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Treatments for Acute Pain | Effective Health Care (EHC) Program
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report here. </div> <p></p> <ul class="download-group"> <li class="download-group-item highlight "> <a class="download-item" href="/sites/default/files/related_files/main-apps-surv-report-3-acute-pain.pdf">SURVEILLANCE REPORT 3 - Treatments for Acute Pain - (June 2022)</a> (PDF, 3 MB) <span class="badge badge-ehcd ">NEW</span> </li> <li class="download-group-item highlight "> <a class="download-item" href="/sites/default/files/related_files/app-e-surv-report-3-acute-pain.xlsx">Appendix E: Surveillance Report 3 - Treatments for Acute Pain - (June 2022)</a> (XLSX, 123 KB) <span class="badge badge-ehcd ">NEW</span> </li> <li class="download-group-item highlight "> <a class="download-item" href="/sites/default/files/related_files/app-f-surv-report-3-acute-pain.xlsx">Appendix F: Surveillance Report 3 - Treatments for Acute Pain - (June 2022)</a> (XLSX, 42 KB) <span class="badge badge-ehcd ">NEW</span> </li> <li class="download-group-item "> <a class="download-item" 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href="/sites/default/files/related_files/app-e-surv-rept-1-acute-pain.xlsx">Appendix E: Surveillance Report 1 - Treatments for Acute Pain - (January 2022)</a> (XLSX, 144 KB) </li> <li class="download-group-item "> <a class="download-item" href="/sites/default/files/related_files/app-f-surv-rept-1-acute-pain.xlsx">Appendix F: Surveillance Report 1 - Treatments for Acute Pain - (January 2022)</a> (XLSX, 42 KB) </li> <li class="download-group-item "> <a class="download-item" href="/sites/default/files/cer-240-acute-pain-evidence-summary.pdf">EXECUTIVE SUMMARY - (December 2020)</a> (PDF, 298 KB) </li> <li class="download-group-item "> <a class="download-item" href="/sites/default/files/related_files/cer-240-acute-pain-review.pdf">SYSTEMATIC REVIEW - (December 2020)</a> (PDF, 3 MB) </li> <li class="download-group-item "> <a class="download-item" href="/sites/default/files/cer-240-acute-pain-appendix-e.xlsx">Systematic Review Appendix E - (December 2020) </a> (XLSX, 151 KB) </li> <li 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<div class="toc-contents"> <ul> <li><a href="#field_report_title_1">Surveillance Reports</a></li> <li><a href="#field_report_title_2">Main Points</a></li> <li><a href="#field_report_title_3">Structured Abstract</a></li> <li><a href="#field_report_title_4">Report Citation</a></li> </ul> </div> </div> </div> <div class="col-sm-12 col-md-6"> <div class="hero"> <picture> <source srcset="/sites/default/files/styles/product_hero_desktop/public/images/ehc-acute-pain-collage_0.jpg?itok=kaE0a0NX 1x" media="all and (min-width: 1024px)" type="image/jpeg" width="1800" height="1034"/> <source srcset="/sites/default/files/styles/product_hero_tablet/public/images/ehc-acute-pain-collage_0.jpg?itok=ApH8yWsu 1x" media="all and (min-width: 560px) and (max-width: 1023px)" type="image/jpeg" width="1200" height="689"/> <source srcset="/sites/default/files/styles/product_hero_phone/public/images/ehc-acute-pain-collage_0.jpg?itok=vixUSNdm 1x" media="all and (max-width: 559px)" type="image/jpeg" width="800" height="459"/> <img class="img-responsive w-100 img-fluid" id="hero-image" src="/sites/default/files/styles/product_hero_desktop/public/images/ehc-acute-pain-collage_0.jpg?itok=kaE0a0NX" alt="Treatments for Acute Pain: A Systematic Review" typeof="foaf:Image" /> </picture> </div> </div> </div> </div> </div> <article data-history-node-id="4355" about="/products/treatments-acute-pain/research" class="node node--type-product node--view-mode-full clearfix"> <div class="node__content clearfix"> <div class="row"> <div class="main-content-no-sb2"> <div class="field field--name-field-report-section field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="accordion" id="paragraph__ahrq__report_sub_section"> <div class="card-header product-card" id="field_report_title_"> <h2> <button class="btn btn-link btn-block text-left product-button collapsed" type="button" data-toggle="collapse" data-target="#field_report_body_" aria-expanded="false" aria-controls="collapseOne"> Surveillance Reports <img src="/themes/custom/ahrq_bootstrap_barrio/pattern-lab/source/images/theme_core/plus-solid_5B616B.png" alt="" class="product-plusminus"> </button> </h2> </div> <div id="field_report_body_" class="collapse card-border" aria-labelledby="headingOne"> <div class="card-body"> <p>The three surveillance reports posted above include a literature search updated since the systematic review was posted in December 2020, putting newly identified studies in the context of what is known. No additional surveillance reports are planned.