Systemic Review on the Use of Diclofenac/B Complex as an Anti-Inflammatory Treatment with Pain Relief Effect for Patients with Acute Lower Back Pain

Márquez, Maribel Ortiz; Guzman, Silvia

doi:10.4172/2167-0846.1000216

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Сочетанная терапия НПВП и витаминами группы В способствует быстрейшему купированию болевого синдрома и пролонгирует положительный эффект [51,58,59]. Одновременное применение с анальгетиками и НПВП сокращает сроки лечения и уменьшает потребность в дополнительном использовании обезболивающих препаратов [59][60][61][62][63].…”

Section: комбинирование нейротропных витаминовunclassified

Neurotropic B vitamins effects: overview

Vertkin,

Knorring,

Aliev

2023

Russian Medical Inquiry

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The importance of pain syndromes is obvious not only medically but also socially. Dissatisfaction with the pain relief efficacy, a variety of pathogenetic mechanisms dictate the need to search for new and/or additional analgesics. Previously, the role of neurotropic B vitamins, potentiating analgesic therapy, and having their base potential, including additional effects, was convincingly shown. However, the role of vitamins in this group turned out to be much more important and covers a wide range of vital aspects of the body functioning as a whole and the nervous system in particular. The article considers the importance of vitamins in the following: ensuring the energy metabolism of nervous tissue, regulation of neurons key processes, key neurotransmitters metabolism, structural components, as well as removal of neurotoxic substances. The article also emphasizes synergistic, cooperative effect of these vitamins, as well as it describes their role in the normal state and in the pathology development, including those mediated by vitamin deficiencies. The available data on the use of the entire B vitamins palette, both experimental and clinical, in the treatment of pain syndromes, pathology of the central and peripheral nervous system is analyzed. KEYWORDS: pain, nervous system, neurodegeneration, B vitamins, thiamine, riboflavin, pyridoxine, folic acid, cyanocobalamin. FOR CITATION: Vertkin A.L., Knorring G.Yu., Aliev Z.K. Neurotropic B vitamins effects: overview. Russian Medical Inquiry. 2023;7(10):650–657 (in Russ.). DOI: 10.32364/2587-6821-2023-7-10-6.

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Section: комбинирование нейротропных витаминовunclassified

Neurotropic B vitamins effects: overview

Vertkin,

Knorring,

Aliev

2023

Russian Medical Inquiry

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“…Specifically, providers rarely or never treated underlying biochemical aberrations including nutritional deficiencies (5.2%), oxidative stress (0.7%), or metabolic abnormalities (0%). This is surprising considering the rapidly growing body of high-quality randomized controlled trial data that provide conclusive evidence that treatment with vitamin B (B6, B9, B12), acetyl-L-carnitine, alpha-lipoic acid, coenzyme Q10 (CoQ10), and N-acetylcysteine mitigates severe and persistent pain while improving function [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Randomized Trial on the Clinical Utility of a Novel Biomarker Panel to Identify Treatable Determinants of Chronic Pain

