Journal of Pain Research最新文献

{"title":"Anxiety as a Psychological Modulator of Endogenous Pain Inhibition in Chronic Neck Pain: Implications for Precision Rehabilitation.","authors":"Carla S Enriquez, Alka Bishnoi, Musola N Oniyide, Katherine L Jennings, Roger Luo","doi":"10.2147/JPR.S570197","DOIUrl":"https://doi.org/10.2147/JPR.S570197","url":null,"abstract":"<p><strong>Objective: </strong>Chronic neck pain (CNP) is a highly prevalent musculoskeletal disorder with significant personal and socioeconomic impact. In conjunction with low back pain, CNP accounts for the highest healthcare expenditures in the United States and contributes to 3551 disability‑adjusted life years per 100,000 population globally. This study explores the relationship between psychological factors and pain processing mechanisms, assessed through Quantitative Sensory Testing (QST), in individuals with CNP.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>Hospital-based comprehensive outpatient rehabilitation center.</p><p><strong>Participants: </strong>Forty-one adults diagnosed with nonspecific CNP who presented to physical therapy for initial examination.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Primary predictors were anxiety and pain catastrophizing; secondary predictors included demographics and self-reported pain and disability. Primary outcomes were central pain processing assessed via Quantitative Sensory Tests (QST) through measures of mechanical Pressure Pain Threshold (PPT) and Conditioned Pain Modulation (CPM).</p><p><strong>Results: </strong>Generalized additive model analysis revealed a significant nonlinear association between anxiety and PPT (edf = 3.56, F = 3.25, p = 0.030), suggesting possible threshold effects. For CPM, the model explained 26.5% of deviance (adjusted <i>R²</i> = 0.155), with anxiety showing a significant linear association (edf = 1.00, F = 4.93, p = 0.036), indicating its role in altered pain modulation.</p><p><strong>Conclusion: </strong>Our findings highlight anxiety as a key psychological factor influencing pain modulation in chronic neck pain. Targeting anxiety may enhance endogenous pain control, informing both preventive and therapeutic strategies. Early identification of anxiety in patient care may influence clinical decision-making, inform patient education and counseling strategies, as well as influence decisions regarding targeted preventive strategies, advanced imaging, procedural interventions, or referrals to specialty care.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"570197"},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839287","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":"Comparative Efficacy of Canggui Tanxue Acupuncture Combined with Scapular Stabilization Training versus Scapular Stabilization Training Alone for Rotator Cuff Injury: A Retrospective Cohort Study [Letter].","authors":"Manoj Joshi, Rittu Sharma, Nikita Vaid","doi":"10.2147/JPR.S618258","DOIUrl":"https://doi.org/10.2147/JPR.S618258","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"618258"},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839342","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":"Can Music Therapy Really Alleviate Chronic Pain? Reflections on the Design, Measurement, and Reporting of a Randomized Controlled Trial [Letter].","authors":"Fei-Yi Zhao, Qiang-Qiang Fu, Jie Qian","doi":"10.2147/JPR.S615605","DOIUrl":"https://doi.org/10.2147/JPR.S615605","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"615605"},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839303","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":"Factors Associated with Severe Primary Dysmenorrhea in Adolescent Girls: A Retrospective Single-Center Study.","authors":"Yao Hu, Yan Chen, Gaolian Li, Qingjing Zou, Jiawei Zhan, Dongmei Li","doi":"10.2147/JPR.S593131","DOIUrl":"https://doi.org/10.2147/JPR.S593131","url":null,"abstract":"<p><strong>Objective: </strong>To identify the risk factors for severe primary dysmenorrhea in adolescent girls and provide evidence for clinical prevention and intervention.</p><p><strong>Methods: </strong>This retrospective study enrolled adolescent girls with primary dysmenorrhea from Jingzhou Central Hospital between January 2022 and December 2023. Participants were divided into severe group and mild-to-moderate group grouped by VAS score (VAS 0-10, 0=no pain, 1-3=mild, 4-6=moderate, 7-10=severe). Demographic, lifestyle, menstrual and laboratory parameters were collected via questionnaires and medical records. Bivariate analysis and multivariate Logistic regression were used to screen independent risk factors, and ROC curve was applied to assess model performance.