European Journal of Pain最新文献

{"title":"It Is Time to Feel Better: How Temporal Information of Placebo Analgesia Affects Our Brain","authors":"Volpino Valeria, Piedimonte Alessandro, Campaci Francesco, Camerone Maria Eleonora, Persiani Francesca, Carlino Elisa","doi":"10.1002/ejp.70093","DOIUrl":"https://doi.org/10.1002/ejp.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Placebo and nocebo effects have been thoroughly studied during the last decades using pain models. Two characteristics have been investigated, namely the direction of the effects (i.e., placebo, amelioration of symptoms/nocebo, worsening of symptoms) and their magnitude (i.e., the robustness of the effects). Here, we propose an investigation of the placebo effects considering a third characteristic: time. We employed functional near-infrared spectroscopy (fNIRS), an emerging neuroimaging technique suitable for long-term monitoring and ecological experimental paradigms, to investigate cerebral cortices' activity through oxy-haemoglobin (O<sub>2</sub>Hb).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>42 healthy volunteers were randomised into three groups (No Expectations—NE, Placebo 5′—P5 and Placebo 20′—P20), placebo groups received different information on the timing of a cream's effectiveness (i.e., “the cream will work in 5/20 min”), while the NE group was said they were receiving an inert cream.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Behavioural results showed that pain perception fluctuations mimicked verbal suggestions on cream effectiveness onset. Exploratory analyses of fNIRS signals seem to follow the same pattern: O<sub>2</sub>Hb levels varied by group and time course. In the NE group, no significant differences emerged. In the P5 group, frontal areas were engaged when placebo analgesia occurred soon after treatment, while later, both P5 and P20 showed sustained placebo-related activations alongside areas linked to time perception and memory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study proposes that the cortical network related to the placebo effect may be active and modulated by temporal information of cream effectiveness, as well as their behavioural respective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Implementing fNIRS technology, this study confirms previous behavioral findings and begins to show that cerebral networks respond and encode the temporal characteristics of placebo analgesia. Understanding whether the placebo effect can be switched on and off at specific time points through verbal suggestion could be harnessed when clinically beneficial, aligning its timing with that of pharmacological action, especially for drugs with delayed onset, to ensure continuous pain relief, reduce drug intake, and enhance patient comfort.</p>\u0000 </secti","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751373","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":"Alcohol-Induced Disinhibition of Facial Responses to Pain","authors":"Stefan Lautenbacher,&nbsp;Claudia Horn-Hofmann,&nbsp;Eva Susanne Capito,&nbsp;Jörg Wolstein,&nbsp;Miriam Kunz","doi":"10.1002/ejp.70091","DOIUrl":"https://doi.org/10.1002/ejp.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alcohol in sub-toxic dosages has appeared to slightly reduce experimental pain in psychophysical paradigms. However, this effect may also reflect impaired scaling performance in subjective ratings. To address this, we additionally assessed facial responses as a more direct and cognitively unbiased pain measure, while acknowledging the potential confound of alcohol's effects on motor inhibitory function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated 41 healthy participants (22 females) in a randomised, double-blind, and placebo-controlled design; targeting two moderate breath-alcohol levels (0.6‰, 0.8‰). Before and after an alcoholic or placebo drink, painful heat stimuli were applied to the forearm. Facial responses were analysed using the Facial Action Coding System (FACS). Subjective responses were assessed using a Numerical Rating Scale (NRS). To control for alcohol's effects on motor inhibitory function, participants completed the antisaccade task, which assesses inhibitory control over reflexive motor responses (eye movement).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While pain ratings were unaffected, alcohol significantly affected facial responses to pain, with the high alcohol dose leading to increased facial responses. Moreover, alcohol also led to a decrease in inhibitory control, with poorer performance in the antisaccade task. Not surprisingly, we found a significant association between the alcohol-induced increase in facial responses and the alcohol-induced decrease in inhibitory control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Alcohol-induced motor disinhibition likely enhanced facial responses to pain without altering the subjective pain experience. In consequence, individuals under the influence of alcohol may facially display stronger pain levels (than experienced), which should not be interpreted as intentional exaggeration by clinicians involved in pain assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Subtoxic doses of alcohol are known to produce weak analgesic effects. In contrast, the facial responses to pain were elevated under alcohol in the present study; probably due to an alcohol-induced motor disinhibition. Thus, individuals under the influence of alcohol may be analgized while in parallel being facially overly pain responsive.