Objective: Exploring the potential role of clonidine as an alternative to the currently available neuraxial
medication options for the management of chronic pain.
Methods: A comprehensive literature search was conducted investigating the treatment of chronic pain
using clonidine over the past 73 years. A stepwise filtering approach was used to obtain articles addressing
neuraxial treatment of chronic pain in adults. Selected articles were assessed for their levels of evidence
followed by a discussion of their contribution to the understanding of the role of clonidine in chronic pain
management.
Results: Out of 1,035 articles that described the administration of clonidine for chronic pain management,
seven articles met all of the inclusion criteria. Their levels of evidence ranged from 1a to 4 (Oxford Centre
CEBM). Neuraxial administration of clonidine was found to be effective in the treatment of chronic pain,
often exhibiting a synergistic effect with other analgesics to provide pain reduction with reduced opioid use.
The most common side effect was hypotension, in some cases reported to have been serious.
Conclusion: The use of neuraxial clonidine, in either a primary or adjunctive role, appears promising as an
effective treatment for chronic pain.
Physical therapy as non-pharmacological chronic pain management of adults living with HIV: self-reported pain scores and analgesic use
