Pain Medicine最新文献

{"title":"Predicting adherence and clinical response of cognitive behavioral therapy among individuals with chronic low back pain plus depressive symptoms: A secondary analysis of a randomized controlled trial.","authors":"Juan P Sanabria-Mazo, Estíbaliz Royuela-Colomer, Jaime Navarrete, Carla Rodríguez-Freire, Brenda Robles, Lance M McCracken, Albert Feliu-Soler, Juan V Luciano","doi":"10.1093/pm/pnaf020","DOIUrl":"https://doi.org/10.1093/pm/pnaf020","url":null,"abstract":"<p><strong>Background: </strong>Identifying predictors for adherence and clinical response to psychological therapies is essential for improving individual treatment outcomes.</p><p><strong>Objective: </strong>To explore predictors of adherence and clinical response among individuals with co-occurring chronic low back pain (CLBP) and depression receiving cognitive behavioral therapy (CBT).</p><p><strong>Methods: </strong>This study employs a secondary analysis of data from a randomized controlled trial (NCT04140838), including 156 individuals with CLBP plus depressive symptoms who received CBT. Multiple linear regression analyses were conducted to assess the predictive power of sociodemographic, health status, pain-related, and therapy-related variables on adherence and clinical response. Adherence was measured by therapy progress (number of completed sessions) and therapy completion (attendance at least six out of eight sessions). Clinical response was assessed by a clinically relevant reduction in posttreatment pain interference.</p><p><strong>Results: </strong>Older age, higher therapy credibility, and higher education level predicted greater therapy progress, while higher therapy credibility and lower baseline stress levels predicted greater therapy completion. In addition, higher opioid use, baseline pain interference, and baseline depression levels predicted lower clinical response; in contrast, higher behavioral activation levels, older age, and unemployment predicted higher clinical response.</p><p><strong>Conclusion: </strong>Therapy credibility, age, and education level are key predictors of adherence, and baseline levels of pain interference, depression, and behavioral activation are key predictors of clinical response. These findings may inform opportunities to develop more effective personalized therapeutic plans for individuals with CLBP and depression.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597415","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":"Efficacy of a natural herbal topical analgesic versus oral paracetamol in patients with soft tissue injury. A randomized, double-blind, placebo-controlled study.","authors":"Marwa Toumia, Randa Dhaoui, Sarra Sassi, Cyrine Kouraichi, Khaoula Bel Haj Ali, Adel Sekma, Arij Bakir, Rahma Jaballah, Hajer Yaakoubi, Rym Youssef, Asma Zorgati, Kaouthar Beltaief, Zied Mezgar, Mariem Khrouf, Amira Sghaier, Nahla Jerbi, Imen Zemni, Wahid Bouida, Mohamed Habib Grissa, Jamel Saad, Hamdi Boubaker, Riadh Boukef, Mohamed Amine Msolli, Semir Nouira","doi":"10.1093/pm/pnaf006","DOIUrl":"https://doi.org/10.1093/pm/pnaf006","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the effectiveness and tolerability of a phytotherapeutic topical gel (Douloff®) compared to oral paracetamol for acute pain resulting from minor limb soft tissue injuries.</p><p><strong>Methods: </strong>A prospective, multicenter, randomized, double-blind study conducted over 13 months in three EDs. Patients aged 18 years and older, with minor limb soft tissue injuries, were randomized into Douloff® (n = 765) and paracetamol (n = 750) groups. The primary outcome was the pain resolution rate (reduction of at least 50% of pain intensity, measured by the numeric rating scale (NRS) on active motion at day-7compared to NRS at discharge). Secondary outcomes included time to pain resolution, rescue analgesia, patient satisfaction and adverse events.</p><p><strong>Results: </strong>The groups were comparable in terms of baseline characteristics. On day-7, resolution of pain was observed in 641 patients (83.7%) in Douloff® group versus 535 patients (71.3%) in paracetamol group (OR 1.27; 95% CI 1.015-1.6; p = 0.02). Median time to reach pain resolution was 4.5 ± 2.9 days in Douloff® group compared with 5.6 ± 3.3 days in paracetamol group (p < 0.001). Patients in Douloff® group required less rescue analgesics (48.2%) compared to paracetamol group (59.1%) (-10.9%, 95% CI -15.89 to -5.9; p < 0.001). No major adverse events were observed in either group, and 89.4% of patients in Douloff® group were satisfied, compared to 92.5% in the paracetamol group (p < 0.001).