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Documents are listed in logical categories by treatment modality and, within those, in the order of their publication dates – most recent at the top. All URL links were valid at the time of posting. Please notify us of any broken links at: Info@Pain-Topics.org. Researchers: Winnie Dawson, MA, RN, BSN; Stewart B. Leavitt, MA, PhD.
General Pain Relief - Nondrug, Complementary, Alternative
Khatta M. Medscape Ob/Gyn & Women’s Health. 2007(May). Accessed June 6, 2007.
Gur A. Current Pharmaceutical Design. 2006;12(1):29-35. Accessed May 21, 2007.
Menefee JA, et al. Journal of the American Osteopathic Association. 2005(Nov);105(11 Suppl 5):S15-S20. Accessed May 15, 2007.
Tsao JCI, et al. Evidence-Based Complementary and Alternative Medicine. 2005(Jun);2(2):149-159. Accessed May 15, 2007.
Interventions for Treating Chronic Pelvic Pain in Women Stones W, Cheong YC, Howard FM. Cochrane Database. 2005,3. Accessed May 31, 2007. Non-Invasive Physical Treatments for Chronic/Recurrent Headache Bronfort G, Nilsson N, Haas M, et al. Cochrane Database. 2004,3. Accessed May 31, 2007. < Back to Top > Acupuncture
Manheimer E, White A, Berman B, et al. Annals of Internal Medicine, 2005(Apr);142(8):651-663. Accessed May 16, 2007.
Acupuncture for Shoulder Pain Green S, Buchbinder R, Hetrick S. Cochrane Database. 2005;2. Accessed May 28, 2007. Acupuncture and Dry-Needling for Low Back Pain Furlan AD, van Tulder MW, Cherkin DC , et al. Cochrane Database. 2005,1. Accessed May 28, 2007.
Berman BM, Lao L, Langenberg P, et al. Annals of Internal Medicine. 2004(Dec);141(12):901-910. Accessed May 16, 2007.
< Back to Top > Adjuvant Drugs
Jann MW, Slade JH; Medscape, 2008 [from Pharmacotherapy. 2007;27(11):1571-1587]. See details...>
Pregabalin in Central Neuropathic Pain Associated With Spinal Cord Injury Siddall PJ, Cousins MJ, Otte A, et al. Neurology. 2006(Nov);67(10):1792-1800. Accessed May 28, 2007. Perioperative Ketamine for Acute Postoperative Pain Bell RF, Dahl JB, Moore RA et al. Cochrane Database. 2006;1. Accessed May 28, 2007. Systemic Administration of Local Anesthetic Agents to Relieve Neuropathic Pain Challapalli V, Tremont-Lukats IW, McNicol ED, et al. Cochrane Database. 2005,4. Accessed May 28, 2007. Anticonvulsant Drugs for Acute and Chronic Pain Wiffen P, Collins S, McQuay H, et al. Cochrane Database. 2005;3. Accessed May 28, 2007. Antidepressants for neuropathic pain Saarto T, Wiffen PJ. Cochrane Database. 2005,3. Accessed May 28, 2007. Gabapentin for Acute and Chronic Pain Wiffen PJ, McQuay HJ, Edwards JE, et al. Cochrane Database. 2005,3. Accessed May 28, 2007. Recent Advances in Nonopioid Treatment of Pain Moyer P, Bennett DS. Medscape Ob/Gyn & Women’s Health. 2005(Apr). Accessed May 28, 2007.
Maizels M, McCarberg B. American Family Physician, 2005(Feb);71(3):483-390. Accessed May 15, 2007.
Comparative Efficacy and Safety of Skeletal Muscle Relaxants for Spasticity and Musculoskeletal Conditions: A Systematic Review Chou R, Peterson K, Helfand M. J Pain Symptom Manage. 2004(Aug);28(2):140-175. Accessed May 28, 2007. < Back to Top > Biofeedback
Gatchel RJ. American Pain Society Bulletin, 2004. Accessed May 14, 2007.
< Back to Top > Botulinum Toxin (BOTOX) Injections
Sidhu S, Ruddock B. Canadian Pharmacists Journal. 2006(Nov-Dec);139(6):30-31. Accessed May 24, 2007.
