European Journal of Pain最新文献

{"title":"Uncertain Trajectories in Neuropathic Pain: Rethinking Treatment Response","authors":"Antonio Alcántara Montero","doi":"10.1002/ejp.70155","DOIUrl":"10.1002/ejp.70155","url":null,"abstract":"<p>Chronic neuropathic pain remains one of the most elusive clinical challenges. Despite advances in pharmacology, neuroscience, and phenotypic characterisation, patient trajectories continue to be marked by profound heterogeneity. Some individuals improve, others stagnate, and a few even deteriorate—without a clear ability to anticipate these outcomes. In a context where mechanistic classifications of pain are beginning to show their limitations, and where nociplasticity is emerging as an integrative paradigm, it becomes urgent to reconsider how we evaluate clinical evolution in patients with neuropathic pain. The recent study by Moisset et al. offers an original perspective on this challenge: rather than assessing treatment response as a static endpoint, it proposes viewing it as a trajectory—a curve unfolding over time. This longitudinal approach, grounded in group-based trajectory modelling, enables the identification of evolutionary patterns that elude conventional analyses. It is not merely a question of how much a patient improves, but how, when, and under what circumstances that improvement occurs (Moisset et al. <span>2025</span>).</p><p>The study is based on patients treated in multidisciplinary tertiary care centers, ensuring specialised assessment and structured follow-up. Through this approach, the authors identify three distinct clinical trajectories: one characterised by moderate pain that progressively decreases over time; another marked by persistent moderate pain with no significant change; and a third defined by severe pain that remains stable throughout the follow-up period. These trajectories are not interpreted as fixed response categories, but rather as dynamic expressions of the pain experience. Each poses different challenges in terms of monitoring, therapeutic adjustment, and clinical communication. This segmentation does not aim to label or oversimplify, but rather to offer a more sensitive lens through which to observe the evolution of pain. Nevertheless, it raises inevitable questions: how can these patterns be translated into concrete clinical decisions? Can we anticipate a patient's trajectory during consultation? And what tools do we need to do so without falling into reductionism?</p><p>Factors associated with more favourable outcomes—such as age, pain duration, baseline intensity, psychiatric comorbidities, and type of treatment—have been identified in previous studies, yet their predictive capacity remains limited. In practice, each patient's evolution challenges linear models and statistical expectations. Some improve unexpectedly, while others fail to respond despite all efforts. This compels us to ask whether we are truly measuring what matters. What variables are being left out of our algorithms? What role do social determinants, personal narratives, expectations, and the therapeutic relationship play?</p><p>Personalised medicine has become a therapeutic ideal, yet in the context of neuropathic pain, that id","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312712","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":"Acute Postoperative Pain in Orthopaedic Trauma and Non-Trauma Patients: An Analysis of the China Acute Postoperative Pain Study (CAPOPS)","authors":"Lei Li, Shiyi Han, Feng Zhao, Huikai Yang, Xuecai Lv, Jing Wu, Aisheng Hou, Fan Li, Duo Hou, Changsheng Zhang, Hao Li, Min Li, Jingfeng Li, Zongwang Zhang, Changming Wang, Weidong Mi, Yanhong Liu","doi":"10.1002/ejp.70147","DOIUrl":"10.1002/ejp.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The rising volume of orthopaedic surgeries highlights the importance of optimal postoperative pain management, especially for trauma patients who frequently suffer inadequate analgesia and delayed recovery. This multicenter study aims to evaluate the prevalence of acute postoperative pain and identify contributing factors in traumatic and non-traumatic orthopaedic patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter study analysed adult orthopaedic surgery patients from the China Acute Postoperative Pain Study between September 2019 and August 2023. Patients with preoperative acute physical injuries requiring surgical intervention were defined as trauma patients. Using multivariate regression, we compared pain outcomes between trauma/non-trauma groups and identified risk factors for moderate-to-severe postoperative pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 10,892 orthopaedic patients (2833 trauma, 8059 non-trauma), trauma patients showed higher rates of moderate-to-severe pain (57.3% vs. 50.1%), experienced more anxiety and helplessness, and had a greater desire for additional pain management than non-trauma patients. Trauma was associated with the development of moderate-to-severe postoperative pain in both uni- and multivariate analyses (<i>p</i> < 0.001). Risk factors for postoperative pain differed: age over 65 years and preoperative chronic pain were significant in non-trauma patients, whereas intraoperative non-opioid analgesics and local anaesthetic infiltration were associated with a decreased incidence