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Platelet-Rich Plasma Injection Not Beneficial for Nonoperative Treatment of Rotator ...

Nov 15, 2019 - The review found no evidence that supports any additional benefit of platelet-rich plasma injections compared with various control interventions, including saline placebo, in the non-operative treatment of rotator cuff disease in adults.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p647.html

Oral Antibiotics Are Equal to IV Antibiotics for Serous Bone and Joint Infections - ...

Oct 1, 2019 - Oral antibiotics started within seven days of surgery for patients with a serious bone or joint infection are as safe and effective as six weeks of IV antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p441.html

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

Decompression Surgery No More Effective Than Exercise for Shoulder Impingement Syndrome...

Feb 1, 2019 - Despite being one of the most common orthopedic surgeries performed, subacromial decompression is not significantly better than physical therapy to treat patients with pain and limited function caused by shoulder impingement.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p190.html

Incidental Findings Are Common with Chest CT and MRI of the Spine and Brain - POEMs - ...

Dec 1, 2018 - The risks of imaging, in addition to radiation exposure, include the identification of incidentalomas, which can lead to patient anxiety, further testing, and overtreatment. There is little research to guide what to do when they pop up on an imaging report (as the famous dodge clinical ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682.html

Nonopioids Equivalent to Opioids for Severe Chronic Back, Hip, or Knee Pain with Fewer ...

Sep 1, 2018 - Nonopioid medications were at least as effective as opioid medications for improving pain-related function over 12 months in adults with severe chronic back pain or knee or hip osteoarthritis pain. The evidence that opioids are not superior to nonopioid medications for chronic and acute...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0901/p316.html

Aspirin No Different Than Rivaroxaban for Prevention of VTE After TKA or THA - POEMs - ...

Aug 15, 2018 - Extended prophylaxis with low-dose aspirin is similar in efficacy to rivaroxaban for the prevention of symptomatic VTE following TKA or THA. Aspirin is cheap, widely available, and effective, making it a good alternative to the more costly direct oral anticoagulants.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248.html

Surgery Equal to No Surgery for Patients with Subacromial Shoulder Pain - POEMs - ...

Jul 1, 2018 - In patients with subacromial shoulder pain of at least three months' duration who receive physical therapy, surgical decompression is no better than arthroscopy without decompression in improving pain or function, and neither is much better than no invasive intervention at all.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54.html

Lumbar Fusion of Variable Value Based on Treating Diagnosis, with Significant ...

May 1, 2018 - Lumbar fusion for degenerative spinal disease appears to be most beneficial for patients undergoing the procedure for spondylolisthesis, but it is of little clear benefit for patients with other indications, such as spinal stenosis or chronic back pain.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605a.html

Early PT for Acute Low Back Pain Is Cost-Effective, but Gain in Quality of Life Is ...

Apr 1, 2018 - At $30,000 per quality-adjusted life year (QALY) gained, early PT for acute low back pain in primary care is cost-effective by the usual criteria of $50,000 to $100,000 per QALY. However, the magnitude of improvement in quality of life is small and is probably not clinically meaningful.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p475.html

Gabapentinoids for Chronic Low Back Pain: Limited Evidence, More Harm Than Benefit - ...

Dec 15, 2017 - The existing data on gabapentinoids for chronic low back pain are limited in number and quality. The amount of pain reduction is low to moderate, and the rate of adverse effects is high. The few studies that assessed function found no improvement.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od3.html

Corticosteroid Injections Ineffective for Knee Osteoarthritis - POEMs - American Family...

Sep 15, 2017 - This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p406.html

Pregabalin Does Not Decrease the Pain of Sciatica - POEMs - American Family Physician

Aug 15, 2017 - Pregabalin does not relieve pain in patients with sciatica.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260.html

Arthroscopic Meniscal Surgery Is Equivalent to Nonoperative Management - POEMs - ...

Jul 1, 2017 - The existing research base, with biases that typically make interventions look better, is unable to demonstrate that arthroscopy for meniscal injuries is any better than nonoperative approaches. Because this is a costly intervention and is being used more often, perhaps insurance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0701/p55.html

Placebo Plus Message of Benefit Decreases Chronic Low Back Pain - POEMs - American ...

Apr 1, 2017 - These investigators gave twice daily placebo to patients with chronic back pain and told them it was placebo. They also told them that placebos can have a pronounced effect (which is true). The addition of placebo to usual care improved patients' pain and disability scores over the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p456.html

Lumbar Fusion No Better Than Exercise and Therapy in the Long Term - POEMs - American ...

Dec 1, 2016 - This trial is a good example of how to do just about everything wrong to get the results you want. The authors did not conceal allocation, did not mask anyone in the study, used an unvalidated and subjective primary outcome, and downplayed the intention-to-treat analysis. Funding for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1201/p937.html

Knee Surgery Does Not Reduce Knee Catching or Locking in Patients with Meniscal Tear - ...

Aug 15, 2016 - Removing the torn bits of meniscus in middle-aged patients who have intermittent knee catches or locking does not decrease their likelihood of experiencing symptoms in the following year compared with diagnostic arthroscopy (i.e., looking but not touching). In general, meniscectomy does...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p317a.html

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.html

Hyaluronic Acid Equivalent to Sham Injections in Patients with Knee DJD - POEMs - ...

Apr 15, 2016 - The highest quality studies, which are now fairly plentiful, show that hyaluronic acid injections are only minimally better than sham injections in improving pain and function in patients with knee DJD.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0415/p704.html

Naproxen Alone May Be Best for Acute Low Back Pain - POEMs - American Family Physician

Feb 15, 2016 - Naproxen alone is as effective as naproxen plus oxycodone/acetaminophen or naproxen plus cyclobenzaprine (Flexeril) in reducing pain and improving function in adults with acute musculoskeletal LBP without radicular symptoms. Adverse events were significantly more common in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p316.html

Epidural Steroid Not Better Than Placebo Injection for Sciatica and Spinal Stenosis ...

