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Tramadol with or without paracetamol (acetaminophen) for cancer pain

No firm conclusions could be drawn about the effectiveness or harms of tramadol, alone or with paracetamol, in cancer pain.

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

Version: 2017

Tramadol for osteoarthritis

There is gold level evidence that to treat osteoarthritis, tramadol taken for up to three months may decrease pain, may improve stiffness and function and overall‐well being. Tramadol may cause side effects such as nausea, vomiting, dizziness, constipation, tiredness, and headache.

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

Version: 2015

Dextropropoxyphene in a single dose taken on its own and also with paracetamol to treat postoperative pain

This review assessed the analgesic efficacy and adverse effects that single dose oral dextropropoxyphene taken alone or in combination with paracetamol had in treating moderate to severe postoperative pain. The combination of dextropropoxyphene 65 mg with paracetamol 650 mg showed similar efficacy to that of tramadol 100 mg for single dose studies in postoperative pain but with a lower incidence of side effects. This review also highlighted that Ibuprofen 400 mg was yet more effective than both tramadol 100 mg and dextropropoxyphene 65 mg.

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

Version: 2010

Drug combinations for chronic neuropathic pain in adults

Neuropathic pain – due to nerve disease or damage – is often treated by pain medications which have limited effect and/or dose‐related side effects when given alone. Combinations of more than one drug are often used with the goal of achieving better pain relief or fewer side effects (if the pain relieving effects of the combined drugs are more additive than the side effects), or both. Despite evidence that over 45% of individuals suffering from neuropathic pain take two or more drugs for their pain, we could find only 21 high‐quality studies of various different systemic and topical drug combinations. Given the wide possible variety of different drug combinations and the small number of studies, results for neuropathic pain from this review are insufficient to suggest the value of any one specific drug combination. However, the publication of multiple high‐quality studies suggesting the superiority of some drug combinations, together with evidence that drug combinations are widely used in clinical practice, underline the importance of conducting more combination studies with improved methodology.

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

Version: 2017

Low back pain: Medication for chronic back pain

Over-the-counter painkillers can sometimes relieve chronic low back pain. Studies have also found that some prescription painkillers like opioids may have a benefit. There is no proof that muscle relaxants or antidepressants help relieve chronic low back pain.Low back pain is one of the ten most common diagnoses made by family doctors. It often goes away on its own without treatment, but sometimes it persists or keeps coming back. The causes of chronic low back pain are usually unclear, and treating it is often difficult.Good-quality studies have so far found that only few treatments help. Besides medication, treatments such as exercise therapy, psychological therapy, physiotherapy and acupuncture are used. The medications used include over-the-counter and prescription painkillers, muscle relaxants and antidepressants.Because medication can have side effects – especially when taken over longer periods of time – experts recommend not taking it continuously, but rather only for a short while, for example if the pain is especially severe.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 2, 2015

Noninvasive Treatments for Low Back Pain: A Summary of the Research for Adults

This summary will answer these questions: What is low back pain? How is low back pain treated? » Medicines » Nonmedicine treatments such as heat, exercise, and massage What have researchers found about treatments for low back pain? What are possible side effects of medicines to treat low back pain? What should I discuss with my health care professional about treating my low back pain?

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

Version: November 15, 2016

Slipped disk: Non-surgical treatment options

Most people with a slipped disk are offered “conservative” treatment, meaning that the treatment does not involve surgery. This mainly involves exercise, relaxation and positioning, painkillers or local anesthetics, and manual and physical therapy.Some slipped disks don't cause any symptoms, whereas others lead to severe back pain. A slipped disk in the lumbar region of the spine (the lower back) can press on the sciatic nerve and cause pain that often radiates down one leg and into the foot. Most people recover from a slipped disk within six weeks without treatment. Until then there are a number of treatment options that aim to help relieve the pain and improve mobility.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 1, 2017

Pain management for rheumatoid arthritis with cardiovascular or renal comorbidity

This summary of a Cochrane review presents what we know from research about the safety of using pain‐relieving drugs in people with rheumatoid arthritis who also have either heart or kidney disease, or both.

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

Version: 2011

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

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

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

Morphine‐like drugs for cancer pain

In about 19 of 20 people with moderate to severe pain from cancer, morphine‐like drugs (opioids) can probably reduce pain to mild or no pain within 14 days if they can tolerate the side effects. Most people will have side effects, and about 1 in 10 to 2 in 10 will need to change their treatment because of side effects.

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

Version: 2017

Non‐steroidal anti‐inflammatory drugs for chronic low back pain

We assessed the evidence regarding the effect of non‐steroidal anti‐inflammatory drugs (NSAIDs) among people with chronic low back pain. NSAIDs were compared to placebo, other NSAIDs, other drugs or other kinds of treatment.

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

Version: 2016

Lasting pain after shingles

Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. It’s still not clear how it can be prevented or what the best treatment is.Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word "post-herpetic" means "post-herpes" because the pain arises after infection by the herpes zoster (shingles) virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.The main symptom of post-herpetic neuralgia is pain in the nerves (neuralgia). The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Pain management in metastatic breast cancer

Pain – no matter how severe – can almost always be at least partly relieved through therapy. Well-coordinated pain management with regular adjustments is crucial for maintaining quality of life. It is one of the most important medical interventions used in metastatic breast cancer.Metastatic breast cancer treatment targets not only the cancer cells, but also the related symptoms such as pain and any possible side effects of more aggressive treatments.The symptoms caused by breast cancer will depend on various factors, including the size of the tumor and the rate at which it is growing. A growing tumor can cause pain if the cancer cells press against nearby nerves or damage healthy tissue. Large tumors may prevent organs from working properly if they grow into the chest wall or the skin. The location of metastatic tumors also influences the kind of symptoms they cause. For instance, if the lungs are affected, breathing may become difficult. Metastases in the bones can be painful and make the bones more fragile.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 7, 2016

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

Opioids for cancer‐related pain in children and adolescents

There is no evidence from randomised controlled trials to support or contradict the suggestion that opioids in any dose will reduce cancer‐related pain in children or adolescents.

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

Version: 2017

Cancer Pain (PDQ®): Patient Version

Expert-reviewed information summary about pain as a complication of cancer or its treatment. Approaches to the management and treatment of cancer-associated pain are discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 30, 2017

Systematic Reviews in PubMed

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