Pain Medicine最新文献

{"title":"Cancer Patients Quality of Life After Intrathecal Drug Delivery for Advanced Pain Management: A Patient-Reported Outcome Analysis.","authors":"Vasudha Goel, Alexander Kaizer, David Darrow, Drew Rosielle, Benjamin Owens, Anne Blaes","doi":"10.1093/pm/pnaf012","DOIUrl":"https://doi.org/10.1093/pm/pnaf012","url":null,"abstract":"<p><strong>Objectives: </strong>Cancer-related pain (CRP) is a common, most feared symptom experienced by cancer patients, adversely affecting quality of life and cancer outcomes. Patient-reported outcomes (PRO) measures are a patient's report of their health condition without interpretation of the response by a health care provider. This study assesses PRO measures after therapy using an intrathecal drug delivery system (IDDS) for cancer pain management.</p><p><strong>Design, setting, subjects, and methods: </strong>The retrospective study included adult patients undergoing IDDS implantation from January 2022 to January 2023 at the University of Minnesota Medical Center. Patients with moderate to severe cancer-related pain (VAS > 4) who had failed conventional medical therapy for pain control or had severe opioid-related side effects were considered for IDDS therapy. PRO measures were evaluated by the Patient Reported Outcomes Measurement Information System (PROMIS). The measurements were collected weekly during the first month after implantation and then during monthly follow-up. Linear mixed effects models with a random intercept for each participant are fit to the PROMIS outcomes to compare the change in scores.</p><p><strong>Results: </strong>During the study period, 23 patients received IDDS treatment for cancer-related pain, and 20 patients (age 57.2 ± 17.1 years, female sex 65%, Caucasian ethnicity 90%, stage IV cancer 90%) were included in the final analysis. The mean oral morphine equivalent consumption at implantation was 237 ± 309. The patients started with severely reduced physical function, mobility, self-efficacy, social activity, social role, and satisfaction with roles. They also presented with mild-moderate sleep disturbance, anxiety, and depression symptoms. Of all the domains, pain interference and sleep disturbance consistently improved throughout the study period.</p><p><strong>Conclusions: </strong>Pain interference and Sleep disturbance as measured by PRO measures improved with IDDS therapy among patients with refractory pain and advanced metastatic cancer.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Transforaminal Epidural Steroid Injection on Pain and Disability Outcomes by Lumbar Intervertebral Disc Herniation Class: A Prospective Study.","authors":"Tuba Tanyel Saraçoğlu, Burak Erken","doi":"10.1093/pm/pnaf040","DOIUrl":"https://doi.org/10.1093/pm/pnaf040","url":null,"abstract":"<p><strong>Background: </strong>Lumbosacral radicular pain significantly affects daily life activities and is typically caused by nerve root compression owing to disc herniation. Transforaminal epidural steroid injection (TFESI) is a prevalent treatment modality; however, the impact of varying disc morphologies on treatment outcomes remains unclear. The aim of this study was to evaluate the effects of TFESI on pain and disability across different lumbar disc morphologies using the Michigan State University (MSU) classification system.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 168 patients with single-level lumbar disc herniation at L4-L5 or L5-S1 treated with TFESI. Patients were divided into seven subgroups according to the MSU classification based on MRI findings. The Numerical Rating Scale (NRS) for pain and Oswestry Disability Index (ODI) for assessing disability were measured at baseline, 1-month and 3-months post-procedure.</p><p><strong>Results: </strong>TFESI significantly reduced NRS and ODI scores in all groups (p < 0.001). At 1-month follow-up, NRS scores of group 1B were significantly lower than those of groups 2A and 2AB (p < 0.001 and p = 0.020, respectively); at the 3-month follow-up, no differences were observed between the groups. Although ODI scores improved over time, they did not exhibit significant differences among the subgroups throughout the study period.</p><p><strong>Conclusion: </strong>TFESI effectively reduces pain and disability across varying disc morphologies. At the 1-month mark, pain relief was more pronounced in group 1B compared to 2A and 2AB groups, whereas at the 3-month mark, the results were similar between subgroups. Larger studies with longer follow-up are needed to improve patient selection criteria and optimize treatment strategies.</p><p><strong>Data sharing statement: </strong>This study was registered at ClinicalTrials.gov under the identifier (NCT06275529).