European Journal of Pain最新文献

{"title":"Prevalence of Painful Temporomandibular Disorders and Overlapping Primary Headaches Among Young Adults","authors":"Cristina Rocha Exposto, Mojdeh Mansoori, Bodil Hammer Bech, Lene Baad-Hansen","doi":"10.1002/ejp.70013","DOIUrl":"https://doi.org/10.1002/ejp.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Large population-based estimates of the prevalence of painful temporomandibular disorders (p-TMD) utilising standardised screening tools are scarce and have not investigated the prevalence of overlapping primary headaches. We aimed to estimate the prevalence of p-TMD in a large population of young adults (18 to 23 years) and to estimate the co-occurrence of p-TMD and two primary headaches, migraine and tension-type headache (TTH). The study also aimed to examine the extent of psychological (PHQ-4) and physical (PHQ-15) comorbidities and report prevalence across three gender categories (<i>women</i>, <i>men</i> and <i>other</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Survey data from the Danish National Birth Cohort were collected (<i>n</i> = 11,982), in a cross-sectional observational design. A sensitivity analysis was conducted to address participation bias, revealing minimal impact on the estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall prevalence of p-TMD was 26.4% with gender-specific prevalence of <i>women:</i> 31.5%, <i>other:</i> 39.2% and <i>men:</i> 16.8%. Among those with p-TMD, 80.5% reported headaches at least once a month, and 13.8% over 15 days monthly. For the p-TMD individuals with a medical headache diagnosis, 31.9% experienced TTH and 10.9% migraine. The study also identified a higher proportion of moderate/severe psychological distress and physical symptoms in the p-TMD group compared to the non-p-TMD group. Logistic regression revealed a positive association between PHQ-4 and p-TMD, modified by gender (<i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High overall prevalence of p-TMD and overlapping primary headaches was found in young adults. In addition, the study reports gender-specific associations between p-TMD, psychological distress and physical comorbidities indicating that this association is stronger for men than for women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study found a higher-than-expected prevalence of painful temporomandibular disorders in young adults. It is based on a large population cohort and used standardised and validated screening tools. The study also reported common co-occurrence of primary headaches and explored gender differences. The study raises awareness for a possibly underestimated health burden in young individuals, particularly among individuals experiencing psychological distres","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Phase Inpatient Withdrawal Programme for Long-Term Opioid Use in Non-Cancer Pain","authors":"Konrad Streitberger,&nbsp;Michael A. Harnik,&nbsp;Anna Saliba,&nbsp;Nina Bischoff,&nbsp;Larissa T. Blättler,&nbsp;Kyrill Schwegler,&nbsp;Christine Baumgartner,&nbsp;Nora Sutter,&nbsp;Maria M. Wertli","doi":"10.1002/ejp.70010","DOIUrl":"10.1002/ejp.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High-dose long-term opioid treatment for chronic non-cancer pain (CNCP) has become an increasing burden in industrialised countries. Opioid tapering and withdrawal in patients with CNCP remain challenging. This study evaluated a two-phase inpatient opioid withdrawal (OW) programme aimed at safely discontinuing opioid use in CNCP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study was conducted from 2018 to 2023 at a Swiss tertiary care centre, involving CNCP patients on long-term opioid therapy (≥ 6 months, ≥ 100 mg morphine equivalent daily dose) who had failed outpatient withdrawal attempts. The programme consisted of a withdrawal phase (Phase 1) followed by multimodal pain rehabilitation (Phase 2). Outcomes included the proportion of patients opioid-free after Phase 2 (primary) and at 3 months, pain intensity changes, and adverse events (secondary).