European Journal of Pain最新文献

{"title":"A Cross-Sectional Analysis of Traumatic Experiences, Post-Traumatic Stress Disorder Symptoms and Chronic Pain in Northern Ireland","authors":"Kevin E. Vowles,&nbsp;Christina Mallett,&nbsp;Jason Brooks,&nbsp;Emma Berry,&nbsp;Danielle Rainey,&nbsp;Claire Briggs,&nbsp;Maura McCarron","doi":"10.1002/ejp.70044","DOIUrl":"https://doi.org/10.1002/ejp.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic pain and post-traumatic stress disorder (PTSD) are frequently comorbid and are associated with more significant pain-related disruption than chronic pain alone. It is not clear if these disruptions are due to traumatic experience or specific symptoms related to PTSD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This issue was evaluated in a large sample (<i>N =</i> 1367) of individuals with chronic pain presenting for treatment at an interdisciplinary pain rehabilitation service. As a secondary objective, the comorbidity of chronic pain and PTSD in Northern Ireland (NI) was also examined given high regional prevalence rates. Participants completed a PTSD screening measure, along with measures of pain interference, social functioning, pain anxiety, pain self-efficacy, pain intensity and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Screening indicated that 46.4% had never experienced a traumatic event, 22.5% had experienced a traumatic event but screened negative for PTSD and 31.1% screened positive for PTSD. Following identification of covariates, a Multivariate Analysis of Covariance examined differences in dependent measures by PTSD category, which yielded a similar pattern of results across measures. The group that screened positive for PTSD reported worse functioning and more disruptions in comparison to the other two PTSD groups, with the latter groups not differing on any measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These analyses indicate that poorer functioning was not associated with trauma exposure alone; rather, it was experienced in association with PTSD symptoms. Further, comorbidity rates of PTSD and chronic pain in this NI dwelling sample were at the high end of the range in relation to previous work and exceeded past year regional prevalence estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>PTSD assessment in those with chronic pain may be best served by evaluating the impact of these experiences on function, rather than focusing on the traumatic experiences in isolation. Further, there is scope to develop integrated chronic pain and PTSD treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171889","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":"Elucidating the Significance of Endogenous Hydrogen Sulfide as a Novel Candidate for Postoperative Pain Recovery in a Murine Model","authors":"Jorge Luiz Dallazen,&nbsp;Larissa Gonzaga Santos,&nbsp;Simone Aparecida Teixeira,&nbsp;Gilberto De Nucci,&nbsp;Marcelo Nicolás Muscará,&nbsp;Soraia Katia Pereira Costa","doi":"10.1002/ejp.70043","DOIUrl":"https://doi.org/10.1002/ejp.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hydrogen sulfide (H₂S) is proposed to be a key regulator of inflammatory diseases; however, its role in the complex and often inadequately managed pathophysiology of postoperative pain is frequently mishandled. This study was undertaken to elucidate the role of endogenous H₂S in the recovery of nociceptive thresholds using a mouse model of postoperative pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Male BALB/c mice (6–7 weeks) underwent sham or plantar incision surgery (PIS). Thermal and mechanical thresholds were assessed before surgery and 1–7 days post-PIS. At 1, 4 and 7 days post-PIS, the endogenous production of H₂S and the expression of its synthesising enzymes—cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3-MPST)—were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One day post-PIS, a reduction in H₂S production was observed in the operated hindpaw, with mechanical and thermal hyperalgesia lasting 5 and 6 days, respectively. CSE expression decreased in the operated hindpaw, while that of CBS increased on day 1 in the sciatic nerve and on day 4 in the L4–L5 spinal cord segments. The expression of 3-MPST remained unchanged. Intraplantar injection of aminooxyacetic acid (AOAA) or <span>dl</span>-propargylglycine (PGly), inhibitors of CSE/CBS activity, significantly delayed nociceptive threshold recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that while H₂S signalling via CSE appears to play a limited role in postoperative pain recovery, targeting CBS activity to preserve endogenous H2S levels may offer a promising alternative for enhancing pain and accelerating recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Targeting CBS to sustain H₂S signalling offers a new strategy to enhance postoperative pain recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171639","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":"Reference Values of Joint-Specific Pressure Pain Thresholds in Healthy Male Individuals: A Retrospective Study","authors":"Fabian Tomschi,&nbsp;Alexander Schmidt,&nbsp;Marius Brühl,&nbsp;Thomas Hilberg","doi":"10.1002/ejp.70050","DOIUrl":"https://doi.org/10.1002/ejp.