</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping and Crosswalk of Patient-Reported Pain Measures After Surgery in the Michigan Surgical Quality Collaborative Registry.","authors":"Ashwin J Kulkarni, Jorge Vinales, Vidhya Gunaseelan, Chad M Brummett, Yen-Ling Lai, Jennifer Waljee, Michael F McGee, Michael Englesbe, Mark C Bicket","doi":"10.1093/pm/pnaf041","DOIUrl":"https://doi.org/10.1093/pm/pnaf041","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-reported pain is a crucial measure for postoperative recovery, but the correlation between numeric and categorical scales remains unclear. The Michigan Surgical Quality Collaborative (MSQC) used categorical rating scales (CRS) from 2017-2020 and 2022, switching to numeric rating scales (NRS) in 2021, offering a chance to compare both.</p><p><strong>Methods: </strong>We analyzed surgical patients ≥18 years of age across 70 MSQC hospitals. We compared the 2020 CRS regarding pain in the week after surgery with 2021 NRS surgical site (primary outcome) and overall body (secondary outcome) pain questions using modified equipercentile equating. A secondary analysis equated surgical site pain for 2021 NRS and 2022 CRS.</p><p><strong>Results: </strong>Among 31,362 respondents (55.4 mean age, 57.4% female, 19.5% non-white, 46.6% publicly insured), 81.1% noted \"minimal\" or \"moderate\" pain in the 2020 CRS while 76.6% noted surgical site pain scores between 2 through 8 in the 2021 NRS. Responses from surgical site pain NRS were matched to CRS as: 0 = no pain, 1 through 4 = minimal pain, 5 through 8 = moderate pain, and 9 through 10 = severe pain. The mapping of overall body pain NRS was similar except that minimal pain included 0 through 4. The secondary analysis added 21,113 cases confirming these findings.</p><p><strong>Discussion: </strong>NRS surgical site and overall body pain scores map effectively to the single-question CRS, with pain scores similar over three years. This analysis establishes a framework for integrating pain scores across both scales, unlocking their potential to be used as quality postoperative pain measures.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrimination and Wellbeing are Differentially Related to Pain Severity for the Racially Marginalized.","authors":"Annwesha Dasgupta, Destiny Printz, Sergio R Pérez Rosal, Sonya C Faber, Monnica T Williams","doi":"10.1093/pm/pnaf039","DOIUrl":"https://doi.org/10.1093/pm/pnaf039","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the relationship between racial discrimination and physical pain outcomes.</p><p><strong>Methods: </strong>A geographically representative sample of 887 individuals was recruited online through CloudResearch from diverse racial backgrounds, including Black/African American, Latine/Hispanic American, Asian American, and White/European American adults. Participants completed measures on racial and ethnic discrimination, racial microaggressions, pain severity, depression symptoms, and coping styles. Statistical analyses included multiple regression and mediation models.</p><p><strong>Results: </strong>Our findings indicate that racialized participants experienced greater ethnic discrimination and racial microaggressions compared to their non-Hispanic White counterparts. Hispanic/Latine participants also reported greater pain severity than other groups. Lifetime experiences of discrimination, depression symptoms, avoidant coping style, and age emerged as significant predictors of pain severity, while mediation analyses revealed that lifetime discrimination partially mediated the relationship between race/ethnicity and pain severity for racially marginalized participants, compared to non-Hispanic White participants. Further, greater reliance on avoidant coping combined with greater lifetime discrimination experiences was associated with increased severity of pain.</p><p><strong>Conclusions: </strong>The findings indicate how racism may result in worse pain outcomes in people of color, with potentially amplified adverse effects for those who engage in avoidant coping. While therapeutic interventions targeting avoidance may benefit racialized individuals, ultimately, the results highlight the critical need for large-scale policy interventions targeting racial discrimination to improve health equity and reduce the burden of pain among racialized populations.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who is being represented in research? A researcher-driven method for assessing diversity and representation in prospective research cohorts.","authors":"Alexandra G Tremblay-McGaw, Emma E Biggs, Olivia E Sokol, Amanda W Miner, Ana B Goya Arce, Laura E Simons","doi":"10.1093/pm/pnaf037","DOIUrl":"https://doi.org/10.1093/pm/pnaf037","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic pain education: past, present, and future of psychedelics for the management of chronic pain.","authors":"Christopher L Robinson, Pawan K Solanki, Sean Snyder, Adam Amir, Antje Barreveld, Rory Vu Mather, Ivo H Cerda, Michael Motoc, Harman Chopra, Robert Jason Yong, Joel Castellanos, Timothy Furnish, Alan D Kaye, Vwaire Orhurhu, Trent Emerick","doi":"10.1093/pm/pnae124","DOIUrl":"10.1093/pm/pnae124","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"216-218"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of an interdisciplinary