of moderate-to-severe postoperative pain in trauma patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Over half of orthopaedic surgery patients experienced moderate to severe postoperative pain, with trauma patients reporting higher levels and greater impacts on their activities and emotional state, along with a greater need for additional pain relief. Distinct risk factors for trauma and non-trauma patients highlight the need for personalised perioperative analgesic strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study advances perioperative pain management by identifying trauma as an independent risk factor for moderate-to-severe postoperative pain in orthopaedic patients, with distinct risk profiles for trauma and non-trauma subgroups. Trauma patients reported higher pain levels, greater distress and increased analgesic needs. These findings directly inform clinical practice, emphasising the need for personalised, risk-strati","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299332","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":"Obesity as a Disruptor of the Pain Inhibition Response in Fibromyalgia: A Pooled Multi-Trial Analysis of 521 Patients","authors":"Wolnei Caumo,&nbsp;Kevin Pacheco-Barrios,&nbsp;Guilherme J. M. Lacerda,&nbsp;Bárbara Regina França,&nbsp;Felipe Fregni","doi":"10.1002/ejp.70145","DOIUrl":"10.1002/ejp.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>BMI has been strongly associated with poor outcomes in fibromyalgia syndrome (FMS) patients, but no previous studies have examined its role in pain inhibition response. This study examines the influence of high BMI on the pain inhibition response and clinical severity of FMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This pooled cross-sectional analysis of baseline data from nine clinical trials involving 521 adult female FMS patients included the largest mechanistic FMS sample to date. Pain inhibition responses (conditioned pain modulation, CPM) were assessed using a computer-based thermode. Clinical assessments included numeric pain scales and Beck's Depression Inventory. Unadjusted and multivariate analyses were conducted to assess the influence of BMI on FMS symptoms using generalised linear models. Interaction terms for BMI and CPM were also tested. Non-linear effects of BMI were assessed with piecewise-linear models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A high body mass index (BMI) significantly correlated with a weakened CPM response and increased severity of pain and depression symptoms. The relationship between BMI and pain inhibition was distinctly non-linear, with detrimental effects becoming prominent beyond a BMI of 24 kg/m², marking a critical slope change point. Moreover, patients with a higher BMI did not benefit from pain inhibition on pain and depression scores, unlike their normal-weight counterparts, suggesting a disruption in the endogenous pain modulation mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study confirms that high BMI is detrimental to the clinical profile of FMS patients, adversely affecting pain inhibition and contributing to the severity of pain and depression, suggesting that weight management could be an integral component of FMS treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study uniquely explores the relationship between BMI and pain inhibition response in fibromyalgia patients, revealing a non-linear association and highlighting BMI's role as a moderator of CPM. The findings emphasise that obesity disrupts endogenous pain regulation, leading to more severe pain and depression symptoms. This underscores the potential for weight management in FMS treatment and supports developing personalised interventions considering obesity status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285810","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":"Mirogabalin: Promising Evidence, Uncertain Access","authors":"Antonio Alcántara Montero","doi":"10.1002/ejp.70148","DOIUrl":"10.1002/ejp.70148","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279287","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":"Phenotyping Chronic Pain and Neuropathic Pain in Population Studies","authors":"Ian-Ju Liang,&nbsp;Dhaneesha N. S. Senaratne,&nbsp;Blair H. Smith","doi":"10.1002/ejp.70146","DOIUrl":"10.1002/ejp.70146","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 is a major global health challenge with substantial individual and societal burden. Epidemiological studies are essential for understanding the scale of the problem and identifying approaches to management. However, they reveal wide variation in reported prevalence, largely due to variations in defining and phenotyping of pain, with estimates spanning roughly 10%–50% depending on wording, recall period, severity thresholds, sampling and ascertainment mode. This paper discusses phenotyping approaches in pain epidemiology, highlighting the need for pre-specified, transparent case definitions with harmonisation to improve comparability and reproducibility across studies.&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 drew from epidemiological literature on chronic pain phenotyping, focusing on methodological approaches. Examples of successful phenotyping strategies from large cohorts and consortia were identified to illustrate scalable and reproducible methods.