Pain Medicine最新文献

{"title":"Topical analgesics for neuropathic pain: An Evidence-Informed guide for the practicing clinician.","authors":"Erin Lawson, Priyanka Singla, Jeremy Adler, Charles E Argoff, Jeffrey J Bettinger, Arun Bhaskar, Hance Clarke, Anthony Eidelman, Salman Hirani, W Michael Hooten, Jordan Tishler, Mark S Wallace, Antje M Barreveld","doi":"10.1093/pm/pnaf130","DOIUrl":"https://doi.org/10.1093/pm/pnaf130","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate available evidence regarding efficacy and safety of topical analgesics for neuropathic pain and offer treatment guidance.</p><p><strong>Methods: </strong>An expert panel searched PubMed (Medline) and reference lists of published articles for available literature assessing 8 categories of topical analgesics used to treat various neuropathic pain conditions. The panel rated the level of analgesic efficacy evidence for each treatment and considered safety, ease of use, and cost. Degree of consensus among panelists regarding recommendations was measured.</p><p><strong>Results: </strong>There was strong evidence and high consensus that capsaicin 8% is effective for diabetic peripheral neuropathy and postherpetic neuralgia, and lidocaine is effective for postherpetic neuralgia. There was strong evidence and moderate consensus that capsaicin 8% may be effective for HIV-induced neuropathy. There was moderate evidence and high consensus that lidocaine is likely effective for diabetic peripheral neuropathy, idiopathic neuropathy, and post-surgical neuropathy and that capsaicin 8% may be effective for chemotherapy-induced peripheral neuropathy and complex regional pain syndrome. Evidence was weak for other topical medications, though the panel strongly agreed that antidepressants may help with postherpetic neuralgia, complex regional pain syndrome, post-surgical neuropathy, and post-traumatic neuropathy; that non-steroidal anti-inflammatory drugs may help with post-surgical neuropathy; and that gabapentin may benefit vulvodynia. There was less agreement whether antidepressants may benefit diabetic peripheral neuropathy, chemotherapy-induced peripheral neuropathy, and vulvodynia and whether capsaicin 8% could be effective for post-surgical neuropathy.</p><p><strong>Conclusions: </strong>Recommendations were based on a survey and grading of existing literature and, when strong evidence was lacking, the collective clinical expertise of panelists.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186452","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":"Quantitative Sensory Testing of Pain in Persons with Opioid Use Disorder on Opioid Agonist Treatment: A Scoping Review.","authors":"Debora Oliveira, Gabriel P A Costa, Rodrigo Fontenele, Mateo A Córdoba-Delgado, Melissa C Funaro, Claudia M Campbell, David A Fiellin, Gustavo A Angarita, Joao P De Aquino","doi":"10.1093/pm/pnaf132","DOIUrl":"https://doi.org/10.1093/pm/pnaf132","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the use of quantitative sensory testing (QST) in assessing pain responses and mechanisms among individuals with opioid use disorder (OUD) receiving opioid agonist treatment (OAT).</p><p><strong>Design: </strong>Scoping review following PRISMA-ScR guidelines.</p><p><strong>Setting: </strong>Systematic literature search across five major databases.</p><p><strong>Subjects: </strong>Studies investigating QST outcomes in adults with OUD receiving OAT (methadone, buprenorphine, or other opioid agonists) with or without co-occurring chronic pain.</p><p><strong>Methods: </strong>We searched Ovid MEDLINE, Embase, APA PsycINFO, Cochrane Library, and Web of Science from inception through March 2025. Eligible studies included original research employing QST methodologies in adults with OUD receiving OAT. Data extraction focused on study characteristics, QST methodologies, and pain-related outcomes.</p><p><strong>Results: </strong>Of 45 included studies, 64.4% employed cross-sectional designs with limited protocol standardization. Static QST measures predominated, with thermal stimuli most common. The most consistent finding was reduced cold pain tolerance in individuals with OUD compared to controls (60% of studies). Dynamic QST measures (3 studies) revealed altered pain modulation suggestive of central sensitization. Pain processing abnormalities frequently persisted despite prolonged abstinence from non-OAT opioids, suggesting lasting neuroadaptive changes. Methodological heterogeneity and inconsistent reporting of clinical variables limited synthesis.