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Oral painkillers available without prescription for acute pain

Acute pain is often felt soon after injury, and is of short duration. Most people who have surgery have moderate or severe pain afterwards. Painkillers (analgesics) are tested in people with pain, often following the removal of wisdom teeth. Study participants have to have at least moderate pain levels and the pain is usually treated with painkillers taken by mouth. This overview is useful mainly for acute pain lasting only a few days or weeks, and not for chronic pain lasting for many months. For this overview we have not included information from reviews on migraine, tension headache, or period pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Headaches: Diagnosis and Management of Headaches in Young People and Adults [Internet]

Many non-specialist healthcare professionals can find the diagnosis of headache difficult, and both people with headache and their healthcare professionals can be concerned about possible serious underlying causes. This leads to variability in care and may mean that people with headaches are not always offered the most appropriate treatments. People with headache alone are unlikely to have a serious underlying disease. Comparisons between people with headache referred to secondary care and those treated in primary care show that they do not differ in terms of headache impact or disability.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: September 2012
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Opioid therapy for treating rheumatoid arthritis pain 

This summary of a Cochrane review presents what we know from research about the effect of opioids for treating rheumatoid arthritis pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Combining two or more drugs vs one drug for pain control in inflammatory arthritis

This summary of a Cochrane review presents what we know from research about the effect of a combination of two pain relieving drugs for pain control in inflammatory arthritis (IA).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Adverse events after single doses of oral analgesics for acute pain after operation in adults

Acute pain is often felt soon after injury. Most people who have surgery have moderate or severe pain afterwards. Painkillers (analgesics) are tested in people with pain, often following the removal of wisdom teeth. In all these studies, the participants have to have at least moderate pain in order for there to be a sensitive measure of pain‐relieving properties. The pain is usually treated with painkillers taken by mouth. Results can be applied to other forms of acute pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Pain tablets taken by mouth for post‐caesarean pain

Tablets are convenient and easy to take to ease the pain after caesarean section, which involves cutting through the abdomen and uterus to deliver the baby. We aimed to assess the effectiveness, safety and cost‐effectiveness of different types of tablets for the pain. Different types of pain tablets relieve the pain in different ways. Opioids decrease the feeling of pain, decrease reaction to pain as well as increase pain tolerance by their action on the nervous system. Some non‐opioid pain tablets act on the tissues to reduce the response to the inflammatory substances released at the site of tissue damage. Combination drugs (such as paracetamol and codeine) may have more pronounced effects because of the different mechanism of action of their components. We do not know how some other tablets, such as alpha‐2 agonists (clonidine) and gabapentin (usually used for nerve pain that follows shingles and long‐term pain) relieve pain. Good pain control may shorten the time spent in hospital after caesarean section, improve satisfaction and reduce healthcare costs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Single dose oral aceclofenac for postoperative pain in adults

Pain is commonly experienced after surgical procedures. Acute postoperative pain of moderate or severe intensity is often used (as a model) to test whether or not drugs are effective painkillers. In this case we could find only a single study testing oral aceclofenac 150 mg against placebo, and aceclofenac was not statistically better than placebo. It is possible that other studies were done, possibly at larger or more effective doses, but not reported because they were used only to register aceclofenac with licensing authorities throughout the world. However, this leaves an important gap in our knowledge, and it means that we cannot be confident about using oral aceclofenac for acute painful conditions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Pain in patients with inflammatory arthritis and gastrointestinal or liver problems

This summary of a Cochrane review presents what we know from research about the effect of pain relieving drugs for people with inflammatory arthritis plus stomach or gut disease, or liver disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Low Back Pain and Sciatica in Over 16s: Assessment and Management

This guideline covers the assessment and management of low back pain and sciatica in adults over the age of 16 years.

NICE Guideline - National Guideline Centre (UK).

