Journal of Pain Research最新文献

{"title":"Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Endometriosis: A Protocol for Data Mining.","authors":"Linglin Dai, Yin Zhang, Lili Wang","doi":"10.2147/JPR.S645956","DOIUrl":"https://doi.org/10.2147/JPR.S645956","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis, characterized by dysmenorrhea and pelvic pain, is a common gynecological disease. Acupuncture, as a complementary and alternative therapy for endometriosis, has been supported by a large body of clinical evidence. However, due to the heterogeneity of acupoint prescriptions, the commonly used acupoints remain undetermined.</p><p><strong>Purpose: </strong>This study aims to identify the commonly used acupoint selection and combination patterns for the treatment of endometriosis through a comprehensive data mining analysis based on existing literature.</p><p><strong>Methods: </strong>We will systematically search 8 databases (Web of Science (WOS), PubMed, Embase, Cochrane Library, Wanfang, Chongqing VIP database, China National Knowledge Infrastructure (CNKI), and the Chinese Biomedical Literature Database (CBM)) from their inception to September 30, 2026. Only acupuncture clinical trials will be included. All other types will be excluded. Literature deduplication will be performed using NoteExpress 4.3. Data management and descriptive statistical analysis will be completed using WPS Spreadsheets (version 12.1.0.26375). Association rule analysis will be conducted in SPSS Modeler 14.1. Cluster analysis, exploratory factor analysis, and decision tree analysis will be implemented using SPSS Statistics 26.0.</p><p><strong>Results: </strong>Our study will conduct an in-depth exploration of the frequently uesd acupoint selection and combination patterns for treating patients with endometriosis.</p><p><strong>Conclusion: </strong>The findings of this study will identify commonly used acupoints and potentially relevant acupoint combinations for acupuncture treatment in patients with endometriosis, and provide a basis for subsequent clinical decision-making, and for the selection of acupoints in prospective randomized controlled trials, thereby helping both clinicians and patients make more informed choices.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"645956"},"PeriodicalIF":3.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194676","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":"Prevalence, Incidence, and Associated Conditions of Complex Regional Pain Syndrome in a Large Real-World Dataset.","authors":"Adam P Rufa, Michelle R Dolphin, Kyle R Adams","doi":"10.2147/JPR.S612185","DOIUrl":"https://doi.org/10.2147/JPR.S612185","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this retrospective cohort study was to characterize the prevalence, incidence, associated conditions, and demographics of complex regional pain syndrome (CRPS) using a large, real-world dataset.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from the TriNetX Global Collaborative Network, including over 150 million patients across 18 countries, to identify CRPS prevalence, incidence, demographics, and comorbidities.</p><p><strong>Results: </strong>A total of 99,878 patients with CRPS were identified over a 20-year period, based on ICD-10-coded electronic health record data. Overall prevalence was 62 per 100,000 individuals, and incidence was 13.5 per 100,000 person-years, with rates more than twice as high in females compared to males. Both measures peaked in individuals aged 40-44 years and were highest among Native Hawaiians/Pacific Islanders. Lower extremity involvement was 1.5 times more common than upper extremity involvement, and cumulative incidence was noticeably higher following fractures, particularly foot fractures (495 per 100,000). Rates of CRPS more than doubled from 2004-2008 to 2019-2023. Bidirectional associations were observed between CRPS and multiple conditions, including depression, anxiety, insomnia, and irritable bowel syndrome, with relative risks ranging from approximately 1.4-fold to 24-fold.</p><p><strong>Discussion: </strong>Using one of the largest CRPS cohorts reported to date, this real-world analysis clarifies contemporary epidemiology and reveals bidirectional associations with psychological, inflammatory, and autoimmune conditions. The findings are consistent with a multifactorial clinical profile involving immune, neurologic, and psychosocial mechanisms, guiding future mechanistic and clinical research.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"612185"},"PeriodicalIF":3.