DISCUSSION Although cannabinoids are now being used to manage different pain conditions , the evidence for the clinical effects are unclear .
INTRODUCTION Pain is a frequent clinical symptom with significant impact on the patient 's well-being .
Therefore , adequate pain management is of utmost importance .
While cannabinoids have become a more popular alternative to traditional types of pain medication among patients , the quality of evidence supporting the use of cannabinoids has been question ed .
The beneficial and harmful effects of cannabinoids in patients with pain is unknown .
Accordingly , we aim to assess the efﬁcacy , tolerability and safety of cannabinoids ( herbal , plant-derived extracts and synthetic ) compared with placebo or no intervention for any type of pain .
The clinical importance of changes in outcome scores after treatment for chronic low back pain
Abstract . When measuring treatment effect in chronic low back pain with multi-item outcome instruments , it is necessary , both for clinical decision-making and research purpose s , to underst and the clinical importance of the outcome scores . The aims of the present study were three-fold . Firstly , it aim ed to estimate the minimal clinical ly important difference of three multi-item outcome instruments ( the Oswestry Disability Index , the General Function Score and the Zung Depression Scale )  and of the  visual analogue scale ( VAS ) of back pain .  Secondly , it aim ed to estimate the error of measurement of these instruments ; and its third aim was to describe the clinical meaning of score change . The study population consisted of 289 patients treated surgically or non-surgically in a r and omised controlled trial . The minimal clinical ly important difference was estimated with patient global assessment as the external criterion . It was compared with the st and ard error of measurement of the instruments . The individual items of the instruments were compared for score changes related to improvement and deterioration . The st and ard error of measurement of the Oswestry Disability Index , the General Function Score and the Zung Depression Scale was 4 , 6 and 3 units , respectively . The 95 % tolerance interval was 10 , 16 and 8 units , respectively . The minimal clinical ly important difference was 10 , 12 and 8–9 units , respectively , thus not significantly exceeding the tolerance interval . The minimal clinical ly important difference of VAS back pain was 18–19 units , well exceeding the 95 % tolerance interval , which was 15 units . Improvement after treatment for chronic low back pain tends to occur to a greater extent in sleep disturbance , ability to do usual things and psychological irritability , but to a lesser extent in the ability to sit , st and and lift . We conclude that the VAS of back pain is responsive enough to detect the minimal clinical ly important difference , whereas the smallest acceptable score changes of the Oswestry Disability Index , the General Function Score and the Zung Depression Scale may require an increase to exceed the 95 % tolerance interval when used for clinical decision making and for power calculation . Despite improvement after treatment , the ability to sit , st and and lift , remain notable problems
DISCUSSION Although cannabinoids are now being used to manage different pain conditions , the evidence for the clinical effects are unclear .
INTRODUCTION Pain is a frequent clinical symptom with significant impact on the patient 's well-being .
Therefore , adequate pain management is of utmost importance .
While cannabinoids have become a more popular alternative to traditional types of pain medication among patients , the quality of evidence supporting the use of cannabinoids has been question ed .
The beneficial and harmful effects of cannabinoids in patients with pain is unknown .
Accordingly , we aim to assess the efﬁcacy , tolerability and safety of cannabinoids ( herbal , plant-derived extracts and synthetic ) compared with placebo or no intervention for any type of pain .