10/04/2021
LINEE GUIDA NICE 2021 PER IL DOLORE CRONICO 🔥🔥
🥂In soldoni :
☑️trattamento incentrato sul paziente
☑️esercizio fisico e terapeutico
☑️supporto psicologico
☑️educazione.
Alcuni farmaci ammessi, altri no come:
❌ il paracetamolo
❌i FANS
❌gli oppioidi
Inoltre bocciati:
❌TENS
❌ultrasuoni
❌correnti interferenziali
📒https://www.nice.org.uk/guidance/ng193/chapter/Recommendations -chronic-primary-pain
Exercise programmes and physical activity for chronic primary pain
1.2.1Offer a supervised group exercise programme to people aged 16 years and over to manage chronic primary pain. Take people's specific needs, preferences and abilities into account.
1.2.2Encourage people with chronic primary pain to remain physically active for longer-term general health benefits (also see NICE guidelines on physical activity and behaviour change: individual approaches).
Psychological therapy for chronic primary pain
1.2.3Consider acceptance and commitment therapy (ACT) or cognitive behavioural therapy (CBT) for pain for people aged 16 years and over with chronic primary pain, delivered by healthcare professionals with appropriate training
[...]
1.2.6Do not offer any of the following to people aged 16 years and over to manage chronic primary pain because there is no evidence of benefit:
TENS
ultrasound
interferential therapy
[...]
1.2.7Consider an antidepressant, either amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine or sertraline, for people aged 18 years and over to manage chronic primary pain, after a full discussion of the benefits and harms
1.2.10
Do not initiate any of the following medicines to manage chronic primary pain in people aged 16 years and over:
antiepileptic drugs including gabapentinoids, unless gabapentinoids are offered as part of a clinical trial for complex regional pain syndrome (see the recommendation for research on pharmacological interventions)
antipsychotic drugs
benzodiazepines
corticosteroid trigger point injections
ketamine
local anaesthetics (topical or intravenous), unless as part of a clinical trial for complex regional pain syndrome (see the recommendation for research on pharmacological interventions)
local anaesthetic/corticosteroid combination trigger point injections
non-steroidal anti-inflammatory drugs
opioids
paracetamol
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🇮🇹Fisioterapista Osteopata Pt Marco Di Ruscio
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