European Journal of Pain最新文献

{"title":"A Model of Body Perception Disturbances in Chronic Limb Pain: The Predictive Role of Kinesiophobia, Depersonalization and Symptom Severity","authors":"Hana Karpin, Jean-Jacques Vatine, Anatoly Livshitz, Irit Weissman-Fogel","doi":"10.1002/ejp.70123","DOIUrl":"https://doi.org/10.1002/ejp.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Body Perception Disturbances (BPD) are common in chronic limb pain conditions characterised by negative feelings toward the limb and a reduced sense of agency. Prior research has focused on isolated associations between psychological factors, pain hypersensitivity and BPD. Therefore, an integrated examination of the interconnections between these variables within a theory-driven model is necessary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The model hypothesises that pain hypersensitivity (hyperalgesia, allodynia), directly linked with BPD (assessed by the Bath-BPD and Neurobehavioral questionnaires) or indirectly, via symptom severity [assessed by complex regional pain syndrome (CRPS) severity score]; coping strategies (depersonalization, kinesiophobia) and psychological symptoms (somatization, depression) are directly related to BPD; and BPD is associated with pain severity and Quality of Life (QoL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The model was examined using a path analysis of 92 patients with chronic limb pain. Results indicate that depersonalization was directly linked with the Bath-BPD (<i>β</i> = 0.50, <i>p</i> < 0.001), and depersonalization and kinesiophobia with the Neurobehavioral (<i>β</i> = 0.24, <i>p</i> = 0.010; <i>β</i> = 0.22, <i>p</i> = 0.020, respectively). CRPS severity score accounts for the associations between hyperalgesia intensity and BPD and is directly related to the Bath-BPD (<i>β</i> = 0.25, <i>p</i> = 0.014), Neurobehavioral (<i>β</i> = 0.24, <i>p</i> = 0.037), pain (<i>β</i> = 0.28, <i>p</i> = 0.014) and QoL (<i>β</i> = −0.34, <i>p</i> = 0.001). The Bath-BPD marginally associated with QoL (<i>β</i> = −0.20, <i>p</i> = 0.052) but not with pain severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The theory-driven model fits the data, suggesting that psychological copying strategies play a dominant role in BPD. The symptom severity explains the associations between pain hypersensitivity and BPD and is directly linked to BPD, pain and QoL. The model revealed potential mechanisms underlying BPD and its associated clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study is the first to use path analysis to examine the predictors and effects of Body Perception Disturbances (BPD) in chronic limb pain. Results identified depersonalization and kinesiophobia as key psychological predictors of BPD, while hyperalgesia has no dir","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012337","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 Catastrophising Amplifies Parietal Responses to Painful Laser Stimulation in Healthy Controls","authors":"Dan Wang, Xiaohan Zhang, Shuqi Ye, Patrick Realyvasquez, Patrick Finan, Mark Quigg, Shayan Moosa, W. Jeffrey Elias, Chang-Chia Liu","doi":"10.1002/ejp.70117","DOIUrl":"https://doi.org/10.1002/ejp.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pain catastrophising is a maladaptive cognitive–emotional trait linked to greater pain severity and poorer outcomes, yet its neurophysiological correlates remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We tested whether pain catastrophising amplifies cortical responses to nociceptive input, independent of subjective pain intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-two healthy adults underwent EEG during painful laser stimulation (<i>n</i> = 29; mean age 24.3 ± 10.9 years; 55.2% female) or non-painful electrical stimulation (<i>n</i> = 23; mean age 23.3 ± 8.5 years; 56.5% female). Each trial comprised a triplet of stimuli (S1, S2, S3) with a 1.5-s interstimulus interval; 30 triplets were delivered per modality. Associations between Pain Catastrophising Scale (PCS) scores and amplitudes of laser-evoked potentials (LEP-N2P2) and somatosensory-evoked potentials (SEP-N1P2) were tested using mixed-effects models, with trial-level pain ratings as a covariate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher PCS scores were associated with greater LEP-N2P2 amplitude for the first stimulus (S1) in the painful condition, independent of pain ratings, at the parietal midline electrode (Pz). No associations were observed between PCS and SEP-N1P2 in the non-painful condition, or between PCS and early N1 components of LEP or SEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pain catastrophising selectively amplifies later-stage cortical responses to painful stimuli, strongest at first presentation (S1) and localised to parietal Pz channel, with no effects in non-painful controls stimulation modality. These findings support LEPs