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758535","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":"Exercise Therapy Versus Manual Therapy for the Management of Pain Intensity, Disability, and Physical Function in People With Chronic Low Back Pain: A Systematic Review With Meta-Analysis and Meta-Regression","authors":"Luis González-Gómez,&nbsp;Jose A. Moral-Munoz,&nbsp;Abel Rosales-Tristancho,&nbsp;Alejandro Cuevas-Moreno,&nbsp;Melania Cardellat-González,&nbsp;Álvaro-José Rodríguez-Domínguez","doi":"10.1002/ejp.70090","DOIUrl":"https://doi.org/10.1002/ejp.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Guidelines recommend combining physical and psychological programmes for chronic low back pain (CLBP); however, exercise therapy (ET) and manual therapy (MT) are often delivered separately. This systematic review with meta-analysis and meta-regression of randomised controlled trials (RCTs) aimed to compare the efficacy of ET with MT in terms of pain intensity, disability and physical function in people with CLBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Databases and Data Treatment</h3>\u0000 \u0000 <p>MEDLINE, Web of Science, PEDro, Cochrane Library and Scopus were searched July–August 2024 for RCTs comparing ET with MT in participants aged 18–54 years. Outcomes were extracted for the short-, medium- and long-term follow-up periods. Risk of bias (RoB 2.0 Cochrane Tool) and certainty of evidence (GRADE) were appraised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six RCTs (743 patients) were included. Meta-analyses showed, albeit non-clinically relevant, a significant difference for long-term in favour of ET for disability (SMD = −0.25, 95% CI [−0.43, −0.07], <i>p</i> = 0.007). Meta-regression showed that the female–male ratio, treatment duration and mean age explain variability in pain intensity and disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ET had a small beneficial effect on long-term disability in people with CLBP. Nevertheless, evidence does not provide conclusive differences between both the treatments overall, influenced by heterogeneity and the number of studies included. Biopsychosocial factors may moderate the differences in outcomes. The GRADE assessment revealed very low certainty across all outcomes, highlighting the lack of high-quality research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>ET may offer small long-term benefits over MT for disability in people with CLBP. Differences seem to be influenced by sex, age and treatment duration. The choice of ET over MT, or vice versa, as a stand-alone treatment does not appear to be supported by current evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PROSPERO Registration Number</h3>\u0000 \u0000 <p>CRD42024569120</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751374","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":"Four MBE Therapies to Improve Pain Scores, Physical Functioning, and Quality of Life in Patients With Chronic Nonspecific Low Back Pain: Network Meta-Analysis of Randomised Controlled Trials","authors":"Yi Xia,&nbsp;Yimin Hu,&nbsp;Juan Ouyang,&nbsp;Rui Huang","doi":"10.1002/ejp.70092","DOIUrl":"https://doi.org/10.1002/ejp.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic nonspecific low back pain (CNSLBP) is a common musculoskeletal disorder that severely affects patients' quality of life and work capacity. Due to its complex aetiology and lack of clear pathological markers, conventional treatments often provide limited relief. Mind–body exercises (MBEs), including Tai Chi (TC), Qigong (QG), Daoyin, and Yoga, have gained attention for their dual physical and psychological benefits. This study evaluates these four MBEs to determine their efficacy in managing CNSLBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of seven databases (PubMed, Embase, Web of Science, Cochrane, EBSCO, CNKI, WANFANG) identified 29 randomised controlled trials (RCTs) involving 3803 CNSLBP patients. Outcomes included pain scores (PS), physical functioning (PF), and quality of life (QOL). A network meta-analysis was conducted using Stata 17.0 to compare intervention effectiveness and assess direct/indirect evidence consistency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results of the network meta-analysis showed that in terms of pain scores (PS), Qigong (QG, SUCRA = 79.5%, SMD = −3.08) had the best effect; in terms of physical functioning (PF), Qigong (SUCRA = 86.5%, SMD = −4.94) remained the best intervention; whereas, in terms of quality of life (QOL), Tai Chi (TC, SUCRA = 94.3%, SMD = 13.15) had the most significant effect. Qigong was superior in terms of pain and functional improvement, while Tai Chi performed optimally in terms of quality-of-life improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>QG is the most effective for pain relief and improving physical function, while TC best enhances QoL. Different MBEs have distinct effects on functional outcomes, suggesting that interventions should be tailored to individual patient needs. Combining multiple approaches may optimise results for CNSLBP management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study highlights the efficacy of mind–body exercises (Qigong, Yoga, Tai Chi) in improving pain, function, and quality of life for chronic low back pain. Qigong and Yoga excel in pain relief, while Tai Chi enhances well-being. By integrating physical movement with mental focus, these low-intensity, adaptable therapies offer a holistic, non-pharmacological approach, emphasising personalised care for long-term management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740178","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":"Lifestyle Behaviours and Future Healthcare Utilisation for Musculoskeletal Pain in Young Adults: A Cohort Study of Norwegian University Students With Three-Year Follow-Up","authors":"Kaja Smedbråten,&nbsp;Margreth Grotle,&nbsp;Milada Hagen,&nbsp;Børge Sivertsen,&nbsp;Henriette Jahre,&nbsp;Kåre Rønn Richardsen,&nbsp;George Peat,&nbsp;Eva Skillgate,&nbsp;Britt Elin Øiestad","doi":"10.1002/ejp.70087","DOIUrl":"https://doi.org/10.1002/ejp.70087","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;It is unclear whether lifestyle behaviours influence use of healthcare for musculoskeletal pain in young adults. This study examined if lifestyle behaviours among college/university students were associated with future healthcare utilisation for musculoskeletal pain.