Persistent pain (often referred to as "chronic pain") is pain that continues for three months or more, and does not respond to usual medical treatment. ISCRR researchers have evaluated several existing treatment options for persistent pain. The objective of this work is to help compensation bodies maximise the health outcomes of claimants with persistent pain.

Implantable pain therapy: Intrathecal infusions Evidence Review

This review sought to find the most up-to-date, high quality sources of evidence to determine whether intrathecal infusions are an effective treatment compared to placebo or active treatment in the treatment of persistent non-cancer pain.

Authors: Clavisi, O; Chee, M; Pattuwage, L; Synnot, A

Keywords: persistent pain; pain relief

Date published: April 2015

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Implantable pain therapy: Neurostimulation Evidence Review

Persistent pain is a difficult condition to cure and there are few known effective treatments but patients may not experience complete pain relief with these treatments and side effects may occur. A potential alternative treatment option for these patients is neurostimulation. Neurostimulation is the electrical activation of nerves using electrodes and leads—a low voltage electrical charge to the nerves may block the sensation of pain.

Authors: Clavisi, O; Chee, M; Pattuwage, L; Synnot, A

Keywords: persistent pain; pain relief

Date published: February 2015

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Spinal injection therapies: Radiofrequency denervation Evidence Review

Radiofrequency denervation is sometimes used to treat persistent neck and back pain. The procedure involves insertion of a needle next to joints in the spine, electricity sent through the needle then destroys the nerve to the joint, stopping the pain signals to the brain. There is not enough evidence to be clear about the benefits and harms of radiofrequency denervation in the treatment of persistent pain in the neck or back.

Authors: Clavisi, O; Chee, M; Pattuwage, L

Keywords: back pain; persistent pain; pain relief

Date published: November 2014

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Lumbar spinal fusion Evidence Review

Spinal fusion is a surgical technique used in the treatment of chronic pain in cases where other options are not suitable. This systematic review identified that while several studies have compared surgery with other treatments for effectiveness on pain, muscle strength, function, work and quality of life, there is insufficient evidence to determine the effectiveness of fusion on chronic pain, compared to other treatments.

Authors: Clavisi, O; Dodge, N; Donoghue, E; Wasiak, J

Keywords: persistent pain; chronic pain; pain relief

Date published: May 2013

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Beds and mattresses for back pain Evidence Review

This systematic review examined the impact of mattress type on back pain or the treatment of back pain. The evidence available did not provide sufficient data for effectiveness to be determined, largely due to the diversity of studies and inconsistencies in study methodology.

Authors: Donoghue, E; Wasiak, J

Keywords: back pain

Date published: June 2012

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Psychosocial interventions for chronic pain Evidence Review

Chronic pain is often comorbid with a range of psychological disorders including post-traumatic stress disorder, depression, anxiety, sleep problems and substance use. This review examined the evidence of interventions to reduce mental health conditions in injured workers experiencing chronic pain. The evidence led to the bio-physical model as a framework for comprehensively identifying the factors associated with chronic pain and comorbid psychological problems. A growing evidence base in the area of risk factors identification was identified, as well as evidence of the effectiveness of early interventions for reducing the likelihood of developing chronic pain problems.

Authors: Mitchell, D; O’Donnell, M

Keywords: chronic pain; psychosocial factors; mental health; post-traumatic stress disorder

Date published: July 2011

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Implantable pain therapies: Neurostimulation Evidence Review

Neurostimulation is a therapy that directs electricity on to the nerves in cases where other methods are not suitable. The treatment requires surgery to insert a device under the skin that will provide electricity directly to the nerves. The treatment is only used where no other options are available to patients. This systematic review examined the clinical effectiveness of neurostimulation for the treatment of persistent pain.

Authors: Donoghue, E; Piccenna, L

Keywords: persistent pain; pain relief

Date published: June 2011

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Implantable pain therapies: Intrathecal infusions Evidence Review

Intrathecal infusion is a technique used to administer drugs through the stomach where other methods are not suitable. Existing clinical guidelines indicate that intrathecal infusions are only to be used where no other treatments are available. This systematic review examined the scientific literature to determine if intrathecal infusions are effective for the treatment of persistent pain.

Authors: Piccenna, L; Donoghue, E

Keywords: persistent pain; pain relief

Date published: June 2011

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Spinal injection therapies: Radiofrequency denervation Evidence Review

Radiofrequency denervation has been used to treat patients with chronic pain of spinal origin. The technique involves insertion of a small electrode into the spinal area where the pain originates; an electrical current is passed through the electrode destroying the target nerve, so that transmission of pain signals from this nerve is interrupted. There is not enough evidence to assess the benefit and harm of radiofrequency denervation in the treatment of persistent pain in the neck or back.

Authors: Donoghue, E; Ouakrim, D

Keywords: persistent pain; back pain; pain relief

Date published: January 2011

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Radiofrequency denervation Evidence Review

This review examined the evidence of clinical effectiveness of the use of radiofrequency denervation for the treatment of persistent pain. Both the initial review and update concluded that there was insufficient evidence to determine with confidence the benefits and harms of radiofrequency denervation for the treatment of persistent pain.

Keywords: persistent pain; pain relief

Date published: April 2010

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