</p> </div> </div> </div> </div> <div class="field__item"> <div class="accordion" id="paragraph__ahrq__report_sub_section"> <div class="card-header product-card" id="field_report_title_"> <h2> <button class="btn btn-link btn-block text-left product-button collapsed" type="button" data-toggle="collapse" data-target="#field_report_body_" aria-expanded="false" aria-controls="collapseOne"> Main Points <img src="/themes/custom/ahrq_bootstrap_barrio/pattern-lab/source/images/theme_core/plus-solid_5B616B.png" alt="" class="product-plusminus"> </button> </h2> </div> <div id="field_report_body_" class="collapse card-border" aria-labelledby="headingOne"> <div class="card-body"> <ul> <li>Opioids are probably less effective than nonsteroidal anti-inflammatory drugs (NSAIDs) for surgical dental pain and kidney stone pain and might be similarly effective to NSAIDs for low back pain.</li> <li>Opioids might be and NSAIDs are probably more effective than acetaminophen for surgical dental pain, but opioids are probably less effective than acetaminophen for kidney stone pain.</li> <li>An opioid might be more effective than gabapentin for acute neuropathic pain.</li> <li>Opioids are probably associated with increased risk of short-term adverse events versus nonopioid pharmacologic therapy for acute pain, including any adverse event, study withdrawal due to adverse events, nausea, dizziness, and somnolence, but serious adverse events are uncommon in randomized trials.</li> <li>Being prescribed an opioid for acute low back pain or postoperative pain might be associated with increased likelihood of use of opioids at long-term followup versus not being prescribed.</li> <li>Heat therapy is probably effective for acute low back pain, spinal manipulation might be effective for acute back pain with radiculopathy, massage might be effective for postoperative pain, and a cervical collar or exercise might be effective for acute neck pain with radiculopathy.</li> <li>Research is very limited on the comparative effectiveness of therapies for sickle cell pain, acute neuropathic pain, neck pain, and management of postoperative pain following discharge.</li> </ul> </div> </div> </div> </div> <div class="field__item"> <div class="accordion" id="paragraph__ahrq__report_sub_section"> <div class="card-header product-card" id="field_report_title_"> <h2> <button class="btn btn-link btn-block text-left product-button collapsed" type="button" data-toggle="collapse" data-target="#field_report_body_" aria-expanded="false" aria-controls="collapseOne"> Structured Abstract <img src="/themes/custom/ahrq_bootstrap_barrio/pattern-lab/source/images/theme_core/plus-solid_5B616B.png" alt="" class="product-plusminus"> </button> </h2> </div> <div id="field_report_body_" class="collapse card-border" aria-labelledby="headingOne"> <div class="card-body"> <p><strong>Objectives.</strong> To evaluate the effectiveness and comparative effectiveness of opioid, nonopioid pharmacologic, and nonpharmacologic therapy in patients with specific types of acute pain, including effects on pain, function, quality of life, adverse events, and long-term use of opioids.</p> <p><strong>Data sources.</strong> Electronic databases (Ovid<sup>庐</sup> MEDLINE<sup>庐</sup>, PsycINFO<sup>庐</sup>, Embase<sup>庐</sup>, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews) to August 2020, reference lists, and a Federal Register notice.</p> <p><strong>Review methods.</strong> Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) of outpatient therapies for eight acute pain conditions: low back pain, neck pain, other musculoskeletal pain, neuropathic pain, postoperative pain following discharge, dental pain (surgical or nonsurgical), pain due to kidney stones, and pain due to sickle cell disease. Meta-analyses were conducted on pharmacologic therapy for dental pain and kidney stone pain, and likelihood of repeat or rescue medication use and adverse events. The magnitude of effects was classified as small, moderate, or large using previously defined criteria, and strength of evidence was assessed.