&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;Data from the Students' Health and Wellbeing Study (SHoT2018) were linked with the Norwegian Registry for Primary Health Care, comprising 31,358 college/university students. We analysed associations of physical activity level, sleep duration, alcohol consumption, smoking, illicit drug use and cumulative adverse lifestyle behaviours with healthcare utilisation for musculoskeletal pain over the following three years, including ‘any use’, ‘high use’ and for back and neck pain specifically.&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;High physical activity levels, compared to recommended levels, were associated with a higher risk of ‘any’ healthcare utilisation for musculoskeletal pain (females: RR 1.14, 99% CI [1.04–1.25]; males: RR 1.20, 99% CI [1.07–1.36]); below recommended physical activity levels were associated with a lower risk (females: RR 0.90, 99% CI [0.85–0.96]; males: RR 0.84, 99% CI [0.76–0.93]). Illicit drug use was associated with a lower risk of healthcare utilisation for neck pain in females (RR 0.77, 99% CI [0.62–0.97]). Four or more adverse lifestyle behaviours, compared to ≤ 1, were associated with a lower risk of high healthcare utilisation for musculoskeletal pain (females: RR 0.66, 99% CI [0.48–0.90]; males: RR 0.68, 99% CI [0.48–0.97]) and a lower risk of healthcare utilisation for neck pain in females (RR 0.63, 99% CI [0.41–0.97]).&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;Associations between college/university students' lifestyle behaviours and healthcare utilisation for musculoskeletal pain were identified, but with some unexpected patterns. Future research should explore long-term effects of these behaviours on healthcare utilisation for musculoskeletal pain.&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;High levels of physical activity among college and university students were associated with a greater risk of seeking healthcare for musculoskeletal pain within the following three years. Illicit drug use was associated with a lower risk of seeking healthcare for neck pain in females. Surprisingly, the presence of many adverse lifestyle behaviours appeared to be associated with a lower risk of healthcare utilisation for musculoskeletal pain, particularly healthcar","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144725390","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":"Healthcare Use and Non-Recovery in Patients With Spinal Disorders","authors":"Lise Grethe Kjønø,&nbsp;Marianne Bakke Johnsen,&nbsp;Margreth Grotle,&nbsp;Jan Hartvigsen,&nbsp;Stine Clausen,&nbsp;Maja Wilhelmsen,&nbsp;Kåre Rønn Richardsen,&nbsp;Kjersti Storheim,&nbsp;Karin Magnusson","doi":"10.1002/ejp.70074","DOIUrl":"https://doi.org/10.1002/ejp.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between different patterns of healthcare use and non-recovery in patients with spinal disorders is unclear. We aimed to assess the association between healthcare use and non-recovery 6 months after a specialist evaluation in Norwegian secondary care and whether non-recovery was linked to adherence to specialist-recommended care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational registry-based cohort study includes 3745 patients aged 18–70 years (mean (SD) 46 (12) years, 59% women) from the Norwegian Neck and Back Registry (NNRR). We studied non-recovery 6 months after the specialist evaluation using the Global Perceived Effect (GPE) scale, defined as ‘slightly improved’, ‘unchanged’, ‘slightly worse’, ‘much worse’, or ‘worse than ever’. Using logistic regression, we examined the association between non-recovery and specialist-recommended healthcare (i.e., recommended follow-up in primary or secondary care) and actual healthcare use identified in national registries (visits to general practitioners, physical therapists, and chiropractors in primary care and outpatient and inpatient visits in secondary care).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 80% self-reported non-recovery at 6 months. Adherence to specialist-recommended healthcare was not associated with non-recovery (adjusted OR [aOR] 1.09, 95% CI 0.91–1.29). Highest odds for non-recovery were among patients using primary care alone (aOR 1.68, 95% CI 1.37–2.07) or no healthcare (aOR 1.81, 95% CI 1.44–2.27). Secondary care alone (aOR 0.75, 95% CI 0.59–0.96) or combined with primary care (aOR 0.49, 95% CI 0.41–0.59) was associated with recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings raise questions about the value of the specialist recommendations and also the content of healthcare services provided after a specialist evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Our findings suggest that follow-up after specialist evaluation may not adequately meet patient needs, indicating a need for improved management of spinal disorders. Given the low proportion of patients reporting recovery at 6-month follow-up, we highlight the importance of good transitions, care coordination, and coherent messages across sectors and professions. More effective healthcare and reduced sick leave could save societal costs. Moreover, this approach could improve quality of life, enabling a more active and participatory lifestyle.