Pain Medicine最新文献

{"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}

{"title":"Pressure pain sensitivity is independent of structural pathology in patients with subacromial pain syndrome: a cross-sectional analysis.","authors":"Chris Pierson, Richard Wilson, Karen Brewer-Mixon, Yi-Ting Tzen, Jon Williamson, Kristine Hansen, Terri Hisel, Nitin Jain","doi":"10.1093/pm/pnae123","DOIUrl":"10.1093/pm/pnae123","url":null,"abstract":"<p><strong>Objective: </strong>To compare localized (primary) and widespread (secondary) hyperalgesia through the measurement of the pressure pain threshold (PPT) of patients with normal imaging findings, rotator cuff tear, or other pathologies.</p><p><strong>Design: </strong>This was a cross-sectional design with data collected at a single time point.</p><p><strong>Setting: </strong>This study was performed at 2 large, urban, academic medical centers.</p><p><strong>Subjects: </strong>The included participants had had chronic subacromial pain syndrome for 3 months or longer. Each participant was categorized into 1 of 3 imaging groups: normal imaging, rotator cuff tear, or other structural pathology.</p><p><strong>Methods: </strong>Primary hyperalgesia was assessed with PPT at the midsection of the painful shoulder's lateral deltoid. Secondary hyperalgesia was assessed with PPT at the contralateral tibialis anterior muscle (TA). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were performed for each objective. ANCOVA covariates included age, sex, education level, and pain duration.</p><p><strong>Results: </strong>The 103 participants included 55 males and had a median age of 55 years, a median pain duration of 14.0 months, and a median composite Shoulder Pain and Disability Index (SPADI) score of 43.1%. The ANCOVA for primary hyperalgesia showed no significant difference in square-root-adjusted deltoid PPT among imaging groups (F = 1.04, P = .3589). The ANCOVA for secondary hyperalgesia showed no significant difference in log-adjusted TA PPT among imaging groups (F = 0.24, P = .7900).</p><p><strong>Conclusions: </strong>No significant difference was observed in the analysis of ipsilateral deltoid or contralateral TA PPT among patients with differing structural shoulder pathologies. These findings suggest that the 3 types of structural shoulder abnormalities we examined are not significantly associated with differences in one measure of hyperalgesia.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID NCT03752619.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"173-179"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731397","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":"Association of opioid tapering with pain-related emergency department visits, hospitalizations, and primary care visits: a retrospective cohort study.","authors":"Elizabeth Magnan, Daniel J Tancredi, Guibo Xing, Alicia Agnoli, I E Tseregounis, Joshua J Fenton","doi":"10.1093/pm/pnae121","DOIUrl":"10.1093/pm/pnae121","url":null,"abstract":"<p><strong>Objective: </strong>Tapering of chronic opioids has increased, with subsequent reports of exacerbated pain among patients who tapered. We aimed to evaluate the association between opioid dose tapering and subsequent pain-related healthcare utilization (emergency department [ED] visits, hospitalizations and primary care visits).</p><p><strong>Design, setting, and subjects: </strong>We conducted a retrospective cohort study from years 2015-2019 using data from the Optum Labs Data Warehouse that contains de-identified retrospective administrative claims data for commercial and Medicare Advantage enrollees in the United States. Adults aged ≥18 years who were prescribed stable doses of opioids, ≥50 morphine milligram equivalents (MME)/day, during a 12-month baseline period.</p><p><strong>Methods: </strong>Tapering was defined as ≥15% relative reduction in mean daily opioid dose during one of 6 overlapping 60-day periods. Tapered patient-periods were subclassified as tapered-and-continued (MME > 0) vs tapered-and-discontinued (MME = 0). We modeled monthly counts of visits for pain diagnoses up to 12 months after cohort entry using negative binomial regression as a function of tapering, baseline utilization, and patient level-covariates.</p><p><strong>Results: </strong>Among 47 033 patients, 13 793 patients tapered. Compared to no taper, any taper was associated with more ED visits for pain (adjusted incidence rate ratio [aIRR] 1.21, 95% confidence interval [CI]: 1.11-1.30), tapered then continued status was associated with more ED visits (aIRR 1.23, CI: 1.14-1.32) and hospitalizations (aIRR 1.14, CI: 1.03-1.27) f-or pain, and tapered-and-discontinued was associated with fewer primary care visits for pain (aIRR 0.68, CI: 0.61-0.76).