Anticonvulsants Don't Seem to Ease Low Back Pain

Posted on: 2018-09-19 10:35:59

Anticonvulsant medications like gabapentin and pregabalin don't appear to improve low back pain, a meta-analysis in the Canadian Medical Association Journal finds.

Researchers examined nine studies of nearly 900 patients with chronic low back pain or lumbar radicular pain. Patients received either anticonvulsants (gabapentinoids or topiramate) or placebo. Gabapentinoids had no effect on low back pain or disability, but topiramate appeared to have a small effect on pain in the short term. No treatment affected lumbar radicular pain.

Gabapentinoids were associated with increased risk for adverse events relative to placebo, including drowsiness, dizziness, and nausea (pooled risk ratio, 1.4). Topiramate didn't appear to carry increased risk.

The authors conclude: "Evidence to date does not support the use of anticonvulsants for chronic low back pain or lumbar radicular pain. This review found mostly moderate- to high-level quality of evidence suggesting no treatment benefit for pain and disability, and high-level evidence supporting the risk of harms."

CMAJ article (Free abstract)

Background: NEJM perspective on increased use of gabapentinoids for pain (Free)

Background: NEJM Journal Watch General Medicine coverage of American College of Physicians' guidelines on noninvasive treatments for low back pain (Your NEJM Journal Watch registration required)






List of other forums, you may also like

Request from Dr Ashish Goel:

Posted on: 2018-10-03 05:49:57

I edited a book entitled "Doctors Do Cry" and published this in 2004. This is a collection of short stories written by doctor all over the world and patient interaction incidents that changed the way they practice. Touching stories that impacted their thinking.

This is an attempt in my part to help the society understand doctors as humans and reduce the rising incidents of conflict. This is a link between doctors and humanities that helps them

Read more

Firstpost West Bengal passes stringent bill against medical negligence in private hospitals

Posted on: 2018-09-19 10:44:50

Sanjjeev Nehraa

"QUOTE
The West Bengal Assembly on Thursday passed a bill to regulate functioning of private health facilities, providing for up to three-year jail terms and trials under the IPC for offenders and fines up to Rs 50 lakh in case of death of patients due to medical negligence.

The West Bengal Clinical Establishments (Registration, Regulation and Transparency) Bill, 2017l, tabled by Parliamentary Affairs Minister Partha Chatte

Read more

Types of residents

Posted on: 2018-09-19 10:42:49

Michelle M. Kittleson, MD, PhD, is Director of Education in Heart Failure and Transplantation and Director of Heart Failure Research, Department of Cardiology, Cedars-Sinai Heart Institute.

Corresponding author: Michelle M. Kittleson, MD, PhD, Cedars-Sinai Heart Institute, Department of Cardiology, 8536 Wilshire Boulevard, Suite 301, Los Angeles, CA 90211, 310.248.8300, fax 310.248.8333, michelle.kittleson@cshs.org

My parents taught me that

Read more

Medical trainees should question why they preemptively order "routine" tests and investigations

Posted on: 2018-09-19 10:42:01

Medical students from around the world utter the Hippocratic Oath when graduating medical school as an age-old commitment to professionalism. Yet, much of what we are taught during medical school conflicts with the oath's focus on communication and shared-decision making. There is a hidden curriculum in medicine that encourages trainees to do extensive workups to demonstrate their knowledge and curiosity. Choosing Wisely campaigns, in Canada and

Read more

Medical negligence: there are no winners

Posted on: 2018-09-19 10:41:20

No single measure will unravel the unsustainable problem of rising medical negligence costs. However, several key activities-in the context of a continued requirement to increase expenditure-might help: the promotion of candour, the advocacy of a problem-solving culture rather than one based on blaming the individual, and the improvement in quality of a service that has, for 70 years, been crucial in delivering equitable health care for millions

Read more

The Art of Constructive Worrying

Posted on: 2018-09-19 10:40:52

Some nights I lie awake and think about patients from the past. Mistakes play back like a movie reel in my mind. Some details are now lost to me, as many of these mistakes hark back to when I was a resident. But the sick sensation of realizing an error comes back as vividly as if it were happening now. Why didn't I immediately transfer the patient with a suspected gastrointestinal bleed to the intensive care unit? Shouldn't I have made a diagnosi

Read more

Getting Doctors to Make Better Decisions Will Take More than Money and Nudges

Posted on: 2018-09-19 10:40:19

Research has repeatedly shown that U.S. patients receive recommended care only half of the time. It is also known that patients receive non-recommended or "low-value" care as much as 20% of the time. Despite the proliferation of evidence-based guidelines to improve clinicians' practice patterns, clinicians often don't respond to them. So healthcare leaders have long wondered: what's the best way to change clinicians' behavior and improve their qu

Read more

Inappropriate Care as the main patient safety issue.

Posted on: 2018-09-19 10:35:21

We have been emphasising inappropriate Care as a core patient safety issue all these years. The WHO report below reiterates the same.
Low quality healthcare is increasing the burden of illness and health costs globally

5 July 2018 Geneva

Poor quality health services are holding back progress on improving health in countries at all income levels, according to a new joint report by the OECD, World Health Organization (WHO) and the World Ban

Read more

3 Things to Know about the National Steering Committee for Patient Safety

Posted on: 2018-09-19 10:34:45

Some 85 percent of people in the United States had an encounter with a health professional in the past year, according to the Centers for Disease Control and Prevention.

Most patients will never experience unintended medical harm, but health care can be high risk, and technological and treatment advances continually create new opportunities for safety lapses. While the field has made considerable progress in advancing targeted patient safety i

Read more

Pursuit of TRUST

Posted on: 2018-09-19 10:34:08

Pursuit of Trust: - Srinivasa Raghavan

She was a 15-year-old school kid; came in with multiple episodes of seizures ('epileptic fit' in street language). IV injections controlled her fits; CT scan and MRI painlessly sliced through her brain; millimeter by millimeter searching for a focus; negative. 24-hours later she was stable and ready to be started on long term medicines to prevent recurrences.

He was one of the most respected neurolog

Read more

Video Gallery


Latest Blogs

Anticonvulsant medications like gabapentin and pregabalin don't appear to improve low back pain, a meta-analysis in the Canadian Medical Association Journal finds. Researchers examined nine studies of nearly 900 patients with chronic low back pain or lumbar radicular pain.Patients received either anticonvulsants (gabapentinoids or topiramate) or placebo. Read More …

We have been emphasising inappropriate Care as a core patient safety issue all these years. The WHO report below reiterates the same. Low quality healthcare is increasing the burden of illness and health costs globally Read More …
Some 85 percent of people in the United States had an encounter with a health professional in the past year, according to the Centers for Disease Control and Prevention. Most patients will never experience unintended medical harm, but health care can be high risk, and technological and treatment advances continually create new opportunities for safety lapses. Read More …
She was a 15-year-old school kid; came in with multiple episodes of seizures ('epileptic fit' in street language). IV injections controlled her fits; CT scan and MRI painlessly sliced through her brain; millimeter by millimeter searching for a focus; negative. 24-hours later she was stable and ready to be started on long term medicines to prevent recurrences. Read More …

Image Gallery

Have a query?

info@icha.in

Follow Us on Facebook

Contact Us

  • Indian Confederation for Healthcare Accreditation
  • B2/211, 1st Floor, Safdarjang Enclave, New Delhi-110029, India
  • Dr. Akhil K. Sangal
  • +91-11-26183842, 9811061853
  • info@icha.in
  • www.icha.in

Find Us on Google