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Non-pharmacological therapies for pain management in Parkinson's disease: A systematic review.

Acta neurologica Scandinavica
August 1, 2021
Abdul Rehman Qureshi et al. (9 authors)
Journal ArticleReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to examine the effectiveness of non-pharmacological therapies, including massage, for pain management in Parkinson's disease patients.

Results Summary

The study found that massage therapy demonstrated a reduction in pain perception, attributed to tactile stimulation and the release of anti-nociceptive molecules, though the literature on its effectiveness is limited.

Population

Parkinson's disease patients experiencing pain.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
exercise therapy
decrease
pain perception
PD patients
-
found a reduction in
#1
hydrotherapy
decrease
pain perception
PD patients
-
has been shown to reduce
#2
combined treatment of exercise and hydrotherapy
decrease
pain management
PD patients
-
an effective treatment for
#3
deep brain stimulation
decrease
certain pain types (dystonic and central)
PD patients
-
showed efficacy in alleviating
#4
deep brain stimulation
no change
musculoskeletal pain
PD patients
-
not others
#5
spinal cord stimulation
decrease
VAS scores for pain
PD patients
-
showed significant improvement in reducing
#6
massage therapy
decrease
pain perception
PD patients
-
demonstrated a reduction in
#7
acupuncture
decrease
pain perception
PD patients
-
demonstrated a reduction in
#8
Abstract

Among the various non-motor symptoms of Parkinson's disease (PD), pain is often cited as the most common and debilitating feature. Currently, the literature contains gaps in knowledge with respect to the various forms of treatment available, particularly non-pharmacological therapies. Thus, the purpose of this systematic review is to provide an examination of the literature on non-pharmacological therapies for pain in PD. We compared the findings of research articles indexed within various literature databases related to non-pharmacological treatments of pain in PD patients. Our review identified five major non-pharmacological methods of pain therapy in PD: acupuncture, hydrotherapy, massage therapy, neuromodulation, and exercise. Treatments such as exercise therapy found a reduction in pain perception due to various factors, including the analgesic effects of neurotransmitter release during exercise and increased activity leading to a decrease in musculoskeletal rigidity and stiffness. By the same token, hydrotherapy has been shown to reduce pain perception within PD patients, with authors often citing a combined treatment of exercise and hydrotherapy as an effective treatment for pain management. Multiple methods of neurostimulation were also observed, including deep brain stimulation and spinal cord stimulation. Deep brain stimulation showed efficacy in alleviating certain pain types (dystonic and central), while not others (musculoskeletal). Hence, patients may consider deep brain stimulation as an additive procedure for their current treatment protocol. On the other hand, spinal cord stimulation showed significant improvement in reducing VAS scores for pain. Finally, although the literature on massage therapy and acupuncture effectiveness on pain management is limited, both have demonstrated a reduction in pain perception, with common reasons such as tactile stimulation and release of anti-nociceptive molecules in the body. Although literature pertaining to non-pharmacological treatments of pain in PD is sparse, there is copious support for these treatments as beneficial to pain management. Further exploration in the form of clinical trials is warranted to assess the efficacy of such therapies.

Medical Subject Headings (MeSH)
Acupuncture AnalgesiaExercise TherapyHumansHydrotherapyMassagePainPain ManagementParkinson DiseaseTranscutaneous Electric Nerve Stimulation
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality70/10
Citation Metrics
Total Citations17
Citations/Year4.3
Relative Citation Ratio2.12
NIH Percentile76.3%
Research Impact Scores
APT Score0.75
Weight Score2.37
Normalized Score0.60
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