</p><p><strong>Conclusions: </strong>These associations suggest that opioid tapering may lead to increased emergency and hospital utilization for acute pain and possibly a decreased perceived need for primary care for those whose opioids were discontinued.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"199-206"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710619","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":"Exploring the interplay between catastrophizing and endometriosis pain through 2-wave and intensive longitudinal data.","authors":"Marcelo França Moreira, Marco Aurelio Pinho Oliveira","doi":"10.1093/pm/pnae132","DOIUrl":"10.1093/pm/pnae132","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis, characterized by the presence of endometrial-like tissue outside the uterus, results in chronic pelvic pain. However, lesion characteristics alone cannot fully explain the complexity of endometriosis-related pain. Pain catastrophizing, a cognitive process that influences pain perception, has traditionally been studied through cross-sectional or 2-wave designs, which struggle to capture its dynamic interplay with endometriosis pain. To address these gaps, our study explores the bidirectional relationship between pain catastrophizing and pain outcomes-including intensity, frequency, and flares-over a detailed 4-week period and an aggregated 30-day time frame and across sensory and affective dimensions.</p><p><strong>Methods: </strong>A latent growth curve model assessed the relationship between pain catastrophizing, initial pain levels, and endometriosis pain trajectories over 4 weeks. Additionally, 4 mediator models explored how baseline pain catastrophizing affects various pain aspects, including sensory and affective dimensions, and its subsequent influence on pain catastrophizing.</p><p><strong>Results: </strong>Results indicate that high levels of pain catastrophizing significantly escalate endometriosis pain over 4 weeks, affecting average pain intensity, episode frequency, and flares over 30 days. Pain catastrophizing also adversely impacts sensory and affective dimensions. These elements partially mediate baseline pain catastrophizing's effect on week 5 levels, revealing a bidirectional relationship. Notably, whereas the affective dimension amplifies subsequent pain catastrophizing, the sensory dimension exerts a contrasting negative association.</p><p><strong>Conclusion: </strong>The study highlights the bidirectional influence between pain catastrophizing and several aspects of endometriosis-related pain. Sensory and affective dimensions play distinct roles, with implications for personalized interventions. Limitations and clinical relevance are discussed.</p><p><strong>Trial registration: </strong>Brazilian Registry of Clinical Trials ID: U1111-1233-4802.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"207-215"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896496","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":"RE: Exploring new educational approaches in neuropathic pain: assessing accuracy and consistency of AI responses from GPT-3.5 and GPT-4.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/pm/pnae115","DOIUrl":"10.1093/pm/pnae115","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"225-226"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625667","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":"Concordance of International Classification of Diseases, 10th Edition Diagnostic Codes for Chronic Migraine without Aura with International Classification of Headache Disorders, 3rd Edition Diagnoses at a Tertiary Headache Center: a retrospective analysis.","authors":"Rishita Patlolla, Leon S Moskatel","doi":"10.1093/pm/pnaf038","DOIUrl":"https://doi.org/10.1093/pm/pnaf038","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753772","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":"https://doi.org/10.1093/pm/pnaf036","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auricular Point Acupressure for Older Adults with Chronic Low Back Pain: A Randomized Controlled Trial.","authors":"Jennifer Kawi, Chao Hsing Yeh, Nada Lukkahatai, Hulin Wu, Natalia E Morone, Ronald Glick, Elizabeth A Schlenk, Claudia Campbell, Johannes Thrul, Xinran Huang, Hongyu Wang, Hejingzi Monica Jia, Paul Christo, Constance Johnson","doi":"10.1093/pm/pnaf035","DOIUrl":"https://doi.org/10.1093/pm/pnaf035","url":null,"abstract":"<p><strong>Objective: </strong>Efficacious modalities are limited in chronic low back pain (cLBP). We determined the efficacy of auricular point acupressure (APA) in older adults with cLBP.