Pain Medicine最新文献

{"title":"Psychosocial factors are associated with altered pain processing in individuals with hip osteoarthritis: a cross-sectional study.","authors":"Abner Sergooris, Jonas Verbrugghe, Bonnechère Bruno, Timo Meus, Maaike Van Den Houte, Corten Kristoff, Bogaerts Katleen, Annick Timmermans","doi":"10.1093/pm/pnaf030","DOIUrl":"https://doi.org/10.1093/pm/pnaf030","url":null,"abstract":"<p><strong>Objectives: </strong>Alterations in central pain processing are hypothesized to underlie the discordance between pain and radiographic osteoarthritis severity, as well as the association between psychological trauma and pain sensitivity. This cross-sectional study explored whether psychosocial factors and traumatic experiences are associated with central pain processing in individuals with hip osteoarthritis.</p><p><strong>Method: </strong>Independent variables included sociodemographic information, traumatic experiences, psychiatric disorders, symptoms of anxiety and depression, fear-avoidance, perceived injustice, general self-efficacy, perceived stress, social support, and pain-related variables. Thermal quantitative sensory testing was used to assess central pain processing through heat pain thresholds, temporal adaptation and summation, and conditioned pain modulation. Least Absolute Shrinkage and Selection Operator regression analyses were performed.</p><p><strong>Results: </strong>One hundred thirty-three individuals with hip osteoarthritis were included. Sex differences were identified in measures of central pain processing. In combination with biological and pain-related factors, psychosocial factors explained between 11% and 21% of the variance in central pain processing. The selection of biopsychosocial variables and the direction of their effect differed between male and female participants. Inconsistent results were found regarding the association between traumatic experiences and central pain processing.</p><p><strong>Conclusions: </strong>Psychosocial factors contributed to the variance in quantitative sensory testing outcomes beyond the influence of biomedical variables. Different associations were found in male and female participants between psychosocial factors and central pain processing. Inconsistent results were found regarding the association between traumatic experiences and altered central pain processing.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701125","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":"Neuroscientific underpinnings of psychosocial factors in chronic pain.","authors":"Brian Key, Deborah J Brown","doi":"10.1093/pm/pnaf014","DOIUrl":"https://doi.org/10.1093/pm/pnaf014","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693066","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":"Response to the Commentary on Psychosocial Interventions and Neural Mechanisms in Chronic Pain.","authors":"Yan Yuan, Kristin Schreiber, K Mikayla Flowers, Robert Edwards, Desiree Azizoddin, LauraEllen Ashcraft, Christina E Newhill, Valerie Hruschak","doi":"10.1093/pm/pnaf031","DOIUrl":"https://doi.org/10.1093/pm/pnaf031","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693071","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":"Provider Perceptions of Burden in Patients with Chronic Pain: Implications for Disparities in Healthcare Delivery.","authors":"Raymond C Tait","doi":"10.1093/pm/pnaf028","DOIUrl":"https://doi.org/10.1093/pm/pnaf028","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670562","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":"Evidence Based Patient Centered Pain Management and AAPM.","authors":"Charles E Argoff","doi":"10.1093/pm/pnaf021","DOIUrl":"https://doi.org/10.1093/pm/pnaf021","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670560","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":"Do Difficult Encounters Affect Pain Treatment Outcomes? A Prospective Cohort Study.","authors":"Winnie L Liu, Evelien van Gelderen, Resham Mawalkar, Eric J Wang, Glenn Treisman, Steven P Cohen","doi":"10.1093/pm/pnaf027","DOIUrl":"https://doi.org/10.1093/pm/pnaf027","url":null,"abstract":"<p><strong>Background: </strong>Difficult encounters represent an enormous burden and drain on resources in pain medicine, but their effect on outcome has not been studied.</p><p><strong>Objective: </strong>To determine the effect of \"difficult\" encounters on chronic pain outcomes.</p><p><strong>Methods: </strong>In this prospective study, new chronic pain visits were rated by an attending physician and trainee on a 6-point Likert scale and stratified into \"difficult\" and \"non-difficult\". The main outcome was successful treatment, defined as a ≥ 2-point reduction in average pain 4 weeks after initiating pharmacological, integrative or injection therapy or 12 weeks after invasive procedures. The secondary outcome was lost-to-follow-up.