European Journal of Pain最新文献

{"title":"The mRNA Translation Inhibitor Vioprolide A Prevents Inflammatory Pain-Like Behaviour With Limited Action on Already Established Pain-Like Behaviour in Mice","authors":"Patrick Engel,&nbsp;Tilman Gross,&nbsp;Gesine Wack,&nbsp;Rekia Sinderwald,&nbsp;Luisa Burgers,&nbsp;Robert Fürst,&nbsp;Achim Schmidtko","doi":"10.1002/ejp.70099","DOIUrl":"https://doi.org/10.1002/ejp.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accumulating evidence indicates that pharmacological inhibition of the translational machinery is a therapeutic strategy for various diseases. However, whether inhibitors of mRNA translation might be suitable for pain therapy remains poorly understood. Here, we tested the potential analgesic effects of the natural product vioprolide A, which targets nucleolar protein 14 (NOP14) that is essential for ribosome biogenesis, in mouse models of pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed the antinociceptive effects of vioprolide A in C57BL/6 mice using four different models: zymosan-induced peritonitis, zymosan-induced paw inflammation, complete Freund's adjuvant-induced paw inflammation and spared nerve injury. Plasma and brain levels of vioprolide A were determined in a pharmacokinetic study. Immunostaining and western blot experiments were performed to investigate the distribution and expression of NOP14 in dorsal root ganglia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pretreatment with vioprolide A alleviated the visceral inflammatory hypersensitivity during zymosan-induced peritonitis, and it attenuated the somatic inflammatory hypersensitivity during zymosan-induced paw inflammation in a dose-dependent manner. However, treatment with vioprolide A did not affect established hypersensitivities. Pharmacokinetic measurements revealed that vioprolide A was not brain-penetrant and exhibited a short plasma half-life, which however seems to be sufficient to exert long-lasting antinociceptive effects. Tissue stainings revealed that NOP14 is expressed in a population of sensory neurons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings imply that vioprolide A may alleviate inflammatory nociceptive behaviours, but highlight that these effects may be limited to specific types of pain and treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>The inhibitor of mRNA translation, vioprolide A, produced robust antinociception in distinct murine models of pain. This study provides evidence supporting further investigation of mRNA translation inhibitors, which attenuate pain by a novel mechanism of action that is not shared by established analgesics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832562","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":"Representation of Pain and Injury in Children's Picture Books—A Content Analysis","authors":"Dur-E-Nayab Mehar,&nbsp;Sue Nichols,&nbsp;Abbie Jordan,&nbsp;G. Lorimer Moseley,&nbsp;Melanie Noel,&nbsp;Sarah B. Wallwork","doi":"10.1002/ejp.70102","DOIUrl":"https://doi.org/10.1002/ejp.70102","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 and injury experiences are common throughout childhood (e.g., minor injuries, vaccine injections) and provide important and frequent opportunities for children to learn about pain. Sociocultural contexts, such as reading picture books, may also provide critical opportunities for children to learn about pain/injury. This study aimed to investigate the representation of pain and injury in children's literature.&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 systematically screened for pain/injury representations in children's picture books, freely available from public libraries in South Australia. A content analysis of pain/injury representations was conducted on all included books.&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;Two hundred and fifty-four picture books were screened until 50 books with pain/injury representations were identified. There were 63 pain (i.e., subjective experience) and 43 injury (i.e., associated with tissue damage) representations. ‘Minor’ pains/injuries were frequently represented (&lt;i&gt;n&lt;/i&gt; = 69; 86%), whereas ‘procedural’ (e.g., vaccine injections) (&lt;i&gt;n&lt;/i&gt; = 1; 1%) and ‘chronic’ pain (&lt;i&gt;n&lt;/i&gt; = 2; 3%) were not. Gender differences were observed where boy characters experienced more pain/injury incidents (&lt;i&gt;n&lt;/i&gt; = 42; 53%) than girl characters (&lt;i&gt;n&lt;/i&gt; = 23; 28.8%). Behavioural responses to pain/injury also differed, with girl characters being portrayed to experience more emotional responses (e.g., crying; &lt;i&gt;n&lt;/i&gt; = 7; 77.8%) than boy characters (&lt;i&gt;n&lt;/i&gt; = 2; 22.2%). Other characters present during pain/injury experiences were more likely to be passive bystanders (i.e., did not respond; &lt;i&gt;n&lt;/i&gt; = 109; 59.6%) than active responders (&lt;i&gt;n&lt;/i&gt; = 51; 27.6%) to characters experiencing pain.&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;While the type of pain/injury representations in picture books seem consistent with young children's everyday pain/injury experiences (i.e., ‘minor’ pains/injuries), gendered stereotypes and dominant societal perspectives around pain and injury appear to be reinforced.&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;Shared reading of children's picture books provides an important sociocultural context for children to learn about pain and injury. In this study, we investigated how pain and injury are represented in children's picture books. We found that pain/injury incidents were consistent with young children's common pa","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832561","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":"Patient Characteristics Are Associated With Differences in Perceptions of Reassurance After a Consultation for Low Back Pain: Analysis of an Observational Study in Primary Care","authors":"Anika Young,&nbsp;Adrian C. Traeger,&nbsp;Simon D. French,&nbsp;Alice Kongsted,&nbsp;Mark J. Hancock,&nbsp;Tue S. Jensen,&nbsp;Hazel J. Jenkins","doi":"10.1002/ejp.70098","DOIUrl":"https://doi.org/10.1002/ejp.70098","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;People with low back pain (LBP) report different perceptions of reassurance after a consultation. We aimed to determine whether patient characteristics are associated with differences in patient perceptions of reassurance.