</p> <p><strong>Results.</strong> One hundred eighty-three RCTs on the comparative effectiveness of therapies for acute pain were included. Opioid therapy was probably less effective than nonsteroidal anti-inflammatory drugs (NSAIDs) for surgical dental pain and kidney stones, and might be similarly effective as NSAIDs for low back pain. Opioids and NSAIDs were more effective than acetaminophen for surgical dental pain, but opioids were less effective than acetaminophen for kidney stone pain. For postoperative pain, opioids were associated with increased likelihood of repeat or rescue analgesic use, but effects on pain intensity were inconsistent. Being prescribed an opioid for acute low back pain or postoperative pain was associated with increased likelihood of use of opioids at long-term followup versus not being prescribed, based on observational studies. Heat therapy was probably effective for acute low back pain, spinal manipulation might be effective for acute back pain with radiculopathy, acupressure might be effective for acute musculoskeletal pain, an opioid might be effective for acute neuropathic pain, massage might be effective for some types of postoperative pain, and a cervical collar or exercise might be effective for acute neck pain with radiculopathy. Most studies had methodological limitations. Effect sizes were primarily small to moderate for pain, the most commonly evaluated outcome. Opioids were associated with increased risk of short-term adverse events versus NSAIDs or acetaminophen, including any adverse event, nausea, dizziness, and somnolence. Serious adverse events were uncommon for all interventions, but studies were not designed to assess risk of overdose, opioid use disorder, or long-term harms. Evidence on how benefits or harms varied in subgroups was lacking.</p> <p><strong>Conclusions.</strong> Opioid therapy was associated with decreased or similar effectiveness as an NSAID for some acute pain conditions, but with increased risk of short-term adverse events. Evidence on nonpharmacological therapies was limited, but heat therapy, spinal manipulation, massage, acupuncture, acupressure, a cervical collar, and exercise were effective for specific acute pain conditions. Research is needed to determine the comparative effectiveness of therapies for sickle cell pain, acute neuropathic pain, neck pain, and management of postoperative pain following discharge; effects of therapies for acute pain on non-pain outcomes; effects of therapies on long-term outcomes, including long-term opioid use; and how benefits and harms of therapies vary in subgroups.</p> </div> </div> </div> </div> <div class="field__item"> <div class="accordion" id="paragraph__ahrq__report_sub_section"> <div class="card-header product-card" id="field_report_title_"> <h2> <button class="btn btn-link btn-block text-left product-button collapsed" type="button" data-toggle="collapse" data-target="#field_report_body_" aria-expanded="false" aria-controls="collapseOne"> Report Citation <img src="/themes/custom/ahrq_bootstrap_barrio/pattern-lab/source/images/theme_core/plus-solid_5B616B.png" alt="" class="product-plusminus"> </button> </h2> </div> <div id="field_report_body_" class="collapse card-border" aria-labelledby="headingOne"> <div class="card-body"> <p>Chou R, Wagner J, Ahmed AY, Blazina I, Brodt E, Buckley DI, Cheney TP, Choo E, Dana T, Gordon D, Khandelwal S, Kantner S, McDonagh MS, Sedgley C, Skelly AC. Treatments for Acute Pain: A Systematic Review. Comparative Effectiveness Review No. 240. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I.) AHRQ Publication No. 20(21)-EHC006. Rockville, MD: Agency for Healthcare Research and Quality; December 2020. DOI: 10.23970/AHRQEPCCER240. <a href="/products?f%5B0%5D=field_product_type%3Aresearch_report&f%5B1%5D=field_product_type%3Asystematic_review&f%5B2%5D=field_product_type%3Atechnical_brief&f%5B3%5D=field_product_type%3Awhite_paper&f%5B4%5D=field_product_type%3Amethods_guide_chapter&sort_by=field_product_pub_date">Posted final reports</a> are located on the Effective Health Care Program search page</p> </div> </div> </div> </div> </div> </div> </div> </div> </article> </div> <div class="col-md-3 pg-sb2"> <div id="block-timeline--4" class="block block-ahrq block-timeline"> <div class="content"> <div