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194656","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":"Postoperative Analgesic Practices and Pain Control Outcomes After Caesarean Delivery: A Cross-Sectional Survey of 215 Hospitals in Hubei Province, China.","authors":"Jing Chen, Yu Wang, Li Hu, Yuwei Liu, Qinghong Chen, Dong Han, Shanglong Yao, Jing Wu","doi":"10.2147/JPR.S621099","DOIUrl":"10.2147/JPR.S621099","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the spectrum of analgesic regimens, their effectiveness, and related adverse events following cesarean sections (CS) in Hubei Province, China, to provide an evidence base for refining post-CS pain management.</p><p><strong>Methods: </strong>This facility-based cross-sectional study used aggregate institutional data submitted by department heads through the Hubei Anesthesia Quality Control and Service Cloud Platform. The analgesic practice (the utilization of intravenous analgesia and epidural analgesia and corresponding medication regimens), their effects (the incidence of inadequate analgesia), and safety profiles (the incidence of adverse reactions) of different pain management strategy following CS were collected for analyses. The primary outcome was the incidence of inadequate analgesia, which was defined as a Visual Analog Scale (VAS) score of ≥4 points within 48 hours. Unadjusted comparisons between groups were performed using chi-square tests and Spearman's rank correlation; multivariable logistic regression was additionally applied to adjust for institutional-level covariates.</p><p><strong>Results: </strong>36,620 CS cases were included in our analysis. Intravenous analgesia was the most common strategy (21,142 cases, 57.7%), followed by epidural analgesia (8569 cases, 23.4%). Despite its widespread use, our unadjusted comparison indicated that intravenous analgesia had significantly higher rates of inadequate pain control (VAS ≥4) than epidural analgesia (3.94% vs. 2.21%, p<0.001). Measurable disparities in analgesic practices and pain control outcomes across hospitals of different tiers and cities with different levels of economic development in Hubei Province were also observed.</p><p><strong>Conclusion: </strong>In this large aggregate institutional dataset, intravenous analgesia was the predominant strategy. Unadjusted comparisons suggest a higher rate of inadequate analgesia in the intravenous group relative to the epidural group. Future studies with patient-level data and validated adverse event capture are needed to confirm these patterns. Better resource allocation and anesthesiologist training would be beneficial to promote equitable post-CS pain management.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"621099"},"PeriodicalIF":3.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194614","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":"Nociplastic Pain: A Contemporary Narrative Review of Mechanisms, Clinical Assessment, Controversies, and Management.","authors":"Chin-Chen Chu, Yao-Tsung Lin, Jhi-Joung Wang","doi":"10.2147/JPR.S642440","DOIUrl":"https://doi.org/10.2147/JPR.S642440","url":null,"abstract":"<p><strong>Background: </strong>Nociplastic pain was introduced by the International Association for the Study of Pain (IASP) in 2017 as a third mechanistic descriptor alongside nociceptive and neuropathic pain, denoting pain from altered nociception without unambiguous tissue damage or somatosensory lesion. Fibromyalgia is its prototypical example; nociplastic mechanisms have also been proposed to contribute, often alongside nociceptive or neuropathic components, to irritable bowel syndrome, temporomandibular disorders, chronic primary headache, and much chronic musculoskeletal and visceral pain.</p><p><strong>Objective and methods: </strong>This narrative review synthesizes evidence published between January 2016 and June 2026 on the mechanisms, clinical assessment, controversies, and management of nociplastic pain, integrating recent (2024-2026) conceptual debates with mechanistic and clinical data. We aimed to clarify the distinctions among central sensitization (a mechanism), nociplastic pain (a clinical-mechanistic descriptor), and chronic primary pain (a diagnosis) in a clinically usable form, to appraise the recent validation evidence for the 2021 IASP clinical criteria, and to identify research priorities for the domains in which those criteria remain unvalidated.</p><p><strong>Key findings: </strong>The descriptor reflects central sensitization, deficient descending modulation, neuroimmune/glial activation, and maladaptive plasticity, plus increasingly recognized peripheral contributions. The 2021 IASP criteria show acceptable reliability in trained raters but uncertain performance in primary care and non-musculoskeletal domains. Management prioritizes, as first line, exercise, psychological therapy, pain neuroscience education, and multidisciplinary rehabilitation, together with centrally acting agents, although the pharmacological evidence derives largely from fibromyalgia trials; opioids and anti-inflammatory drugs are largely ineffective in predominantly nociplastic pain. Controversies concern the mechanism-versus-diagnosis distinction and the risk that an over-inclusive label obscures occult peripheral pathology.