Journal of Pain Research最新文献

{"title":"Preferential Flow Patterns of Injectate in Epidural and Inadvertent Subdural Anesthesia: Exploring the Hemodynamic Stability of High-Level Epidural, Subdural and Combined Epidural-Subdural Blocks in Relation to ASA Class.","authors":"Seung Youn Kang, Hyeun Sung Kim, Hyun Kang","doi":"10.2147/JPR.S531946","DOIUrl":"10.2147/JPR.S531946","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the hemodynamic responses elicited by epidural, subdural, and combined epidural-subdural anesthesia during spinal surgery, with a focus on anesthetic levels and ASA classifications. It integrates image findings to enhance understanding of the anesthetic impact on hemodynamic stability.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted involving patients who underwent endoscopic, open, or fusion spine surgeries with epidural anesthesia and monitored anesthesia care (MAC) between March 2018 and September 2023. Comprehensive demographic data, details regarding anesthetic levels, ASA class and hemodynamic measurements were systematically collected. Additionally, fluoroscopic images were assessed to investigate the distribution patterns of anesthetics and their relationship to hemodynamic outcomes.</p><p><strong>Results: </strong>In patients undergoing epidural, subdural, and combined epidural-subdural anesthesia with high-level blocks above T5 and classified as ASA class III or higher, no significant differences were observed in hypotensive events or vasopressor usage compared to those with lower-level blocks or ASA classifications. The mean duration of surgery was 90.6 ± 40.9, 105.4 ± 42.5, and 100.8 ± 46.6 minutes, respectively, across the three groups. Subdural anesthesia exhibited a similar hemodynamic profile, with milder blood pressure decreases. Imaging analysis indicated distinct anesthetic distribution patterns primarily in the posterior epidural and subdural spaces, which helped preserve anterior sympathetic and motor functions, suggesting a relationship between fluoroscopic imaging features and hemodynamic stability.</p><p><strong>Conclusion: </strong>Hemodynamic stability was maintained in the subdural and combined epidural-subdural groups compared to the epidural group in ASA I to III patients. However, epidural anesthesia showed better hemodynamic outcomes for ASA class above III. High-level epidural and subdural anesthesia primarily induced posterior diffusion, resulting in minimal anterior sympathetic block while preserving stability. These findings suggest that epidural anesthesia may be a viable alternative for spinal surgeries and applicable to other procedures for patients with high ASA classifications.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4727-4741"},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069738","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":"Circadian Rhythms and Pain: A Narrative Review on Clock Genes and Circadian-Based Interventions.","authors":"Zong-Qi Huang, Xiao-Qin Li, Yin-Di Wang, Jia-Yi Li, Yu-He Tian, Yong-Min Liu, Jun-Qiang Si","doi":"10.2147/JPR.S533508","DOIUrl":"10.2147/JPR.S533508","url":null,"abstract":"<p><p>Pain is a common symptom of many diseases and seriously affects the quality of life. Circadian rhythm is the regular, cyclical physiological, biochemical, and behavioral changes that occur within a 24-hour period in biological organisms, primarily regulated by clock genes. Pain sensitivity may have circadian rhythms, with clock genes likely influencing this pain-related rhythmicity. Therefore, restoring normal circadian rhythms and regulating the expression of clock genes are regarded as viable strategies to combat the development of pain. First, this review elucidates the core operational mechanisms of clock genes. Second, it also discusses the relationship among multiple types of pain and clock genes, such as sciatic nerve injury, inflammatory pain, chemotherapy-induced neuropathic pain, headache, the pain of Restless Legs Syndrome and fibromyalgia. Third, it presents the pain treatment and pain management strategies based on the current research on circadian rhythms. Exploring the role of circadian rhythm in pain can help increase our understanding of pain and have significant clinical implications for pain patients.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4687-4698"},"PeriodicalIF":2.