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 38 enrolled patients (58% female, median age 54 years [IQR 49, 62]), 34 (89%) completed both phases, and 32 (84%) were opioid-free at the end of Phase 2. At 3 months, 23 patients (61%) remained opioid-free, while 4 (11%) resumed opioids, and 11 (29%) were lost to follow-up. Median pain intensity remained stable after discharge. One patient died by suicide 10 days post-withdrawal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This two-phase inpatient withdrawal and rehabilitation programme enabled most CNCP patients to discontinue opioids without increased pain intensity, with a majority remaining opioid-free at 3 months. These findings highlight the importance of ongoing psychological support and careful patient selection in OW management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study introduces a structured inpatient opioid withdrawal model tailored for chronic non-cancer pain patients on high-dose opioid therapy, demonstrating that high cessation rates can be achieved without worsening pain intensity. By addressing the gap in care for patients who fail outpatient tapering, this research provides clinical insights into optimising withdrawal protocols and highlights the need for targeted resource allocation for intensive, multidisciplinary pain management. These findings support evidence-based decision-making in designing more effective opioid tapering strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attachment in Young Adults With Chronic Pain: The Mediating Role of Cognitive Appraisals in the Relationship Between Attachment Security, Pain Coping and Functioning","authors":"Nicole Harte,&nbsp;Olivia Noon,&nbsp;Andreea Heriseanu,&nbsp;Blake F. Dear,&nbsp;Joanne Dudeney","doi":"10.1002/ejp.70008","DOIUrl":"10.1002/ejp.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Attachment styles can influence how individuals perceive and cope with chronic pain. This study examined the relationships between attachment security, pain coping and functioning in young adults with chronic pain, focusing on the mediating role of cognitive appraisals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included 206 young adults attending university aged 17–29 with chronic pain (<i>M</i>age = 19.24, <i>SD</i> = 2.03) and 346 without pain (<i>M</i>age = 19.11, <i>SD</i> = 1.79). Participants completed measures assessing pain characteristics, attachment security, pain coping strategies, physical and social functioning and cognitive appraisals relating to bodily and social threat bias and pain catastrophising. SPSS PROCESS macro was used to test mediational hypotheses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Young adults with chronic pain had greater insecure attachment than controls (Mann–Whitney <i>U</i> = 41639.50, <i>p</i> &lt; 0.001). Insecure attachment was significantly associated with poorer solution-focused coping and social functioning (<i>r</i> = −0.330 and − 0.355 respectively), and increased emotion-focused avoidance (<i>r</i> = 0.317). Social threat bias partially mediated the effects of attachment security on emotion-focused avoidance and social functioning. Pain catastrophising partially mediated the effects of attachment security on solution-focused coping and social functioning, and fully mediated its effects on emotion-focused avoidance. An indirect effect of attachment security on reframing and distraction was found via social threat and pain catastrophising.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Insecure attachment is heightened in young adults with chronic pain and may contribute to poorer pain coping and social functioning through cognitive appraisals, specifically social threat and pain catastrophising. These may be useful targets for intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLA-Region Genetic Association Analysis of Breast Cancer Patients With and Without Persistent Postsurgical Neuropathic Pain","authors":"L. Mustonen,&nbsp;J. K. Nieminen,&nbsp;S. Koskela,&nbsp;M. Kaunisto,&nbsp;E. Kalso,&nbsp;P. J. Tienari,&nbsp;H. Harno","doi":"10.1002/ejp.70009","DOIUrl":"https://doi.org/10.1002/ejp.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Surgical nerve injuries lead to persistent neuropathic pain (NP) in up to 30% of patients. Among many other factors, polymorphisms in the human leukocyte antigen (HLA) genes have been suggested to contribute to the development of neuropathic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a genetic association analysis of HLA class I and class II alleles in women who had been operated on for breast cancer. Patients had a surgeon-confirmed perioperative nerve injury and were examined 4–9 years after their surgery. Patients with painful (cases, <i>n</i> = 27) and painless (controls, <i>n</i> = 30) intercostobrachial nerve resection were studied. Cases included patients with definite NP with worst pain intensity in the past week ≥ 4/10 on a numerical rating scale (NRS) and controls had the same nerve injury with no NP or other pains. Whole-genome single nucleotide polymorphism data were produced, and HLA class I (HLA-A, -B, -C) and class II (HLA-DRB1, -DQA1, -DQB1 and -DPB1) alleles were determined by imputation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HLA-DRB1*03:01, DQA1*05:01 and DQB1*02:01 alleles appeared to be associated with painful nerve injury after breast cancer surgery (nominal <i>p</i> = 0.007 for all, carriership OR = 12.0, 95% CI 1.38–104; FDR corrected <i>p</i> &gt; 0.07). These alleles comprise the DR3-DQ2 haplotype, which is part of the ancestral haplotype AH8.1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results provide further support for the role of HLA genetic variation in the development of persistent post-surgical neuropathic pain, which indirectly implies a mechanism involving immunological memory in this process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>We report a novel association between the HLA-DR3-DQ2 haplotype and the development of persistent neuropathic pain after breast cancer surgery. Our results provide further evidence for the role of HLA polymorphism in persistent neuropathic pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Leptin and Insulin Levels Influence Pain and Disability in Subjects With Frozen Shoulder? A Cross-Sectional Study","authors":"José Javier Pérez-Montilla,&nbsp;Rafael Guzmán-García,&nbsp;Leo Pruimboom,&nbsp;Santiago Navarro-Ledesma","doi":"10.1002/ejp.70007","DOIUrl":"https://doi.org/10.1002/ejp.70007","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To investigate the relationship between leptin levels, insulin resistance (measured by HOMA), and clinical outcomes related to pain, disability, and shoulder range of motion (ROM) in patients with frozen shoulder (FS).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This cross-sectional study included 34 patients diagnosed with FS. Leptin and HOMA levels were measured and analysed in relation to pain and disability scores, as assessed by the Shoulder Pain and Disability Index (SPADI), along with shoulder ROM (flexion, extension, abduction, adduction, and internal/external rotation). Linear regression models were used to evaluate associations between leptin, HOMA, and clinical outcomes, adjusting for potential confounders such as age and sex.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Higher leptin levels were significantly associated with increased SPADI pain (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.114, &lt;i&gt;β&lt;/i&gt; = 0.397, &lt;i&gt;p&lt;/i&gt; = 0.005) and disability scores (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.110, &lt;i&gt;β&lt;/i&gt; = 0.425, &lt;i&gt;p&lt;/i&gt; = 0.006), as well as an inverse association with shoulder flexion (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.074, &lt;i&gt;β&lt;/i&gt; = −1.088, &lt;i&gt;p&lt;/i&gt; = 0.025), indicating reduced ROM with higher leptin levels. Similarly, higher HOMA levels were associated with increased SPADI pain (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.096, &lt;i&gt;β&lt;/i&gt; = 1.078, &lt;i&gt;p&lt;/i&gt; = 0.010) and disability scores (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.081, &lt;i&gt;β&lt;/i&gt; = 1.517, &lt;i&gt;p&lt;/i&gt; = 0.017), as well as combined SPADI scores (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.089, &lt;i&gt;β&lt;/i&gt; = 2.595, &lt;i&gt;p&lt;/i&gt; = 0.014). HOMA also showed a significant inverse relationship with shoulder flexion (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.061, &lt;i&gt;β&lt;/i&gt; = −2.097, &lt;i&gt;p&lt;/i&gt; = 0.028), suggesting that insulin resistance may contribute to ROM limitations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Elevated leptin and insulin resistance levels were linked to greater pain, disability, and decreased ROM in patients with FS. These findings underscore the potential role of metabolic and inflammatory pathways in FS pathogenesis and highlight the importance of considering lifestyle interventions targeting leptin and insulin regulation as adjuncts to traditional management strategies for this condition.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Elevated levels of leptin and HOMA (insulin resistance) are significantly associated with increased pain and disability in patients with frozen shoulder, as measured by SPADI scores. Higher leptin and HOMA levels are also associated with reduced range of motion, particularly in shoulder flexio","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Painful Mondays: Exploring Weekly Sleep Variations and Pain Perception in Healthy Women—An Experimental Study","authors":"Shima Rouhi,&nbsp;Natalia Egorova-Brumley,&nbsp;Amy S. Jordan","doi":"10.1002/ejp.70004","DOIUrl":"https://doi.org/10.1002/ejp.70004","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Acute experimental sleep deprivation induces pain hypersensitivity, particularly in females. While the impact of extreme sleep loss on pain perception has been largely studied, how subtle sleep fluctuations, for example, sleep variations across the week, affect pain perception remains unclear. This study investigated how weekly sleep variations affect pain perception in young healthy women.