scholarly journals Can herbal medicinal products or preparations alleviate neuropathic pain in adults? A Cochrane Review summary with commentary

2020 ◽  
pp. 1-4
Author(s):  
Chiara Arienti
Keyword(s):  
Neuropathic Pain ◽  
Side Effects ◽  
Cochrane Review ◽  
Current Evidence ◽  
Chronic Neuropathic Pain ◽  
Herbal Products ◽  
Herbal Medicinal Products ◽  
Relieve Pain ◽  
Total Pain ◽  
Herbal Medicinal

BACKGROUND: Several medicines have been shown to be effective in treating neuropathic pain, but they can have damaging side effects, therefore people are now trying herbal products to help relieve pain. OBJECTIVE: The aim of the Cochrane Review was to evaluate whether herbal products/preparations have an analgesic effectiveness in neuropathic pain and whether any side effects are associated with their use. METHODS: The population addressed were adults aged ≥18 years, suffering from chronic neuropathic pain. Studies that investigated the effects of herbal products/preparations for the relief of neuropathic pain compared to any or no interventions were included. RESULTS: Included studies did not show that herbal products/preparations have reduced pain intensity of 30% or above and there was no observable reduction in the total pain score. CONCLUSIONS: There is insufficient evidence to suggest that herbal products/preparations have any efficacy in any neuropathic pain conditions. The current evidence is of very low quality resulting in serious uncertainties about the estimates of effect observed.

scholarly journals Use of Scrambler Therapy in Acute Paediatric Pain: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sabrina Congedi ◽  
Silvia Spadini ◽  
Chiara Di Pede ◽  
Martina Ometto ◽  
Tatiana Franceschi ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Case Report ◽  
Side Effects ◽  
Pain Perception ◽  
Paediatric Population ◽  
Review Of The Literature ◽  
Chronic Neuropathic Pain ◽  
Relieve Pain ◽  
Scrambler Therapy ◽  
Mixed Pain

We report our clinical experience on the effect of Scrambler Therapy (ST) for a child with acute mixed pain refractory to pharmacological treatment. ST, recently proposed as an alternative treatment for chronic neuropathic pain in adults, is a noninvasive approach to relieve pain, by changing pain perception at brain level. It is safe and has no side effects. Further research is needed to assess its efficacy for acute pain and for paediatric population.

scholarly journals Herbal medicinal products or preparations for neuropathic pain

2019 ◽  
Author(s):  
Adele Boyd ◽  
Chris Bleakley ◽  
Deirdre A Hurley ◽  
Chris Gill ◽  
Mary Hannon-Fletcher ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Medicinal Products ◽  
Herbal Medicinal Products ◽  
Herbal Medicinal

scholarly journals Risk of Fungi Associated with Aflatoxin and Fumonisin in Medicinal Herbal Products in the Kenyan Market

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Lucia Keter ◽  
Richard Too ◽  
Nicholas Mwikwabe ◽  
Charles Mutai ◽  
Jennifer Orwa ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Experimental Design ◽  
Medical Research ◽  
Microbial Quality ◽  
Medicinal Products ◽  
Herbal Products ◽  
Herbal Medicinal Products ◽  
Toxigenic Fungi ◽  
Herbal Medicinal ◽  
Fungal Contaminants

Utilization of herbal products is a major concern due to the possibility of contamination by toxigenic fungi that are mycotoxin producers such as Aspergillus species during processing and packaging. Research was carried out to determine the presence of aflatoxins and fumonisins in herbal medicinal products sold in Eldoret and Mombasa towns in Kenya. The study employed both exploratory and laboratory experimental design. The herbal products were purchased from the market and transported to Kenya Medical Research Institute for processing and analysis. Fungal contaminants were determined according to Pharmacopoeia specifications. The toxins were quantified using ELISA based technique. The genus Aspergillus was the most dominant followed by Penicillium. Fungal counts ranged between 1 CFU/g and >1000 cfu/g. Analysis of variance showed that the rate of fungal contaminants for Eldoret and Mombasa samples had significant association (p≤0.001). Aflatoxin levels ranged from 1 to 24 ppb, while fumonisin levels ranged from 1 to >20 ppb. Only 31% of samples met the standards for microbial limits as specified in Pharmacopoeia. There is need for product microbial quality improvement through proper harvesting, processing, storage, and marketing. It is recommended that a policy be enacted to enable regulation of herbal products in Kenya.