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716888","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":"Influence of Social Support on Peri-Operative Pain: A Secondary Sub-Sample Analysis of a Prospective Observational Trial","authors":"Philipp Wenzel,&nbsp;Marthe Gründahl,&nbsp;Monika Fischer,&nbsp;Grit Hein,&nbsp;Fabian Fuchtmann,&nbsp;Kathrin Schnabel,&nbsp;Daniela C. Rosenberger,&nbsp;Esther M. Pogatzki-Zahn,&nbsp;Heike L. Rittner,&nbsp;Karolin Teichmüller","doi":"10.1002/ejp.70094","DOIUrl":"https://doi.org/10.1002/ejp.70094","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;Research on the role of social support in the context of acute pain is lacking, although a possible correlation between social support and acute pain might imply consequences for clinical practice. We expected perceived social support to predict the intensity of acute postsurgical pain and the dose of opioids given.&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;Within a multicentre prospective observational study, &lt;i&gt;n&lt;/i&gt; = 217 adult patients undergoing major surgery were recruited at the University Hospital of Würzburg with an additional questionnaire for assessing perceived social support using the Multidimensional Scale of Perceived Social Support (MSPSS). We also measured pre-operative pain, opioid intake and psychological factors, such as depressiveness or pain catastrophising. Main outcomes were pain intensities at rest and at movement, and morphine equivalent on Day 1 and Day 7 after surgery.&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;Perceived social support was higher in general than expected from previous studies and depended on marital status. Certain socio-demographic characteristics, pre-operative chronic pain and depressive symptoms also correlated with perceived social support. Using multiple linear regression, we could confirm known risk factors for high intensity acute postsurgical pain, for example, younger age and pre-operative pain. Perceived social support, however, was not a significant predictor of neither postsurgical pain intensity nor postsurgical opioid requirements.&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;Perceived social support measured by MSPSS does not add to the prediction of acute postsurgical pain in our study. Acute pain might be influenced more strongly by biological and psychological factors than social factors. More fine-grained measures might be necessary to record, for example, daily social support.&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;Although social interactions are known to influence pain perception, studies on the role of social support on post-operative acute pain are lacking. In a broad spectrum of surgeries, we found that perceived social support was positively related to pre-operative health measures, for example, lower average pain intensity over the past 3 months or lower morphine equivalent and opioid intake before surgery. Perceived social support, however, was not a significant predictor of neither postsurgical pain intensity no","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714933","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":"EXPRESSION OF CONCERN: Group-Based Task-Oriented Exercises Aimed at Managing Kinesiophobia Improved Disability in Chronic Low Back Pain","authors":"","doi":"10.1002/ejp.70089","DOIUrl":"https://doi.org/10.1002/ejp.70089","url":null,"abstract":"<p><b>EXPRESSION OF CONCERN</b>: M. Monticone, E. Ambrosini, B. Rocca, D. Cazzaniga, V. Liquori, and C. Foti, “Group-Based Task-Oriented Exercises Aimed at Managing Kinesiophobia Improved Disability in Chronic Low Back Pain,” <i>European Journal of Pain</i> 20, no. 4 (2016): 541–551, https://doi.org/10.1002/ejp.756.</p><p>This Expression of Concern is for the above article, published online on 22 July 2015 in Wiley Online Library (wileyonlinelibrary.com), and has been issued by agreement between the journal Editor-in-Chief, Didier Bouhassira; the European Pain Federation; and John Wiley &amp; Sons Ltd.</p><p>The Expression of Concern has been agreed due to the apparent statistical implausibility of the effect sizes reported in this article and in other articles by the same author group [<span>1-3</span>]. These were brought to our attention by third parties and raise concerns regarding the reliability of the data. The authors provided an explanation and some original data during an investigation; however, the editorial office found that this was not sufficient to conclusively address the concerns. The original patient case report forms were no longer available due to the age of the paper. Therefore, the journal has decided to issue an Expression of Concern to inform and alert the readers.