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064928","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":"Tuina Combined with Other Treatment Methods for Scapulohumeral Periarthritis (Frozen Shoulder): Bayesian Network Meta-Analysis.","authors":"Shiheng Wang, Fengxia Zhang, Jing Chen, Guilong Fu","doi":"10.2147/JPR.S544637","DOIUrl":"10.2147/JPR.S544637","url":null,"abstract":"<p><strong>Background: </strong>Frozen Shoulder (FS), a debilitating stage of scapulohumeral periarthritis (SP), significantly impairs daily life and working capacity. Compared with pharmacological treatments and surgical interventions, Tuina offers the advantages of being non-invasive and safe. Although substantial clinical evidence supports the efficacy of Tuina in treating FS, most studies involve its combination with other therapeutic modalities. The effectiveness and safety of various Tuina combinations remain unclear. Therefore, a network meta-analysis is warranted to provide a more comprehensive evidence-based foundation for clinical decision-making.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) investigating Tuina for Frozen Shoulder were systematically retrieved from PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang, and SinoMed. The search was conducted up to May 20, 2025. Data analysis was performed using R 4.2.0 and Stata 16.0.</p><p><strong>Results: </strong>A total of 23 RCTs involving 11 intervention measures were included. Network meta-analysis results indicated that the effective rates of Tuina combined with Acupotomy, Tuina combined with external application of traditional Chinese medicine, Tuina combined with acupuncture, and Tuina combined with Leverspin Technique were significantly higher than those of Tuina alone (P < 0.05). The top three rankings based on Surface Under the Cumulative Ranking Area (SUCRA) were as follows: Tuina combined with Leverspin Technique (0.81), Tuina combined with acupuncture (0.75), and Tuina combined with Acupotomy (0.64). Regarding Visual Analog Scale (VAS) scores, Tuina combined with Acupotomy demonstrated superior efficacy compared to Tuina alone (P < 0.05). The top three SUCRA rankings for VAS were: Tuina combined with Acupotomy (0.70), Tuina combined with Fu's subcutaneous needling (0.66), and Tuina combined with acupuncture (0.65). Considering all factors, Tuina combined with acupuncture and Tuina combined with Acupotomy are the optimal intervention strategies for scapulohumeral periarthritis (Frozen Shoulder).</p><p><strong>Conclusion: </strong>Based on the available evidence, Tuina combined with acupuncture and Tuina combined with Acupotomy represent the most effective interventions for scapulohumeral periarthritis (Frozen Shoulder). However, there is the possibility of heterogeneity and publication bias.further high-quality research is required to validate and refine these conclusions.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4673-4686"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12428646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064981","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":"Pain Medicine Needs an Open-Access Data Revolution.","authors":"Shravani Durbhakula, Michael E Schatman, Brett C Byram, Stephen Bruehl","doi":"10.2147/JPR.S563184","DOIUrl":"10.2147/JPR.S563184","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4635-4637"},"PeriodicalIF":2.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065046","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":"Comparison of Mobile Health-Based Exercise vs Traditional Exercise for Chronic Neck Pain: A Systematic Review and Meta-Analysis.","authors":"XiaoYa He, Hang Zhou, Yue Shuai Jiang, Da-Chao Liu, Fei Qi, ZiPu Wang","doi":"10.2147/JPR.S526845","DOIUrl":"10.2147/JPR.S526845","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to assess the effectiveness of mobile health (mHealth) exercise interventions in comparison to traditional exercise methods (exercises guided offline by a rehabilitation therapist or performed independently according to the instruction manual) for relieving pain intensity, decreasing functional disability, and improving the overall quality of life for individuals suffering from Chronic Neck Pain (CNP).</p><p><strong>Methods: </strong>A systematic search was performed to identify randomized controlled trials (RCTs) published from their inception until December 25, 2024, across multiple databases, such as Cochrane, Embase, Medline, and Web of Science. Data extraction was carried out independently by pairs of reviewers, who also evaluated bias using the Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>In total, six studies were identified, encompassing 381 participants with an average age of 41.17±11.72 years. No statistically significant differences were observed in pain relief when comparing mHealth-based exercise to traditional exercise methods that did not incorporate mHealth (standard mean difference [SMD]=-0.31; 95% CI: -0.73 to 0.12, P=0.16). Additionally, there were no significant differences concerning functional disability (SMD=-0.33; 95% CI: -0.68 to 0.02; P=0.06) or quality of life (SMD=0.19; 95% CI: -0.19 to 0.56; P=0.34). Conversely, a significant difference was noted when comparing mHealth-supported exercise to unsupervised traditional exercise regarding pain alleviation (SMD=-0.76; 95% CI: -1.06 to -0.45; <i>P</i><0.001) and functional disability (SMD=-0.66; 95% CI: -1.01 to -0.32; <i>P</i><0.001).