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A sleep-monitoring headband and self-reported questionnaire were used to assess sleep. Quantitative sensory testing was conducted on Monday and Friday, including heat, cold, pressure pain thresholds, tonic pain summation and conditioned pain modulation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 26 healthy young (23.9 ± 0.9 years) women were included. Repeated measures ANOVAs revealed significant sleep variation across the week, including differences in N3 sleep stage duration (&lt;i&gt;M&lt;/i&gt; = 89.2 ± 5.42 min; &lt;i&gt;p&lt;/i&gt; = 0.022, lowest on Friday and Sunday nights), bedtime (&lt;i&gt;M&lt;/i&gt; = 00:56 &lt;i&gt;AM&lt;/i&gt; ± 0.29; &lt;i&gt;p&lt;/i&gt; = 0.038, latest on Friday vs. Sunday night) and wake-up time (&lt;i&gt;M&lt;/i&gt; = 07:04 &lt;i&gt;AM&lt;/i&gt; ± 0.30; &lt;i&gt;p&lt;/i&gt; = 0.007 latest on Saturday vs. Monday morning). With most changes affecting Sunday night and Monday morning, pain sensitivity was higher on Monday compared to Friday, with a lower heat pain threshold (&lt;i&gt;B&lt;/i&gt; = −11.89; &lt;i&gt;p&lt;/i&gt; = 0.002) and increased heat pain summation (&lt;i&gt;B&lt;/i&gt; = 1.65; &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The results showed higher heat pain hyperalgesia on Mondays due to weekly sleep variation. Since sleep is a modifiable factor, maintaining a consistent sleep schedule throughout the week could benefit pain management, particularly in chronic pain patients with less effective pain modulatory pathways.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Statement of Significance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;How weekly sleep variations in real life between weekends and weekdays affect pain perception has not been studied before. This paper provides the first evidence that natural weekend–weekday sleep alterations, including shifts in bedtime and wake-up time over the weekend and the transition back on Sunday night, heighten pain sensitivity on Monday—known as the ‘Monday effect’. The compromised pain pathways on Monday underscore the importance of maintaining a consistent sleep schedule throughout the week, potentially benefiting patients with","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subgrouping People With Acute Low Back Pain Based on Psychological, Sensory, and Motor Characteristics: A Cross-Sectional Study","authors":"Patrick Ippersiel,&nbsp;Claudia Côté-Picard,&nbsp;Jean-Sébastien Roy,&nbsp;Hugo Massé-Alarie","doi":"10.1002/ejp.70006","DOIUrl":"https://doi.org/10.1002/ejp.70006","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Clustering helps identify patient subgroups with similar biopsychosocial profiles in acute low-back pain (LBP). Motor factors are common treatment targets and are associated with disability but have not been included in acute LBP cluster development. This study aimed to identify subgroups of individuals with acute LBP based on motor, sensory and psychological characteristics and to compare these subgroups regarding clinical outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ninety-nine participants with acute LBP were recruited, and motor (bending range of motion [ROM], flexion relaxation), pain sensitivity (pressure-pain thresholds, temporal summation of pain) and psychological factors (pain catastrophising, kinesiophobia, self-efficacy) were measured, along with pain, disability and demographics.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Principal component analysis accounted for 66.03% of the variance. Four component scores were entered in a hierarchical linear clustering model, deriving 3 subgroups (‘mild features’ &lt;i&gt;n&lt;/i&gt; = 39, ‘sensorimotor’ &lt;i&gt;n&lt;/i&gt; = 35 and ‘psychomotor’ &lt;i&gt;n&lt;/i&gt; = 25). Between-cluster comparisons revealed significant differences in motor, sensory and psychological variables (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Sensorimotor and psychomotor clusters had higher flexion–relaxation ratios (mean difference: &gt; 0.2), greater disability (mean difference: &gt; 7/100) and smaller ROM (mean difference: 7 cm) compared to the ‘mild’ group. The sensorimotor cluster mostly exhibited higher temporal summation of pain (mean difference: &gt; 1.3/10) and lower pressure-pain thresholds (mean difference: &gt; 1.2 kg/cm&lt;sup&gt;2&lt;/sup&gt;) than ‘mild’ and psychomotor clusters. The psychomotor cluster showed higher kinesiophobia (mean difference: &gt; 6/44) and pain catastrophising (mean difference: &gt; 12/52) than ‘mild’ and sensorimotor groups.