Costa J, Espirito-Santo C, Borges A et al. Cochrane Database. 2005, 1. Accessed May 24, 2007.
Evers S. Curr Opin Otolaryngol Head Neck Surg. 2004;12(3):197-203. Accessed May 24, 2007.
< Back to Top > Cold or Heat TherapyThis topic area includes a wide variety of temperature-based treatments. Cold therapy can be used to reduce acute inflammation and relieve muscle spasm. Typically, the application of cold is superficial; an ice pack or cooling fluids are applied to the skin and local tissues. An unrelated treatment, low-level laser therapy, is also called cold laser therapy because it uses a near-infrared laser which is, basically, nonthermal. Heat therapy is most commonly used to increase blood flow and decrease joint stiffness which, in turn, reduces pain and muscle spasms. The application of heat may be superficial (hot packs, paraffin wax baths, hydrotherapy) or deep (diathermy, ultrasound). One example of deep heat therapy is an ablative treatment such as MRgFUS which is a noninvasive thermal ablation technique using high-intensity focused ultrasound. MR-guided Focused Ultrasound Surgery (MRgFUS) for the Palliation of Pain in Patients With Bone Metastases — Preliminary Clinical Experience Catane R, Beck A, Inbar Y, et al. Ann Oncology. 2007(Jan);18(1):163-167. Accessed May 28, 2007. Superficial Heat or Cold for Low Back Pain French SD, Cameron M, Walker BF, et al. Cochrane Database. 2006,1. Accessed May 28, 2007. Systematic Review of the Literature of Low-Level Laser Therapy (LLLT) in the Management of Neck Pain Chow RT, Barnsley L. Lasers Surg Med. 2005(Jul);37(1):46-52. Accessed May 28, 2007.
O’Connor A, et al. American Pain Society Bulletin, 2005. Accessed May 14, 2007.
McCarberg B, et al. American Pain Society Bulletin, 2004. Accessed May 14, 2007.
Michel T. Pain Relief Connection, 2003. Accessed May 11, 2007.
< Back to Top > Electroanalgesia (incl. CES, MET, PENS, SCS, TENS, & Others)The practice of electroanalgesia during the past 15 years has expanded, and even the task of identifying the acronyms can be a challenge. As an aid to understanding techniques available, the first article below (White et al, 2001) provides a brief historical review, a description, and a summary of significant trials in each procedure—from the noninvasive TENS to the minimally invasive PENS and the most invasive DBS.
White PF, Li S, Chiu JW. Anesthesia & Analgesia. 2001(Feb);92(2);505-513. Accessed May 21, 2007.
Kaye V, Brandstater ME. eMedicine from WebMD. Updated Jan 2007. Accessed May 31, 2007.
Kirsch DL. Practical Pain Management. 2006(Nov/Dec):58-65. Accessed May 31, 2007.
Kirsch DL. Practical Pain Management. 2006(Oct):59-64. Accessed May 31, 2007.
Brosseau L, Yonge KA, Robinson V, et al. Cochrane Database. 2006,1. Accessed May 24, 2007. Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low-Back Pain Khadilkar A, Milne S, Brosseau L, et al. Cochrane Database. 2005,3. Accessed May 28, 2007.
Yokoyama M, Sun X, Oku S, et al. Anesthesia & Analgesia. 2004;98(6):1552-1556. Accessed May 31, 2007.
Spinal Cord Stimulation (SCS) for Chronic Pain Mailis-Gagnon A, Furlan AD, Sandoval JA, et al. Cochrane Database. 2004,3. Accessed May 28, 2007. < Back to Top > Exercise Therapy
Hayden JA, et al. Annals of Internal Medicine. 2005(May);142(9):776-785. Accessed May 14, 2007.
Exercise Therapy for Treatment of Non-Specific Low Back Pain Hayden JA, van Tulder MW, Malmivaara A, et al. Cochrane Database. 2005,3. Accessed May 28, 2007. Exercises for Mechanical Neck Disorders Kay TM, Gross A, Goldsmith C, et al. Cochrane Database. 2005;3. Accessed May 28, 2007. Exercise Prescription for Older Adults With Osteoarthritis Pain: Consensus Practice Recommendations American Geriatrics Society (AGS), 2001. Accessed May 28, 2007.