id="project-timeline"> <div class="project-timeline-data"> <h2>Project Timeline</h2> <h3 class="project-title">Treatments for Acute Pain: A Systematic Review</h3> <div class="product row"> <div class="product-date col-4">Dec 27, 2019</div> <div class="timeline-line inactive col-1"> <div class="circle-line"> <div class="circle"></div> </div> </div> <div class="product-type col-6"> Topic Initiated </div> </div> <div class="product row"> <div class="product-date col-4">Jan 2, 2020</div> <div class="timeline-line inactive col-1"> <div class="circle-line"> <div class="circle"></div> </div> </div> <div class="product-type col-6"> <a class="product-type-text" href="/products/treatments-acute-pain/protocol">Research Protocol</a> </div> </div> <div class="product row"> <div class="product-date col-4">Jun 22, 2022</div> <div class="timeline-line active col-1"> <div class="circle-line"> <div class="circle"></div> </div> </div> <div class="product-type col-6"> <span class="product-type-text"><strong>Systematic Review</strong></span> </div> </div> </div> </div> </div> </div> <div id="block-ahrq-related-collection--4" class="block block-ahrq block-ahrq-related-collection"> <div class="content"> </div> </div> <div class="views-element-container block block-views block-views-blocksecondary-callouts-block-2" id="block-views-block-secondary-callouts-block-2"> <div class="content"> <div><div class="view view-secondary-callouts view-id-secondary_callouts view-display-id-block_2 js-view-dom-id-de5a59360a9473c99539c16e608aa692f3b074de06c366f9ff9fabe0527d71a9"> <div class="view-content row"> <div class="views-row"> <div class="views-field views-field-field-secondary-callout"><div class="field-content"></div></div> </div> </div> </div> </div> </div> </div> <div id="block-dexi-recommended-items--4" class="block block-ahrq-dexi block-dexi-recommended-items"> <div class="content"> <div id="recommended-items-wrapper"> <div class="recommended-items"> <h2 class="recommended-items-title">You Might Also Like</h2> <ul> <li> <span class="ri-prodType">Research Protocol</span> <span class="status-divider"> </span> <div class="date">May 17, 2024</div> <div class="row"> <div class="title"> <a href="/products/peripheral-nerve-blocks/protocol">Peripheral Nerve Blocks for Postoperative Pain Management in Cardiothoracic Surgery</a><br /> </div></div> </li> <li> <span class="ri-prodType">Systematic Review</span> <span class="status-divider"> </span> <div class="date">Aug 08, 2022</div> <div class="row"> <div class="title"> <a href="/products/migraine-treatments/research">Acute Treatments for Episodic Migraine</a><br /> </div></div> </li> <li> <span class="ri-prodType">Rapid Evidence Product</span> <span class="status-divider"> </span> <div class="date">Apr 01, 2021</div> <div class="row"> <div class="title"> <a href="/products/care-coordination-plans/research">Care Coordination and Care Plans for Transitions Across Care Settings</a><br /> </div></div> </li> <li> <span class="ri-prodType">Technical Brief</span> <span class="status-divider"> </span> <div class="date">Nov 03, 2020</div> <div class="row"> <div class="title"> <a href="/products/opioids-older-adults/report">Prevention, Diagnosis, and Management of Opioids, Opioid Misuse, and Opioid Use Disorder in Older Adults </a><br /> </div></div> </li> <li> <span class="ri-prodType">Technical Brief</span> <span class="status">ARCHIVED</span><span class="status-divider"> </span> <div class="date">Oct 22, 2019</div> <div class="row"> <div class="title"> <a href="/products/acute-pain-treatment/technical-brief">Treatment for Acute Pain: An Evidence Map</a><br /> </div></div> </li> </ul> </div> </div> </div> </div> </div> </div> </div> <div class="row"> <div class="col-md-12 col-sm-12 text-right"> <section class="row region region-citation"> <div id="block-citation" class="block block-ahrq block-citation"> <div class="content"> <div id="created-reviewed-citation" class="pad-bottom-sections"> <div id="page-reviewed" class="body-copy-italic">Page last reviewed August 2022</div> <div id="page-created" class="body-copy-italic">Page originally created December 2020</div> </div> <div id="citation"> <div class="twocolordiv"> <div class="twocolordiv-content"> <p> <span class="citation-hdr">Internet Citation:</span> Systematic Review: Treatments for Acute Pain. 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