scholarly journals Nonselective and NR2B-selective N -methyl-d-aspartic Acid Receptor Antagonists Produce Antinociception and Long-term Relief of Allodynia in Acute and Neuropathic Pain

2011 ◽  
Vol 115 (1) ◽  
pp. 165-174 ◽  
Author(s):  
Maarten Swartjes ◽  
Aurora Morariu ◽  
Marieke Niesters ◽  
Leon Aarts ◽  
Albert Dahan
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Side Effects ◽  
Receptor Antagonist ◽  
Nerve Injury ◽  
Side Effect ◽  
Receptor Antagonists ◽  
Chronic Neuropathic Pain ◽  
Pain Model ◽  
Aspartate Receptor

Background At low dose, the nonselective N-methyl-D-aspartate receptor antagonist ketamine produces potent analgesia. In humans, psychedelic side effects limit its use. To assess whether other N-methyl-D-aspartate receptor antagonist have an improved therapeutic utility index, we compared antinociceptive, side effect, and locomotor activity of three N-methyl-D-aspartate receptor antagonists. Methods Ketamine, its active metabolite norketamine, and the NR2B-selective antagonist traxoprodil (CP-101,606) were tested in rat models of acute antinociception (paw-withdrawal response to heat) and chronic neuropathic pain (spared nerve injury). Side effects (stereotypical behavior, activity level) were scored and locomotor function of the nerve-injured paw was assessed using computerized gait analysis. In the chronic pain model, treatment was given 7 days after surgery, for 3 h on 5 consecutive days. Results All three N-methyl-D-aspartate receptor antagonists caused dose-dependent antinociception in the acute pain model and relief of mechanical and cold allodynia for 3-6 weeks after treatment in the chronic pain model (P < 0.05 vs. saline). In both tests, ketamine was most potent. Norketamine was as much as two times less potent and traxoprodil was up to 8 times less potent than ketamine (based on area under the curve measures). Nerve injury caused an inability to use the affected paw that either did not improve after treatment (ketamine, traxoprodil) or showed only a limited effect (norketamine). Traxoprodil, but not ketamine or norketamine, showed clear separation between effect and side effect. Conclusions The observation that traxoprodil causes relief of chronic pain outlasting the treatment period with no side effects makes it an attractive alternative to ketamine in the treatment of chronic neuropathic pain.

Herbal medicinal products or preparations for neuropathic pain and fibromyalgia

2016 ◽  
Author(s):  
Adele Boyd ◽  
Chris Bleakley ◽  
Chris Gill ◽  
Suzanne McDonough ◽  
Deirdre A Hurley ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Medicinal Products ◽  
Herbal Medicinal Products ◽  
Herbal Medicinal

scholarly journals Spinal Cord Stimulation for Chronic Refractory Neuropathic Pain: A Technical Note Initial Experience of Two cases

2021 ◽  
Author(s):  
Sanjeev Srivastava ◽  
Pawan Goyal ◽  
Anurag Sharma ◽  
Sanjay K. Rajan ◽  
Aditya Gupta
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Pain Relief ◽  
Spinal Cord Stimulation ◽  
Pulse Generator ◽  
Technical Note ◽  
Current Evidence ◽  
Chronic Neuropathic Pain ◽  
Thoracic Spinal Cord ◽  
Dorsal Aspect

