusions were consistent with an International Collaboration on Neck (ICON) overview of systematic reviews on medicines and injections for neck pain [16] in suggesting that there is evidence against the use of BoNT-A for chronic neck pain or subacute/chronic whiplash. Further the ICON review of systematic reviews gave evidence against medial branch block with steroids for chronic facet joint pain, but for the use of eperison hydrochloride for chronic neck pain.…”

Section: Introductionmentioning

confidence: 88%

“…Further the ICON review of systematic reviews gave evidence against medial branch block with steroids for chronic facet joint pain, but for the use of eperison hydrochloride for chronic neck pain. In the Peloso 2012 [16] review of reviews it was noted that the search update for lidocaine and epidural ended in 2008 while the searches for steroids, nerve blocks and insufflation ended in 2006. During this 6 year gap additional trials have been published on medicinal injections for neck pain; therefore, an update literature search was warranted.…”

Section: Introductionmentioning

confidence: 99%

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Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

Gross

Peloso²,

Galway³

et al. 2013

TOORTHJ

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Background: Controversy persists regarding medicinal injections for mechanical neck disorders (MNDs).Objectives: To determine the effectiveness of physician-delivered injections on pain, function/disability, quality of life, global perceived effect and patient satisfaction for adults with MNDs.Search Methods: We updated our previous searches of CENTRAL, MEDLINE and EMBASE from December 2006 through to March 2012.Selection Criteria: We included randomized controlled trials of adults with neck disorders treated by physician-delivered injection therapies.Data Collection and Analysis: Two authors independently selected articles, abstracted data and assessed methodological quality. When clinical heterogeneity was absent, we combined studies using random-effects models.Results: We included 12 trials (667 participants). No high or moderate quality studies were found with evidence of benefit over control. Moderate quality evidence suggests little or no difference in pain or function/disability between nerve block injection of steroid and bupivacaine vs bupivacaine alone at short, intermediate and long-term for chronic neck pain. We found limited very low quality evidence of an effect on pain with intramuscular lidocaine vs control for chronic myofascial neck pain. Two low quality studies showed an effect on pain with anaesthetic nerve block vs saline immediately post treatment and in the short-term. All other studies were of low or very low quality with no evidence of benefit over controls.Authors' Conclusions: Current evidence does not confirm the effectiveness of IM-lidocaine injection for chronic mechanical neck pain nor anaesthetic nerve block for cervicogenic headache. There is moderate evidence of no benefit for steroid blocks vs controls for mechanical neck pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

Gross

Peloso²,

Galway³

et al. 2013

TOORTHJ

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“…Since the majority of new cases of neck pain can be managed with a stay active approach, and a substantial minority are at risk of transitioning into adverse outcomes, it is essential that appropriate management include selection and timing. While systematic reviews and overviews published in this special issue indicate a wealth of evidence [12-16], that information is imperfect and poorly implemented. Neck pain interventions typically demonstrate small to modest effects, with neck pain successfully rehabilitated in comparison to other orthopedic disorders [17].…”

Section: The Knowledge To Action Gapmentioning

confidence: 99%

Knowledge Translation Tools are Emerging to Move Neck Pain Research into Practice

MacDermid

Miller²,

Gross³

2013

TOORTHJ

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Development or synthesis of the best clinical research is in itself insufficient to change practice. Knowledge translation (KT) is an emerging field focused on moving knowledge into practice, which is a non-linear, dynamic process that involves knowledge synthesis, transfer, adoption, implementation, and sustained use. Successful implementation requires using KT strategies based on theory, evidence, and best practice, including tools and processes that engage knowledge developers and knowledge users. Tools can provide instrumental help in implementing evidence. A variety of theoretical frameworks underlie KT and provide guidance on how tools should be developed or implemented. A taxonomy that outlines different purposes for engaging in KT and target audiences can also be useful in developing or implementing tools. Theoretical frameworks that underlie KT typically take different perspectives on KT with differential focus on the characteristics of the knowledge, knowledge users, context/environment, or the cognitive and social processes that are involved in change. Knowledge users include consumers, clinicians, and policymakers. A variety of KT tools have supporting evidence, including: clinical practice guidelines, patient decision aids, and evidence summaries or toolkits. Exemplars are provided of two KT tools to implement best practice in management of neck pain—a clinician implementation guide (toolkit) and a patient decision aid. KT frameworks, taxonomies, clinical expertise, and evidence must be integrated to develop clinical tools that implement best evidence in the management of neck pain.

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“…Nonsteroidal antiinflammatory drugs (NSAIDs) could relieve pain as firstline agents in acute settings [7]. The efficacy of ibuprofen in the treatment of cervical nerve root pain has also been reported [8], but it can only relieve pain and has no effect on the other symptoms of CSR.…”

Section: Introductionmentioning

confidence: 99%

Thunder-fire moxibustion for cervical spondylotic radiculopathy: Study protocol for a randomized controlled trial

Huang

Zhang

Xiong

et al. 2020

Trials

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Background: Thunder-fire moxibustion originated in China and contains traditional Chinese medicine. It can produce strong firepower, infrared thermal radiation, and medicinal effects when burning on the acupoints. Thunder-fire moxibustion is commonly used in patients with neck pain, but its efficacy has rarely been systematically demonstrated. We designed a randomized trial of thunder-fire moxibustion on cervical spondylotic radiculopathy (CSR) to investigate whether it is more effective than ibuprofen sustained-release capsules. Methods: One hundred patients will be recruited and randomly divided into thunder-fire moxibustion and ibuprofen groups. The intervention consists of ten treatments and will last for 2 weeks. The Yasuhisa Tanaka 20 Score Scale is used as the primary outcome measure. It contains a combination of the self-conscious symptom in patients, objective clinical evaluation from doctors, and social evaluation (the ability to work and live). The objective and comprehensive evaluation of CSR patients before and after treatment is particularly needed. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Neck Disability Index score scale (NDI), and the Quality of Life Assessment (SF-36) are applied as secondary outcome measures. The assessment will take place at the baseline and the first and second weekends of treatment. If an adverse event (AEs) occurs, it will be reported. Discussion: The aim of this trial is to determine whether thunder-fire moxibustion is more effective than ibuprofen in the treatment of patients with CSR.

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Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON Project

Cited by 16 publications

References 97 publications

Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

Knowledge Translation Tools are Emerging to Move Neck Pain Research into Practice

Thunder-fire moxibustion for cervical spondylotic radiculopathy: Study protocol for a randomized controlled trial

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