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pressure pain thresholds (PPT) are a component of Quantitative Sensory Testing and are used to assess mechanical pain sensitivity. Joint-specific PPT measurements are relevant because many joint disorders involve altered pain processing at and around joints. This study aims to establish such reference values that might contribute to evaluate deviations in pain sensitivity in specific patient populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study retrospectively analysed PPT data from 407 healthy male individuals. Pressure was applied in a standardised manner using an algometer at eight anatomical landmarks: bilaterally at the elbow, knee and ankle joints, as well as the sternum and forehead. Percentile-based, landmark-discriminative normative data were calculated for PPT in general and segmented for age, BMI and mean subjective pain over 4 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median (IQR) PPT values (N/cm²) for anatomical landmarks are as follows: ankle = 47.2 (35.9, 63.8), knee = 65.9 (48.6, 89.1), elbow = 58.0 (40.5, 81.1), sternum = 39.8 (30.2, 53.3) and forehead = 35.5 (26.8, 45.0). Between-group analyses revealed no significant effect of BMI on PPT at any landmark assessed, no significant effect of age, except for the elbow joint (<i>p</i> = 0.035) and no effect of the presence of pain, except for the ankle (<i>p</i> = 0.020) and elbow joint (<i>p</i> = 0.010).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides normative joint-specific PPT values in healthy male individuals, offering reference values for both clinical and research applications. These values can assist in interpreting PPT measured in clinical settings and in identifying abnormal pain sensitivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Pressure pain thresholds are an important measure in Quantitative Sensory Testing, yet comprehensive normative data for joint-specific PPT in healthy individuals have been lacking. This study establishes reference values across multiple anatomical landmarks, providing a critical benchmark for evaluating pain sensitivity deviations in musculoskeletal disorders. These findings enhance the interpretation of PPT measurements, supporting improved pain assessment and diagnostic accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171818","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":"Short-Term Effects of Kinesio Taping on Pain and Functionality in Patients With Cervical Spine Surgery","authors":"Masoud Amir Rashedi Bonab,&nbsp;Tugba Kuru Colak,&nbsp;Ipek Yeldan,&nbsp;Deniz Konya,&nbsp;Zafer O. Toktaş","doi":"10.1002/ejp.70049","DOIUrl":"https://doi.org/10.1002/ejp.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective postoperative pain management following cervical spine surgery is essential for optimal recovery. This study was conducted to determine the short-term effects of Kinesio Taping (KT) on pain and functionality in patients undergoing cervical spine surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ninety patients diagnosed with cervical disc herniation, cervical stenosis or cervical spondylolisthesis who underwent posterior cervical spine surgery were randomly assigned to three groups: Group I (conventional rehabilitation [CR] + KT, <i>n</i> = 30), Group II (CR, <i>n</i> = 30) and Group III (KT, <i>n</i> = 30). The Visual Analogue Scale (VAS), pressure pain threshold (PPT), range of motion (ROM), Neck Pain and Disability Scale (NPAD), Upper Extremity Functional Index-15 (UEFI-15) and short form-36 (SF-36) were assessed at baseline, on the first and third days after intervention, and after the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistically significant difference in mean changes across all scores was observed among the three groups, favouring the CR + KT group (<i>p</i> &lt; 0.001). CR + KT intervention significantly improved VAS, PTT, NPAD and SF-36 emotional scores after treatment, with improvements maintained at 2-week follow-up (<i>p</i> &lt; 0.001). In terms of treatment interaction, CR + KT intervention showed a significantly larger effect size on PPT and NPAD scores (<i>p</i> &lt; 0.001). CR + KT and CR groups demonstrated similar improvements in functionality (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating KT into a CR programme during the early postoperative phase of cervical spine surgery may improve clinical outcomes, specifically in pain intensity, PPT, disability levels and emotional components. However, the addition of KT to the CR programme does not appear to provide any meaningful benefits in terms of functionality compared to the CR programme alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study reveals that integrating the KT method into the CR programme during the early postoperative period after cervical spine surgery can serve as a supportive and complementary intervention, particularly for painful conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171484","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":"Oxycodone and Morphine Use in Hospitals and Primary Care in Norway 2010–2021: A Nationwide Study","authors":"Eirik Haarr,&nbsp;Marte Handal,&nbsp;Svetlana Skurtveit,&nbsp;Torgeir Gilje Lid","doi":"10.1002/ejp.70045","DOIUrl":"https://doi.org/10.1002/ejp.70045","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;Increasing oxycodone prescribing and its association with opioid-related harms have raised concerns. In Norway, nearly 90% of opioids are prescribed in primary care, making primary care decisions important to overall opioid exposure. In-hospital use may influence primary care practices through several mechanisms. This study analyses oxycodone and morphine use in Norwegian hospitals and its association with primary care prescribing from 2010 to 2021, alongside a review of tender agreements for these medications.