as mechanistic biomarkers of catastrophising-related vulnerability. Combined with psychological assessment, such markers could improve early screening, risk stratification, and personalised interventions targeting maladaptive salience and attentional processes in pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Pain catastrophising was associated with amplified laser-evoked potential (LEP-N2P2) responses during painful, but not non-painful, stimulation in healthy adults. The effect was localised to the parietal midline, strongest for the first stimulus in a sequence, and diminished with repetition. These findings suggest modality-dependent cortical modulation and highlight LEP-N2P2 as a potential neural marker of maladaptive pain processing.</p>\u0000 </s","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990700","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":"Effective Spinal Cord Stimulation Does Not Improve Caregiver Burden in Patients With Chronic Neuropathic Pain. Results of the CARESTIM-Study","authors":"Robin M. Bouttelgier,&nbsp;Stijn Vandamme,&nbsp;Bart Billet,&nbsp;Barbara Declercq,&nbsp;Karel Hanssens,&nbsp;Werner Nagels,&nbsp;Amaury Verhamme,&nbsp;Jan Dossche,&nbsp;Olivier De Coster,&nbsp;Nick De Naeyer,&nbsp;Ruben De Vos,&nbsp;Wim Maenhoudt,&nbsp;Jeroen Van Lerbeirghe,&nbsp;Olivier Van Damme,&nbsp;Stephanie Du Four,&nbsp;Dimitri Vanhauwaert","doi":"10.1002/ejp.70122","DOIUrl":"https://doi.org/10.1002/ejp.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic and ischaemic pain. Although patient-reported outcomes have increasingly gained recognition, the impact of SCS on informal caregivers—an equally important consideration—remains underexplored. This study aims to address this gap by evaluating multidimensional outcomes following SCS, with a particular focus on the burden experienced by informal caregivers over a one-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort study was conducted involving 35 patient-caregiver dyads treated with SCS between January and December 2021 at AZ Delta and Jan Yperman Hospital. Inclusion required the availability of a spousal or offspring caregiver. Patients and caregivers were evaluated preoperatively and at 3, 6 and 12 months postoperatively using validated instruments including the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQuality of Life-5 Dimensions (EQ5D), Zarit Burden Index (ZBI), Modified Caregiver Strain Index (MCSI) and Relation Quality Indexes (RQI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients reported significant reductions in leg and back pain (<i>p</i> &lt; 0.001), leading to decreased disability (<i>p</i> &lt; 0.001) and improved quality of life (<i>p</i> &lt; 0.05) during follow-up. However, no significant changes were observed in caregiver burden or in the quality of the patient-caregiver relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While patients reported significantly lower pain and better quality of life following SCS, these benefits do not extend to reducing caregiver burden or strengthening the patient-caregiver relationship. A holistic treatment approach that actively involves caregivers may be necessary to optimise outcomes for both patients and caregivers. Further research with a larger cohort is required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This prospective cohort study is the first to analyze the patient-caregiver dyad in chronic pain patients treated with SCS. Although SCS effectively reduces pain and improves the quality of life of patients, these benefits do not extend to reducing caregiver burden or enhancing the patient-caregiver relationship. We argue that a more holistic approach, including caregiver involvement in the treatment process, may be necessary to improve outcomes for both patients and caregivers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990701","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":"Exploring the Association of Migraine Susceptibility SNPs With the Risk of Chronic Migraine","authors":"Sarah Cargnin,&nbsp;Martina Giacon,&nbsp;Elisa Del Corona,&nbsp;Anna Maria Zanaboni,&nbsp;Sara Facchetti,&nbsp;Roberto De Icco,&nbsp;Gloria Vaghi,&nbsp;Grazia Sances,&nbsp;Natascia Ghiotto,&nbsp;Elena Guaschino,&nbsp;Daniele Martinelli,&nbsp;Rosaria Greco,&nbsp;Cristina Tassorelli,&nbsp;Salvatore Terrazzino,&nbsp;Marta Allena","doi":"10.1002/ejp.70120","DOIUrl":"https://doi.org/10.1002/ejp.