&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;Secondary analysis of 2048 adults presenting with back pain to a chiropractor. We used linear mixed models to determine associations between patient sociodemographic, clinical and psychological characteristics and the outcome of reassurance measured using the four subscales of the Consultation-based Reassurance Questionnaire (CRQ).&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 higher perceived risk of pain persistence reported perceiving less reassurance in their consultation, on all four subscales of the CRQ: data-gathering (regression co-efficient −0.13 [99% confidence interval: −0.23, −0.03]), relationship-building (−0.13 [−0.22, −0.04]), cognitive reassurance (−0.20 [−0.30, −0.10]) and generic reassurance (−0.27 [−0.39, −0.15]). Older age was associated with lower cognitive reassurance (−0.03 [−0.05, −0.01]) and generic reassurance (−0.04 [−0.07, −0.02]). Males were associated with lower relationship-building scores (0.70 [−1.13 to −0.28]), compared to females. Previous spinal imaging was associated with lower generic reassurance (−0.68 [−1.28, −0.09]). Compared to acute pain, higher levels of reassurance were perceived by patients with subacute pain [data-gathering (0.83 [0.10, 1.65]), relationship-building (0.70 [0.02, 1.37]), cognitive reassurance (0.87 [0.11, 1.56])]. Higher back pain intensity was associated with higher levels of relationship-building (0.13 [0.01, 0.25]) and generic reassurance (0.18 [0.02, 0.34]).&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;People with higher perceived risk of pain persistence, previous spinal imaging, male and older age perceived slightly lower levels of reassurance. The impact of these associations on the success of a LBP consultation is unclear.&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;People seeking care for LBP report receiving variable levels of reassurance from healthcare providers. It is unknown whether perceived reassurance may differ according to patient characteristics. We identified several patient characteristics associated with lower perceived reassurance during a consultation for LBP, including higher perceived risk of pain persistence, previous ima","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773640","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":"Effectiveness of Equimolar Mixture of Oxygen and Nitrous Oxide Combined With Audiovisual in Young Children: A Randomised Controlled Trial","authors":"Stefano Maiandi,&nbsp;Sergio Coluccia,&nbsp;Greta Ghizzardi,&nbsp;Romana Nicardi,&nbsp;Roberta Giacchero,&nbsp;Maura Lusignani,&nbsp;Maria Lorella Giannì,&nbsp;Valeria Carla Edefonti","doi":"10.1002/ejp.70096","DOIUrl":"https://doi.org/10.1002/ejp.70096","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;Children undergoing painful procedures often experience distress and anxiety, impacting their cooperation and perception of healthcare. This study evaluates the effectiveness of combining Equimolar Mixture of Oxygen and Nitrous Oxide (EMONO) with audiovisual distraction (experimental group) versus EMONO only (control group) to improve cooperation and reduce pain during peripheral venous catheter (PVC) placement.&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;The first 120 eligible children 2–5 years old and requiring PVC placement were enrolled. Sixty children were randomly assigned to the experimental group and 60 to the control group. Cooperation and pain were assessed by employing validated tools throughout the procedure. The presence of side effects was also investigated as a secondary outcome.&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;Among the 120 recruited children, 46.7% were males and the mean age ± SD was 3.35 ± 1.11 years. In univariate analyses, no differences between the groups were detected for socio-demographic and clinical variables; in the experimental group, a significantly increased cooperation during the procedure and a reduced pain were observed (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). In logistic regression models, children receiving the experimental treatment were more than 15-fold likely to collaborate (OR = 17.0, &lt;i&gt;p&lt;/i&gt; &lt; 0.01) and less likely to perceive more than mild pain (OR = 0.22, &lt;i&gt;p&lt;/i&gt; &lt; 0.01). Older children were more likely to collaborate (OR = 1.65, &lt;i&gt;p&lt;/i&gt; &lt; 0.02) and to be less prone to experience serious or worse levels of pain (OR = 0.51, &lt;i&gt;p&lt;/i&gt; = 0.005). The experimental treatment was associated with reduced vomiting episodes in univariate models only.&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 combination of audiovisuals with EMONO may be effective in increasing cooperation and reducing pain in children 2–5 years during PVC placement.&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;Children often experience pain during illness-related procedures, such as peripheral venous catheter placement. EMONO is recognised for its effectiveness in reducing pain and enhancing cooperation. Additionally, audiovisual distraction techniques are employed to divert children's attention during medical procedures. Our study addresses a gap in knowledge regarding cooperation, pain and symptom management by utilising a non-pharmacological, safe and easily accessible technique—watching audiovisuals. This approach is particularly relevant for a population that is underrepr","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773739","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":"It Is Time to Feel Better: How Temporal Information of Placebo Analgesia Affects Our Brain","authors":"Volpino Valeria,&nbsp;Piedimonte Alessandro,&nbsp;Campaci Francesco,&nbsp;Camerone Maria Eleonora,&nbsp;Persiani Francesca,&nbsp;Carlino Elisa","doi":"10.1002/ejp.70093","DOIUrl":"https://doi.org/10.1002/ejp.70093","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;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&lt;sub&gt;2&lt;/sub&gt;Hb).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;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.&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;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&lt;sub&gt;2&lt;/sub&gt;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.&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;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.&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;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.&lt;/p&gt;\u0000 &lt;/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}