Pain, pregnancy or Pilates – there is plenty to peruse

Steve McDonald and Tari Turner
Med J Aust 2015; 203 (7): 278. || doi: 10.5694/mja15.00919
Published online: 5 October 2015

Paracetamol has been under the microscope a lot recently. A new review of oral non-steroidal anti-inflammatory drugs (NSAIDs) versus other oral analgesics for acute soft tissue injury continues this trend. Sixteen trials involving more than 2100 mostly young adults with various strains, sprains and bruises evaluated a range of drugs, including paracetamol and opioids. The review found low-quality but consistent evidence that NSAIDs and paracetamol are similar with respect to pain relief, swelling and return to function but, as you might expect, there is evidence that NSAIDs result in slightly more gastrointestinal side effects (doi:10.1002/14651858.CD007789.pub2).

Meanwhile, the rising tide of allergies in children has spawned an ocean of research. A recent review of eight trials of over 3350 women asks whether giving pregnant women or breastfeeding mothers marine omega-3 supplementation prevents allergies in their young children. The short answer is possibly for some allergies, notably food allergies, but probably not for other conditions such as allergic rhinitis or asthma (doi:10.1002/14651858.CD010085.pub2).

If too much sitting around over this year’s cold winter has brought on extra cases of low back pain, it’s good to know that Pilates can be added to the list of exercise interventions effective for relieving pain and improving function. A review of 10 studies involving over 500 adults with chronic low back pain also compared Pilates with other forms of exercise but found no conclusive evidence that it is superior (doi:10.1002/14651858.CD010265.pub2).

Making sense of the burgeoning evidence included in multiple systematic reviews has become an exercise in itself. Cochrane’s response is to publish overviews. In recent issues, assisted reproductive technology (ART), bronchiectasis and dressings for foot ulcer have all been given the overviews treatment. The ART overview, for example, synthesises the findings of 59 Cochrane reviews categorising 19 interventions as effective, 13 as promising and 14 as ineffective or possibly ineffective (doi:10.1002/14651858.CD010537.pub4). The evidence is less clear-cut when it comes to dressings for treating foot ulcers in people with diabetes. There is no shortage of systematic reviews but a paucity of included studies in these reviews makes drawing robust conclusions an ongoing challenge (doi:10.1002/14651858.CD010471.pub2).

For more on these and other reviews, check out

  • Steve McDonald
  • Tari Turner

  • Australasian Cochrane Centre, Melbourne, VIC



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