< Back to Top > Headache - Drug Therapies
Bigal ME, Krymchantowski AV. Medscape General Medicine. 2006(May);5(10). Accessed May 28, 2007.
Selective Serotonin Re-Uptake Inhibitors (SSRIs) for Preventing Migraine and Tension-Type Headaches Moja PL , Cusi C, Sterzi RR, et al. Cochrane Database. 2005,3. Accessed May 28, 2007. Oral Sumatriptan for Acute Migraine McCrory DC , Gray RN. Cochrane Database. 2003,3. Accessed May 28, 2007. < Back to Top > Herbal Medicines and Dietary Supplements
Stewart B. Leavitt, MA, PhD, Pain Treatment Topics, June 2008. Vitamin D – A Neglected ‘Analgesic’ for Musculoskeletal Pain > Practitioner Briefing (7 pages) > Full Report (50 pages) Vitamin D: A Champion of Pain Relief > Patient Brochure (6-pages)
Gagnier JJ, vanTulder M, Berman B, et al. Cochrane Database. 2006,2. Accessed May 28, 2007.
Wirth JH, Hudgins JC, Paice JA. Medscape Ob/Gyn & Women’s Health, 2006(Jan). Similarly published in Pain Manage Nurs. 2005(Dec);6(4):145-167. Accessed May 28, 2007.
American Society of Anesthesiologists (ASA), 2003. Accessed May 18, 2007.
< Back to Top > Interventional Pain ManagementInterventional pain management is an emerging medical discipline devoted to the diagnosis and treatment of pain and related disorders. Interventional techniques include minimally invasive procedures, such as percutaneous precision needle placement, with placement of drugs in targeted areas or ablation of targeted nerves; and some surgical techniques, such as laser or endoscopic discectomy, intrathecal infusion pumps and spinal cord stimulators, for the diagnosis and management of chronic, persistent, or intractable pain. Interventional Techniques: Evidence-Based Practice Guidelines in the Management of Chronic Spinal Pain Boswell MV, Trescot AM, Datta S, et al. Pain Physician. 2007(Jan);10(1):7-111. Accessed May 28, 2007.
Ziconotide: A New Nonopioid Intrathecal Analgesic for the Treatment of Chronic Pain Wallace MS. Expert Rev Neurother. 2006(Oct);6(10):1423-1428. Accessed May 28, 2007. Local Anesthetic Sympathetic Blockade for Complex Regional Pain Syndrome Cepeda MS, Carr DB, Lau J. Cochrane Database. 2005;4. Accessed May 28, 2007.
Sloan PA. Journal of Supportive Oncology. 2004(Nov-Dec);2(6):491-500,503. Accessed May 15, 2007.
Prolotherapy Injections for Chronic Low-Back Pain Yelland MJ , Del Mar C, Pirozzo S, et al. Cochrane Database. 2004,2. Accessed May 28, 2007. Corticosteroid Injections for Shoulder Pain Buchbinder R, Green S, Youd JM. Cochrane Database. 2003,1. Accessed May 28, 2007. Radiofrequency Denervation for Neck and Back Pain Niemisto L, Kalso E, Malmivaara A, et al. Cochrane Database. 2003,1. Accessed May 28, 2007. < Back to Top > NSAIDs
These documents, all released in early 2007, variously discuss the benefits and risks of non-opioid pharmacologic therapies for acute and chronic pain conditions, primarily musculoskeletal in nature.
Use of Nonsteroidal Antiinflammatory Drugs. An Update for Clinicians. A Scientific Statement From the American Heart Association Choosing Non-Opioid Analgesics for Osteoarthritis: Clinician's Guide Medication Guide for Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) Go to details and links to these documents...>
Mason L, et al. BioMedCentral Family Practice, 2004. Accessed May 15, 2007.
< Back to Top > Nuclear MedicineNuclear Medicine is commonly used as a diagnostic tool, but it can also be administered therapeutically to provide pain relief from certain types of bone cancers. Very small amounts of radiopharmaceuticals can treat targeted bone cancer tumors locally without affecting other parts of the body. Radioactive drugs act on the metastatic bone tumor directly to reduce the effects of the cancer and, therefore, the associated pain.
