Journal of Pain Research最新文献

{"title":"Feasibility of Ultrasound-Guided Lumbar Transforaminal Epidural Steroid Injections for Management of Lumbar Radicular Back Pain.","authors":"Amaresh Vydyanathan, Priya Agrawal, Khaled Donia, Sayed E Wahezi, Sarang S Koushik, Kateryna Slinchenkova, Karina Gritsenko, Naum Shaparin","doi":"10.2147/JPR.S499091","DOIUrl":"10.2147/JPR.S499091","url":null,"abstract":"<p><strong>Background: </strong>Whereas traditional image guidance for placement of transforaminal epidural steroid injections (TFESI) has been fluoroscopy, it has disadvantages including inability to identify soft tissue, radiation exposure, and contrast administration need. Several studies found that ultrasonography is reliable in localizing lumbar nerve root. Few have investigated the feasibility of performing ultrasound guided TFESI in the lumbar spine. This study seeks to aid in filling this gap.</p><p><strong>Methods: </strong>Patients meeting inclusion criteria (BMI < 25) and exclusion criteria (no spinal deformity or previous lumbar surgery) were enrolled. Ultrasound visualization of nerve root and proximate placement of needle tip guided needle placement. Vascular signals were monitored. The contrast injection was done under real-time ultrasound visualization. Final needle placement with transforaminal epidural spread was assessed for accuracy by contrast fluoroscopy. Complications were assessed.</p><p><strong>Results: </strong>Thirty ultrasound guided lumbar TFESI were performed. Visualization at the L2, L3, and L4 levels was successful. At the L5 level, needle tip was placed in proximity to the nerve root, but the final needle tip position for transforaminal placement and injection was not visualized; fluoroscopic guidance was used instead. There was no evidence of intravascular injection. No complications were noted.</p><p><strong>Conclusion: </strong>Ultrasonography shows feasibility as an imaging modality in localizing lumbar intervertebral foramina at higher lumbar levels in patients with normal BMI and no spinal deformities. However, ultrasonography was consistently unable to assist transforaminal needle placement at the L5 level due to poor final needle tip visualization and the requirement of fluoroscopy to advance needle tip transforaminally. While no complications were seen, further controlled trials with larger sample size are needed to investigate safety.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"759-767"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commentary on \"Effect of Acupuncture Intervention on Chronic Musculoskeletal Pain in Hemodialysis-Dependent Kidney Failure Patients: Study Protocol for a Randomized Controlled Clinical Trial\" [Letter].","authors":"Danlei Song, Dan Cheng, Mengqin Qiu","doi":"10.2147/JPR.S518524","DOIUrl":"10.2147/JPR.S518524","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"743-744"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commentary on \"Clinical Efficacy of Tuina Therapy for Acute Lumbar Sprain: A Bayesian Network Meta-Analysis Based on Randomized Controlled Trials\" [Letter].","authors":"Yuqi Yin, Qiang Liu","doi":"10.2147/JPR.S517289","DOIUrl":"10.2147/JPR.S517289","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"745-746"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Xuefu Zhuyu Decoction on Inflammatory Factors and the NF-kappaB Signaling Pathway in Rats Model of Radicular Pain.","authors":"Xing Liu, Tao Jiang, Bing Lu","doi":"10.2147/JPR.S499469","DOIUrl":"10.2147/JPR.S499469","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the therapeutic effects and mechanisms of Xuefu Zhuyu Decoction (XFZYD) on radicular pain in rats with lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>Rat models of radicular pain were established and randomly divided into five groups: a control group, a model group, and three groups receiving low, medium, and high doses of XFZYD, with 12 rats per group. The rats in the treatment groups received different doses of XFZYD via oral administration, while the control and model groups received an equal volume of normal saline once daily for 7 days. Pain thresholds were measured, including the paw withdrawal threshold (PWT) and thermal paw withdrawal latency (PWL). The levels of inflammatory factors in the spinal dorsal horn tissue, including tumor necrosis factor α (TNF-α), transforming growth factor-β (TGF-β), interleukin-1β (IL-1β), and interleukin-6 (IL-6), were assessed using enzyme-linked immunosorbent assay (ELISA). Additionally, the expression of phosphorylated NF-κB in the spinal dorsal horn tissue was analyzed by Western blotting.