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although robust genetic markers for episodic migraine (EM) have been identified, variants associated with chronic migraine (CM) are still unknown. Given the potential pathophysiologic overlap between EM and CM, we investigated whether six single nucleotide polymorphisms (SNPs), robustly associated with EM susceptibility (<i>LRP1</i> rs11172113, <i>PRDM16</i> rs10797381, <i>FHL5</i> rs7775721, <i>TRPM8</i> rs10166942, near <i>TSPAN2</i> rs2078371 and <i>MEF2D</i> rs1925950) also play a role in the risk of developing CM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 200 EM and 202 CM participants were prospectively included. Genotyping of selected SNPs was performed by TaqMan real-time PCR in 192 individuals with EM and 198 with CM who consented to genetic analysis. A validation group of 312 healthy individuals was used. Genetic associations were assessed by logistic regression using dominant, recessive, and allelic models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In multivariable logistic regression analysis, <i>LRP1</i> rs11172113 T&gt;C and (near) <i>TSPAN2</i> rs2078371 T&gt;C were nominally associated with CM. However, only the association for <i>LRP1</i> rs11172113 survived Bonferroni correction, with carriers of the minor C allele (genotypes T/C or C/C) having a lower risk of CM compared to wild-type homozygous subjects (OR: 0.38; 95% CI: 0.20–0.71; <i>p</i>-value: 0.0025). This protective effect was also observed in the analysis comparing CM participants with healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Carriers of the minor allele of <i>LRP1</i> rs11172113 have a reduced risk of CM. However, further large-scale studies, ideally with a multicentre design, are warranted to confirm the association between <i>LRP1</i> rs11172113 and CM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study identified an association between the minor allele of <i>LRP1</i> rs11172113 (low-density lipoprotein receptor-related protein 1, a receptor with key roles in lipid metabolism, vascular integrity, and inflammation control) and a reduced risk of chronic migraine. These findings support the hypothesis that episodic and chronic migraine share genetic risk factors and suggest a potential protective role for this variant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Adding Electroanalgesic Modalities to a Multimodal Therapeutic Program Improve Clinical Outcomes in Individuals With Chronic Nonspecific Neck Pain? A Randomised Controlled Trial","authors":"Gabriela Nascimento de Santana,&nbsp;Aron Charles Barbosa da Silva,&nbsp;Patrícia Gabrielle dos Santos,&nbsp;Carlos Eduardo Girasol,&nbsp;Adriano Rodrigues de Oliveira,&nbsp;Almir Vieira Dibai-Filho,&nbsp;Cid André Fidelis de Paula Gomes","doi":"10.1002/ejp.70121","DOIUrl":"https://doi.org/10.1002/ejp.70121","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 nonspecific neck pain (CNSNP) is a prevalent and complex condition. Although many studies have evaluated the effectiveness of transcutaneous electrical nerve stimulation (TENS), interferential current (IFC), therapeutic exercise (TE), and manual therapy (MT) individually, this study aimed to determine whether adding IFC and/or TENS to a Multimodal Therapeutic Intervention Program (MTIP) would produce better outcomes than the MTIP alone concerning functional capacity, pain intensity, pain catastrophising, kinesiophobia and overall perceived effect in individuals with CNSNP.&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;Seventy-five individuals with CNSNP were randomly assigned to one of three groups: MTIP, MTIP + IFC, or MTIP + TENS. Interventions were conducted over 8 weeks. Outcomes were assessed at baseline, post-intervention, and at a 1-month follow-up. The primary outcome was the Neck Disability Index (NDI). Secondary outcomes included the Numeric Pain Rating Scale (NPRS) at rest and during movement, the Pain-Related Catastrophizing Thoughts Scale (PRCTS), the Tampa Scale for Kinesiophobia (TSK), the Copenhagen Neck Functional Disability Scale (CNFDS), the WHO Disability Assessment Schedule (WHODAS 2.0), and the Global Perceived Effect Scale (GPES).&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;No significant differences were observed between groups for the primary outcome. For secondary outcomes, the MTIP group showed improved results for NPRS-m and CNFDS. Additionally, MTIP was superior to MTIP + IFC for NPRS-r post-intervention, while MTIP + TENS outperformed both groups at follow-up. No significant differences were found for GPES, and none of the differences reached clinical significance.&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 addition of IFC and/or TENS to an MTIP did not enhance clinical outcomes in individuals with CNSNP.&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;The results of this study assist clinicians in making informed decisions regarding the selection of therapeutic resources for managing chronic nonspecific neck pain. They also support researchers in refining and conducting new studies focused on improving the implementation of multimodal intervention protocols. Additionally, these findings help individuals with chronic nonspecific neck pain better understand which interventions may be most appropriate to include in their rehabilitation process.