</p><p><strong>Conclusion: </strong>Nociplastic pain is a clinical-mechanistic descriptor, not a diagnosis, and is best applied as a continuous component of complex pain rather than a fixed diagnostic label. Priorities include validation of criteria beyond the musculoskeletal system, objective biomarkers, and phenotype-stratified trials.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"642440"},"PeriodicalIF":3.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182656","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":"Frailty and Incident Low Back Pain in Middle-Aged and Older Adults: Methodological Considerations [Letter].","authors":"Siqi Wang, Wei Zou","doi":"10.2147/JPR.S657433","DOIUrl":"https://doi.org/10.2147/JPR.S657433","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"657433"},"PeriodicalIF":3.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182705","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":"The Effect of Oliceridine versus Sufentanil on the Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Cholecystectomy [Response to Letter].","authors":"Li-Hao Rao, Ze-Xue Yang, Lun Huang, Li-Dong Zheng","doi":"10.2147/JPR.S638976","DOIUrl":"https://doi.org/10.2147/JPR.S638976","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"638976"},"PeriodicalIF":3.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182641","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":"EEG-Derived Pain Threshold Index-Guided Remifentanil Titration During Laparoscopic Abdominal Surgery: A Randomized Trial.","authors":"Bin Cao, Zheng Qi, Ying-Ying Zhao, Qiong Xue, Juan-Juan Ren, Wei-Wei Xu, Yu-Ning Fan, Zhen-Hua Nan, Pei-Pei Sun, Hui-Juan Li, Jie Zhang, Jian-Jun Yang","doi":"10.2147/JPR.S642801","DOIUrl":"https://doi.org/10.2147/JPR.S642801","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether remifentanil titration guided by the pain threshold index (PTi), an electroencephalography-derived proxy for nociceptive tolerance rather than subjective pain, reduces intraoperative remifentanil infusion during laparoscopic abdominal surgery.</p><p><strong>Methods: </strong>In this prospective, single-center, assessor-blinded randomized trial, adults undergoing elective laparoscopic abdominal surgery with propofol-remifentanil target-controlled infusion were assigned 1:1 to PTi-guided or conventional hemodynamic-guided remifentanil titration. The primary endpoint was intraoperative remifentanil infusion rate. The principal analysis used the full-analysis set and covariate-adjusted linear regression with heteroskedasticity-consistent robust standard errors.</p><p><strong>Results: </strong>Among 200 randomized patients, 195 were analyzed (98 PTi-guided; 97 control). The primary endpoint was neutral: mean (SD) remifentanil infusion rate was 7.44 (1.43) versus 7.63 (1.41) µg kg^-1 h^-1; adjusted mean difference, -0.06 µg kg^-1 h^-1 (95% CI, -0.44 to 0.32; P=0.758). Per-protocol results were similar. Median (IQR) NRS at post-anesthesia care unit (PACU) admission was 2.0 (2.0-3.0) versus 3.0 (2.0-4.0), and Ramsay score was 2.0 (2.0-2.0) in both groups. In exploratory secondary analyses, rescue opioid was used in the PACU by 18/98 (18.4%) versus 31/97 (32.0%) patients and any rescue opioid through 48 h by 29/98 (29.6%) versus 44/97 (45.4%). Any postoperative nausea and vomiting (PONV) through 48 h occurred in 17/98 (17.3%) versus 29/97 (29.9%) patients. Total postoperative opioid exposure through 48 h was not reduced.</p><p><strong>Conclusion: </strong>PTi-guided remifentanil titration did not reduce intraoperative remifentanil infusion. PACU pain and sedation scores were not materially different. Lower early rescue-opioid use and fewer PONV events through 48 h were exploratory secondary findings, were not accompanied by lower postoperative opioid dose, and require prospective confirmation.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"642801"},"PeriodicalIF":3.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182678","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":"Warm-Needling Acupuncture Plus Tuina for Knee Osteoarthritis: Considerations Regarding Effect Estimates, Comparator Design, and Assay Standardization [Letter].","authors":"Keqin Ye","doi":"10.2147/JPR.S659186","DOIUrl":"https://doi.org/10.2147/JPR.S659186","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"659186"},"PeriodicalIF":3.