</p><p><strong>Conclusion: </strong>The results indicate that exercise facilitated by mHealth is more effective than traditional unsupervised exercise in preventing pain and enhancing functional capabilities in young and middle-aged patients experiencing chronic non-specific neck pain. Traditional exercise can serve as a foundational intervention for the rehabilitation of non-specific neck pain, while mobile health-assisted exercise offers a feasible alternative in situations where offline interventions are limited. This approach enhances the accessibility and coverage of rehabilitation services.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4639-4649"},"PeriodicalIF":2.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065000","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 Therapy for Sciatica: An Overview of Systematic Reviews and Meta-Analysis.","authors":"Jiewen Zhang, Zining Guo, Liying Wang, Run Lin, Bijuan Xiao, Wenhao Liu, Nenggui Xu, Shaoyang Cui","doi":"10.2147/JPR.S549214","DOIUrl":"10.2147/JPR.S549214","url":null,"abstract":"<p><strong>Purpose: </strong>Acupuncture shows potential as a treatment for sciatica, but the credibility and consistency of supporting evidence remain unclear, warranting critical and comprehensive evaluation. This overview is aims to assess the reliability, adequacy, and limitations of current evidence on acupuncture for sciatica using a multidimensional approach and further examine its efficacy through a secondary meta-analysis.</p><p><strong>Methods: </strong>Systematic reviews and meta-analyses (SRs/MAs) meeting PICOS criteria were identified from eight databases by two independent reviewers. Evidence reliability was assessed using AMSTAR-2, ROBIS, PRISMA-A, and the GROOVE tool across four domains: methodological quality, bias risk, reporting accuracy, and study overlap. Duplicate randomized controlled trials (RCTs) were excluded based on the Corrected Covered Area (CCA) analysis, and a secondary meta-analysis was conducted. Sensitivity analyses and funnel plots assessed robustness and publication bias.</p><p><strong>Results: </strong>Seven SRs/MAs were included. AMSTAR-2 revealed significant methodological flaws, particularly due to a lack of protocol pre-registration. ROBIS assessments showed a high risk of bias, with most studies relying on single-database searches and lacking comprehensive strategies. PRISMA-A indicated generally low reporting quality, especially regarding descriptions of acupuncture sensation. The GROOVE tool yielded a CCA of 7.23%, reflecting moderate study overlap. The secondary meta-analysis showed that acupuncture significantly improved treatment effectiveness (RR = 1.23; 95% CI: 1.20-1.26; <i>P</i> = 0.008), reduced pain intensity, and increased pain threshold. Sensitivity analyses confirmed the robustness of results, while funnel plots suggested some publication bias. Acupuncture was generally considered safe across studies.</p><p><strong>Conclusion: </strong>Although current evidence is limited by methodological flaws, publication bias, and poor reporting quality, acupuncture shows promising clinical potential for sciatica. High-quality, rigorously designed studies are needed to confirm its efficacy.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4651-4671"},"PeriodicalIF":2.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064941","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":"Exploratory Analysis of Respiratory Variability in Relation to Disease Impact, Affective Symptoms, and Pain Sensitivity in Fibromyalgia.","authors":"Oscar F C van den Bosch, Johan P A van Lennep, Ricardo Alvarez-Jimenez, Henriët van Middendorp, Andrea W M Evers, Monique A H Steegers, Patrick Schober, Stephan A Loer","doi":"10.2147/JPR.S530506","DOIUrl":"10.2147/JPR.S530506","url":null,"abstract":"<p><strong>Purpose: </strong>Fibromyalgia is a complex multisystem disorder characterized by generalized chronic pain. While its etiology remains largely unclear, neuroinflammation, chronic stress, and autonomic dysregulation may play significant roles. Resultantly, respiratory patterns could serve as both a biomarker and a therapeutic target in fibromyalgia. We hypothesized that fibromyalgia impact, anxiety, depression, pain intensity, and pain sensitivity are associated with reduced respiratory variability.