</p><p><strong>Results: </strong>Compared to the control group, the PWT and PWL in the model group were significantly decreased (<i>p</i> < 0.05), while the levels of TNF-α, TGF-β1, IL-1β, IL-6, and phosphorylated NF-κB in the spinal dorsal horn were significantly elevated (<i>p</i> < 0.05). The PWT and PWL in the low, medium, and high dose groups receiving XFZYD showed significant increases (<i>p</i> < 0.05) compared to the model group, and the levels of TNF-α, TGF-β1, IL-1β, IL-6, and phosphorylated NF-κB were significantly reduced (<i>p</i> < 0.05) across all dose groups.</p><p><strong>Conclusion: </strong>Xuefu Zhuyu Decoction effectively reduces the release of inflammatory factors in the spinal dorsal horn of rats, enhances pain thresholds, and alleviates radicular neuropathic pain. The underlying mechanism may involve the inhibition of the NF-κB signaling pathway.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"735-742"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Painfully Sensitive: How Sensory Processing Sensitivity Affects Healthy Adolescents' Perception of Pain.","authors":"Jana Hochreuter, Susanne Wehrli, Cosima Locher, Francesca Lionetti, Joe Kossowsky, Michael Pluess, Helen Koechlin","doi":"10.2147/JPR.S473575","DOIUrl":"10.2147/JPR.S473575","url":null,"abstract":"<p><strong>Objective: </strong>Sensory processing sensitivity (SPS) describes a common trait characterized by lower sensory threshold, depth of processing, and ease of overstimulation. Low sensory threshold is also potentially important in the context of pain. To date, the relationship between SPS and pain perception has not been investigated, particularly in adolescents. This randomized experimental study aimed to explore whether SPS was associated with pain threshold and tolerance in healthy adolescents. Further, we examined differences in pain perception following positive, negative, or neutral mood induction.</p><p><strong>Methods: </strong>A total of 100 healthy adolescents aged 16 to 19 years were recruited through schools and online advertisement. Participants completed psychosocial questionnaires and underwent a randomized mood induction (positive, negative, or neutral). Pain levels (in °C) and self-reported pain tolerance and threshold were assessed by an experimental heat pain paradigm. Regression models were applied to determine effects of mood induction on pain perception, while multiple analyses of variance (ANOVAs) were computed to compare sensitivity across groups.</p><p><strong>Results: </strong>The mood induction significantly influenced self-reported pain ratings, demonstrating a positive interaction coefficient for the positive mood condition (<i>b</i> = 1.140, <i>p</i> < 0.01). ANOVAs revealed significant differences between sensitivity groups for baseline scores of pain threshold (F_(2,97) = 5.009, p < 0.01) and tolerance (F_(2,97) = 3.193, <i>p</i> < 0.05) (F_(2,97) = 7.431, p < 0.001).</p><p><strong>Conclusion: </strong>Our findings reveal that highly sensitive adolescents had the lowest ratings of measured pain tolerance and threshold measures at baseline, suggesting heightened sensitivity to pain. This highlights the importance of considering sensory processing sensitivity in pain research, particularly in adolescent populations.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"719-733"},"PeriodicalIF":2.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Oral Celecoxib Preoperatively Reduces Risk of Delirium and Favors Functional Recovery in Elderly Patients with Femoral Neck Fracture: A Propensity Score-Matched Analysis.","authors":"Minyan Ju, Xiaofei Han, Li He, Jingjing Jiang, Mengmeng Wang, Wenting Lin, Yuan Liu","doi":"10.2147/JPR.S507116","DOIUrl":"10.2147/JPR.S507116","url":null,"abstract":"<p><strong>Background: </strong>We aim to explore whether the effect of oral celecoxib (OC) preoperatively in elderly patients with femoral neck fracture (FNF) receiving surgery on the pain control, complications, functional outcomes, and mortality.