</p><p><strong>Conclusion: </strong>Douloff®, a topical herbal paste, is superior to oral paracetamol in the management of acute pain related to soft tissue injuries. It can be considered as an alternative to conventional analgesics.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567778","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 NIH HEAL pain common data elements (CDE): a great start but a long way to the finish line.","authors":"Meredith C B Adams, Afton L Hassett, Daniel J Clauw, Robert W Hurley","doi":"10.1093/pm/pnae110","DOIUrl":"10.1093/pm/pnae110","url":null,"abstract":"<p><strong>Background: </strong>The National Institutes of Health (NIH) Pain Common Data Elements (CDEs) provide a standardized framework for pain research, but their implementation and interpretation present challenges.</p><p><strong>Objectives: </strong>To review the NIH CDE Program's selected pain domains, provide best practices for implementing required questions, and offer a checklist for appropriate CDE use in clinical trials and secondary data analysis. This work analyzed the 10 core pain research domains selected by the NIH CDE Program and discuss their limitations and considerations for use.</p><p><strong>Results: </strong>The manuscript provides an overview of the 10 core pain research domains, including pain intensity, interference, physical function, sleep, catastrophizing, depression, anxiety, global impression of change, substance use screening, and quality of life. It offers sample scenarios for implementing required questions and presents a checklist to guide researchers in using pain CDEs effectively for clinical trials and secondary data analysis.</p><p><strong>Conclusion: </strong>Key challenges identified include contextual variability, lack of validation across all pain conditions and populations, and potential misuse or misinterpretation of measures. This work proposes solutions such as supplementary measures, context-specific guidance, comprehensive training programs, and ongoing refinement of the CDE framework. While NIH Pain CDEs are valuable tools for standardizing pain assessment in research, addressing challenges in their implementation and interpretation is crucial for improving the consistency, validity, and interpretability of pain research data, ultimately advancing the field and enhancing patient care.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"146-155"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569227","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":"Single arm feasibility trial of a mobile application for adolescent migraine management.","authors":"Amy E Noser, Abigail S Robbertz, James Peugh, Marielle Kabbouche, Joanne Kacperski, Scott W Powers, Andrew D Hershey, Kevin A Hommel","doi":"10.1093/pm/pnae111","DOIUrl":"10.1093/pm/pnae111","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"170-172"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581895","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":"Enhancing early career development in pain medicine: the comprehensive role of mentorship.","authors":"Yashar Eshraghi, Meredith Barad, Scott Pritzlaff, Trent Emerick, Sayed Wahezi, Magdalena Anitescu, Lynn Kohan","doi":"10.1093/pm/pnae128","DOIUrl":"10.1093/pm/pnae128","url":null,"abstract":"<p><p>Mentorship plays a vital role in pain medicine, guiding professionals from medical training through independent practice. This article explores how mentorship fosters research, enhances clinical competence, and promotes multidisciplinary collaboration. Drawing on insights from leading institutions, we propose a structured mentorship framework tailored to different career stages. Effective mentorship cultivates research skills, expands academic networks, and provides early exposure to the field, shaping long-term career trajectories. It also strengthens clinical expertise, encourages cross-disciplinary collaboration, and advances diversity, equity, and inclusion in medicine. Structured academic mentorship models offer longitudinal guidance for sustained professional development. By aligning mentor-mentee goals and ensuring consistent support, mentorship programs maximize professional growth and ultimately improve patient outcomes. This article outlines key strategies and tools for building effective mentorship programs, emphasizing their transformative impact on the field of pain medicine.