Journal of Pain Research最新文献

{"title":"Efficacy and Safety of Acupuncture and Acupuncture-Combined Therapies in the Treatment of Sciatica Caused by Lumbar Disc Herniation: A Network Meta-Analysis.","authors":"Dongyi Ni, Haiyang Tong, Shen Wei, Yitong Zheng, Wenyan Wu, Min Li, Yunpeng Dong","doi":"10.2147/JPR.S542831","DOIUrl":"10.2147/JPR.S542831","url":null,"abstract":"<p><strong>Purpose: </strong>Sciatica is a common complication of lumbar disc herniation (LDH). This network meta-analysis compared the efficacy of acupuncture monotherapies, acupuncture versus conventional rehabilitation, and acupuncture monotherapy versus combination therapies for LDH-related sciatica.</p><p><strong>Patients and methods: </strong>We systematically searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, CQVIP, and CBM. Bayesian network meta-analysis was performed using RStudio and GEMTC. STATA generated network and funnel plots. Treatment rankings were assessed using the Surface Under the Cumulative Ranking curve (SUCRA). Bias risk was evaluated with the Cochrane Risk of Bias tool 2.0.</p><p><strong>Results: </strong>According to SUCRA, in terms of total effective rate, the more effective intervention was electroacupuncture combined with cupping therapy (EA+Cupping, 92.93%); in terms of VAS, the better intervention was needle knife combined with rehabilitation therapy (NK+RT, 95.96%); in terms of ODI, the more effective intervention was electroacupuncture combined with cupping therapy (EA+Cupping, 98.03%); in terms of JOA, the best intervention was electrostimulation combined with rehabilitation therapy (ES+RT, 88.27%); in terms of IL-6 and TNF-α, the better intervention was electroacupuncture combined with electrostimulation (EA+ES, 99.99%).</p><p><strong>Conclusion: </strong>Acupuncture combined with other therapies demonstrates superior efficacy compared to rehabilitation treatment. Specifically, NK+RT is possibly a more effective intervention for pain relief; EA+Cupping shows a better benefit in improving disability and quality of life; ES+RT is likely a more effective strategy for promoting neurological recovery; and EA+ES is possibly better in reducing inflammatory responses.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4809-4832"},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113454","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":"Erector Spinae Plane versus Pectoralis Nerve Block for Mastectomy in Cancer Patients: A Retrospective, Multicenter Cohort Study.","authors":"Edward N Yap, Julia Wei, Curtis Darling, Elizabeth Linehan, Matthias Behrends, Kevin P Ng","doi":"10.2147/JPR.S538581","DOIUrl":"10.2147/JPR.S538581","url":null,"abstract":"<p><strong>Background: </strong>Mastectomy patients require effective acute postoperative pain management. Regional anesthesia techniques such as fascial plane blocks are important pain treatment modalities to address pain control. This study compared the effects of the erector spinae plane (ESP) block versus the pectoralis nerve (PECS) block in providing postoperative analgesia for mastectomy patients.</p><p><strong>Methods: </strong>This retrospective study included 517 breast cancer patients undergoing mastectomy from 2017 to 2020, with 428 receiving a PECS block and 89 an ESP block. The primary outcome examined was total opioid use during hospital stay measured in morphine milligram equivalents (MME). Secondary outcomes included length of hospital stay, post-anesthesia care unit (PACU) pain scores, PACU postoperative nausea and vomiting (PONV), 30-day readmission rates, and development of postmastectomy pain within six months of surgery.</p><p><strong>Results: </strong>No significant difference in median total opioid use between the ESP (53 MME (IQR: 38-80 MME)) and PECS (60 MME (IQR: 30-82.5 MME)) groups. Multivariable analysis confirmed no difference in total opioid consumption. There was no significant difference between the two groups in PACU average and maximum pain scores, PACU PONV, hospital length of stay, 30-day hospital readmission, and development of postmastectomy pain within six months of surgery.</p><p><strong>Conclusion: </strong>Compared to the PECS block, the ESP block demonstrated no significant difference in acute pain outcomes and recovery in patients undergoing mastectomy for breast cancer, with similar hospital discharge times and long-term outcomes.