</p><p><strong>Methods: </strong>We collected data on elderly patients with FNF in two hospitals between Jan. 2020 and May. 2024. According to OC use or not, patients were divided into OC group and non-OC group. We performed propensity score matching (PSM) analysis to minimize potential confounding and selection bias. We observed the factors that may influence pain control by Spearman correlations.</p><p><strong>Results: </strong>Finally, 908 patients met our inclusion criteria, including 494 patients in the OC group and 414 in non-OC patients. We found that many factors, such as age, body mass index, and fracture type, were significantly different. Thus, we used PSM analysis to lower potential confounding, and 215 patients remained in each group. The results showed that VAS scores at the time of 1^st day after surgery, 3^rd day after surgery and at discharge were markedly lower in OC group. Additionally, lower delirium rate and better functional outcomes were found in OC group. Our finding showed no significant difference in mortality rates at 30-day, 90-day, and 12-month between two groups.</p><p><strong>Conclusion: </strong>Preoperative OC can manage pain control, have better functional recovery, and minimize pain-related complications such as delirium in elderly patients with femoral neck fracture.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"709-717"},"PeriodicalIF":2.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Location of the Segmental Spinal Arteries in the Cervical Intervertebral Foramina: 3D-Micro CT Findings Relevant to Transforaminal Epidural Injection.","authors":"Byongnam Jun, Hun-Mu Yang, Dong Ah Shin, Hyun Ho Jung, Tae-Hyeon Cho, Shin Hyung Kim","doi":"10.2147/JPR.S495046","DOIUrl":"10.2147/JPR.S495046","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical transforaminal epidural steroid injection (TFESI) is a common treatment for cervical radiculopathy but carries potential risks because of the presence of crucial arteries in the intervertebral foramina (IVF). This study analyzed the precise anatomical location of the segmental spinal artery (SSA) within the cervical IVF using 3D micro-CT imaging to provide guidance for safer TFESI procedures.</p><p><strong>Participants and methods: </strong>Fourteen embalmed cadavers were used in this study: three for serial sectional dissection, two for histological examination, and nine for micro-CT analysis. Each IVF was divided into quadrants (ASQ, antero-superior quadrant; PSQ, postero-superior quadrant; AIQ, antero-inferior quadrant; PIQ, postero-inferior quadrant) for detailed measurements of SSA locations, comparing dimensions and spatial relationships among C4-5, C5-6, and C6-7 levels.</p><p><strong>Results: </strong>Forty-four IVFs were analyzed by micro-CT, and the results revealed that SSAs were predominantly located in the ASQ (36 of 44 cases, 82%) and PSQ (8 of 44 cases, 18%) of the IVF. No SSAs were observed in the AIQ and PIQ. Significant dimensions and shapes were consistent across individuals, with cervical IVF increasing in size from C4-5 to C6-7.</p><p><strong>Conclusion: </strong>Together, these findings demonstrated the predominance of SSAs in the ASQ, emphasizing the need for precise anatomical guidance during TFESI to avoid vascular injury. In addition, the cervical spine exhibits anatomical variability, indicating that greater caution is required when treating the cervical spine compared with the lumbar spine and highlighting the importance of targeting the PIQ to avoid the SSA and other vascular structures.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"701-708"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the Principle and Value of Test Signaling (\"Pinging\") in Pain Pathways: A Part of an Overarching Principle in Psychophysical Phenomena?","authors":"Robert B Raffa, Wolfgang Fink","doi":"10.2147/JPR.S514929","DOIUrl":"10.2147/JPR.S514929","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"685-687"},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Fascial Plane Block on Postoperative Length of Stay and Opioid Use Among Colectomy Patients Within an Established Enhanced Recovery After Surgery Program: A Retrospective Cohort Study.","authors":"Jonathan Khersonsky, Mubarika Alavi, Edward N Yap, Cynthia I Campbell","doi":"10.2147/JPR.S475139","DOIUrl":"10.2147/JPR.S475139","url":null,"abstract":"<p><strong>Background: </strong>Use of fascial plane blocks is increasing yet their impact on hospital length of stay (LOS) and opioid use within the context of an enhanced recovery after surgery (ERAS) pathway has been inconclusive. We address this gap by examining the impact of fascial plane blocks on postoperative LOS and opioid use for colorectal surgical procedures in a hospital setting with a robust ERAS program.