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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

机译：膳食成分作为减轻慢性肌肉骨骼疼痛的替代方法：在军队的实践和研究的基于证据的建议

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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.
机译：客观的。大约55-76％的服务会员用膳食补充剂出于各种原因，包括疼痛和相关结果。这项工作评估了对慢性肌肉骨骼疼痛的膳食成分研究，以告知实践和自我保健的决策，专门针对特殊运营部队人员。方法。召开指导委员会召集制定决策所需的研究问题和因素。通过2016年8月搜索了主要数据库。符合条件的系统评估和随机对照试验被评估为方法论质量。在可行的地方应用META分析。等级用于确定对效果估计的信心。委员会对实践和自我保健使用作出了证据告知判决和建议。结果。 199年符合条件的饮食成分评估了质量，疗效和安全性。鳄梨大豆未加工，辣椒素，姜黄，姜（作为食物来源），葡萄糖胺，褪黑激素，多不饱和脂肪酸和维生素D被条件推荐，因为它们的益处超过风险，但仍有一些不确定性对权衡。没有建议Boswellia，Ginger（作为膳食补充剂），玫瑰果髋或S-腺苷-1-甲硫氨酸。建议采用胶原蛋白，肌酸，魔鬼爪，左旋肉碱，甲基磺基甲烷，枸杞，柳树皮提取物和维生素E.开发了研究优先事项，以解决更强调更强大的建议。结论。目前，科学证据无法制定明确的临床实践指导，但可以建立过程以跟踪这些成分的影响。在此之前，提供商有证据表明有关这些膳食成分安全使用的明智决策，未来的研究可以解决现有的空白。

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