Top 20 Research Studies of 2017 for Primary Care Physicians

Mark H. Ebell, MD, MS; Roland Grad, MD, MSc,

Disclosures

Am Fam Physician. 2018;97(9):581-588. 

In This Article

Musculoskeletal Conditions

The next group of POEMs addresses musculoskeletal conditions (Table 4).[21–24] Gabapentin (Neurontin) and pregabalin (Lyrica) have become popular options for the management of acute and chronic low back pain. Study 12, a well-designed Australian randomized trial, found that in patients with moderate to severe sciatica, pregabalin did not improve any clinical outcomes.[21] Similarly, Study 13, a systematic review of gabapentin and pregabalin for chronic back pain, found at best limited evidence for benefit and consistent evidence of adverse events.[22] Unless other studies find evidence of more benefit than harm for these drugs, they should not be prescribed for patients with low back pain.

Study 14 randomized 503 adults with ankle sprain to supervised physical therapy or usual care. It found that 65% of those receiving usual care had an excellent recovery at three months compared with 56% in the physical therapy group (P = .09).[23] Finally, a previous Cochrane review concluded that corticosteroid injections provide modest benefit for patients with osteoarthritis of the knee.[25] However, many of those studies were poorly controlled or compared injections with no treatment rather than placebo injections. Study 15 randomized 140 adults with knee osteoarthritis to regular triamcinolone, 40 mg, or saline injection every three months for two years. The authors found no benefit in pain or function and a worrisome reduction in cartilage thickness in the corticosteroid group when comparing magnetic resonance imaging studies performed before and after the study period.[24]

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