</p><p><strong>Patients and methods: </strong>In this observational study, twenty-three female participants with fibromyalgia completed the Revised Fibromyalgia Impact Questionnaire (FIQR) and Hospital Anxiety and Depression Scale (HADS). Chronic pain intensity was assessed using a numerical rating scale. Pain sensitivity was measured using pain pressure thresholds, wind-up pain, and aftersensations. Respiratory rate, respiratory rate variability, and tidal volume variability were measured noninvasively using a thoracic bioimpedance electrode during restful waiting.</p><p><strong>Results: </strong>No association was observed of respiratory variability with fibromyalgia impact, anxiety, chronic pain intensity, wind-up pain, and aftersensations. Higher depression scores were associated with lower tidal volume variability (r = -0.45, 95% CI: -0.04 to -0.73, p = 0.033). Additionally, higher pain pressure thresholds correlated with lower respiratory rate variability (R = -0.43, 95% CI: -0.02 to -0.72, p = 0.039) and tidal volume variability (R = -0.47, 95% CI: -0.07 to -0.74, p = 0.023).</p><p><strong>Conclusion: </strong>While no direct association was found between respiratory variability and overall fibromyalgia impact, respiratory variability was associated with depression and pain sensitivity, both of which influence quality of life. These findings suggest that respiratory variability may have potential as a biomarker reflecting specific symptom dimensions of fibromyalgia. Further research is warranted.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4565-4574"},"PeriodicalIF":2.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040584","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":"Pain Phenotyping Indicators in Older Adults with Chronic Low Back Pain: A Secondary Analysis of a Randomized Controlled Trial.","authors":"Katrina R Hamilton, Nada Lukkahatai, Wanqi Chen, Hulin Wu, Jennifer Kawi, Constance M Johnson, Paul J Christo, Claudia M Campbell","doi":"10.2147/JPR.S523699","DOIUrl":"10.2147/JPR.S523699","url":null,"abstract":"<p><strong>Purpose: </strong>A multimodal approach to clinical care is often recommended for chronic low back pain (cLBP); however, treatment responses are highly variable. Phenotyping could help determine subgroups of patients, allowing for targeted and tailored interventional approaches.</p><p><strong>Patients and methods: </strong>263 (Mage=69.8 (7.2); 64.6% female) individuals with cLBP participated in the parent study, a 3-arm, randomized clinical trial examining auricular point acupressure treatment outcomes. Parent study participants were randomized (1:1:1) to APA ear points targeted to cLBP (T-APA, n=92), non-targeted to cLBP (NT-APA, n=91), or education control (n=89). The current study used latent class analysis to identify clustering for pain severity (intensity, neuropathic pain) and pain impact (anxiety, depression, pain catastrophizing, fatigue, sleep disturbance) and determine if these classes were related to treatment outcomes (pain and disability reduction). Bayesian Information Criterion (BIC) was used for model selection. Post-LCA, ANOVA and Fisher's exact tests examined potential subgroup differences.</p><p><strong>Results: </strong>The three-class model emerged as the best fit due to relatively low BIC (-12105.46) and good patient distribution per class; class 1 n=79, class 2 n=109, class 3 n=75. Latent class 1 had moderate pain severity and pain impact, class 2 had high pain severity and pain impact, and class 3 had low pain severity and pain impact. No significant differences between classes were seen for age, sex, or BMI (p-value>0.05); however, latent class 3 had the highest physical functioning, lowest fear of physical activity, and disability, and significantly lower unemployment rate. There were no significant differences in treatment outcomes among the three classes.</p><p><strong>Conclusion: </strong>Three distinct clusters of factors related to pain and psychological function for individuals with cLBP were found. These clusters align with previous work and add to the literature by providing important associations with demographic and clinical factors that have not been previously examined.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4589-4598"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040546","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 Swiss Cross-Sectional Study on Patients' Perspectives on Chronic Pain Management, Analgesic Treatment, and Genetic Susceptibility.","authors":"Anna Bollinger, Céline K Stäuble, Isabelle O Urdieux, Henriette E Meyer Zu Schwabedissen, Samuel S Allemann","doi":"10.2147/JPR.S543460","DOIUrl":"10.2147/JPR.S543460","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a prevalent and complex condition that often results in inadequate pharmacotherapy due to interindividual variability in drug response. Pharmacogenetics (PGx) offers a promising approach to personalize pain management, particularly since many analgesic drugs are PGx actionable. However, knowledge about the clinical relevance and patient perspective on PGx in Swiss chronic pain care remains limited.