Version: November 2016
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Fractures (Non-Complex): Assessment and Management

Two of the five guidelines in the NICE trauma suite relate to fractures. These are titled non-complex and complex fractures. In broad terms, non-complex fractures are those likely to be treated at the receiving hospital, whereas complex fractures require transfer or the consideration of transfer of the injured person to a specialist.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: February 2016
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Single dose oral diflunisal for acute postoperative pain in adults

This review assessed evidence from nine randomised, double‐blind, placebo‐controlled clinical trials, in which there were 906 adults in comparisons of diflunisal (a non‐steroidal, anti‐inflammatory drug) with placebo for treatment of moderate to severe acute post‐operative pain. It is an effective analgesic over the dose range 250 mg to 1000 mg, with a long duration of action. At 1000 mg, the analgesic effect over 4 to 6 hours is as good as the combination of paracetamol 1000 mg and codeine 60 mg in similar studies using the same methods.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Regular painkillers in people undergoing laparoscopic cholecystectomy

About 10% to 15% of the adult western population have gallstones. Between 1% and 4% become symptomatic each year. Removal of the gallbladder (cholecystectomy) is the mainstay treatment for symptomatic gallstones. More than half a million cholecystectomies are performed per year in the US alone. Laparoscopic cholecystectomy (removal of gallbladder through a keyhole, also known as port) is now the preferred method of cholecystectomy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Managing Pain From a Broken Hip: A Guide for Adults and Their Caregivers

You or the person you care for is an older adult (more than 50 years old) who is in a hospital because of a hip fracture (a broken hip that occurs suddenly from an event like a fall).

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: May 17, 2011

Transdermal fentanyl for cancer pain

Fentanyl patches placed on the skin produced good pain relief for most people with moderate or severe cancer pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults

There are over 400,000 people with rheumatoid arthritis (RA) in the UK. Although this makes it a common disorder, there are numerous other conditions ahead of it in terms of numbers, and indeed as causes of excess mortality. What this does not capture however, is the dreadful morbidity associated with the disease. The synovitis of RA affects multiple sites causing widespread pain, and the subsequent destruction of the joints can lead to severe disability affecting all aspects of motor function from walking to fine movements of the hand. Furthermore, RA is not simply a disease of the joints but can affect many other organs causing, for example, widespread vasculitis or severe lung fibrosis. More recently it has become apparent that RA is associated with an increased prevalence of coronary artery disease and significant increased risk of premature mortality.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: February 2009
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The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model

Sciatica is a symptom characterised by well-localised leg pain with a sharp, shooting or burning quality that radiates down the back of the leg and normally to the foot or ankle. It is often associated with numbness or altered sensation in the leg.

Health Technology Assessment - NIHR Journals Library.

Version: November 2011
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Oral aspirin for treatment of acute episodic tension‐type headache in adults

This review found only very low quality evidence that people with 2 to 14 tension‐type headaches a month get good pain relief from taking aspirin 1000 mg or lower doses. There are questions about how studies of this type of headache are conducted. These questions involve the type of people chosen for the studies, and the types of outcomes reported. This limits the usefulness of the results, especially for people who just have an occasional headache.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain

Chronic pain is common and use of long-term opioid therapy for chronic pain has increased dramatically. This report reviews the current evidence on effectiveness and harms of opioid therapy for chronic pain, focusing on long-term (≥1 year) outcomes.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: September 2014
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End of Life Care for Infants, Children and Young People with Life-Limiting Conditions: Planning and Management

This guideline covers the physical, emotional, social and spiritual elements of end of life care, and focuses on improving the child or young person’s quality of life and supporting their family and carers. There are, for instance, recommendations on managing distressing symptoms and providing care and bereavement support after death. Recommendations have also been made about how services should be delivered. The guideline is aimed at all providers of paediatric end of life care, whatever their level of practise, and also for children and young people with life-limiting conditions and their parents or carers.

NICE Guideline - National Guideline Alliance (UK).

Version: December 2016
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Postnatal Care: Routine Postnatal Care of Women and Their Babies [Internet]

This guideline has been written within a conceptual framework which places the woman and her baby at the centre of care, appreciating that all postnatal care should be delivered in partnership with the woman and should be individualised to meet the needs of each mother-infant dyad. The guideline aims to identify the essential ‘core care’ which every woman and her baby should receive, as appropriate to their needs, during the first 6–8 weeks after birth, based upon the best evidence available.

NICE Clinical Guidelines - National Collaborating Centre for Primary Care (UK).

Version: July 2006
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