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4775-4785"},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113508","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":"Application of Intraoperative Awake Anesthesia and Three-Dimensional Reconstruction Technique in Percutaneous Microballoon Compression for Trigeminal Neuralgia.","authors":"Xingke Li, Yanfeng Fan, Ziyang Chen, Ou-Yang Hui, Min Guo, Guili Feng, Jianzhi Zhou, Yuhui Ling, Deliu Lin","doi":"10.2147/JPR.S534449","DOIUrl":"10.2147/JPR.S534449","url":null,"abstract":"<p><strong>Objective: </strong>To examine the role of intraoperative awake anesthesia and the three-dimensional reconstruction technique in percutaneous microballoon compression (PBC) for the treatment of trigeminal neuralgia.</p><p><strong>Methods: </strong>Seventy patients diagnosed with trigeminal neuralgia and admitted to Guangdong Sanjiu Brain Hospital from 2019 to 2022 were selected for the study.All patients were treated with PBC by three-dimensional (3D) reconstruction of preoperative and intraoperative images and intraoperative awake anesthesia. The duration of balloon compression during surgery was three minutes.After balloon compression during the procedure, the patient is awakened for effect assessment, allowing for real-time adjustments of the surgical strategy based on the evaluation.Postoperative pain relief was evaluated using the Brisman criteria.</p><p><strong>Results: </strong>Pain completely disappeared immediately post-operation in 68 patients, and was significantly alleviated in two patients, with an efficacy rate of 100% and a cure rate of 97.1%. 60 patients experienced facial numbness on the affected side postoperatively, which showed different degrees of remission or disappearance within 6-12 months after surgery. Eleven cases of herpes labialis (15.7%), one case of facial hematoma (1.4%), and three cases of postoperative psychiatric symptoms (4.3%) occurred, all of which recovered within 1-2 weeks after surgery. Weakness in the masticatory muscles on the affected side was observed in four patients (5.7%), and all cases returned to normal within six months post-surgery.During follow-up 36-60 months, there were five cases (7.1%) of pain recurrence on the affected side.</p><p><strong>Conclusion: </strong>Awake anesthesia combined with 3D reconstruction technology for PBC surgery may provide a safer and more effective alternative for the treatment of trigeminal neuralgia.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4833-4843"},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113463","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":"Pericapsular Nerve Group Block for Hip Fracture Pain Management: A Narrative Review of Emergency Applications.","authors":"Ya-Bei Li, Man Zuo, Jing-Ping Zhu, Ri-Liang Ma, Xiao-Zu Liao","doi":"10.2147/JPR.S528497","DOIUrl":"10.2147/JPR.S528497","url":null,"abstract":"<p><p>The pericapsular nerve group (PENG) block is a regional anaesthesia technique for acute pain management that is becoming frequently employed for emergency lower limb fractures, particularly hip injuries. While current evidence has been predominantly derived from postoperative randomized trials and case series, the results of recent clinical reports support the preprocedural utility of the PENG block in emergency settings for rapid analgesia 40-60% pain score reduction and preservation of motor function. This review synthesizes mechanistic insights and clinical outcomes from the literature, comparing the targeted sensory blockade of the hip capsule with the PENG block with that of systemic opioids (which risks inducing respiratory depression) and fascia iliaca block (which can induce motor impairment). Key advantages of PENG blockade include significant opioid-sparing effects (50-70% reduction morphine use) and almost no motor complications. Standardized ultrasound-guided protocols can address challenges related to anatomical variability. Preliminary evidence from case reports suggests that the efficacy of the PENG block to pelvic and femoral shaft fractures, although multicentre trials are needed to establish optimal doses and long-term functional outcomes. This evidence indicates that PENG blockade could serve as a promising emergency intervention, but further protocol refinement is warranted.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4801-4807"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113443","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":"Single- versus Multiple-Injection Intertransverse Process Block for VATS: A Randomized Trial on Dermatomal Sensory Blockade.","authors":"Kittitorn Supphapipat, Artid Samerchua, Prangmalee Leurcharusmee, Panuwat Lapisatepun, Tanyong Pipanmekaporn, Nichagoon Konkarn, Kullaphun Prapussarakul, Thidarut Jinadech, Mullika Wanvoharn","doi":"10.2147/JPR.S545731","DOIUrl":"10.2147/JPR.S545731","url":null,"abstract":"<p><strong>Purpose: </strong>While the intertransverse process (ITP) block can enhance chest wall analgesia, the optimal injection technique remains unclear. This study compared the efficacy of single versus multiple injections of the ITP block, hypothesizing that multiple injections would provide superior sensory blockade.