&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;We identified ‘broad and shallow’ versus ‘deep and narrow’ approaches to phenotyping, and how they form part of a pyramid model. We explored this further using neuropathic pain as a worked example, with reference to the International Association for the Study of Pain's Special Interest Group on Neuropathic Pain (NeuPSIG) grading system for neuropathic pain and the Neuropathic Pain Phenotyping by International Consensus (NeuroPPIC) project, which aimed to offer a standardised and scalable phenotype suitable for epidemiological and genetic research. We also briefly reviewed other, modern approaches to phenotyping that have been developed, which combine large population samples, data integration and advanced statistical modelling, with the promise of enhanced comparability, and replication.&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;Consensus on phenotyping is needed. We have illustrated a structured, scalable approach to standardised phenotyping, supporting data integration, comparability and replication.&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 review highlights the critical importance of standardised phenotyping in chronic pain epidemiology. We introduce the pyramid model as a framework addressing key methodological gaps. Enabling scalable and reproducible phenotyping strengthens the foundation for future research and clinical translation, ultimately","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250542","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":"Direction Matters: A Crossover Study on Motor Adaptations to Movement-Evoked Pain Induced in the Lumbar Region","authors":"Valter Devecchi,&nbsp;Deborah Falla,&nbsp;Hélio V. Cabral,&nbsp;Jacques Abboud,&nbsp;Paul Hodges,&nbsp;Alessio Gallina","doi":"10.1002/ejp.70142","DOIUrl":"10.1002/ejp.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>People with chronic low back pain (LBP) often experience pain evoked by movement (movement-evoked pain [MEP]). Although pain changes how people move, it remains unclear whether motor adaptations to LBP are specific to the pain-provocative movement. This crossover experimental study aimed to understand whether pain modulated by movement in different directions induces distinct motor adaptations, and if these adaptations are consistent with a purposeful strategy to minimise pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty healthy adults performed a repetitive box lifting task in two experimental sessions. Experimental pain was induced in the lumbosacral region using nociceptive electrical stimulation, with intensity modulated proportionally to either lumbar flexion or extension. Within-subject changes in kinematics and centre of pressure were assessed both during and post-pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During both sessions and over time, participants reduced their lumbar movement in the pain-provocative direction (<i>p</i> &lt; 0.01), but not in the non-pain-provoking direction (<i>p</i> &gt; 0.078). The reduction in lumbar flexion was strongly associated with perceived pain intensity (<i>p</i> &lt; 0.001) and persisted beyond pain resolution (<i>p</i> &lt; 0.001). Pain during lumbar flexion also induced other acute motor adaptations, including reduced elbow flexion (<i>p</i> = 0.027) and an anterior shift of the centre of pressure (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed that the direction of the pain-provocative movement is a determinant factor in motor adaptations to pain, with clinical implications in developing personalised, movement-based interventions for LBP. Further, motor adaptations were not simply a generic acute response to pain but evolved to minimise pain, supporting the proposal that MEP is a motivational stimulus for adaptive behaviour driven by learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study shows that motor adaptations to MEP are specific to the direction of pain-provocative movement, evolve over time and represent a purposeful strategy to reduce pain. These findings highlight the reciprocal interactions between pain and movement, supporting the rationale for assessing motor strategies in people with movement-evoked LBP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238288","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":"Associations of Graded Chronic Non-Cancer Pain Severity With Well-Being and Modifiable Lifestyle Behaviour: Findings From a Danish Population-Based Cross-Sectional Survey","authors":"Sophie Sell Hellmann,&nbsp;Henrik Bjarke Vaegter,&nbsp;Gitte Handberg,&nbsp;Pernille Lykke Petersen,&nbsp;Geana Paula Kurita,&nbsp;Per Sjøgren,&nbsp;Lau Caspar Thygesen,&nbsp;Ola Ekholm","doi":"10.1002/ejp.70138","DOIUrl":"10.1002/ejp.70138","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;The Graded Chronic Pain Scale-Revised (GCPS-R) framework enables a standardised measure of disease severity and was incorporated into the national disease surveillance in Denmark in 2023. Novel dose–response associations between GCPS-R-systemised disease severity, general health, well-being, and modifiable lifestyle behaviour were analysed to enhance awareness of risk associations related to chronic non-cancer pain disease severity.