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey among chronic pain patients in the German-speaking regions of Switzerland. The questionnaire was developed to (1) assess the proportion of patients currently or previously treated with PGx actionable drugs, (2) evaluate therapy satisfaction and the perception of being taken seriously by healthcare professionals (HCPs), and (3) explore patients' awareness of PGx and their interest in genetic pain predisposition.</p><p><strong>Results: </strong>Among the 725 participants who completed the survey, most reported current or past use of PGx actionable drugs: 85% non-steroidal anti-inflammatory drugs (NSAIDs), 54% opioids, 38% co-analgesics (antidepressants), and 73% proton-pump-inhibitors (PPIs) used as adjunctive therapy. Over one-third of participants reported no use of any analgesic drug. Therapy dissatisfaction was reported by 33%, and 28% felt not taken seriously by HCPs. Notably, 97% had never been offered PGx testing by an HCP. Despite this, 60% expressed interest in knowing their genetic pain predisposition, even if it would not affect their treatment. This interest was significantly higher among younger participants and those who were dissatisfied or felt not taken seriously by HCPs.</p><p><strong>Conclusion: </strong>This study provides the first large-scale, representative insights into the use of PGx actionable drugs and treatment patterns in Swiss chronic pain care. In particular, the high prevalence of PGx actionable drug use and the strong patient interest in genetic information support not only the clinical, but also the biopsychosocial potential of PGx for chronic pain management.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4575-4587"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040561","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 of Myofascial Trigger Point Dry Needling in Treatment of Primary Dysmenorrhea: A Study Protocol for a Three-Arm Randomized Controlled Trial.","authors":"Yanxia Sun, Lihua Yang, Lihong Zhu, Shu Zhang, Wei Cheng, Lei Lin, Wei Li, Min Li, Xueli Zhao, Jing Guo, Zhen Hua","doi":"10.2147/JPR.S537971","DOIUrl":"10.2147/JPR.S537971","url":null,"abstract":"<p><strong>Background and objective: </strong>Primary dysmenorrhea carries substantial medical, social, and economic burdens, leading many patients to seek low-risk complementary and alternative therapies, such as acupuncture. Myofascial trigger point dry needling (MTrP-DN) has recently gained attention as a potential treatment, though evidence remains limited and its distinction from acupuncture is debated. Therefore, this study aims to evaluate the therapeutic efficacy of MTrP-DN for primary dysmenorrhea, using traditional acupuncture as an active control and sham needling as a passive control.</p><p><strong>Methods and analysis: </strong>This is a randomized, subject-blind, sham-controlled trial. A total of 150 subjects with primary dysmenorrhea will be randomly assigned in a 1:1:1 ratio to the MTrP-DN, acupuncture, or sham group, receiving consecutive 3-week treatments with follow-up for 12 months. The primary outcome is pain intensity, measured by the visual analogue scale (VAS). Secondary outcomes include quality of life, non-steroidal anti-inflammatory drug (NSAID) usage, self-reported improvement using the Global Rate of Change (GROC) scale, serum inflammatory markers, and uterine blood flow assessed by Doppler. Outcomes will be evaluated at baseline, 1^st month, 2^nd months, and 12^thmonths post-treatment during menstruation. Multivariate analysis of variance will be used to analyze the interactions between different groups, different time periods, and the interaction of group and time.</p><p><strong>Discussion: </strong>This study is the first to compare the efficacy of MTrP-DN with acupuncture in the treatment of primary dysmenorrhea, focusing on their effects on pain intensity, uterine blood flow, and inflammatory markers. Including a sham control group helps address blinding issues and accurately assess MTrP-DN's effects on pain and quality of life.</p><p><strong>Trial registration number: </strong>Clinicaltrial.gov (NCT06316583).</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"4623-4633"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040558","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}