Feb 15, 2016 - It is hard to figure out what to do with these results. On the one hand, steroid injection did not provide a significant benefit compared with placebo injection in patients with radicular pain or spinal stenosis. However, part of the reason for this may be the significant and sustained ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315a.html

Gabapentin Equals Epidural Steroid for Radicular Pain - POEMs - American Family Physician

Nov 1, 2015 - After controlling for the placebo effect that may accompany an epidural steroid injection, treatment with gabapentin is as effective as the injection in reducing radicular leg pain in the short term (three months). A placebo bump in response, if present, is likely to be transient.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814a.html

Acetaminophen (Paracetamol) Minimally Effective for Back Pain and Osteoarthritis - ...

Oct 1, 2015 - Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p642.html

Focused Extracorporeal Shock Wave Therapy Better Than Placebo to Relieve Pain in ...

Oct 1, 2015 - In this study, unlike others, patients with chronic plantar fasciitis treated with extra-corporeal shock wave therapy had greater pain relief than those treated with placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p635.html

Spinal Stenosis: Physical Therapy Before Surgery - POEMs - American Family Physician

Sep 15, 2015 - Assigning patients to six weeks of physical therapy is as effective as initially sending them for decompression surgery, with fewer complications, even in patients who have a strong preference for surgery. A trial of six weeks of physical therapy makes sense for many patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p528.html

Walking Program Effective for Chronic Low Back Pain - POEMs - American Family Physician

Aug 1, 2015 - Giving patients a pedometer, a walking diary, and instructions to walk at least four days per week, then gradually increase the walk's duration and intensity (see synopsis) results in improvement in pain and disability similar to usual physical therapy or a group exercise program.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0801/p230.html

Early Imaging for Low Back Pain in Older Adults Raises Costs Without Improving Quality ...

Aug 15, 2015 - Among adults 65 years or older who present to primary care clinicians for a new episode of back pain, early imaging (before six weeks) resulted in no improved outcomes at one year, but increased overall health care costs by almost 30%.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0815/p310.html

No Long-Term Benefit of Arthroscopic Surgery for Meniscal Tears in Middle-Aged Persons ...

May 1, 2015 - Arthroscopic repair of degenerative meniscal tears in middle-aged adults does not significantly improve long-term pain or function. Patients should do physical therapy and try to avoid surgery if possible.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p643.html

Injection Equals Physical Therapy for Shoulder Impingement - POEMs - American Family ...

Feb 15, 2015 - Both physical therapy and corticosteroid injection decrease pain and disability by about 50% within one month of beginning treatment. However, average scores will not improve beyond that over the course of the year, and the average person will have pain, disability, and an altered ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p260a.html

Epidural Steroid Injections Ineffective for Lumbar Spinal Stenosis - POEMs - American ...

Dec 1, 2014 - Epidural glucocorticoid injections are ineffective for lumbar spinal stenosis. Whether this will change practice for this lucrative procedure will be an interesting question.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p795a.html

Physical Therapy No Better Than Sham Therapy for Hip Osteoarthritis - POEMs - American ...

Oct 1, 2014 - In this study, physical therapy was no more effective than sham therapy in reducing pain and improving function in adults with hip osteoarthritis.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1001/p497a.html

Opioids for Chronic Back Pain: Short-Term Effectiveness, Long-Term Uncertain - POEMs - ...

Aug 15, 2014 - Overall, in patients with chronic low-back pain, opioids are moderately more effective than placebo in the short term for pain relief and slightly more effective in the short term for improving function. However, data for long-term use are virtually nonexistent. The long-term use of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od5.html

Nontraumatic Supraspinatus Tears: PT Is Equal to PT Plus Surgery at One Year - POEMs - ...

May 15, 2014 - In this study, the long-term outcomes of adults with nontraumatic supraspinatus tears who are treated conservatively are similar to those of patients treated with two different surgical approaches.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0515/p824.html

Platelet-Rich Plasma May Minimally, If at All, Benefit Patients with Knee ...

Apr 1, 2014 - Compared with normal saline or hyaluronic acid, multiple intra-articular injections of platelet-rich plasma significantly improved knee function but did not reduce perceived pain or improve patient satisfaction in adults with symptomatic knee osteoarthritis.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0401/p578.html

Impact of Bracing in Adolescents with Idiopathic Scoliosis - POEMs - American Family ...

Mar 15, 2014 - When compared with observation, bracing significantly slows progression of high-risk curves to the surgery threshold (Cobb angle greater than 50 degrees), with a number needed to treat (NNT) of 4 in the randomized portion of the trial. This benefit is greater with more daily hours of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0315/p481.html

Aspirin Is as Safe and Effective as LMWH for Extended Thromboprophylaxis After Total ...

Dec 1, 2013 - Aspirin is as effective as dalteparin for extended thromboprophylaxis in patients who had total hip arthroplasty and had initially received 10 days of dalteparin prophylaxis postoperatively. Because of its relative safety, low cost, and easy administration, aspirin is an attractive ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1201/p739.html

Dextrose Prolotherapy Decreases Pain and Stiffness in Knee Degenerative Joint Disease -...

Nov 1, 2013 - Dextrose prolotherapy appears to be more effective in decreasing pain and stiffness, and improving function in patients with knee degenerative joint disease than saline injections and home exercise.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/od1.html

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