&lt;/p&gt;\u0000 ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990699","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":"Prevalence of Chronic Overlapping Pain Conditions in Participants With Chronic Low Back Pain Enrolled in a Pragmatic Trial of Mindfulness-Based Stress Reduction","authors":"Vanessa Eve Miller,&nbsp;Jessica Barnhill,&nbsp;Carol M. Greco,&nbsp;Gabriela Castro,&nbsp;Tra P. Nguyen,&nbsp;Paula Gardiner,&nbsp;Keturah R. Faurot,&nbsp;Susan Gaylord,&nbsp;Janice M. Weinberg,&nbsp;Holly N. Thomas,&nbsp;Karim Sariahmed,&nbsp;Natalia E. Morone","doi":"10.1002/ejp.70119","DOIUrl":"https://doi.org/10.1002/ejp.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic low back pain (cLBP) is extremely common and is one of the Chronic Overlapping Pain Conditions (COPCs), 10 conditions thought to have similar underlying pathophysiology. Little is known about the prevalence and co-occurrence of cLBP with other commonly accepted conditions referred to as COPCs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed participants enrolled in a pragmatic trial of mindfulness-based stress reduction for cLBP to determine the prevalence of co-occurring COPCs using a validated COPC screener. We compared psychosocial and physical functioning among participants with only cLBP and participants with cLBP and additional COPCs using Student's <i>t</i>-tests, chi-squared tests and multivariable linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 285 enrollees (age range: 18–88 years, mean age: 52.2 years, SD = 15.3), 272 (95%) reported pain outside the upper and lower back region. One hundred and twenty-nine people (45%) had one COPC, and 68 (24%) had two or more COPCs not including cLBP. The most common COPCs were irritable bowel syndrome (<i>n</i> = 56, 20%); myalgia encephalomyelitis/chronic fatigue syndrome (<i>n</i> = 54, 19%); and fibromyalgia (<i>n</i> = 42, 15%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found strong differences when comparing people with cLBP alone to those with cLBP and COPCs. People with COPCs reported more pain symptoms, higher levels of anxiety, depression, fatigue and scored worse across measures of physical functioning and pain symptoms. An additional COPC was associated with a 7.6-point increase in fatigue scores (95% CI: 5.6, 9.7) on a T-score metric (mean = 50, SD = 10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Compared to people with low back pain alone, individuals with additional chronic pain experienced more severe pain symptoms, more anxiety, depression and fatigue. In this sample of people with cLBP, overlapping pain conditions were common, affecting 45% of people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Registration Number and Registry Name</h3>\u0000 \u0000 <p>Clinicaltrials.gov identifier NCT04129450.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927304","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":"Pain, Stress and Mental Well-Being Over Three Generations","authors":"Nikola Stanisic,&nbsp;Sonia Sharma,&nbsp;Simon Vallin,&nbsp;Peter M. Nilsson,&nbsp;Per-Olof Östergren,&nbsp;Anna Lövgren,&nbsp;Thomas List,&nbsp;Birgitta Häggman-Henrikson","doi":"10.1002/ejp.70110","DOIUrl":"https://doi.org/10.1002/ejp.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The multifactorial nature of chronic pain should be reflected in pain assessment. The aim of this observational study comparing samples from three generations assessed at different times was to present differences in pain, stress and mental well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pain sites, widespread pain, stress (Perceived Stress Scale-4) and mental well-being (30-item General Health Questionnaire) were described across generations from the Malmö neck and shoulder study (parents, Generation 1, <i>n</i> = 12,607), Malmö offspring study, and Malmö Offspring pain study (children and grandchildren, Generation 2, <i>n</i> = 1572; Generation 3, <i>n</i> = 936).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pain prevalence remained comparable across generations. In all generations, women reported more pain sites compared to men, mean difference 1.0 (95% CI 0.9–1.1) in Generation 1, mean difference 1.3 (95% CI 1.0–1.6) in Generation 2, and mean difference 0.9 (95% CI 0.5–1.3) in Generation 3. The frequency of widespread pain for women and men was 28% and 16% in Generation 1, 27% and 12% in Generation 2, and 22% and 15% in Generation 3, respectively. Perceived stress levels were consistently higher in Generation 2 and 3 compared to Generation 1 for both women and men. Among women, mental well-being remained stable between Generation 1 and 2 but declined significantly in Generation 3 (mean difference 3.2, 95% CI 2.4–4.3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results suggest significant gender disparities, with women consistently reporting more pain sites, higher stress levels, and reduced mental well-being compared to men. Furthermore, the findings suggest that generational differences