&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 cross-sectional study including 8329 non-cancer participants aged 16 years and older from the Danish National Health Survey 2023. The participants completed a comprehensive self-reported questionnaire on general health, well-being, and modifiable lifestyle behaviour, including the GCPS-R framework. Multivariate-adjusted odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using logistic regression models for dichotomous outcomes related to general health, well-being, and modifiable lifestyle behaviour adjusted for sex, age, area of residence, BMI, country of origin, education and marital status.&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;The GCPS-R score had strong positive dose–response associations with odds of poor/fair general health, showing ORs 1.66 (95% CI: 1.32–2.10) in mild-impact, 6.08 (5.02–7.37) in bothersome-impact, and 13.53 (11.53–15.88) in high-impact compared with no chronic non-cancer pain. The GCPS-R score had overall strong positive associations with odds of poor well-being outcomes and moderate positive associations with odds of unhealthy modifiable lifestyle behaviour outcomes concerning illicit drugs, obesity, sedentary lifestyle, unhealthy diet and tobacco.&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 GCPS-R framework is applicable in national surveys enabling graded measures for associations related to chronic non-cancer pain disease severity. Unified cross-country strategies for national surveillance could strengthen the evidence base for equitable public health policies.&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;Chronic non-cancer pain is a highly prevalent disease associated with elevated risks of several bio- psychosocial health conditions. However, whether risks related to chronic non-cancer pain vary by disease severity is currently unknown. Hellmann et al. found the validated GCPS-R framework useful in national survey-based disease surveillance. The GCP","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238224","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":"Pain, Emotions, Interoception, and Bodily Sensations in Patients With Endometriosis","authors":"Saara Pasternack,&nbsp;Juulia Suvilehto,&nbsp;Päivi Härkki,&nbsp;Oskari Heikinheimo,&nbsp;Reetta Sipilä,&nbsp;Eija Kalso","doi":"10.1002/ejp.70144","DOIUrl":"10.1002/ejp.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Psychosocial aspects underlie and maintain persistent pain. Emotions have emerged as a target for psychological interventions in pain management. Our aim was to better understand the relationship between emotions and bodily sensations, including pain sensitivity, using two new approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>110 patients with confirmed endometriosis and 110 age- and gender-matched pain-free controls completed computer-based Bodily Sensation Maps for six basic emotions and a neutral emotional state, tactile, nociceptive, and hedonic sensitivities, as well as current and persistent pain. All participants also evaluated their current emotional experience of six basic emotions, depression, and anxiety, and answered the Brief Pain Inventory questionnaire; 102 endometriosis patients also answered the Multidimensional Assessment of Interoceptive Awareness questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Endometriosis patients coloured in significantly larger painful areas on body maps and greater sensitivities to both nociceptive and hedonic sensations than did the pain-free controls. The endometriosis patients reported more current fear than controls but did not differ from controls in the colouring in of basic emotions on the body maps. Emotional awareness was associated with higher pain intensity, and with more colouring for persistent pain. More trusting was associated with less affective interference and with less colouring for current pain. Less worrying and more trusting were associated with more colouring for hedonic sensitivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bodily sensation maps and multidimensional assessment of interoceptive awareness provide important information about the interface of emotions and pain. Our results suggest that a less worrying and a more trusting nature have a protective role in pain interference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Bodily emotions and interoceptive awareness associate with sensitivity to pain and should be addressed when targeting emotions in pain management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238291","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":"Effects of Training Modalities and Additional Pain Education on Exercise-Induced Hypoalgesia in People With Osteoarthritis of the Knee: A Randomised Controlled Feasibility Trial","authors":"Marie-Sofie Anderheide,&nbsp;Jana Szargiej,&nbsp;Katja Ehrenbrusthoff,&nbsp;Michael Schuler,&nbsp;Christian Thiel","doi":"10.1002/ejp.70141","DOIUrl":"10.1002/ejp.