&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;Morphine and oxycodone, available in all relevant formulations, served as opioid proxies to compare covariation between hospitals and their catchment areas. We analyzed 2010–2021 procurement data from hospital pharmacies and primary care dispensing data from the Norwegian Prescription Database for all hospital trusts. Correlations between hospital and primary care morphine-to-oxycodone prescribing ratios were assessed using Pearson's &lt;i&gt;r&lt;/i&gt;. Annual tender agreements were obtained from the national Hospital Procurement Organization.&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;Hospital oxycodone use increased by 67.0% and primary care prescribing rose by 86.5%. Morphine use increased by 12.6% in hospitals but decreased by 23.2% in primary care. A moderate covariation (Pearson's &lt;i&gt;r&lt;/i&gt; = 0.48) between hospital use and primary care prescribing was observed. Hospital tender agreements for morphine declined by 80%, while those for oxycodone remained stable.&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;Oxycodone use substantially increased relative to morphine in Norwegian hospitals and primary care. Prescription patterns show moderate covariation, suggesting a potential link between hospital and primary care prescribing, though causality remains uncertain. Tender agreements may contribute to prescribing trends in hospitals, with possible associations in primary care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study is the first to provide quantitative evidence of covariation between in-hospital use and primary care opioid prescribing across a national healthcare system. Despite recommendations favoring morphine, oxycodone prescribing continues to rise in Norway, with marked geographical variation. By linking procurement data, prescription patterns and tender agreements, our findings highlight the need to consider hospital practices and structural factors when addressing opioid prescribing. These results offer new insights into potential lever","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140354","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 Mediating Role of Psychological Flexibility and Inflexibility Between Impulsivity and Opioid Misuse in People With Chronic Noncancer Pain","authors":"Victoria Barrado-Moreno,&nbsp;Rosa Esteve,&nbsp;Lance M. McCracken,&nbsp;Carmen Ramírez-Maestre","doi":"10.1002/ejp.70048","DOIUrl":"https://doi.org/10.1002/ejp.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prescription of opioid medication is a frequent therapeutic approach in chronic noncancer pain, as is misuse of prescribed opioids. There is previous evidence for associations between personal variables such as impulsivity and opioid misuse. Psychological flexibility and inflexibility have also been associated with pain-related outcomes and opioid misuse. The aim of this cross-sectional study was to examine the combined role of a dispositional variable (impulsivity) along with psychological factors (Psychological Flexibility and Inflexibility) in pain outcomes and opioid misuse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The sample comprised 155 people with chronic noncancer pain. A hypothetical model was tested using correlation and structural equation modelling analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results show significant associations between impulsivity and Psychological Flexibility, Psychological Inflexibility and opioid misuse. Psychological Flexibility and Inflexibility were related to pain intensity, interference and opioid misuse. Structural equation modelling showed significant associations between impulsivity, Psychological Inflexibility and pain interference, and opioid misuse. Associations between Psychological Flexibility and pain interference and opioid misuse were nonsignificant. These results support the hypothesis that impulsivity and Psychological Inflexibility are factors that contribute to pain interference and opioid misuse, but do not support the hypothesis that Psychological Flexibility reduces opioid misuse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It is recommended to assess these psychological aspects prior to the prescription of opioid medication, and, if necessary, offering Acceptance and Commitment and Mindfulness Based Therapies could be desirable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The results of this study provide further evidence of the role of trait impulsivity as a transdiagnostic antecedent variable in opioid misuse, both by a direct association and through psychological inflexibility. It can be drawn from these results that psychological transdiagnostic variables, rather than pain outcomes alone, would be key factors influencing opioid misuse. These findings underscore the need for comprehensive psychological assessments prior to the prescription of opioids.