Pain Medicine最新文献

{"title":"Pain Relief by Targeting Nonrestorative Sleep in Fibromyalgia: A Phase 3 Randomized Trial of Bedtime Sublingual Cyclobenzaprine.","authors":"Seth Lederman, Lesley M Arnold, Ben Vaughn, Jean M Engels, Mary Kelley, Gregory M Sullivan","doi":"10.1093/pm/pnaf089","DOIUrl":"https://doi.org/10.1093/pm/pnaf089","url":null,"abstract":"<p><strong>Objective: </strong>Fibromyalgia is the prototypic nociplastic chronic pain syndrome, characterized by widespread pain, nonrestorative sleep, and fatigue. We evaluated efficacy and safety of bedtime TNX-102 SL (sublingual cyclobenzaprine) 5.6 mg for treatment of fibromyalgia.</p><p><strong>Methods: </strong>This phase 3, double-blind, multicenter, placebo-controlled trial randomized patients 1:1 to once-nightly TNX-102 SL 2.8 mg for 2 weeks, followed by 5.6 mg for 12 weeks, or to matching placebo (NCT05273749). The primary endpoint was change from baseline at week 14 in weekly average of daily diary pain intensity scores. Secondary endpoints included Patient Global Impression of Change, Fibromyalgia Impact Questionnaire (Revised) Symptoms and Function domains, Patient-Reported Outcomes Measurement Information System instruments for Sleep Disturbance and Fatigue, and daily diary sleep quality scores.</p><p><strong>Results: </strong>Overall, 81.0% (n = 187/231) and 79.6% (n = 179/225) of patients receiving TNX-102 SL and placebo completed the trial, respectively. Treatment with TNX-102 SL vs placebo was associated with significantly greater reductions in the primary pain endpoint (P < 0.001; mean [SE], -1.8 [0.12] vs -1.2 [0.12]) and in each of the 6 secondary endpoints (P ≤ 0.001; all). The most common systemic treatment-emergent adverse events (TEAEs) with TNX-102 SL and placebo were COVID-19 (4.3% vs 3.1%, respectively), headache (3.0% vs 1.8%), and somnolence (3.0% vs 1.3%); the most common TEAEs overall were local administration-site reactions including oral hypoesthesia (23.4% vs 0.4%), product taste abnormal (11.3% vs 0.9%), and oral paresthesia (6.9% vs 0.9%), which were transient and self-limited.</p><p><strong>Conclusion: </strong>Bedtime TNX-102 SL treatment was associated with significant improvements in fibromyalgia symptoms and function and was well tolerated.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584493","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":"Lumbar Retrodural Space of Okada.","authors":"Jeffrey Chapman, Rajiv Reddy, Paul DeJulio","doi":"10.1093/pm/pnaf090","DOIUrl":"https://doi.org/10.1093/pm/pnaf090","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575967","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":"Commentary on the Veterans Health Administration Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) Pain Measure Set.","authors":"Sara N Edmond, Jennifer L Murphy, Daniel G Rogers, Brian C Coleman, Daniel Hadidi, Tara McMullen, Friedhelm Sandbrink","doi":"10.1093/pm/pnaf088","DOIUrl":"https://doi.org/10.1093/pm/pnaf088","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554128","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":"Combined Coracohumeral and Coracoacromial Ligament Release for Refractory Frozen Shoulder: A Comparative Cohort Study.","authors":"Sayed E Wahezi, Nimesha Mehta, Tahereh Naeimi, Ugur Yener, Hatice Begum Ciftci, Guillermo Rodriguez-Maruri","doi":"10.1093/pm/pnaf087","DOIUrl":"https://doi.org/10.1093/pm/pnaf087","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541803","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":"Multimodal pain management strategies mediating racial and ethnic differences in chronic pain outcomes.","authors":"Esha Thakkar, Em Long-Mills, Dmitry Tumin","doi":"10.1093/pm/pnaf018","DOIUrl":"10.1093/pm/pnaf018","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"422-424"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557605","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":"Evaluation of internally cooled radiofrequency ablation targeting multiple shoulder nerves for chronic shoulder pain relief and function restoration: a prospective study.","authors":"Mitsukuni Yoshida, Peter K Park, Loc V Thang","doi":"10.1093/pm/pnaf016","DOIUrl":"10.1093/pm/pnaf016","url":null,"abstract":"<p><strong>Objective: </strong>Shoulder pain is a prevalent musculoskeletal disorder, affecting up to 70% of adults over their lifetimes. Recently, radiofrequency ablation (RFA) has gained attention as a treatment for joint pain. This study aims to evaluate the efficacy of internally cooled RFA (icRFA) in alleviating shoulder pain and improving both qualitative and quantitative measures of shoulder function.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Subjects: </strong>Patients with chronic shoulder pain (n = 35) who responded positively to diagnostic blocks of the suprascapular nerve (SSN), axillary nerve (AN), and lateral pectoral nerve (LPN).</p><p><strong>Methods: </strong>Patients underwent icRFA targeting the SSN, AN, and LPN. Treatment response was assessed with the numeric rating scale (NRS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (AROM) in flexion and abduction. Outcomes were measured at baseline and at 1, 3, and 6 months after icRFA. Patient characteristics were compared between responders and nonresponders to icRFA treatment, and correlation analyses were conducted to explore the relationship between pain relief and functional improvement.</p><p><strong>Results: </strong>NRS pain levels significantly decreased at 1 month (Adjusted [Adj.] P < .0001), 3 months (Adj. P < .0001), and 6  months (Adj. P = .0002) after icRFA. ASES score improved at 1 month (Adj. P < .0001), 3 months (Adj. P < .0001), and 6 months (Adj. P < .0001) after icRFA. Flexion AROM improved at 1 month (Adj. P < .0001), 3 months (Adj. P < .0001), and 6 months (Adj. P = .0139) after icRFA. Abduction AROM improved at 1 month (Adj. P < .0001), 3 months (Adj. P < .0001), and 6 months (Adj. P < .0001) after icRFA.</p><p><strong>Conclusion: </strong>iccRFA targeting the SSN, AN, and LPN is a safe and effective intervention, providing significant improvements in pain, functional activities of daily living, and AROM of the shoulder for at least 6 months.