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Findings indicate 3 subgroups, suggesting that motor factors may add granularity to acute LBP clusters. Stratified care based on these subgroups may help refine treatment pathways for acute LBP.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Including motor factors in cluster development adds a clinically relevant metric to describe people with acute LBP and generates insight into underlying mechanisms of motor adaptation. Longitudinal testing is required to see if these subgroups are differentially related to ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Child Pain-Related Injustice Appraisals: A Discriminant Content Analysis Study","authors":"F. Daenen,&nbsp;F. Baert,&nbsp;D. Van Ryckeghem,&nbsp;Z. Trost,&nbsp;T. Vervoort","doi":"10.1002/ejp.70005","DOIUrl":"https://doi.org/10.1002/ejp.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Child pain-related injustice appraisals, associated with adverse pain-related functioning, are commonly assessed using the Injustice Experience Questionnaire (IEQ). However, the IEQ was initially developed for adults. Recent qualitative phenomenological work highlighted pain-related injustice themes among children that are seemingly not captured by the IEQ. Furthermore, research in adults and children has shown strong associations between the IEQ and both pain catastrophising and disability. These issues raise concerns regarding the content validity and discriminant content validity of the IEQ for paediatric populations. This study assessed the content validity and discriminant content validity of the IEQ items and a set of novel items generated through previous qualitative work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Content and discriminant content validity of the items was assessed by 96 adult judges rating items as measuring child injustice appraisals, as well as measuring competing constructs: pain catastrophising, disability and negative affect. Wilcoxon signed-rank tests were applied to assess content and discriminant content validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four of 12 IEQ items displayed content validity as well as discriminant content validity against pain catastrophising and disability. Eight of 13 newly generated items displayed content validity as well as discriminant content validity against pain catastrophising and disability. Only two of all 25 items displayed discriminant content validity against negative affect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed the IEQ to lack discriminant content validity for use in a paediatric context. An item pool was created to assess child pain-related injustice appraisals, displaying both content validity and discriminant content validity against the competing constructs of pain catastrophising and disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>The current study both reveals issues in applying the IEQ to assess child pain-related injustice appraisals and advances research on child pain-related injustice appraisals by providing an item pool displaying both content validity and discriminant content validity against the competing constructs of child pain catastrophising and child disability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Safety of Botulinum Neurotoxin Type A in Treating Chronic Low Back Pain: A Systematic Review, Meta-Analysis, Trial Sequential Analysis, and Meta-Regression","authors":"Waseem Wagrees,&nbsp;Hesham Kelani,&nbsp;Hazem Mohamed Salamah,&nbsp;Abdelrahman Mahmoud,&nbsp;Yehya Khlidj,&nbsp;Mohamed R. Abdelraouf,&nbsp;Bahaa Sharaf,&nbsp;Moustafa Elnewishy,&nbsp;Nadia Albaramony,&nbsp;Ahmed Naeem,&nbsp;Ahmed Abd Elazim,&nbsp;Mohammad El-Ghanem,&nbsp;Diana Greene-Chandos,&nbsp;Mohammad Jadidi,&nbsp;David P. Lerner,&nbsp;Arthur D. Kay,&nbsp;Lisa R. Merlin,&nbsp;Charles Brock","doi":"10.1002/ejp.4796","DOIUrl":"https://doi.org/10.1002/ejp.4796","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic low back pain (CLBP) is a leading cause of disability. Botulinum neurotoxin type A (BoNT-A) has strong anti-spasmodic and analgesic effects, suggesting that its local muscular injection can reduce CLBP compared to other therapies. In this systematic