Conditional Recommendations for Specific Dietary Ingredients as an Approach to Chronic Musculoskeletal Pain: Evidence-Based Decision Aid for Health Care Providers, Participants, and Policy Makers.
Study Goal
The researchers aimed to evaluate whether capsaicin, among other dietary ingredients, provides sufficient evidence to inform decisions for practice and self-care in alleviating chronic musculoskeletal pain, specifically for Special Operations Forces personnel.
Results Summary
The study found that capsaicin had desirable effects that outweighed undesirable effects for alleviating musculoskeletal pain, though there was uncertainty about trade-offs due to low-quality evidence or closely balanced benefits and downsides. Conditional evidence-based recommendations were made for its use.
Population
Special Operations Forces personnel and potentially broader populations with chronic musculoskeletal pain.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
avocado soybean unsaponifiables | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #1 |
capsaicin | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #2 |
curcuma | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #3 |
ginger | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #4 |
glucosamine | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #5 |
melatonin | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #6 |
polyunsaturated fatty acids | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #7 |
vitamin D | decrease | musculoskeletal pain | Special Operations Forces personnel | - | desirable effects outweighed undesirable effects | #8 |
certain dietary ingredients | decrease | musculoskeletal pain | - | - | may alleviate | #9 |
OBJECTIVE: Approximately 55-76% of Service members use dietary supplements for various reasons; although such use has become popular for a wide range of pain conditions, decisions to use supplements are often driven by information that is not evidence-based. This work evaluates whether the current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence 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. A decision table was constructed to make evidence-informed judgments across factors required for decision-making, and recommendations were made for practice and self-care use. RESULTS: Nineteen dietary ingredients were included. Conditional evidence-based recommendations were made for the use of avocado soybean unsaponifiables, capsaicin, curcuma, ginger, glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D. In these cases, desirable effects outweighed undesirable effects, but there was uncertainty about the trade-offs, either because the evidence was low quality or because benefits and downsides were closely balanced. CONCLUSIONS: The evidence showed that certain dietary ingredients, when taken as part of a balanced diet and/or as a supplement (e.g., pill, tablet, capsule, cream), may alleviate musculoskeletal pain with no to minimal risk of harm. This finding emphasizes and reinforces the critical importance of shared decision-making between Operators and their health care providers.