in coping—or other factors—may mitigate the impact of psychosocial distress on pain prevalence, warranting further research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study highlights the comparability of pain prevalence across generations despite increasing stress and declining mental well-being, particularly in women. These findings emphasise the importance of integrating mental health support and gender-specific coping strategies into pain management, offering insights into biopsychosocial mechanisms underlying the interactions between pain and perceived stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927303","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":"Healthcare Practitioner and Other Professionals' Perspectives on Gabapentinoid Misuse and Dependence: A Systematic Review of Qualitative Studies","authors":"Amy G. McNeilage,&nbsp;Evan Browne,&nbsp;Suzanne Nielsen,&nbsp;Claire E. Ashton-James,&nbsp;Bridin Murnion","doi":"10.1002/ejp.70116","DOIUrl":"https://doi.org/10.1002/ejp.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>The global rise in gabapentinoid prescriptions for chronic pain has been striking. However, this trend has been accompanied by growing concerns about misuse and dependence. This qualitative systematic review aimed to synthesise the perspectives of healthcare practitioners and other professionals on these emerging challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Databases and Data Treatment</h3>\u0000 \u0000 <p>Six databases (MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, PsycINFO) were searched to May 2025. Eligible studies used qualitative or mixed methods to explore professional views on gabapentinoid misuse or dependence. Studies focusing solely on patient perspectives or therapeutic use were excluded. Methodological quality was assessed using the Critical Appraisal Skills Programme checklist. Data were analysed using thematic synthesis, and confidence in the findings was evaluated using GRADE-CERQual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After screening 1584 records, 19 original studies were included. Most were conducted in substance use treatment and law enforcement settings, where professionals frequently encounter vulnerable populations and more severe patterns of misuse than in general clinical care. Reported drivers of misuse included polydrug use, opioid substitution, psychological distress and poor access to non-pharmacological care. Signs of misuse included early refills, dose escalation and reluctance to taper. Professionals described ethical tensions in prescribing and dispensing and proposed harm reduction strategies, including prescriber education, regulatory reform, expanded treatment access and public awareness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Gabapentinoid misuse is shaped by clinical, social and structural factors. Tackling these challenges requires systemic responses that go beyond individual prescribers. Lessons from opioid policy responses should inform balanced, compassionate and evidence-informed strategies to reduce harm and improve care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This is the first systematic review to synthesise professional perspectives on gabapentinoid misuse and dependence, drawing on studies from Europe, North America, the Middle East and Africa. Integrating insights from healthcare, law enforcement and policy settings, it reveals the structural drivers behind rising misuse—including opioid regulation, socioeconomic hards","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927260","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":"Patterns of Analgesic Prescribing and High-Risk Prescribing in Primary Care in Ireland 2014–2022—A Repeated Cross-Sectional Study","authors":"Molly Mattsson,&nbsp;Ahmed Hassan Ali,&nbsp;Fiona Boland,&nbsp;Michelle Flood,&nbsp;Ciara Kirke,&nbsp;Emma Wallace,&nbsp;Derek Corrigan,&nbsp;Mary E. Walsh,&nbsp;Tom Fahey,&nbsp;Brian MacKenna,&nbsp;Frank Moriarty","doi":"10.1002/ejp.70115","DOIUrl":"https://doi.org/10.1002/ejp.70115","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;Pain is a significant burden on individuals, healthcare systems and society. Analgesic drugs carry many therapeutic benefits; however, all drugs are associated with adverse effects and risk of harm. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids have been identified as particularly high-risk due to the risk of side effects and/or dependency. This study aims to examine how patterns of analgesic prescribing have changed in primary care in Ireland between 2014 and 2022.&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;Monthly data on medicines prescribed and dispensed in primary care on the means-tested General Medical Services (GMS) scheme in Ireland was used. Prevalence, initiations, discontinuations, chronic use and high-risk prescribing, as defined by Scottish Polypharmacy Guidance, were summarised per year.