</p><p><strong>Results: </strong>426 participants were included (158 in severe group, 268 in mild-to-moderate group). Early menarche (≤12 years old), frequent cold food intake (≥3 times/week), high serum PGF2α level and low physical activity level were independent risk factors (all P<0.05). The predictive model yielded an AUC of 0.826 (95% CI: 0.783-0.869), showing good predictive efficiency.</p><p><strong>Conclusion: </strong>Early menarche, frequent cold food intake, high serum PGF2α and low physical activity are independent risk factors for severe primary dysmenorrhea in adolescent girls. Targeted interventions on these factors can help reduce the occurrence of severe dysmenorrhea.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"593131"},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839345","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":"Esketamine for Postoperative Multimodal Analgesia in Laparoscopic Surgery: A Systematic Review and Meta-Analysis.","authors":"Jinze Li, Xiuqin Wang","doi":"10.2147/JPR.S597557","DOIUrl":"https://doi.org/10.2147/JPR.S597557","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Postoperative pain management after laparoscopic surgery remains challenging. Esketamine, a potent N-methyl-D-aspartate receptor antagonist, may improve multimodal analgesia while mitigating opioid-related side effects. This meta-analysis evaluates the efficacy and safety of perioperative intravenous esketamine in adults undergoing laparoscopic surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a systematic review and meta-analysis of randomized controlled trials according to PRISMA guidelines. Databases were searched from inception to October 1, 2025. Primary outcomes were postoperative pain intensity (at rest and during movement at 24 hours) and 24-hour opioid consumption. Secondary outcomes included rescue analgesia, postoperative nausea and vomiting (PONV), hallucinations, and depressive symptoms. Data were pooled using random-effects models, and evidence certainty was assessed with GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-eight RCTs (3160 patients), all conducted in China, were included. Esketamine significantly reduced pain at rest (SMD -0.65, 95% CI -0.90 to -0.40) and during movement (SMD -0.64, 95% CI -1.09 to -0.19), and decreased 24-hour opioid consumption (SMD -16.83, 95% CI -31.60 to -2.05). It also reduced rescue analgesia requirements (RR 0.51, 95% CI 0.35 to 0.76) and PONV incidence (RR 0.76, 95% CI 0.63 to 0.93) without increasing hallucinations (RR 1.11, 95% CI 0.41 to 3.03). A reduction in postoperative depressive symptoms was observed (SMD -0.67, 95% CI -1.29 to -0.05). Subgroup analyses suggested greater analgesic benefit with low-dose regimens (&lt;0.5 mg/kg) and in biliary surgeries. Evidence certainty was low to very low for primary outcomes. Twenty-eight RCTs (3160 patients), all conducted in China, were included, which may limit the generalizability of the findings. Esketamine was associated with reductions in pain at rest (SMD -0.65, 95% CI -0.90 to -0.40) and during movement (SMD -0.64, 95% CI -1.09 to -0.19), and decreased 24-hour opioid consumption (SMD -16.83, 95% CI -31.60 to -2.05), although substantial heterogeneity was observed. It also reduced rescue analgesia requirements (RR 0.51, 95% CI 0.35 to 0.76) and PONV incidence (RR 0.76, 95% CI 0.63 to 0.93) without increasing hallucinations (RR 1.11, 95% CI 0.41 to 3.03). A reduction in postoperative depressive symptoms was observed (SMD -0.67, 95% CI -1.29 to -0.05). Subgroup analyses suggested greater analgesic effects with low-dose regimens (&lt;0.5 mg/kg) and in biliary surgeries. Evidence certainty was low to very low for primary outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Perioperative intravenous esketamine may be associated with improvements in postoperative pain, opioid requirements, rescue analgesia, and PONV in laparoscopic surgery without increasing neuropsychiatric adverse events. However, the certainty of the evidence is low and substantial heterogeneity limits confidence in these estimates. Therefore, these findings sho","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"597557"},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816700","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 