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Dietary Ingredients as an Alternative Approach for Mitigating Chronic Musculoskeletal Pain: Evidence-Based Recommendations for Practice and Research in the Military.

Identifieur interne : 000515 ( Main/Exploration ); précédent : 000514; suivant : 000516

Dietary Ingredients as an Alternative Approach for Mitigating Chronic Musculoskeletal Pain: Evidence-Based Recommendations for Practice and Research in the Military.

Auteurs : Cindy Crawford [États-Unis] ; Courtney Boyd [États-Unis] ; Charmagne F. Paat [États-Unis] ; Karin Meissner [Allemagne] ; Cindy Lentino [États-Unis] ; Lynn Teo [États-Unis] ; Kevin Berry [États-Unis] ; Patricia Deuster [États-Unis]

Source :

RBID : pubmed:30986309

Descripteurs français

English descriptors

Abstract

OBJECTIVE

Approximately 55-76% of Service members use dietary supplements for various reasons, including pain and related outcomes. This work evaluates current research on dietary ingredients for chronic musculoskeletal pain to inform decisions for practice and self-care, specifically for Special Operations Forces personnel.

METHODS

A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. The committee made evidence-informed judgments and recommendations for practice and self-care use.

RESULTS

Nineteen eligible dietary ingredients were assessed for quality, efficacy, and safety. Avocado soybean unsaponifiables, capsaicin, curcuma, ginger (as a food source), glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D were conditionally recommended as their benefits outweighed risks, but there was still some uncertainty about the trade-offs. No recommendations were made for boswellia, ginger (as a dietary supplement), rose hip, or s-adenosyl-L-methionine. Recommendations were made against the use of collagen, creatine, devil's claw, l-carnitine, methylsulfonylmethane, pycnogenol, willow bark extract, and vitamin E. Research priorities were developed to address gaps precluding stronger recommendations.

CONCLUSIONS

Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients. Until then, providers have the evidence needed to make informed decisions about the safe use of these dietary ingredients, and future research can address existing gaps.


DOI: 10.1093/pm/pnz040
PubMed: 30986309
PubMed Central: PMC6544555


Affiliations:

Links toward previous steps (curation, corpus...)

Le document en format XML

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<term>Dietary Supplements (MeSH)</term>
<term>Evidence-Based Medicine (methods)</term>
<term>Evidence-Based Medicine (standards)</term>
<term>Humans (MeSH)</term>
<term>Military Medicine (methods)</term>
<term>Military Medicine (standards)</term>
<term>Military Personnel (MeSH)</term>
<term>Musculoskeletal Pain (diagnosis)</term>
<term>Musculoskeletal Pain (diet therapy)</term>
<term>Musculoskeletal Pain (epidemiology)</term>
<term>Phytotherapy (methods)</term>
<term>Phytotherapy (standards)</term>
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<term>Randomized Controlled Trials as Topic (methods)</term>
<term>Randomized Controlled Trials as Topic (standards)</term>
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<term>Compléments alimentaires (MeSH)</term>
<term>Douleur musculosquelettique (diagnostic)</term>
<term>Douleur musculosquelettique (diétothérapie)</term>
<term>Douleur musculosquelettique (épidémiologie)</term>
<term>Essais contrôlés randomisés comme sujet (méthodes)</term>
<term>Essais contrôlés randomisés comme sujet (normes)</term>
<term>Guides de bonnes pratiques cliniques comme sujet (normes)</term>
<term>Humains (MeSH)</term>
<term>Médecine factuelle (méthodes)</term>
<term>Médecine factuelle (normes)</term>
<term>Médecine militaire (méthodes)</term>
<term>Médecine militaire (normes)</term>
<term>Personnel militaire (MeSH)</term>
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<term>Randomized Controlled Trials as Topic</term>
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<p>
<b>OBJECTIVE</b>
</p>
<p>Approximately 55-76% of Service members use dietary supplements for various reasons, including pain and related outcomes. This work evaluates current research on dietary ingredients for chronic musculoskeletal pain to inform decisions for practice and self-care, specifically for Special Operations Forces personnel.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. The committee made evidence-informed judgments and recommendations for practice and self-care use.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Nineteen eligible dietary ingredients were assessed for quality, efficacy, and safety. Avocado soybean unsaponifiables, capsaicin, curcuma, ginger (as a food source), glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D were conditionally recommended as their benefits outweighed risks, but there was still some uncertainty about the trade-offs. No recommendations were made for boswellia, ginger (as a dietary supplement), rose hip, or s-adenosyl-L-methionine. Recommendations were made against the use of collagen, creatine, devil's claw, l-carnitine, methylsulfonylmethane, pycnogenol, willow bark extract, and vitamin E. Research priorities were developed to address gaps precluding stronger recommendations.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients. Until then, providers have the evidence needed to make informed decisions about the safe use of these dietary ingredients, and future research can address existing gaps.</p>
</div>
</front>
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<DateCompleted>
<Year>2020</Year>
<Month>04</Month>
<Day>28</Day>
</DateCompleted>
<DateRevised>
<Year>2020</Year>
<Month>04</Month>
<Day>28</Day>
</DateRevised>
<Article PubModel="Print">
<Journal>
<ISSN IssnType="Electronic">1526-4637</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>20</Volume>
<Issue>6</Issue>
<PubDate>
<Year>2019</Year>
<Month>06</Month>
<Day>01</Day>
</PubDate>
</JournalIssue>
<Title>Pain medicine (Malden, Mass.)</Title>
<ISOAbbreviation>Pain Med</ISOAbbreviation>
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<ArticleTitle>Dietary Ingredients as an Alternative Approach for Mitigating Chronic Musculoskeletal Pain: Evidence-Based Recommendations for Practice and Research in the Military.</ArticleTitle>
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<MedlinePgn>1236-1247</MedlinePgn>
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<Abstract>
<AbstractText Label="OBJECTIVE">Approximately 55-76% of Service members use dietary supplements for various reasons, including pain and related outcomes. This work evaluates current research on dietary ingredients for chronic musculoskeletal pain to inform decisions for practice and self-care, specifically for Special Operations Forces personnel.</AbstractText>
<AbstractText Label="METHODS">A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. The committee made evidence-informed judgments and recommendations for practice and self-care use.</AbstractText>
<AbstractText Label="RESULTS">Nineteen eligible dietary ingredients were assessed for quality, efficacy, and safety. Avocado soybean unsaponifiables, capsaicin, curcuma, ginger (as a food source), glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D were conditionally recommended as their benefits outweighed risks, but there was still some uncertainty about the trade-offs. No recommendations were made for boswellia, ginger (as a dietary supplement), rose hip, or s-adenosyl-L-methionine. Recommendations were made against the use of collagen, creatine, devil's claw, l-carnitine, methylsulfonylmethane, pycnogenol, willow bark extract, and vitamin E. Research priorities were developed to address gaps precluding stronger recommendations.</AbstractText>
<AbstractText Label="CONCLUSIONS">Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients. Until then, providers have the evidence needed to make informed decisions about the safe use of these dietary ingredients, and future research can address existing gaps.</AbstractText>
<CopyrightInformation>© 2019 American Academy of Pain Medicine.</CopyrightInformation>
</Abstract>
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<AffiliationInfo>
<Affiliation>The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.</Affiliation>
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