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695931","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":"Sleep Quality and Cognitive Performance in Chronic Primary Musculoskeletal Pain: An Observational Study With Healthy Controls","authors":"Alejandro Arévalo-Martínez,&nbsp;Carlos Barbosa-Torres,&nbsp;María Elena García-Baamonde,&nbsp;César Luis Díaz-Muñoz,&nbsp;Juan Manuel Moreno-Manso","doi":"10.1002/ejp.70085","DOIUrl":"https://doi.org/10.1002/ejp.70085","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;Chronic primary musculoskeletal pain (CPMP) is a recently defined diagnosis characterised by persistent pain accompanied by emotional distress and/or functional disability. Although sleep disturbances and cognitive complaints are common in individuals with chronic pain, few studies have examined their relationship in CPMP, a condition that remains underexplored. This study aimed to examine whether cognitive functioning in individuals with CPMP is affected by sleep quality, exploring its potential contribution across cognitive domains to the neuropsychological profile of this condition.&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 60 adults, of whom 30 were diagnosed with CPMP and 30 were healthy controls. Participants completed the Numeric Pain Rating Scale, the Symptom Checklist-90-Revised and the Pittsburgh Sleep Quality Index, followed by a standardised neuropsychological assessment consisting of the Stroop test, the TESEN, the Rings Test and the Working Memory Index from the Wechsler Adult Intelligence Scale.&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;Patients with chronic pain exhibited mild cognitive impairment in selective and sustained attention, processing speed, working memory, planning, problem solving, inhibition and resistance to interference. Poorer sleep quality was independently associated with greater cognitive impairment, particularly in sustained attention, processing speed and working memory. Sleep quality significantly predicted performance in these cognitive domains, beyond the influence of sociodemographic factors, pain intensity and psychological distress.&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;This study contributes to characterising the neuropsychological profile of individuals with CPMP and highlights the role of sleep quality in cognitive functioning. These findings may help inform interventions aimed at improving executive performance in chronic pain populations.&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;This study contributes to a deeper understanding of the cognitive difficulties experienced by individuals with chronic primary musculoskeletal pain, a recently defined diagnosis in the 11th revision of the International Classification of Diseases. It highlights the importance of sleep quality as a predictor of cognitive performance—particularly in attention, processing speed and working memory—independently of p","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688267","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":"Differential Effects of Repetitive Transcranial Magnetic Stimulation on Mood and Pain Symptoms in People With Chronic Pain and Major Depressive Disorders—A Review","authors":"Daniel Ciampi de Andrade,&nbsp;Leandro Valiengo","doi":"10.1002/ejp.70077","DOIUrl":"https://doi.org/10.1002/ejp.70077","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Chronic pain and major depressive disorder (MDD) are among the most prevalent and disabling conditions globally, often co-occurring and sharing overlapping symptoms such as fatigue, cognitive dysfunction and mood disturbances. While fibromyalgia, a primary pain syndrome, and MDD have distinct clinical manifestations, their comorbidity presents therapeutic challenges. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, has shown efficacy in treating both pain and mood disorders when targeted at specific brain regions (motor cortex for pain, dorsolateral prefrontal cortex for mood). This review aimed to investigate whether rTMS interventions for fibromyalgia or MDD improve symptoms across both domains, particularly in comorbid cases.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Databases and Data Treatment&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A structured search of PubMed was conducted between January and February 2025. Clinical trials were included if they were randomised, peer-reviewed, in English and involved ≥ 30 participants. Studies included addressed rTMS effects on pain in MDD or mood in fibromyalgia, or both. Out of 143 identified articles, 36 met the inclusion criteria.&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;Evidence shows rTMS has target- and symptom-specific effects: Motor cortex stimulation improves pain without reliably affecting mood, while dorsolateral prefrontal cortex stimulation alleviates depressive symptoms but inconsistently influences pain. These outcomes suggest that symptom improvement with rTMS is not global over different symptom clusters, but rather different for specific syndromes and the respective neural networks engaged by therapy. Personalised treatment strategies guided by pre-treatment connectivity profiles and symptom clusters, already in use for psychiatric disorders, could enhance outcomes in chronic pain management. However, limitations include small sample sizes, low session numbers and potential floor effects in studies involving non-depressed fibromyalgia patients.&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;Noninvasive neuromodulation therapy with repetitive transcranial magnetic stimulation for chronic pain improves pain on fibromyalgia and neuropathic pain but does not improve mood symptoms significantly. Therapy targeting mood symptoms in people with major depressive disorder may have antinociceptive effects in experimental pain models but are not clearly detectable in instances of clinical pain. The relationship between a disease and i","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 7","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672961","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}