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This randomised controlled feasibility study aimed to evaluate the feasibility of a main study and provide a first assessment of whether the exercise-induced hypoalgesia (EIH) response differs depending on the training modalities in people with knee osteoarthritis (OA) and whether it can be enhanced by education about pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>People with knee OA (<i>n</i> = 36, 60 ± 11 years, WOMAC total 51.7 ± 36.6) were randomly assigned to receive lower body resistance training (RTL), upper body resistance training (RTU), or aerobic training (AET). Each participant performed three training sessions (t1, t2, t3) separated by 1 week, and education about pain and EIH after t2. Pressure pain threshold (PPT) was measured at six sites before (PPT0), immediately after (PPT1), and 30 min after (PPT30) each training session. Feasibility was assessed using indicators for practicability, acceptance, and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study's procedures were deemed feasible, including high acceptance of the measurement method and educational information, well-tolerated training exercises, and a dropout rate of 8%. In each group and after each session, an EIH response could be detected at PPT1 and PPT30 (Cohen's <i>d</i> ≥ 0.5 to ≥ 0.8). At most measurement sites, effect sizes tended to be largest after RTL and at t3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Progression to a larger study is warranted. RTL, but also AET and RTU may induce EIH in people with knee OA. Pain education might have a useful supporting function, but its effect would need to be determined in a study design using a control group that receives training and no education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Lower body resistance training, but also aerobic training and upper body resistance training may induce hypoalgesia in people with knee osteoarthritis. Being less pain sensitive after performing various exercise training modalities provides a significant benefit and can improve the quality of life of people with knee OA. If confirmed in a larger study, these findings might also allow better consideration of patients' individual preferences and potential comorbidities for exercise prescription.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>German Clinical Trials Register: DRKS00024480</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212162","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":"Role of Latissimus Dorsi–Thoracolumbar Fascia Complex Stretching on Pain and Pain-Related Parameters in Patients With Chronic Low Back Pain: A Randomised Clinical Trial","authors":"Naime Ulug,&nbsp;Seyde Busra Kodak,&nbsp;Muhammed İhsan Kodak,&nbsp;Sema Nur Aslan","doi":"10.1002/ejp.70143","DOIUrl":"10.1002/ejp.70143","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;Fascial stretching is gaining interest as a potential intervention for pain management. However, evidence regarding the effect of latissimus dorsi–thoracolumbar fascia (LD-TLF) complex stretching in patients with chronic low back pain (CLBP) remains limited. Therefore, this study aimed to investigate the effects of LD-TLF complex stretching on pain-related factors and disability in patients with CLBP.&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;Thirty patients with CLBP were randomly assigned to a study group (&lt;i&gt;n&lt;/i&gt; = 15; 7 men, 8 women) and a control group (&lt;i&gt;n&lt;/i&gt; = 15; 7 men, 8 women). The study group received 4 weeks of LD-TLF complex stretching in combination with conventional physiotherapy, while the control group received conventional physiotherapy only. Outcomes were assessed before and after the interventions, including primary measures of pain pressure thresholds (PPT) at thoracolumbar fascia levels (L1, L3 and 12th costa), and secondary measures included the Pain Sensitivity Questionnaire (PSQ), the effects of pain on daily activities measured by the Brief Pain Inventory (BPI), and disability assessed by the Oswestry Disability Questionnaire (ODQ).&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;Pre- and post-treatment PPTs, at the L1, L3 vertebrae and 12th costa levels, demonstrated significant differences between the study group and control groups. Post-treatment thresholds were significantly higher compared to pre-treatment thresholds (&lt;i&gt;p&lt;/i&gt; &lt; 0.001, ηp&lt;sup&gt;2&lt;/sup&gt; = 0.67; &lt;i&gt;p&lt;/i&gt; &lt; 0.001, ηp&lt;sup&gt;2&lt;/sup&gt; = 0.61; &lt;i&gt;p&lt;/i&gt; &lt; 0.001, ηp&lt;sup&gt;2&lt;/sup&gt; = 0.74). Additionally, significant improvements were found in PSC, BPI and ODQ scores in the study group compared to the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).&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;The results of this study suggest that stretching the LD-TLF complex may be a beneficial addition to the conventional physiotherapy approach for patients with CLBP. Specifically, LD-TLF complex stretching, when used in combination with conventional physiotherapy, appears to provide improved pain thresholds, decreased pain sensitivity and pain during activity, as well as reduced disability compared to conventional physiotherapy alone in patients with CLBP.&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;Chronic low back pain (CLBP) is a multifactorial condition, with the thoracolumbar fascia increasingly recognized as a potential contributing factor. This study suggests that stretching the latissimus dorsi-thoracolumbar fascia ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205931","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}