</p><p><strong>Methods: </strong>Participants, ≥ 60 years with cLBP, were randomized (1:1:1) to APA with ear points targeted to cLBP (T-APA, n = 92), points non-targeted to cLBP (NT-APA, n = 91), or waitlist education control (n = 89), and followed up to 6 months (6M). Participants in the APA groups received 4 weekly APA sessions; the education control group received 4 weekly educational sessions. Primary outcomes were pain and function.</p><p><strong>Results: </strong>There were 272 participants (174 women [64%]; mean [SD] age 70.0 [6.95] years; 62% non-White). Compared to control, the T-APA group had significant improvement on pain from baseline to post-intervention and one-month (1M) follow-up by 1.73 and 1.26 points (p ≤ 0.001) respectively. The NT-APA group achieved similar improvements in pain. The improvement in function by T-APA and NT-APA was significant at post-intervention by 1.89 and 2.68 points (p = 0.04 and 0.004) respectively, minimal at 1M follow-up, but significant at 6M in both APA groups. There were no statistically significant differences in treatment responses between the APA groups. Both APA groups had higher responder rates in pain and function at post-intervention and 1M follow-up compared to the control group (odds ratio ranged from 2.11 to 6.32). The APA effects were sustained at 6M follow-up.</p><p><strong>Conclusions: </strong>APA treatments significantly improved pain and function compared to control; effects were sustained at 6M. APA should be recommended as a nonpharmacologic therapy for older adults with cLBP.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730835","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":"Patient-Reported Duration of Opioid Analgesic Use After Discharge from Surgical Procedures or Other Types of Acute Pain: A Scoping Review.","authors":"Candice L Collins, Karen England, Saranrat Conrad, Hannah Day, Ermias Tilahun, Gerald Dal Pan, Tamra Meyer","doi":"10.1093/pm/pnaf029","DOIUrl":"https://doi.org/10.1093/pm/pnaf029","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a scoping literature review of patient-reported duration and amount of post-discharge or outpatient opioid analgesic use for acute pain.</p><p><strong>Methods: </strong>We searched PubMed for studies, published from January 1, 2017, through June 27, 2022, describing patient-reported opioid analgesic use after discharge from surgical procedures or other types of acute pain. We abstracted and standardized information on the duration (days) and amount of use (converted to 5 mg oxycodone tablets using morphine milligram equivalents).</p><p><strong>Results: </strong>From 86 studies, we found that duration and amount of opioid analgesic use varied greatly across and within surgical procedures. For some minimally invasive procedures, a minority of patients reported using no opioids. Various factors were associated with the duration or amount of opioid analgesic use, such as preoperative opioid use. Gaps and limitations in the literature include: Few studies assessing non-surgical acute pain and certain specific surgical procedures, and methodologic differences limiting comparability across studies.</p><p><strong>Conclusions: </strong>Patient-reported data of opioid analgesic use to manage various types of acute pain helps inform opioid prescribing guidelines, but gaps across the existing literature must be carefully considered. We conclude that 1) there is wide variation in patient-reported opioid analgesic use across types of surgical procedures as well as within surgical procedures, potentially driven by patient, surgical, and institutional factors and 2) there continue to be unused tablets prescribed for many types of postsurgical pain, especially for minimally invasive procedures. In part, this work informed the April 2023 Food and Drug Administration's opioid analgesic labeling changes.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730869","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":"Lowering pain & inflammation drug costs: evaluating the impact of a cost plus drug company model.","authors":"Kaylyn Rowsey, Adam Khan, Jillian Brassfield, Matthew Rashid, Jacob Duncan, Matt Vassar","doi":"10.1093/pm/pnaf034","DOIUrl":"https://doi.org/10.1093/pm/pnaf034","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730853","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}