</p><p><strong>Patients and methods: </strong>Forty patients undergoing video-assisted thoracic surgery were randomized to receive single or multiple ultrasound-guided ITP block injections with 30 mL of 0.25% bupivacaine and 1% lidocaine with epinephrine (5 μg/mL). The single-injection group received 30 mL at the T4-5 level, while the multiple-injection group received 10 mL/injection at the T3-4, T4-5, and T5-6 levels. The primary outcome was dermatomal sensory changes on the anterolateral chest wall. Secondary outcomes included block performance time, complications, and postoperative analgesia.</p><p><strong>Results: </strong>The median (interquartile range [IQR]) dermatomal sensory levels were 2 (2-4) for single-injection and 3 (1.5-3.5) for multiple-injection (median difference: 0, 95% confidence interval [CI]: -1 to 1, <i>p</i> = 0.91). The single-injection group had a shorter median (IQR) block performance time than the multiple-injection group [7 (5.2-8.4) min versus 9.1 (7.8-11.2) min; median difference: -1.9 min; 95% CI: -4 to -0.1 min; <i>p</i> = 0.01]. Intraoperative hypotension occurred in 63.2% of the single-injection group and 65% of the multiple-injection group (<i>p</i> = 0.91). There was no statistically significant difference in postoperative pain intensity between groups.</p><p><strong>Conclusion: </strong>Single- and multiple-injection ITP blocks showed no significant difference in sensory changes or analgesic effect. The shorter performance time of the single-injection technique suggests it may be a more practical option. However, larger, higher powered studies are required to confirm equivalence and establish definitive recommendations.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4791-4800"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113611","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":"Interpreting the Evidence for Laser Acupuncture in Knee Osteoarthritis Management: A Call for Methodological Rigor and Nuance [Letter].","authors":"Fei-Yi Zhao, Qiang-Qiang Fu, Yuen-Shan Ho","doi":"10.2147/JPR.S562822","DOIUrl":"10.2147/JPR.S562822","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4787-4790"},"PeriodicalIF":2.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113470","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":"Rebuttal Letter to the Editor: Defending Evidence-Based Practices in Interventional Pain Medicine [Letter].","authors":"Hemant Kalia, Tolga Suvar, Matthew Chung, Amitabh Gulati","doi":"10.2147/JPR.S557417","DOIUrl":"10.2147/JPR.S557417","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4755-4757"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081050","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":"Efficacy and Safety of Fu's Subcutaneous Needling in the Treatment of Cervical Spondylosis: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials.","authors":"Yating Shen, Jing Chen, Sen Tang, Binbin Xiao","doi":"10.2147/JPR.S530364","DOIUrl":"10.2147/JPR.S530364","url":null,"abstract":"<p><strong>Background: </strong>Spondylosis (CS) is a prevalent condition that significantly impacts quality of life and overall health. Fu's subcutaneous needling, a novel acupuncture technique, has been widely used to treat CS. This study employs a meta-analysis to comprehensively evaluate the efficacy of Fu's subcutaneous needling in treating CS.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science Periodical Database (CSPD), Chinese Citation Database (CCD), and Chinese biomedical literature service system (CBM) databases for clinical trials on Fu's subcutaneous needling for CS, from inception to March 1, 2025. The quality of the included studies was assessed using the Cochrane Handbook for Systematic Reviews, and meta-analysis was performed using Stata 16.0.</p><p><strong>Results: </strong>A total of 46 studies involving 3767 cases were included. The results showed that the Fu's subcutaneous needling group had a higher effective rate than the control group (RR: 1.17, 95% CI: 1.14-1.20, p < 0.05). The Fu's subcutaneous needling group also had lower Visual Analog Scale (VAS) scores (WMD: -1.55, 95% CI: -1.98 to -1.12, p < 0.05), lower Northwick Park Neck Pain Questionnaire (NPQ) scores (WMD: -2.65, 95% CI: -5.27 to -0.03, p < 0.05), and lower Neck Disability Index (NDI) scores (WMD: -3.40, 95% CI: -6.59 to -0.21, p < 0.05) compared to the control group. The Fu's subcutaneous needling group also demonstrated higher safety (RR: 0.32, 95% CI: 0.13-0.75, p < 0.05). Subgroup analysis indicated that Fu's subcutaneous needling was effective across various subtypes of CS and showed significant advantages over other treatment modalities. The Efficacy of Fu's subcutaneous needling improved with longer treatment durations.