</p><p><strong>Conclusions: </strong>QST demonstrates potential for enhancing clinical understanding of pain mechanisms in individuals receiving OAT. Future research should prioritize protocol standardization, longitudinal designs tracking pain sensitivity changes, and exploration of QST's predictive value for treatment responses to facilitate clinical integration.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131599","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":"Pudendal Nerve Compression by Mucoid Cyst.","authors":"Rayan Fawaz, François Gouin, Aicha Ltaief-Boudrigua, Manon Duraffourg","doi":"10.1093/pm/pnaf126","DOIUrl":"https://doi.org/10.1093/pm/pnaf126","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092218","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":"If you build it, they might come: Lessons learned from the development of a digital intervention for chronic pain.","authors":"Susan E Jarquin, Benedict J Alter, Brian O'Connell, Rebecca S DeSensi, Megan Kenney, Andrew Watson, Ajay D Wasan","doi":"10.1093/pm/pnaf128","DOIUrl":"10.1093/pm/pnaf128","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092297","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":"Nitazenes: Are Pain Physicians Aware of the Risks?","authors":"Ryan Mortman, Shravani Durbhakula, Trent Emerick","doi":"10.1093/pm/pnaf127","DOIUrl":"https://doi.org/10.1093/pm/pnaf127","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092284","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":"Trauma-responsive pain management: A survey of patient characteristics and preferences.","authors":"Hallie Tankha, Jolin B Yamin, Shoshana Krohner, Amanda J Shallcross","doi":"10.1093/pm/pnaf121","DOIUrl":"https://doi.org/10.1093/pm/pnaf121","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030251","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":"Sensorimotor Cortical Integration Remains Unchanged After Dorsal Root Ganglion Pulsed Radiofrequency.","authors":"Ahmet Başarı, Çağrı Cansu, İlker Arslan, Güngör Enver Özgencil, Hanzade Aybüke Ünal, Hasan Kılınç, Bülent Cengiz","doi":"10.1093/pm/pnaf125","DOIUrl":"https://doi.org/10.1093/pm/pnaf125","url":null,"abstract":"<p><strong>Background: </strong>Dorsal root ganglion (DRG) pulsed radiofrequency (PRF) is a minimally invasive neuromodulation technique used for the management of chronic radicular pain. While its analgesic effects are well-documented, its impact on sensorimotor integration at the cortical level remains unclear. This study aimed to investigate whether DRG PRF modulates sensorimotor integration via the cholinergic system using the Short-Latency Afferent Inhibition (SAI) paradigm.</p><p><strong>Methods: </strong>This prospective, two-center study included 30 patients with chronic lumbosacral radicular pain who underwent DRG PRF at the L4-5 and L5-S1 levels. SAI was assessed using paired electrical stimulation of the tibial nerve and transcranial magnetic stimulation (TMS) of the motor cortex before and two weeks after DRG PRF. SAI measurements were conducted at three interstimulus intervals (ISIs: -2 ms, 0 ms, +2 ms of N20 latency). Data were analyzed using repeated measures ANOVA and paired t-tests.</p><p><strong>Results: </strong>The SAI paradigm confirmed significant sensorimotor inhibition at baseline in all three ISIs (p < 0.001). However, no statistically significant difference was found between pre- and post-DRG PRF SAI values at any ISI (p > 0.05). These results suggest that DRG PRF did not significantly modulate cholinergic-driven sensorimotor integration in lower limbs.</p><p><strong>Conclusion: </strong>DRG PRF effectively reduces pain in chronic radicular pain patients, but its effect on cortical cholinergic modulation, as measured by SAI, appears to be limited. This finding suggests that DRG PRF primarily exerts its effects through non-cholinergic mechanisms, such as GABAergic, glutamatergic, or noradrenergic pathways. Further studies are warranted to clarify the broader neurophysiological effects of DRG PRF.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006469","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":"A Novel Low-Profile Self-Expanding Epidural Lead Array System that is Fully Collapsible, Deployable, and Retrievable.","authors":"Hassan Beheshti Seresht, Trent D Emerick, Gaurav Chauhan, Mohamed S Ibrahim, Youngsoo Jung, Jung-Kun Lee, Youngjae Chun","doi":"10.1093/pm/pnaf124","DOIUrl":"https://doi.org/10.1093/pm/pnaf124","url":null,"abstract":"<p><strong>Objective: </strong>Introduced in 1970s, Spinal Cord Stimulator (SCS) devices have played a crucial role in managing a wide range of complex and refractory chronic pain, particularly back/leg pain as well as neuropathic pain. Currently, two primary types of leads, cylindrical and paddle leads, are prevalent in pain management. While both effectively alleviate pain, cylindrical leads, due to their small size, are susceptible to movement and migration as well as a smaller surface area for coverage, leading to device displacement and failure to provide pain relief. On the other hand, paddle leads offer a larger surface area and secure placement but require a relatively large incision for device insertion. To address the limitations of existing SCS devices, a novel SCS device has been developed with a low-profile, deployable, and retrievable design based on the human epidural anatomy.