review and meta-analysis, we investigated the efficacy and safety of BoNT-A on patients with CLBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Scopus, Cochrane, and Web of Science databases for studies comparing BoNT-A to other therapies in terms of functional improvement and pain improvement as measured by visual analog scale (VAS) and clinically significant improvement in pain (50% or greater reduction in VAS score). We employed trial sequential analysis (TSA) to confirm the findings. The GRADE approach was employed to assess the overall quality of the evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search yielded nine studies, seven randomised clinical trials (RCTs), and two prospective observational studies. Compared to the control, BoNT-A increased the incidence of clinically significant improvement in pain (RR = 4.82, 95% CI (3.00, 7.76), <i>p</i> &lt; 0.00001) and functional improvement (RR = 3.81, 95% CI (2.40, 6.04), <i>p</i> &lt; 0.00001) (low-certainty evidence), and reduced VAS score (MD = −1.62, 95% CI (−3.13, −0.11), <i>p</i> = 0.04) (very low-certainty evidence). Subgroup analysis showed that BoNT-A is effective against normal saline (moderate-certainty evidence), and it was comparable to steroids and local anaesthetics (very low-certainty evidence). TSA confirmed the findings regarding clinical improvement in pain and functional improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BoNT-A is a tolerable and effective treatment for CLBP with a longer duration of action. Future high-quality studies are needed to confirm our findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This paper provides good evidence that BoNT-A may be employed in patients suffering from resistant chronic low back pain not responding to normal saline injection due to its higher efficacy and longer duration of action. Compared to steroids and local anaesthetics injections, there is not enough data to draw a firm conclusion and future studies are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Postsurgical Pain Raises Risk of Dementia","authors":"Mingyang Sun,&nbsp;Xiaolin Wang,&nbsp;Zhongyuan Lu,&nbsp;Yitian Yang,&nbsp;Shuang Lv,&nbsp;Mengrong Miao,&nbsp;Wan-Ming Chen,&nbsp;Szu-Yuan Wu,&nbsp;Jiaqiang Zhang","doi":"10.1002/ejp.70002","DOIUrl":"https://doi.org/10.1002/ejp.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to investigate the association between chronic postsurgical pain (CPSP) and the risk of dementia, addressing a significant gap in the existing literature and highlighting potential implications for clinical practice and public health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Utilising data from Taiwan's National Health Insurance Research Database, a propensity score-matched cohort study was conducted involving 142,682 patients who underwent major surgery between 2004 and 2018. CPSP was defined as prolonged analgesic use post-surgery, and dementia diagnosis was tracked until December 31, 2022. Multivariable Cox regression models were employed to calculate adjusted hazard ratios (aHRs) for dementia risk in CPSP versus non-CPSP groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before propensity score matching, the CPSP cohort (<i>n</i> = 37,438) exhibited a higher risk of dementia, with aHRs of 1.35 (95% CI: 1.30–1.40). After matching, the aHR remained elevated at 1.31 (95% CI: 1.26–1.37), indicating a significant association between CPSP and dementia risk. Subgroup analysis confirmed this association across various demographic and clinical factors, with sensitivity analysis reinforcing the robustness of the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study establishes CPSP as an independent predictor of dementia risk, highlighting the importance of postoperative pain management in mitigating long-term cognitive outcomes. Approximately 30% of dementia risk post-CPSP presents an opportunity for risk reduction through effective CPSP management strategies, emphasising the need for targeted interventions to address this critical healthcare issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study provides compelling evidence that chronic postsurgical pain (CPSP) significantly increases the risk of dementia, highlighting a critical and previously underexplored connection between postoperative pain and long-term cognitive decline. By establishing CPSP as an independent predictor of dementia, our findings underscore the importance of effective pain management strategies in surgical patients, particularly to mitigate the heightened risk of dementia and improve long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}