</p><p><strong>Conclusion: </strong>Fu's subcutaneous needling is effective and safe for treating CS. Due to the limited number of included studies, further research is needed to confirm these findings.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4759-4774"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081045","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":"Comprehensive Mechanisms and Non-Invasive Treatment for Complex Regional Pain Syndrome: A Narrative Review.","authors":"Hoa Ngan Doan, Min Cheol Chang","doi":"10.2147/JPR.S534655","DOIUrl":"10.2147/JPR.S534655","url":null,"abstract":"<p><p>Complex Regional Pain Syndrome (CRPS) is a chronic pain condition characterized by an exaggerated response to an initial stimulus, accompanied by autonomic, sensory, motor, and sudomotor dysfunctions. Recognized as a systemic disorder, CRPS involves complex interactions among inflammatory, immunologic, neurogenic, genetic, and psychological factors. The primary mechanisms include peripheral and central sensitization, sympathetic nervous system dysregulation, and altered somatosensory processing. However, the exact pathophysiology remains unclear, contributing to ongoing debate about optimal treatment approaches. Management typically involves a multimodal approach. Pharmacologic options such as corticosteroids, ketamine, and bisphosphonates have demonstrated relative safety and efficacy in clinical practice. Moreover, rehabilitation therapies -including cortically directed sensorimotor rehabilitation, range-of-motion or aerobic exercises, exposure therapy, transcutaneous electrical nerve stimulation, and thermal therapy -serve as valuable nonpharmacologic interventions. No consensus currently exists on standardized treatment protocols for CRPS, particularly regarding the choice of non-invasive approaches. In this context, a comprehensive understanding of the underlying pathophysiological mechanisms is essential for guiding appropriate management strategies. This review provides updated insights into the pathophysiological mechanisms of the disease, alongside a synthesis of evidence-based non-invasive treatment, to support mechanism-driven clinical decision-making, potentially improving treatment outcomes.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4699-4726"},"PeriodicalIF":2.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075552","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 at Myofascial Trigger Points Versus Conventional Acupuncture for Knee Osteoarthritis: A Protocol for a Randomized Controlled Trial.","authors":"Chao Zhang, Hongfei Xue, Jiankang Xu, Aifeng Liu, Kuiliang Gao, Longyao Zhang","doi":"10.2147/JPR.S545853","DOIUrl":"10.2147/JPR.S545853","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that significantly impacts pain and mobility. Acupuncture targeting Myofascial Trigger Points (MTrPs), guided by the \"pain as acupoint\" strategy, has been proposed as a more precise intervention approach.</p><p><strong>Objective: </strong>This study aims to compare the efficacy of MTrP acupuncture versus conventional acupuncture in patients with early- to mid-stage KOA.</p><p><strong>Methods: </strong>In this assessor-blinded randomized controlled trial, 106 KOA patients (Kellgren-Lawrence grade II/III) will be randomly assigned (1:1) to receive either conventional meridian-based acupuncture (Group A) or acupuncture targeting both meridian points and MTrPs (Group B). Both groups will receive treatment five times weekly for two weeks. The primary outcome is the response rate, defined as a ≥2-point reduction in VAS and ≥6-point improvement in WOMAC function score. Secondary outcomes include pressure pain threshold (PPT), three-dimensional gait analysis, and patient acceptability.</p><p><strong>Results: </strong>This study is expected to demonstrate whether MTrP acupuncture provides superior pain relief and functional improvement compared to conventional acupuncture.</p><p><strong>Conclusion: </strong>Findings will contribute novel clinical evidence for optimizing individualized acupuncture strategies in the management of KOA.</p><p><strong>Trial registration: </strong>ChiCTR, ChiCTR2300073707, Registered on July 19, 2023.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4743-4753"},"PeriodicalIF":2.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075526","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}