</p><p><strong>Methods: </strong>This is a retrospective cohort study using electronic health record data from a large, integrated health care delivery system with an established ERAS program in Northern California. Patients include adults who underwent non-emergent laparoscopic (n=5496) or non-laparoscopic (n=708) colectomy surgery from January 1, 2015 to May 20, 2021. The main exposure was type of anesthesia: general with long-acting fascial plane block, general with short-acting fascial plane block, or general only. Outcomes included postoperative LOS and average daily morphine milligram equivalents (MME) up to three days post-surgery.</p><p><strong>Results: </strong>Most patients were older than age 50 (86% laparoscopic; 83% non-laparoscopic), female (52% laparoscopic; 58% non-laparoscopic), and non-Hispanic White (64% laparoscopic; 62% non-laparoscopic). In LOS adjusted models for laparoscopic and non-laparoscopic surgery, there was no significant difference for LOS with general with long-acting fascial plane block or with general with short-acting fascial plane block, compared to general only. In MME adjusted models for laparoscopic surgery, general with short-acting fascial plane block was associated with higher MME compared with general only (RE: 1.14,[95% CI: 1.03-1.25], p-value=0.01). However, in non-laparoscopic surgery, general with long-acting fascial plane block was associated with lower MME (RE: 0.63, [95% CI: 0.42-0.93], p-value=0.02), compared with general only.</p><p><strong>Conclusion: </strong>Fascial plane blocks did not impact postoperative LOS in either surgical group but long acting resulted in lower overall postoperative opioid use for non-laparoscopic surgery.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"689-699"},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroacupuncture Regulates Macrophage Polarization to Alleviate the Neuropathic Pain Induced by Spared Nerve Injury.","authors":"Guangxia Shi, Xiaowan Hao, Jian-Feng Tu, Wen Chen, Yiming Fu, Xin Ma, Cunzhi Liu, Hongping Li","doi":"10.2147/JPR.S486812","DOIUrl":"10.2147/JPR.S486812","url":null,"abstract":"<p><strong>Purpose: </strong>The current therapeutic strategies for neuropathic pain have limited efficacy. The activation of macrophages and pro-inflammatory responses following peripheral nerve injury can effectively prevent the progression of neuropathic pain. Macrophage polarization to the M2 or M1 (respectively anti- and pro- inflammatory) phenotypes frequently occurs during neuroinflammation. Electroacupuncture (EA) therapy has been shown to exert anti-inflammatory functions in several pain models, and has thus been applied to alleviate neuropathic pain. Therefore, the present study aimed to determine whether EA could reduce neuroinflammation and induce analgesia by regulating macrophage polarization.</p><p><strong>Methods: </strong>Forty-five male rats were used to create a spared nerve injury (SNI) model of peripheral nerve injury. Subsequently, EA was applied to the ipsilateral <i>huantiao</i> (GB30) and <i>yanglingquan</i> (GB34), and the von Frey assay was conducted to monitor the effect of EA on the paw withdrawal threshold. Immunofluorescence analyses were further performed to detect the effects of EA on interleukin-1β (IL-1β) expression and peripheral macrophage polarization.</p><p><strong>Results: </strong>EA attenuated pain behavior (<i>P</i>=0.002) and decreased inflammatory cytokines derived from macrophages (<i>P</i>=0.002 in the sciatic nerve; <i>P</i>=0.002 in the dorsal root ganglion, DRG) but not in Schwann (<i>P</i>>0.05) or mast (<i>P</i>>0.05) cells in SNI rats. In addition, EA increased M2 macrophage polarization (<i>P</i><0.0001 in the sciatic nerve; <i>P</i>=0.001 in the DRG) and decreased M1 macrophage expression (<i>P</i>=0.036 in the sciatic nerve; <i>P</i>=0.022 in the DRG).</p><p><strong>Conclusion: </strong>These data revealed that EA exerted analgesia by adjusting the polarization of macrophages and inhibiting the IL-1β expressing in macrophages in SNI rats.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"663-671"},"PeriodicalIF":2.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}