&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 prevalence of overall analgesic use decreased slightly over time, with 48.3% of GMS-eligible individuals dispensed an analgesic in 2014 and 46.3% in 2022. This was largely driven by decreasing NSAID use, from 29.4% in 2014 to 25.0% in 2022. Prevalence for all other analgesic drug classes increased; however, after age/sex adjustment, higher odds of use in 2022 versus 2014 only persisted for gabapentinoids and amitriptyline. Some forms of high-risk prescribing increased over time, including NSAIDs dispensed with oral anticoagulants, corticosteroids and SSRIs, with fewer decreasing.&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;There was an overall reduction of analgesic use in Ireland, driven by decreasing systemic NSAID use. Although most other analgesic drug classes are increasing, this may largely be explained by changing demographics, particularly the age profile of the population. Despite this, interventions addressing rising high-risk prescribing may be needed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Statement of Significance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Analgesic drug classes are an important focus for improving medication safety. This study suggests analgesic use is falling in Ireland, particularly for systemic NSAIDs, especially in older adults where adverse effects may be most harmful. The increasing prevalence of other analgesics may largely be explained by an ageing population. Analgesic use, and high-risk prescribing, remains high, suggesting a need for enhanced access to non-pharmacological services and interventions and also improved education and deprescribing","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923516","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":"Comparative Effectiveness of Exercise Modalities for Fibromyalgia: A Systematic Review and Bayesian Network Meta-Analysis","authors":"Chuanzhi Wang,&nbsp;Jielin Sun,&nbsp;Zhide Liang,&nbsp;Yi Cai,&nbsp;Meng Zhang,&nbsp;Shudong Tian,&nbsp;Wenyi Yang,&nbsp;Shulin Cheng,&nbsp;Rui Duan,&nbsp;Xiuqiang Wang","doi":"10.1002/ejp.70109","DOIUrl":"https://doi.org/10.1002/ejp.70109","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To synthesise existing evidence assessing the impact of exercise-based therapies on pain in patients with fibromyalgia syndrome (FM), determine the efficacy of various exercise modalities, and establish the optimal exercise dosage for pain management.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Systematic review and network meta-analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Data Sources&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;MEDLINE, Embase, Web of Science, Cochrane Library, Scopus and SPORT Discus were searched from inception to July 2024.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Eligibility Criteria&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Randomised controlled trials (RCTs) that included adult patients with FM compared any exercise intervention with a non-exercise control group and reported pain-related outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 50 RCTs involving 3761 participants were included in this meta-analysis. Aerobic + flexibility training demonstrated the most significant intervention effect compared to controls (&lt;i&gt;g&lt;/i&gt; = −0.82, 95% credible interval [CrI]: −1.07 to −0.58; five comparisons; surface under the cumulative ranking curve [SUCRA] = 0.91), followed by water-based exercise (&lt;i&gt;g&lt;/i&gt; = −0.72, 95% CrI: −0.92 to −0.52; 11 comparisons; SUCRA = 0.87) and Pilates (&lt;i&gt;g&lt;/i&gt; = −0.87, 95% CrI: −1.14 to −0.59; 11 comparisons; SUCRA = 0.60). A weekly exercise volume of 875 metabolic equivalent of task (MET) minutes was required to achieve minimal clinically important difference (MCID). The overall quality of evidence ranged from low to very low.&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;Aerobic + flexibility training and water-based exercises may be effective strategies for pain management in patients with FM. However, given the substantial heterogeneity, high risk of bias, and overall low quality of evidence, these findings should be interpreted with caution. The temporary nature of these benefits underscores the importance of maintaining a consistent, professionally guided and tailored exercise regimen.&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;While acknowledging the overall low to very low quality of the available evidence, this study suggests that combining aerobic and flexibility training or engaging in water-based exercises may be effective for pain reduction in fibromyalgia. Our analysis indicates that a weekly exercise volume of approximately 875 METs-min, potent","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923515","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}