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"397-406"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557574","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":"Marrow edema or fat? The importance of utilizing STIR and fat-suppressed T2 sequences.","authors":"Spencer Daniel Brodsky, Judah Burns, Dian Bueno Gonzalez, Sayed Emal Wahezi","doi":"10.1093/pm/pnaf015","DOIUrl":"10.1093/pm/pnaf015","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"420-421"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557599","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":"Notable concerns in methodology and conclusions of the Wang et al. Meta-analysis in BMJ by the American Academy of Pain Medicine.","authors":"Nathaniel M Schuster, Mustafa Broachwala, Farshad M Ahadian, Charles E Argoff, Steven P Cohen, Shravani Durbhakula, Amitabh Gulati, Robert W Hurley, Lynn Kohan, Zachary L McCormick, Sayed E Wahezi, Antje M Barreveld","doi":"10.1093/pm/pnaf036","DOIUrl":"10.1093/pm/pnaf036","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"359-361"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743406","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":"Platelet-rich plasma injections as a second-line treatment in patients with tendinopathy-related chronic pain and failure of conservative treatment: a systematic review and meta-analysis.","authors":"Mathieu Nadeau-Vallée, Sami Ellassraoui, Véronique Brulotte","doi":"10.1093/pm/pnaf022","DOIUrl":"10.1093/pm/pnaf022","url":null,"abstract":"<p><strong>Design: </strong>Platelet-rich plasma (PRP) is a popular treatment option in managing chronic tendinopathies, although the literature is inconsistent, mainly because of significant heterogeneity in patient populations. Patients who failed conservative management may respond differently than those who have not undergone first-line treatment. This systematic review and meta-analysis aimed to evaluate the efficacy of PRP injections in reducing pain and improving function in patients with chronic tendinopathy who failed conservative treatment. A comprehensive search of Medline, Embase, Cochrane Library, CINAHL Complete and Dissertations & Theses Global was conducted to identify randomized controlled trials (RCTs) comparing the effect of PRP vs non-surgical treatments on pain and functional outcomes in adult non-responders to conservative management.</p><p><strong>Results: </strong>A total of 9 RCTs involving 488 patients were included in the review. Of those, 6 studies at low risk of bias were included in the meta-analysis. PRP significantly reduced pain at both 6 and 12 months compared to control treatments (mean difference: -0.83 [95% confidence intervals (CI): -1.61 to -0.04] at 6 months; and -1.11 [95% CI: -2.10 to -0.12] at 12 months). This effect was also seen at 24 months, although based on limited data. Subgroup analysis revealed no significant differences in pain reduction between upper and lower limb tendinopathies. Functional improvement was observed in some studies, though the heterogeneity in outcome measures precluded a pooled analysis. Heterogeneity was substantial across studies, likely due to differences in PRP preparation, site of tendinopathy, and study methodologies.</p><p><strong>Conclusion: </strong>Despite these limitations, the findings suggest that PRP reduces pain in patients suffering from chronic tendinopathy who have not responded to first-line therapies. Further high-quality research with standardized protocols and longer follow-up is necessary to confirm PRP's long-term efficacy and safety.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"407-419"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616665","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":"Longitudinal patterns of opioid dispensing dosages for compensated Australian workers with low back pain: a 3.5-year follow-up study.","authors":"Xinyi Ren, Ting Xia, Stephanie Mathieson, Christina Abdel Shaheed, Suzanne Nielsen, Alex Collie, Michael F Di Donato","doi":"10.1093/pm/pnaf017","DOIUrl":"10.1093/pm/pnaf017","url":null,"abstract":"<p><strong>Objective: </strong>To identify longitudinal patterns in opioid dispensing dosages for workers with low back pain within a workers' compensation setting and to explore the risk factors associated with high-dose and persistent opioid use.</p><p><strong>Method: </strong>We included workers with accepted claims for low back pain received by insurers between January 1, 2010, and June 30, 2016, with a follow-up period of 3.5 years (data censoring on December 31, 2020) across Victoria. Trajectory modeling was used to identify different opioid dispensing patterns. Logistic regressions were utilized to compare the workers' characteristics across different opioid dispensing pattern groups.</p><p><strong>Results: </strong>Among 14 703 accepted claims, 33.1% reported receiving opioid medications as part of their claims. Six opioid dispensing patterns were identified. Individuals in the highest socioeconomic status (SES) quintile were less likely to rapidly escalate to dispensing high-dose opioids (odds ratio [OR]: 0.58, 99% CI 0.34, 0.99) compared to other quintiles. Workers dispensed gabapentinoids and antidepressants showed an increased risk of long-term high-dose opioid use (OR: 7.96, 99% CI 5.42, 11.69; OR: 21.75, 99% CI 14.30, 33.08) relative to workers with a single opioid dispensing. Those who had surgery were also more likely to use long-term high-dose opioids compared to a non-surgery group.</p><p><strong>Conclusion: </strong>Lower SES, having gabapentinoids or antidepressants prescriptions or having had surgery are all associated with persistent opioid use among workers with LBP. These demographic and clinical risk factors for developing persistent opioid use could help identify individuals who would benefit from early intervention, reducing the likelihood of opioid dependence for pain management and minimizing the risk of harm.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"362-371"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557594","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}