Peabody

Paculdo²,

Tamondong-Lachica³

et al. 2020

Diagnostics

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Millions suffer daily from chronic pain diagnosed anatomically and treated with opioids. Research shows that underlying nutritional, metabolic and oxidative stressors, which drive the development or worsening of chronic pain, are not diagnosed despite the fact that treatment of these primary pain pathways relieves pain and increases function. One of the main reasons for this gap in care is the lack of a simple diagnostic assay to help clinicians make these diagnoses. We examined the clinical utility of a urine-based pain biomarker panel. Primary care physicians were randomized into the test group and compared to controls. We measured their ability to make the diagnosis and treat a total of nine standardized patients, with common but challenging cases of chronic pain, over two rounds of data collection in a pre–post design using a fixed-effects model. Intervention doctors received educational materials on a novel pain biomarker panel after the baseline round and had access to biomarker test results. Provider responses were measured against evidence-based criteria. The two study arms at baseline provided similar, poor care for three different primary pain pathways: nutritional deficiencies (5.0% control versus 9.2% intervention treated, p = 0.208), metabolic abnormalities (1.0% control versus 0% for intervention treated, p = 0.314), and oxidative stress (1.2% control versus 0% intervention treated, p = 0.152). After the introduction of the Foundation Pain Index (FPI) biomarker test, physicians in the intervention group were 41.5% more likely to make the diagnosis of a micronutrient deficiency, 29.4% more likely to identify a treatable metabolic abnormality and 26.1% more likely to identify an oxidative stressor. These diagnostic and treatment improvements were seen across all three case types, ranging from a relative +54% (p = 0.004) for chronic neuropathic pain to +35% (p = 0.007) in chronic pain from other causes to +38% (p = 0.002) in chronic pain with associated mental health issues. Intervention doctors were also 75.1% more likely to provide a non-opioid treatment to patients on chronic opioids (O.R. 1.8, 95% C.I. 0.8–3.7), 62% less likely to order unnecessary imaging for their patients with low back pain (O.R. 0.38, 95% C.I. 0.15–0.97) and 66% less likely to order an unnecessary pain referral (O.R. 0.34, 95% C.I. 0.13–0.90). This experimental study showed significant clinical utility of a validated pain biomarker panel that determines nutritional deficiencies, metabolic abnormalities and oxidative stressors that drive underlying treatable causes of pain. When integrated into routine primary care practice, this testing approach could considerably improve diagnostic accuracy and provide more targeted, non-opioid treatments for patients suffering from chronic pain.

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“…pain using B-12, showing promising results to decrease the pain. All three of the studies focused on the efficacy and/or safety of B-12 in low back pain, with the control group receiving a placebo16 .Mauro et al conducted an RCT in 2000 in which 60 patients were included. Patients were randomized into two groups; one group was given intramuscular vitamin B-12 on an alternate day for two weeks, while the other group was given a placebo 2ml normal saline for two weeks.…”

mentioning

confidence: 99%

Role of Vitamin B-12 in chronic low backache: A comparative study

Ali

Shah²,

Qureshi

et al. 2021

Int. j. endorsing health sci. res.

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Background: Chronic low backache is a commonly affecting problem in our population; it has an economic impact due to the consumption of health expenses in its treatment and rehabilitation. Backache interferes with daily activities of life without discriminating age, gender or race, etc. Our study aimed to determine the role of vitamin B-12 in relieving chronic low backache. Methodology: A comparative study was conducted at Baqai University and Fatima Hospital, Karachi, from May 2019 to April 2020. A total of 496 patients were enrolled and divided into two groups; group I was treated with vitamin B-12 (n=256), and group II (n=240) did not receive vitamin B-12 treatment. Pre-treatment Visual Analog Scale (VAS) score and Oswestry Disability Index (ODI) scores were evaluated. Group II was given calcium supplements and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for one month, while group I was given intramuscular injections of vitamin B-12 (500 mcg) on an alternate day for a month along with calcium supplements and NSAIDs. Results: Pre-treatment mean VAS and ODI scores were 6.68 ± 1.45 and 30.11 ± 12.7, while post-treatment VAS and ODI scores were subsequently 3.50 ± 2.07 and 17.73 ± 12.7, respectively. At the end of treatment, a remarkable decrease in ODI and VAS scores was observed after treatment with vitamin B-12 (p<0.05). Conclusion: Concurrent use of vitamin B-12 in the treatment of chronic backache had a better impact in relieving backache symptoms than those treated without vitamin B-12.

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Systemic Review on the Use of Diclofenac/B Complex as an Anti-Inflammatory Treatment with Pain Relief Effect for Patients with Acute Lower Back Pain

Cited by 5 publications

References 13 publications

Neurotropic B vitamins effects: overview

Neurotropic B vitamins effects: overview

Randomized Trial on the Clinical Utility of a Novel Biomarker Panel to Identify Treatable Determinants of Chronic Pain

Role of Vitamin B-12 in chronic low backache: A comparative study

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