</p><p><strong>Results: </strong>Among 428 patients seen for new-patient evaluations, 299 patients had follow-up, of which 127 (42.5%) experienced a positive outcome. Patients involved in difficult encounters were less likely to experience a positive outcome (28% vs. 46%; P = 0.02) than those not involved in difficult encounters. When stratified into quartiles, difficulty continued to be associated with an unsuccessful outcome, with the easiest encounters translating to a 53% success rate vs. 28% for patients involved in the most difficult encounters (P = 0.02). Difficult encounters were not associated with lost-to-follow-up. In multivariable analysis evaluating factors associated with difficultness, ≥10% missed appointments (OR 0.69, 95% CI 0.48 to 0.97; P = 04), nonorganic signs (OR 0.42, 95% CI 0.18 to 0.90; P = 0.03), visiting taking longer than expected (OR 0.49, 95% CI 0.25 to 0.96; P = 0.04) and refusal to try a treatment (OR 0.25, 95% CI 0.08 to 0.70; P = 0.01) were associated with poor outcome.</p><p><strong>Conclusions: </strong>Difficult encounters can not only lead to administrative burdens, poor ratings and lost revenue, but are also associated with negative outcomes for chronic pain, a condition notoriously associated with difficult visits.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT05585619); https://clinicaltrials.gov/study/NCT05585619? id=NCT05585619&rank=1.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657950","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":"Successful non-operative management of symptomatic intradural catheter-tip granuloma in a patient with intrathecal drug delivery system.","authors":"Ratan K Banik, Michel C Park","doi":"10.1093/pm/pnaf025","DOIUrl":"https://doi.org/10.1093/pm/pnaf025","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634198","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":"Painless lower limb complex regional pain syndrome: A Problem-Based learning discussion.","authors":"Annie M Cho, Christopher L Robinson, R Jason Yong, Samuel P Ang","doi":"10.1093/pm/pnaf024","DOIUrl":"https://doi.org/10.1093/pm/pnaf024","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634165","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":"Preoperative management of patients with chronic moderate to severe shoulder pain to improve postoperative outcomes. A systematic review.","authors":"José Manuel López-Millán, Miguel Ángel Ruiz Iban, Jorge Díaz Heredia, Luis Javier Roca Ruiz","doi":"10.1093/pm/pnaf023","DOIUrl":"https://doi.org/10.1093/pm/pnaf023","url":null,"abstract":"<p><strong>Objectives: </strong>To assess if implementing interventions to effectively manage preoperative chronic moderate to severe shoulder pain in patients undergoing rotator cuff repair (RCR) can improve shoulder surgery outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted following the PRISMA and SIGN guidelines. Randomized clinical trials (RCT), metanalysis, systematic revisions and cohort studies in Spanish/English, published within the last 10 years, evaluating interventions to control preoperative chronic moderate to severe shoulder pain in patients undergoing RCR and their impact in postoperative shoulder outcomes were included. Selected records were graded following the 2011 Oxford Centre for Evidence-Based Medicine levels of evidence (OCEBML). RCT were graded using the PEDro scale.</p><p><strong>Results: </strong>Twenty-nine records were included in the analysis. Evidence suggests that preoperative chronic moderate to severe shoulder pain is the strongest risk factor for postoperative shoulder pain (OCEBML III). Patient-related factors and shoulder pain characteristics can also influence surgery outcomes (OCEBML II/III). Predictors of better shoulder function at 2 years after surgery include higher preoperative scores on the Western Ontario Rotator Cuff index and the Constant-Murley score in the contralateral shoulder (OCEBML III). Preoperative analgesia to control shoulder pain can improve postoperative pain (OCEBML I). Preoperative patient teaching and intensive postoperative follow-up also improve pain intensity and function (OCEBML II).</p><p><strong>Discussion: </strong>Preoperative chronic shoulder pain together with patient-related factors are significant predictors of postoperative shoulder outcomes, emphasizing the need for proactive pain assessment and tailored therapeutic programs.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616668","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":"Platelet-rich plasma (PRP) 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":"https://doi.org/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 comparing the effect of PRP versus 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% 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":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}