pain management program for complex regional pain syndrome compared to low back pain and chronic widespread pain: an observational study.","authors":"Debbie J Bean, Natalie L Tuck, Nico Magni, Tipu Aamir, Catherine Pollard, Gwyn N Lewis","doi":"10.1093/pm/pnae126","DOIUrl":"10.1093/pm/pnae126","url":null,"abstract":"<p><strong>Background: </strong>Little research has assessed the efficacy of interdisciplinary pain management programs (IPMPs) for complex regional pain syndrome (CRPS), whereas evidence shows that IPMPs are effective for low back pain (LBP) and chronic widespread pain (CWP). This study aimed to determine whether outcomes following an IPMP differ for people with CRPS compared to LBP and CWP. In addition, we determined whether it is possible to predict IPMP outcomes using baseline characteristics.</p><p><strong>Methods: </strong>People with CRPS (N = 66) who had completed a 3-week IPMP were compared with age- and gender- matched controls with LBP (N = 66) and CWP (N = 66). Measures of pain intensity, pain interference and psychological factors were extracted for pre- and post-program, and at 1, 6, and 12 months. Latent class analysis identified recovery trajectories for pain intensity and pain interference, and χ2 analyses assessed differences between diagnostic groups in recovery trajectories. Machine learning models were implemented to predict recovery trajectories from baseline scores.</p><p><strong>Results: </strong>Two recovery trajectories for each dependent variable (pain interference and for pain intensity) were identified: Good responders and poorer responders. Following IPMPs, 37% of people belonged to a good responder recovery trajectory for pain interference, and 11% belonged to a good responder recovery trajectory for pain intensity. Recovery trajectories were similar across the three diagnostic groups (CRPS, LBP, CWP) for pain interference (χ2 = 1.8, P = .4) and intensity (χ = 0.2, P = .9). Modeling to predict outcomes correctly classified 69% of cases for pain interference and 88% of cases for pain intensity recovery trajectories using baseline scores.</p><p><strong>Conclusion: </strong>People with CRPS, LBP, and CWP experience similar benefits following an IPMP. This supports the use of IPMPs for people with CRPS.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"180-188"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818803","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":"Focused anatomic review: ultrasound-guided peripheral nerve stimulation of the saphenous, lateral femoral cutaneous, and genicular nerves.","authors":"James S Cho, Alanah Grisham, Annette Wang, Rafael Vazquez, Charles Kelly, Pascal Scemama, David Hao","doi":"10.1093/pm/pnaf007","DOIUrl":"10.1093/pm/pnaf007","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"219-221"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What makes life go well? A network topic modeling analysis of well-being practices in adults with chronic pain.","authors":"Dakota W Cintron, Anthony D Ong, M Carrington Reid","doi":"10.1093/pm/pnae131","DOIUrl":"10.1093/pm/pnae131","url":null,"abstract":"<p><strong>Objective: </strong>This study leverages natural language processing techniques to identify specific practices older adults with chronic pain adopt to enhance well-being.</p><p><strong>Method: </strong>We applied network topic modeling to open-ended survey responses from 683 adults (57% female) who reported experiencing chronic pain in the Midlife in the United States (MIDUS) study, analyzing responses to the question \"What do you do to make your life go well?\" Structural equation modeling was used to examine the relationships between identified topics and measures of pain interference and prescription pain medication use, adjusting for sociodemographics and well-being indicators.</p><p><strong>Results: </strong>The analyses revealed 12 key topics, including avoiding stress, maintaining social connections, and practicing spirituality and faith. Notably, maintaining social connections was negatively associated with pain interference (β = -0.14, SE = 0.05, P < .05) and prescription pain medication use (β = -0.11, SE = 0.04, P < .05).</p><p><strong>Conclusion: </strong>The findings demonstrate the utility of network topic modeling in identifying complex psychosocial dimensions influencing chronic pain management, providing insights into the distinct role of well-being practices in shaping pain outcomes.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"189-198"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896499","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":"RE: Exploring new educational approaches in neuropathic pain: assessing accuracy and consistency of AI responses from GPT-3.5 and GPT-4.","authors":"Alejandro García-Rudolph, David Sanchez-Pinsach, Eloy Opisso, Maria Dolors Soler","doi":"10.1093/pm/pnae116","DOIUrl":"10.1093/pm/pnae116","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"227-228"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}