Music Intervention on Pain, Mood, Sleep, and Heart Rate Variability in Patients with Chronic Pain: A Randomized Controlled Trial [Response to LETTER].","authors":"Bo Wang, Fan Yu, Yantao Ma, Huiying Zhao, Wei Wu, Yongjun Zheng","doi":"10.2147/JPR.S618394","DOIUrl":"https://doi.org/10.2147/JPR.S618394","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"618394"},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816615","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":"Advancing the Prevention of Postherpetic Neuralgia: Methodological and Clinical Considerations for the TPI Study Protocol [Response to Letter].","authors":"Xiangjun Zhou, Rong Han, Zhigang Zhao, Fang Luo","doi":"10.2147/JPR.S610123","DOIUrl":"https://doi.org/10.2147/JPR.S610123","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"610123"},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816697","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":"Time-Dependent Efficacy and Safety of Percutaneous Treatments for Lateral Epicondylitis: A Systematic Review and Network Meta-Analysis.","authors":"Yisha Xu, Wenting Lin, Ziyi Qi, Zheng Yan, Qianjun Yan, Jiawen Xu, Lianguo Wu","doi":"10.2147/JPR.S604185","DOIUrl":"https://doi.org/10.2147/JPR.S604185","url":null,"abstract":"<p><strong>Purpose: </strong>Recent reviews on lateral epicondylitis management frequently focus on single modalities or isolated outcomes. This study systematically evaluates the time-dependent efficacy and safety of eight percutaneous treatments (placebo, corticosteroids, platelet-rich plasma [PRP], autologous blood [AB], hyaluronic acid, botulinum toxin [BT], dextrose prolotherapy [DPT], and dry needling [DN]) for lateral epicondylitis.</p><p><strong>Patients and methods: </strong>Four databases (PubMed, Embase, the Cochrane Library, and Web of Science) were searched for randomized controlled trials. Outcomes (pain intensity, functional disability, grip strength) were evaluated across short- (<1 month), mid- (1-3 months), and long-term (>6 months) intervals. Data were synthesized via network meta-analysis using mean differences (MD) or standardized mean differences (SMD) and SUCRA probabilities.</p><p><strong>Results: </strong>Forty-one trials (N=3,285) were included. Corticosteroids showed substantial efficacy for short-term pain relief (MD -1.62, 95% CI -2.52 to -0.72) but were associated with a long-term rebound effect. DPT demonstrated notable advantages for mid-term pain reduction (MD -1.73, 95% CI -2.85 to -0.60) and functional recovery. BT was associated with a potential negative trend in mid-term grip strength compared to placebo, whereas AB showed better outcomes than BT in head-to-head comparisons. For long-term outcomes, regenerative approaches like PRP, along with DN and BT, appeared to provide sustained pain relief.</p><p><strong>Conclusion: </strong>The therapeutic efficacy of percutaneous treatments appears to be time-dependent. Corticosteroids may be considered for rapid short-term relief, while DPT shows potential advantages for mid-term recovery. For long-term management, PRP and DN may offer sustained analgesia, potentially avoiding the grip strength deficits occasionally associated with BT.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"604185"},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816617","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":"Postpartum Pain and Vaginal-Gut Microbiota Interactions: An Integrative Narrative Review with Implications for Maternal Recovery and Pain Modulation.","authors":"Chenyang Ding, Jing Zhou, Yanfei Zhu, Xiaoe Xie, Fenglei Ye, Shangfeng Ying","doi":"10.2147/JPR.S600098","DOIUrl":"https://doi.org/10.2147/JPR.S600098","url":null,"abstract":"<p><strong>Background: </strong>Postpartum pain is a common and often underrecognized complication that adversely affects maternal recovery, quality of life, and psychological well-being. Emerging evidence suggests that alterations in the vaginal and gut microbiota during the puerperium may play a critical role in modulating these outcomes.</p><p><strong>Objective: </strong>This integrative narrative review synthesizes available evidence on the associations between postpartum pain and the composition of the vaginal and gut microbiota, with a focus on mechanistic pathways and clinical implications for maternal recovery.