Pandit-Taskar N, et al. Journal of Nuclear Medicine. 2004(Aug);45(8):1358-1365. Accessed May 11, 2007.
Radioisotopes for Metastatic Bone Pain Roqué i Figuls M, Martinez MJ, Alonso-Coello Pl. Cochrane Database. 2003;4. Accessed May 28, 2007. < Back to Top > Physical Therapies (incl. Massage, Shockwave Therapy, and Others)
Sems A, Dimeff R, Iannotti JP. J Am Acad Orthop Surg. 2006(Apr);14(4):195-204. Accessed May 24, 2007.
Physical Therapy Modalities in Management of Fibromyalgia Gur A. Current Pharmaceutical Design. 2006;12(1):29-35. Accessed May 21, 2007.
Shock Wave Therapy for Lateral Elbow Pain Buchbinder R, Green SE, Youd JM, et al. Cochrane Database. 2005;4. Accessed May 28, 2007. Traction for Low-Back Pain With or Without Sciatica Clarke JA, van Tulder MW, Blomberg SEI, et al. Cochrane Database. 2005,4. Accessed May 28, 2007. Spinal Manipulative Therapy for Low-Back Pain Assendelft WJJ, Morton SC, Yu Emily I, et al. Cochrane Database. 2004,1. Accessed May 28, 2007. Stabilisation Splint Therapy for Temporomandibular Pain Dysfunction Syndrome Al-Ani MZ, Davies SJ, Gray RJM, et al. Cochrane Database. 2004,1. Accessed May 28, 2007. Physiotherapy Interventions for Shoulder Pain Green S, Buchbinder R, Hetrick S. Cochrane Database. 2003;2. Accessed May 28, 2007. Massage for Low-Back Pain Furlan AD, Brosseau L, Imamura M, et al. Cochrane Database. 2002,2. Accessed May 28, 2007. < Back to Top > Psychological Interventions (plus Hypnosis & Music Therapy)
Cepeda MS, Carr DB, Lau J, et al. Cochrane Database. 2006,2. Accessed May 28, 2007. Hypnosis for Procedure-Related Pain and Distress in Pediatric Cancer Patients: A Systematic Review of Effectiveness and Methodology Related to Hypnosis Interventions Richardson J, Smith JE, McCall G, et al. J Pain Symptom Manage. 2006(Jan);31(7):70-84. Full-text accessed May 28, 2007. Psychological Interventions for Needle-Related Procedural Pain and Distress in Children and Adolescents Uman LS, Chambers CT , McGrath PJ, et al. Cochrane Database. 2005,1. Accessed May 28, 2007. Psychological Interventions for Symptomatic Management of Non-Specific Chest Pain in Patients With Normal Coronary Anatomy Kisely S, Campbell LA , Skerritt P. Cochrane Database. 2005,1. Accessed May 28, 2007.
Psychological Therapies for the Management of Chronic and Recurrent Pain in Children and Adolescents Eccleston C, Yorke L, Morley S, et al. Cochrane Database. 2003,1. Accessed May 28, 2007. Psychological Therapies for Sickle Cell Disease and Pain Anie KA, Green J. Cochrane Database. 2002,2. Accessed May 28, 2007. < Back to Top > Topical AnalgesiaTopical NSAIDs for Acute Pain: A Meta-Analysis Mason L, Moore RA, Edwards JE, et al. BMC Fam Pract. 2004(May);5(10). Accessed May 28, 2007.
Topical Agents or Dressings for Pain in Venous Leg Ulcers Briggs M, Nelson EA. Cochrane Database. 2003,1. Accessed May 28, 2007.
Kundu S, et al. American Family Physician. 2002(Jul);66(1):99-102. Accessed May 15, 2007.
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This page was last updated 6/19/08 |
This section of Pain Treatment Topics focuses on the variety of non-opioid therapies -- both pharmacologic and non-pharmacologic -- from an evidence-based, clinical perspective. This information is not offered as medical advice or treatment recommendations from Pain Treatment Topics. In all cases, professional discretion is advised in the acceptance or application of information in this section. See also, 
Also see the following sections for additional documents of interest:
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Electroanalgesia: Its Role in Acute and Chronic Pain Management
Recently-noted concerns about gastrointestinal complications and heart attack or stroke associated with these agents also are considered.