</p><p><strong>Methods and results: </strong>A prototype SCS has been successfully designed, fabricated, and tested in vitro. This innovative design features a laser-trimmed nitinol mesh structure as the self-expanding deployable frame, an ultrathin ePTFE membrane isolating the conductive metallic frame, and platinum-iridium materials which can be seamlessly integrate with an external battery pack for the delivery of efficient electrical potential. The anatomical nitinol mesh frame allows the entire device to collapse into a size smaller than that of a 14-gauge needle (1.5-1.6 mm in diameter) and its corresponding delivery sheath. Additionally, mechanical and electrochemical tests were carried out to assess the performance of the developed device. The mechanical tests demonstrated the backbone's ability to expand within the epidural space. Similarly, electrochemical tests on the electrodes underscored that the selected materials were indeed appropriate.</p><p><strong>Conclusion: </strong>This novel SCS design effectively prevents device dislocation and migration showing great wall apposition while providing a larger surface area for pain management. These results support its potential as a next-generation platform for effective chronic pain management.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993089","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":"Persistent Pain Post Lumbar Spinal Surgery: A Diagnostic Framework for the Non-Operative Clinician.","authors":"Katharine A Smolinski, W Ryan Spiker, Zachary L McCormick, Aaron M Conger","doi":"10.1093/pm/pnaf123","DOIUrl":"https://doi.org/10.1093/pm/pnaf123","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964053","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 Effectiveness of Basivertebral Nerve Radiofrequency Ablation for the Treatment of Vertebrogenic Low Back Pain: 1-Year Results of a Prospective Real-World Cohort Study.","authors":"Zachary L McCormick, Alexandra E Fogarty, Aaron Conger, Taylor Burnham, Richard Kendall, Blake A Dickenson, Napatpaphan Kanjanapanang, Timothy M Curtis, Hasan Sen, Allison Glinka Przybysz, Tyler Clark, Katharine Smolinski, Graham Wagner, Masaru Teramoto, Amanda N Cooper","doi":"10.1093/pm/pnaf122","DOIUrl":"https://doi.org/10.1093/pm/pnaf122","url":null,"abstract":"<p><strong>Summary of background data: </strong>Multiple clinical trials have demonstrated the effectiveness of intraosseous basivertebral nerve radiofrequency ablation (BVNA) for treating vertebrogenic chronic low back pain (vLBP). Few studies have evaluated the effectiveness in a real-world population.</p><p><strong>Objectives: </strong>Evaluate the effectiveness of BVNA for vLBP in a real-world population.</p><p><strong>Methods: </strong>Single-arm prospective cohort study of patients with LBP ≥6 months and Type 1 or 2 Modic changes on MRI. The primary outcome was mean improvement in Oswestry Disability Index (ODI) post-BVNA. Secondary outcomes included the proportion of participants with (1) ≥30% and ≥15-point ODI improvements, (2) ≥2-point and ≥50% reductions in pain on Numerical Rating Scale (NRS), and (3) ≥ \"much improved\" on Patient Global Impression of Change (PGIC) at 3- and 12-month follow-up.</p><p><strong>Results: </strong>60 participants were included (mean age 57.0 ± 13.4 years; 45.0% female). Mean ODI score improvement was 13.9 ± 18.7 and 14.0 ± 15.7 points at 3- and 12-month follow-up, respectively. At 12-months, 52.8% (95%CI: 39.7-65.6) of participants reported ≥30% ODI improvement, and 39.6% (95%CI: 27.6-53.1) of participants reported ≥15-point improvement in ODI. 12-month responder rates for ≥2-point and ≥50% NRS improvement were 67.9% (95%CI: 54.5-78.9) and 49.1% (95%CI: 36.1-62.1). 54.7% (95%CI: 41.5-67.3) of participants reported being \"much or very much improved\" on the PGIC at 12 months.</p><p><strong>Discussion/conclusion: </strong>In this real-world cohort, over half of participants with vLBP experienced clinically meaningful improvements in pain and function at 12-months post-BVNA.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964135","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}