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135716","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":"Astrocytic Inducible Nitric Oxide Synthase Upregulation Contributes to Chronic Below-Level Neuropathic Pain Following Spinal Cord Injury in Male Rats","authors":"Youngkyung Kim,&nbsp;Hyunggoo Kang,&nbsp;Young Wook Yoon","doi":"10.1002/ejp.70047","DOIUrl":"https://doi.org/10.1002/ejp.70047","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;Spinal cord injury (SCI) leads to persistent inflammation, contributing to chronic neuropathic pain. However, current treatments show limited efficacy. Three types of nitric oxide synthase (NOS) play different roles in inflammation and neuronal hyperexcitation. Therefore, this study aimed to determine the predominant NOS subtype involved in neuropathic pain after spinal contusion.&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;We investigated the effects of intrathecal NOS inhibitors on mechanical sensitivity following a moderate spinal contusion injury in male Sprague-Dawley rats. These NOS inhibitors were N(G)-nitro-L-arginine methyl ester hydrochloride (L-NAME; non-selective NOS inhibitor), 1400W (iNOS inhibitor), Nω-propyl-L-arginine hydrochloride (NPLA; nNOS inhibitor) and N5-(1-iminoethyl)-L-ornithine (L-NIO; eNOS inhibitor). Additionally, we analysed protein expression and cellular localisation of spinal NOS subtypes in rats that underwent SCI or sham procedures.&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;Treatment with L-NAME significantly reduced paw withdrawal threshold in a dose-dependent manner, although motor deficits appeared at the highest dose (30 μM), while 1400W effectively alleviated mechanical hypersensitivity without motor side effects. NPLA showed limited efficacy, and L-NIO had no effect. Protein expression of iNOS increased two-fold in the L4-5 spinal segment of SCI rats compared with sham controls. After SCI, iNOS-immunoreactivity colocalized with GFAP in the superficial laminae of the L4-5 spinal segment. Treatment with 1400W reduced the hyper-reactivity of both iNOS and GFAP.&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;These findings indicate that iNOS plays a significant role in below-level neuropathic pain following thoracic spinal cord contusion in rats. Specific blockade of iNOS activity may have potential as a therapeutic intervention for spinal-contusion-induced neuropathic pain with reduced risk of side effects.&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;iNOS inhibition effectively alleviated pain without motor side effects, unlike non-selective NOS, nNOS and eNOS inhibitors. The colocalization of iNOS with astrocytes in the spinal cord suggests a key mechanism in pain maintenance. These findings highlight the potential of targeting iNOS as a therapeutic strategy for SCI-induced neuropathic pain with reduced risks of side effects.&lt;/p&gt;\u0000 ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126010","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":"Family-Related Factors in Children and Adolescents With Chronic Pain: A Systematic Review","authors":"Lorena Martí,&nbsp;Helena Garriga-Cazorla,&nbsp;Josep Roman-Juan,&nbsp;Jordi Miró","doi":"10.1002/ejp.70038","DOIUrl":"https://doi.org/10.1002/ejp.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this systematic review is to synthesise the findings about the role of family-related factors in chronic pain in children and adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a search of the following electronic databases: PubMed/MedLine, CINHAL, PsychINFO, PubPsych, Scopus and Web of Science from inception to July 2024. We only included studies involving children and adolescents (up to 19 years old) with chronic pain and studies that involved the parents or families of these children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 24,049 articles were retrieved, of which 20,921 were screened for evaluation and 119 were included in the review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most of the studies were cross-sectional with a moderate or high risk of bias, reporting on the parenting individual-, dyadic-, and contextual-related factors. In the included studies, significant associations emerged between a number of family-related factors and chronic pain and related disability in 16 of the 119 studies that had been judged to be of good methodological quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The data from these studies showed significant associations between parental individual variables (e.g., parent's mental health), dyadic variables (e.g., parental responses towards their children's pain), and context-related variables (e.g., family functioning), and some key pain-related outcomes, including pain chronification, pain intensity, pain frequency, pain extent, pain-related interference, the ability to cope with chronic pain, and pain-related disability in children and adolescents. Therefore, these factors may be important targets for the prevention and management of chronic pain in children and adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117924","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":"Temporal Summation of Pain Unpleasantness Is Increased in Borderline Personality Disorder","authors":"Annette Löffler,&nbsp;Dieter Kleinböhl,&nbsp;Sylvia Steinmann,&nbsp;Sabine C. Herpertz,&nbsp;Ute Habel,&nbsp;Robin Bekrater-Bodmann,&nbsp;Herta Flor","doi":"10.1002/ejp.70042","DOIUrl":"https://doi.org/10.1002/ejp.