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182690","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":"Acupuncture-Associated Changes in Migraine-Like Behaviors and Serum Proteomic and Metabolomic Profiles in Nitroglycerin-Induced Rats.","authors":"Shijie Wei, Huafeng Cui, Zhe Wang, Guoliang Jiang, Xiaowei Hu, Qianxiu Chen, Yihang Xu, Jing Han","doi":"10.2147/JPR.S632901","DOIUrl":"https://doi.org/10.2147/JPR.S632901","url":null,"abstract":"<p><strong>Purpose: </strong>Acupuncture is widely used as a therapeutic approach for migraine; however, its underlying anti-migraine mechanisms remain incompletely understood. This study aimed to investigate the therapeutic effects of acupuncture on migraine and identify potential molecular mechanisms using integrated multi-omics analyses.</p><p><strong>Patients and methods: </strong>32 male Sprague-Dawley rats were allocated to control, model, sham-acupuncture, and acupuncture groups (n = 8 per group). The model was established by repeated nitroglycerin (NTG) administration. The effects of acupuncture were evaluated by assessing periorbital and hind paw withdrawal thresholds. Serum samples were subsequently analyzed using liquid chromatography-mass spectrometry (LC-MS)-based metabolomics and proteomics. The mRNA levels of key targets in serum were further quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Differential metabolites and proteins were identified and subjected to Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, correlation, and protein-protein interaction (PPI) analyses.</p><p><strong>Results: </strong>Acupuncture alleviated the reduction in periorbital and hind paw withdrawal thresholds in NTG-induced migraine model rats. Integrated metabolomic and proteomic analyses identified differential metabolites and proteins associated with the therapeutic effects of acupuncture. Ten candidate hub proteins were ultimately identified. KEGG enrichment analysis indicated that these candidate hub proteins were closely related to immune defense, inflammatory responses, cholesterol metabolism and clearance, and may also be involved in energy metabolism and hormonal regulation. GO analysis further showed that acupuncture primarily modulated biological processes related to lipoprotein metabolism, transport, and clearance.</p><p><strong>Conclusion: </strong>Acupuncture improved migraine-like mechanical hypersensitivity in NTG-induced rats and was accompanied by changes in serum proteins and metabolites. Lipid/lipoprotein metabolism and complement-related pathways emerged as candidate pathways associated with the response. These exploratory findings do not establish molecular mediation or a direct effect on vascular function and require confirmation by targeted functional studies.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"632901"},"PeriodicalIF":3.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182634","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":"Diabetic Neuropathic Pain Models: Current Limitations and Future Directions.","authors":"Lijun Hao","doi":"10.2147/JPR.S632056","DOIUrl":"https://doi.org/10.2147/JPR.S632056","url":null,"abstract":"<p><p>Diabetic neuropathic pain (DNP) is a disabling complication of diabetes, yet pain develops only in a subset of patients with diabetic neuropathy. Current animal models can reproduce hyperglycemia and many structural, electrophysiological, and metabolic features of diabetic neuropathy, but pain-related phenotypes vary considerably across studies. This variability may arise from methodological differences in model induction, experimental conditions, and behavioral assessment, but may also reflect biologically meaningful heterogeneity analogous to the painful and painless phenotypes observed clinically. This narrative review critically examines the strengths and limitations of commonly used streptozotocin (STZ), genetic, and high-fat diet/STZ models, with particular attention to variability in pain-related phenotypes and its implications for model interpretation. Species, strain, sex, disease duration, metabolic severity, model induction, and behavioral methodology may all contribute to differences among studies. On the basis of this synthesis, we suggest that future studies distinguish methodological variability from biological heterogeneity and use more consistent reporting, longitudinal assessment, and complementary measures of neuropathy to improve interpretation and clinical relevance.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"632056"},"PeriodicalIF":3.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166030","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}