Managing Osteoarthritis

Park, Ju‐Young; Dunn, Dorothy J.; Goodman, Rhonda

doi:10.1097/hnp.0b013e318232c5f9

Cited by 28 publications

(24 citation statements)

References 19 publications

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“…25 Existing evidence suggests that these therapies are safe, can reduce pain, and in many cases improve functioning (Table 2). 13,17,25,26,74-82 However, almost all studies of nonpharmacologic interventions conducted to date have been short-term (less than 6 months). The long-term efficacy of nonpharmacologic interventions and the ability of older adults to sustain their use over time remain inadequately determined.…”

Section: Methodsmentioning

confidence: 99%

Management of Persistent Pain in the Older Patient

Makris

Abrams

Gurland

et al. 2014

JAMA

264

201

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Importance Persistent pain is highly prevalent, costly, and frequently disabling in later life. Objective To describe barriers to the management of persistent pain among older adults, summarize current management approaches, including pharmacologic and nonpharmacologic modalities; present rehabilitative approaches; and highlight aspects of the patient-physician relationship that can help to improve treatment outcomes. This review is relevant for physicians who seek an age-appropriate approach to delivering pain care for the older adult. Evidence Acquisition Search of MEDLINE and the Cochrane database from January 1990 through May 2014, using the search terms older adults, senior, ages 65 and above, elderly, and aged along with non-cancer pain, chronic pain, persistent pain, pain management, intractable pain, and refractory pain to identify English-language peer-reviewed systematic reviews, meta-analyses, Cochrane reviews, consensus statements, and guidelines relevant to the management of persistent pain in older adults. Findings Of the 92 identified studies, 35 evaluated pharmacologic interventions, whereas 57 examined nonpharmacologic modalities; the majority (n = 50) focused on older adults with osteoarthritis. This evidence base supports a stepwise approach with acetaminophen as first-line therapy. If treatment goals are not met, a trial of a topical nonsteroidal anti-inflammatory drug, tramadol, or both is recommended. Oral nonsteroidal anti-inflammatory drugs are not recommended for long-term use. Careful surveillance to monitor for toxicity and efficacy is critical, given that advancing age increases risk for adverse effects. A multimodal approach is strongly recommended–emphasizing a combination of both pharmacologic and nonpharmacologic treatments to include physical and occupational rehabilitation, as well as cognitive-behavioral and movement-based interventions. An integrated pain management approach is ideally achieved by cultivating a strong therapeutic alliance between the older patient and the physician. Conclusions and Relevance Treatment planning for persistent pain in later life requires a clear understanding of the patient's treatment goals and expectations, comorbidities, and cognitive and functional status, as well as coordinating community resources and family support when available. A combination of pharmacologic, nonpharmacologic, and rehabilitative approaches in addition to a strong therapeutic alliance between the patient and physician is essential in setting, adjusting, and achieving realistic goals of therapy.

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Section: Methodsmentioning

confidence: 99%

Management of Persistent Pain in the Older Patient

Makris

Abrams

Gurland

et al. 2014

JAMA

264

201

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“…Five of the 12 did not fully meet the inclusion criteria. One article was a one-page preliminary report (Miles, 2003), a second used a convenience sample with no randomization or control (Birocco et al, 2011), a third used a semi-randomized patient preference design (Hulse, Stuart-Shor, & Russo, 2010), a fourth used a four-group design with a combination of Reiki and sham Reiki and no control (Assefi, Bogart, Goldberg, & Buchwald, 2008) and the fifth included a control group that was different from the stated design and the two experimental groups (Park, McCaffrey, Dunn, & Goodman, 2011). The remaining seven studies met the inclusion criteria for review as determined by both authors (Beard et al, 2011; Gillespie, Gillespie, & Stevens, 2007; Olson, Hanson, & Michaud, 2003; Potter, 2007; Richeson, Spross, Lutz, & Peng, 2010; Tsang, Carlson, & Olson, 2007; Vitale & O’Connor, 2006) (see Table 1).…”

Section: Methods Of Review and Data Extractionmentioning

confidence: 99%

Effect of Reiki Therapy on Pain and Anxiety in Adults: An In-Depth Literature Review of Randomized Trials with Effect Size Calculations

Thrane

Cohen

2014

Pain Management Nursing

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Objective To calculate the effect of Reiki therapy for pain and anxiety in randomized clinical trials. Data Sources A systematic search of PubMed, ProQuest, Cochrane, PsychInfo, CINAHL, Web of Science, Global Health, and Medline databases was conducted using the search terms pain, anxiety, and Reiki. The Center for Reiki Research was also examined for articles. Study Selection Studies that used randomization and a control or usual care group, used Reiki therapy in one arm of the study, published in 2000 or later in peer-reviewed journals in English, and measured pain or anxiety were included. Results After removing duplicates, 49 articles were examined and 12 articles received full review. Seven studies met the inclusion criteria: four articles studied cancer patients; one examined post-surgical patients; and two analyzed community dwelling older adults. Effect sizes were calculated for all studies using Cohen’s d statistic. Effect sizes for within group differences ranged from d=0.24 for decrease in anxiety in women undergoing breast biopsy to d=2.08 for decreased pain in community dwelling adults. The between group differences ranged from d=0.32 for decrease of pain in a Reiki versus rest intervention for cancer patients to d=4.5 for decrease in pain in community dwelling adults. Conclusions While the number of studies is limited, based on the size Cohen’s d statistics calculated in this review, there is evidence to suggest that Reiki therapy may be effective for pain and anxiety. Continued research using Reiki therapy with larger sample sizes, consistently randomized groups, and standardized treatment protocols is recommended.

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“…Park et al 108 completed a quasi-experimental trial, with participants randomized to either sitting yoga or Reiki; however the attention control group was chosen as a convenience sample from other participants meeting the inclusion/exclusion criteria. The primary outcome measures were the WOMAC Arthritis Index score and the pain, function, and stiffness subscales.…”

Section: Osteoarthritis Of the Kneementioning

confidence: 99%

Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States

Nahin

Boineau

Khalsa

et al. 2016

Mayo Clinic Proceedings

230

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While most pain is acute, resolving within a few days or weeks, millions of Americans suffer from persistent or recurring pain that may become chronic and debilitating. Medications may provide only partial relief from this chronic pain and can be associated with unwanted side effects. As a result, many individuals turn to complementary health approaches as part of their pain management strategy. This article examines the clinical trial evidence for the efficacy and safety of several specific approaches – acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements (chondroitin, glucosamine, methylsulfonylmethane, S-adenoysl methionine), tai chi, and yoga – as used to manage chronic pain and related disability associated with back pain, fibromyalgia, osteoarthritis, neck pain, and severe headaches or migraines.

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Managing Osteoarthritis

Cited by 28 publications

References 19 publications

Management of Persistent Pain in the Older Patient

Management of Persistent Pain in the Older Patient

Effect of Reiki Therapy on Pain and Anxiety in Adults: An In-Depth Literature Review of Randomized Trials with Effect Size Calculations

Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States

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