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Borderline personality disorder (BPD) is characterised by deficient regulation of emotions and is associated with reduced pain sensitivity, which has been related to self-injury and dissociation. BPD can therefore be used as a model to better understand pain-modulating mechanisms and their association with affective processing. However, studies assessing pain-modulating processes in BPD are sparse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study investigated temporal summation (TS) of pain intensity and unpleasantness, as well as TS of the RIII-reflex as a marker for spinal nociceptive processing in 24 participants with BPD compared to 24 non-clinical controls (NCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our main result showed that TS of pain unpleasantness, but not TS of pain intensity, was significantly increased in BPD compared to NCC, whereas we replicated higher pain thresholds in BPD compared to NCC. There was no significant correlation between pain threshold and TS of pain intensity or TS of pain unpleasantness in BPD. Moreover, correlative findings suggest a mutual dependence of spinal processing, temporal summation of pain and stimulus intensity in NCC, but not in participants with BPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of reduced pain sensitivity in terms of heightened pain threshold and enhanced TS of pain unpleasantness might explain the so-called pain paradox, describing that individuals with BPD are both hyposensitive to acute pain and more prone to develop chronic pain. Different mechanisms might underlie heightened pain thresholds and increased TS of pain unpleasantness based on a complex interaction of altered ascending and descending mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>The results of this study provide evidence that temporal summation of pain unpleasantness is increased in individuals with borderline personality disorder compared to non-clinical controls. These data suggest that altered pain perception in BPD is composed of several processes, extending beyond well-known pain insensitivity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108880","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":"The Impact of Smoking on Low Back Pain and Disability","authors":"Lukas Schönnagel,&nbsp;Bernhard U. Hoehl,&nbsp;Nima Taheri,&nbsp;Luis Becker,&nbsp;Phillip Suwalski,&nbsp;Friederike Schömig,&nbsp;Paul Köhli,&nbsp;Hendrik Schmidt,&nbsp;Matthias Pumberger","doi":"10.1002/ejp.70041","DOIUrl":"https://doi.org/10.1002/ejp.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Low back pain (LBP) is a predominant cause of disability, imposing a significant burden on healthcare systems and individuals' quality of life. The multifactorial nature of LBP encompasses various risk factors, but the association between smoking and LBP, particularly concerning severity and disability, has not been fully explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study utilised a cross-sectional design with propensity score matching to analyse the relationship between smoking and LBP severity and associated disability among adults aged 18 to 64. We prospectively recruited individuals from the general public, assessing LBP severity and disability using the von Korff questionnaire and the Roland Morris Disability Scale (RMDS). Smoking status was classified as ‘yes’ or ‘no’ and further stratified by pack years (PY). Adjustments were made for age, sex, body mass index (BMI), alcohol consumption, physical activity, and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 430 patients with a median age of 41 (IQR 31–53) were included in the analysis, with 79 (18.4%) being active smokers. In the propensity score-matched analysis, individuals with 0 to &lt; 10 PY did not show a significant increase in pain-related outcomes, whereas those with ≥ 10 PY exhibited a significant increase in pain severity (<i>p</i> = 0.043), disability score (<i>p</i> = 0.001), and RMDS score (<i>p</i> = 0.015). Multivariable linear regression further confirmed a significant association between PY and LBP-related outcomes, whereas smoking status alone was not significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows an independent effect of smoking on disability and pain severity, underscoring the potential importance of smoking cessation in LBP management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study identified a dose–response relationship between smoking and increased low back pain (LBP) severity and disability, particularly among individuals with ≥ 10 pack years, strengthened by the robust propensity score-matched design. By highlighting the independent effect of smoking on pain and disability, these findings emphasise the role of Smoking in the development of LBP and the potential importance of smoking cessation as a critical component in managing LBP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100707","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}