Overall , moderate evidence suggests that nerve blockades are effective for relieving acute pain and reducing delirium .
Low-level evidence suggests that preoperative traction does not reduce acute pain .
Nerve blockade seems to be effective in reducing acute pain after hip fracture .
Sparse data preclude firm conclusions about the relative benefits or harms of many other pain management interventions for patients with hip fracture .
BACKGROUND  Pain management  is integral to the management of hip fracture .
PURPOSE To review the benefits and harms of pharmacologic and nonpharmacologic interventions for managing pain  after hip fracture .
Low back pain after unstable extracapsular hip fractures: randomized control trial on a specific training.
AIM This study compares the efficacy of a walking recovery rehabilitation program with or without specific back exercises in patients affected by unstable extracapsular hip fractures and secondary back pain . Further , it reports data and images about analysed tomographic changes of the psoas muscle ipsilateral to fractures . METHODS A prospect i ve , r and omized , parallel treatment trial was carried out . Patients admitted for rehabilitation after fractures were evaluated for secondary back pain . If clinical ly indicated , patients were further scheduled for a computed tomography ( CT ) scan of the lumbar spine by which we evaluated cross-sectional changes in density and fibroadipose degeneration of the body of the psoas muscle . When back pain matched cross-sectional changes in psoas density , the patient was eligible for our study , enrolled and r and omly assigned to 1 of 2 study groups . Both groups were scheduled for hip rehabilitation and walking training plus a back protocol for the study group only . Pain was evaluated subjectively with a visual analog scale to calculate treatment effectiveness and Harris hip score was used to assess the outcome after surgery . RESULTS Thirty-seven patients out of about hundred were enrolled . In all cases CT scans showed age-related changes commonly seen in the lumbar spine and significant fibroadipose degeneration and altered density in the ipsilateral psoas muscles . With back exercises added to the st and ard rehabilitation protocol , all study patients recovered significantly better than control group patients ( P<0.04 ) in only 4 weeks of treatment . CONCLUSION Results show how hip fractures may cause psoas changes that can be of relevance for a more rational choice of physical exercises . Causes of back pain may be more complex than described by the textbooks and prognosis is more favourable following specific back training
Overall , moderate evidence suggests that nerve blockades are effective for relieving acute pain and reducing delirium .
Low-level evidence suggests that preoperative traction does not reduce acute pain .
Nerve blockade seems to be effective in reducing acute pain after hip fracture .
Sparse data preclude firm conclusions about the relative benefits or harms of many other pain management interventions for patients with hip fracture .
BACKGROUND  Pain management  is integral to the management of hip fracture .
PURPOSE To review the benefits and harms of pharmacologic and nonpharmacologic interventions for managing pain  after hip fracture .