AbstractSpinal cord stimulation is an established procedure for relieving chronic neuropathic pain conditions. Although it has been over five decades since the first spinal cord stimulation (SCS) was developed, it has only been used in a few cases in India. It is primarily based on the “Gate Theory” of pain. The mechanism of its action is not exactly clear, but reports have suggested that it plays the main role in selectively stimulating the large diameter pain fibers in the dorsal aspect of spinal cord. SCS procedure involves a very careful case selection, and current evidence suggests that only a few conditions of chronic refractory neuropathic pain are its established indications. In these patients too, the efficacy rate remains around 50 to 75%. The overall pain relief observed is around 50% decrease in visual analog scale (VAS) scores. It is a technically simple procedure involving placement of electrodes over the dorsal aspect of spinal cord in the epidural space. The procedure is a staged one in which trial lead electrodes are first implanted and stimulated with an external pulse generator (EPG). If the trial is successful and patient has acceptable pain relief over 1 week of stimulation at various settings, the patient undergoes the permanent implantation of electrodes at the same position. The permanent electrodes are then stimulated by an implantable pulse generator (IPG) in the subcutaneous pocket (abdominal or gluteal). Complications are rare and are more related to hardware like lead migration and breakage. Since it is does not damage the cord per se, its acceptance as a procedure for pain is known quite well in the Western world. Its availability and cost of implants is the major hurdle in its use in a developing nation like India. Here, we present a technical note and our experience of two cases of thoracic spinal cord stimulation for chronic neuropathic pain at our institution.

scholarly journals Mechanistic Rationale and Clinical Efficacy of Hyperbaric Oxygen Therapy in Chronic Neuropathic Pain: An Evidence-Based Narrative Review

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Simone Schiavo ◽  
Julian DeBacker ◽  
Carine Djaiani ◽  
Anuj Bhatia ◽  
Marina Englesakis ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Hyperbaric Oxygen ◽  
Clinical Efficacy ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Pain Syndrome ◽  
Narrative Review ◽  
Human Studies ◽  
Current Evidence ◽  
Chronic Neuropathic Pain

Background. Chronic neuropathic pain is a condition affecting an increasing proportion of the general population and its management requires a comprehensive, multidisciplinary program. A growing body of evidence supports the use of hyperbaric oxygen therapy (HBOT) in several chronic neuropathic pain conditions; however, its role and efficacy remain unclear. Purpose. To summarize current evidence for the mechanistic rationale of HBOT in chronic neuropathic pain conditions and to evaluate its clinical efficacy. Methods. This narrative review was conducted after searching the following databases (Medline, Embase, Cochrane, PsycINFO, the Web of Science, Scopus, ClinicalTrials. gov, WHO ICTRP, and ProQuest Digital Dissertation) from January 1946 to March 2020. Articles published in English that involved either animal or human studies with acute or chronic neuropathic pain evaluating any HBOT-related intervention were included. Results. A total of 2971 citations were identified. A total of 29 studies were included in this review. The mechanisms of action for HBOT use in neuropathic conditions included the primary effects of hyperoxia and edema resolution, as well as the secondary effects pertinent to the production of oxygen and nitrogen reactive species (serving as pain signaling molecules), nitric oxide-dependent release of opioid peptides, and reduction of inflammatory mediators. A robust evidence for HBOT use in the clinical setting was associated with chronic regional pain syndrome and chronic primary bladder pain syndrome. Some evidence supported its use for chronic secondary (peripheral) neuropathic pain including radiation-induced plexus neuropathies, postherpetic neuralgia, and trigeminal neuralgia. Conclusions. HBOT has been shown to have antinociceptive and analgesic effects in animal models of inflammatory, neuropathic, and chronic pain. Human studies demonstrated beneficial effects of HBOT in improving clinical outcomes such as pain scores, pain-related symptoms, and quality of life. A systematic methodology of HBOT application is necessary to confirm its safety and efficacy.

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