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, and Web of Science for studies published between January 2017 and December 2025. Search terms encompassed postpartum pain, vaginal microbiota, gut microbiota, dysbiosis, and inflammation. Eligible studies included original research, clinical trials, and systematic reviews examining microbiota composition and pain-related outcomes in postpartum populations. Findings were synthesized narratively due to heterogeneity in study designs and outcome measures.</p><p><strong>Key findings: </strong>Following delivery, the vaginal microbiota frequently shifts from Lactobacillus-dominated communities toward more diverse, pathogen-enriched profiles, while the gut microbiota undergoes substantial remodeling. This microbial dysbiosis, compounded by impaired epithelial barrier function, is associated with increased risks of puerperal infection and enhanced local and systemic inflammation. Such inflammation may sensitize peripheral nociceptors and amplify pain signaling through immune-neural interactions. Furthermore, microbiota-driven inflammation appears to influence central pain processing via the gut-brain axis, including glial activation, which may contribute to pain persistence beyond the acute postpartum period. Key obstetric factors, including mode of delivery, episiotomy, antibiotic exposure, and breastfeeding practices, modulate both microbiota composition and postpartum pain outcomes.</p><p><strong>Conclusion: </strong>Maternal vaginal and gut microbiota represent modifiable contributors to postpartum pain. Microbiota-informed strategies, such as probiotic supplementation or dietary interventions, may serve as adjunctive approaches to pain management. Well-designed longitudinal and interventional studies are needed to establish causality and guide clinical translation.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"600098"},"PeriodicalIF":2.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816652","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":"Psychometric and Molecular Profiling to Predict Outcomes of Spinal Cord Stimulation for Chronic Pain: A Pilot Study.","authors":"Simona D'Agnelli, Giada Amodeo, Marco Cascella, Marco Baciarello, Valentina Bellini, Silvia Franchi, Giulia Galimberti, Paola Sacerdote, Elena Giovanna Bignami","doi":"10.2147/JPR.S551667","DOIUrl":"https://doi.org/10.2147/JPR.S551667","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal cord stimulation (SCS) is a well-established intervention for chronic pain, but the factors predicting treatment success remain unclear. This pilot study investigated psychometric and inflammatory biomarkers associated with clinical outcomes in patients undergoing SCS for chronic low back pain.</p><p><strong>Patients and methods: </strong>Twenty-two eligible patients were enrolled. Clinical evaluations, psychometric assessments, and blood samples were collected at baseline and at 1-, 3-, and 6-month post-implantation. Pain intensity, psychological status, and quality of life were assessed using validated questionnaires. Inflammatory markers were analyzed in peripheral blood mononuclear cells (PBMCs) at both mRNA and protein levels.</p><p><strong>Results: </strong>Nineteen patients completed the trial and received definitive SCS implantation (Trial Completed, TC group), while three were discontinued (Trial Failed, TF group). In the TC group, pain intensity and its interference with emotional and work life significantly improved. Psychometric scores also improved: pain catastrophizing decreased below the clinical threshold, and anxiety and depression scores were significantly reduced, alongside enhanced quality of life. Greater pain relief at follow-up was associated with lower pre-implant anxiety and depression levels. Cytokine analysis revealed downregulation of pro-inflammatory IL-1β and upregulation of anti-inflammatory IL-10 and IL-4 post-SCS. In the TF group, baseline depression was higher compared to the TC group. SCS trial implantation in these patients induced only IL-4 upregulation, without broader cytokine modulation.</p><p><strong>Conclusion: </strong>SCS significantly improved clinical and psychometric outcomes and positively modulated inflammatory profiles in patients with chronic low back pain. High baseline depressive symptoms may predict poorer SCS outcomes, suggesting the importance of psychological assessment in patient selection.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"551667"},"PeriodicalIF":2.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816638","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}