Tags

Type your tag names separated by a space and hit enter

Polyunsaturated Fatty Acids and Chronic Pain: A Systematic Review and Meta-analysis.
Pain Physician. 2016 Nov-Dec; 19(8):521-535.PP

Abstract

BACKGROUND

Chronic pain is one of the most frequent disease symptoms and represents a global health problem with a considerable economic burden. The role of polyunsaturated fatty acids (PUFA) in chronic pain conditions was debated during the last decade with conflicting results.

OBJECTIVE

To assess whether polyunsaturated fatty acids intake is useful as a preventive or curative tool in chronic pain.

STUDY DESIGN

Systematic review and meta-analysis.

SETTING

This study examined all published studies, either preventive or curative, on PUFA supplementation and chronic pain.

METHODS

We retrieved studies published in any language by searching systematically Medline, Embase, Conference Proceedings Citation Index, dissertations databases, and the 5 regional bibliographic databases of the World Health Organization until May 2015. We included both observational and intervention studies reporting effect measures and their confidence intervals of polyunsaturated fatty acids intake in the regular diet or supplementation and pain. Two investigators selected studies; extracted data independently on baseline characteristics, exposure, and outcomes; and rated the quality of interventional studies using Jadad score. We calculated pooled standardized mean differences (SMDs) of pain indexes such as the Visual Analogue Score. We further carried out subgroup analyses by disease, type of PUFA, outcome scale, quality index, dose, and time of supplementation.

RESULTS

We retrieved 5 observational and 46 intervention studies. Only one observational study showed a protective effect of PUFA. On the contrary, the interventional studies yielded a pooled random effects SMD of -0.40 (95% CI -0.58, -0.22), which indicates improvement, as 0 is the value that indicates absence of effect. The largest effect was found for dysmenorrhea (SMD -0.82, 95% CI -1.21, -0.43), Ω-3 supplementation (-0.47, 95% CI -0.68, -0.26) and composite scores (-0.58, 95% CI -1.07, -0.09). Mitigation of pain was stronger for low doses (-0.55, 95% CI -0.79, -0.30) and short supplementation periods (-0.56, 95% CI -0.86, -0.25).

LIMITATIONS

While the number of curative studies was large, that of preventive studies available was limited.

CONCLUSION

Our results suggest that Ω-3 PUFA supplementation moderately improves chronic pain, mainly that due to dysmenorrhea. Further investigation on the preventive potential of PUFA supplementation is needed, as the amount of evidence is scarce. Key words: Meta-analysis, systematic review, chronic pain, PUFA, supplementation, Ω-3, dysmenorrhea.

Authors+Show Affiliations

Universidade de Santiago de Compostela.Universidade de Santiago de Compostela.Universidade de Santiago de Compostela.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27906932

Citation

Prego-Dominguez, Jesus, et al. "Polyunsaturated Fatty Acids and Chronic Pain: a Systematic Review and Meta-analysis." Pain Physician, vol. 19, no. 8, 2016, pp. 521-535.
Prego-Dominguez J, Hadrya F, Takkouche B. Polyunsaturated Fatty Acids and Chronic Pain: A Systematic Review and Meta-analysis. Pain Physician. 2016;19(8):521-535.
Prego-Dominguez, J., Hadrya, F., & Takkouche, B. (2016). Polyunsaturated Fatty Acids and Chronic Pain: A Systematic Review and Meta-analysis. Pain Physician, 19(8), 521-535.
Prego-Dominguez J, Hadrya F, Takkouche B. Polyunsaturated Fatty Acids and Chronic Pain: a Systematic Review and Meta-analysis. Pain Physician. 2016 Nov-Dec;19(8):521-535. PubMed PMID: 27906932.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polyunsaturated Fatty Acids and Chronic Pain: A Systematic Review and Meta-analysis. AU - Prego-Dominguez,Jesus, AU - Hadrya,Fatine, AU - Takkouche,Bahi, PY - 2016/12/2/entrez PY - 2016/12/3/pubmed PY - 2017/7/22/medline SP - 521 EP - 535 JF - Pain physician JO - Pain Physician VL - 19 IS - 8 N2 - BACKGROUND: Chronic pain is one of the most frequent disease symptoms and represents a global health problem with a considerable economic burden. The role of polyunsaturated fatty acids (PUFA) in chronic pain conditions was debated during the last decade with conflicting results. OBJECTIVE: To assess whether polyunsaturated fatty acids intake is useful as a preventive or curative tool in chronic pain. STUDY DESIGN: Systematic review and meta-analysis. SETTING: This study examined all published studies, either preventive or curative, on PUFA supplementation and chronic pain. METHODS: We retrieved studies published in any language by searching systematically Medline, Embase, Conference Proceedings Citation Index, dissertations databases, and the 5 regional bibliographic databases of the World Health Organization until May 2015. We included both observational and intervention studies reporting effect measures and their confidence intervals of polyunsaturated fatty acids intake in the regular diet or supplementation and pain. Two investigators selected studies; extracted data independently on baseline characteristics, exposure, and outcomes; and rated the quality of interventional studies using Jadad score. We calculated pooled standardized mean differences (SMDs) of pain indexes such as the Visual Analogue Score. We further carried out subgroup analyses by disease, type of PUFA, outcome scale, quality index, dose, and time of supplementation. RESULTS: We retrieved 5 observational and 46 intervention studies. Only one observational study showed a protective effect of PUFA. On the contrary, the interventional studies yielded a pooled random effects SMD of -0.40 (95% CI -0.58, -0.22), which indicates improvement, as 0 is the value that indicates absence of effect. The largest effect was found for dysmenorrhea (SMD -0.82, 95% CI -1.21, -0.43), Ω-3 supplementation (-0.47, 95% CI -0.68, -0.26) and composite scores (-0.58, 95% CI -1.07, -0.09). Mitigation of pain was stronger for low doses (-0.55, 95% CI -0.79, -0.30) and short supplementation periods (-0.56, 95% CI -0.86, -0.25). LIMITATIONS: While the number of curative studies was large, that of preventive studies available was limited. CONCLUSION: Our results suggest that Ω-3 PUFA supplementation moderately improves chronic pain, mainly that due to dysmenorrhea. Further investigation on the preventive potential of PUFA supplementation is needed, as the amount of evidence is scarce. Key words: Meta-analysis, systematic review, chronic pain, PUFA, supplementation, Ω-3, dysmenorrhea. SN - 2150-1149 UR - https://www.unboundmedicine.com/medline/citation/27906932/Polyunsaturated_Fatty_Acids_and_Chronic_Pain:_A_Systematic_Review_and_Meta_analysis_ L2 - http://www.painphysicianjournal.com/linkout?issn=1533-3159&vol=19&page=521 DB - PRIME DP - Unbound Medicine ER -