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"129-130"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847293","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":"Focused anatomic review: ultrasound-guided peripheral nerve stimulation of the sciatic, posterior tibial, and obturator nerves.","authors":"James S Cho, Alanah Grisham, Annette Wang, Rafael Vazquez, Charles Kelly, Pascal Scemama, David Hao","doi":"10.1093/pm/pnae127","DOIUrl":"10.1093/pm/pnae127","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"166-169"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824278","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 Q2 approach for percutaneous peripheral neuromodulation stimulator implantation targeting the C2 dorsal root ganglion at the C2 lamina for treatment of intractable headache: a technical note.","authors":"QiLiang Chen, Xiang Qian","doi":"10.1093/pm/pnae113","DOIUrl":"10.1093/pm/pnae113","url":null,"abstract":"<p><strong>Objectives: </strong>Despite significant medical treatment advancements, interventional treatments for intractable headache disorders are limited. This study's objective is to detail a novel percutaneous approach (the \"Q2 approach\") and its technical considerations for implanting peripheral neuromodulation stimulators (PNS) to the C2 dorsal root ganglion (C2-DRG) at the C2 lamina, a previously unattempted target, as a treatment for intractable headache.</p><p><strong>Methods: </strong>In an outpatient setting, under combined ultrasound and fluoroscopic guidance, PNS electrodes were percutaneously implanted at the C2-DRG in patients under moderate sedation. The final electrode position was determined by intraoperative patient feedback to ensure optimal stimulation. Four patients were included to demonstrate technical parameters and feasibility. Follow-ups were conducted on postoperative days 10, 30, 60, and 100-120.</p><p><strong>Results: </strong>The Q2 approach allows safe C2-DRG PNS implantations in an outpatient setting. Average operative duration was <60 minutes. All 4 patients achieved >50% pain relief during the 60-day implant period, and 3 of 4 demonstrated sustained benefit beyond the implant period. No complications (eg, lead migration, infection) were observed.</p><p><strong>Conclusions: </strong>The present technical note demonstrates the feasibility of a novel, safe, minimally invasive approach to access the C2-DRG at the C2 lamina for the treatment of intractable headaches. The use of PNS on the C2-DRG fills an important gap in headache management, as it provides an alternative neuromodulation treatment modality to the existing destruction/denervation-based techniques.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"140-145"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625674","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":"Proinflammatory diet is associated with higher pain, disease severity and biochemical parameters associated with inflammation in fibromyalgia.","authors":"Nursena Ersoy Söke, Hansa İnceöz, İlker Solmaz, Hülya Yardımcı","doi":"10.1093/pm/pnae118","DOIUrl":"10.1093/pm/pnae118","url":null,"abstract":"<p><strong>Objective: </strong>Fibromyalgia, which is becoming increasingly common today, affects the quality of life of those affected. The aim of this study was to investigate the relationship between diet and pain, disease severity, and biochemical parameters in fibromyalgia.</p><p><strong>Design: </strong>Cross-sectional design using validated questionnaires.</p><p><strong>Setting: </strong>Fibroyalgia patients with Traditional and Complementary Medicine clinics.</p><p><strong>Subject: </strong>In total, 84 patients with fibromyalgia (FM), which was diagnosed by a rheumatologist.</p><p><strong>Methods: </strong>The cross-sectional study was conducted with 84 fibromyalgia patients in Turkey. The Dietary Inflammatory Index (DII) was calculated by a 24-hour diet recall. Self-reported pain levels and disease severity were evaluated by the Visual Analog Scale (VAS) and a Revised Fibromyalgia Impact Questionnaire (FIQR), respectively. Antropometric measures and biochemical parameters associated with inflammation were also evaluated.</p><p><strong>Results: </strong>Linear regression analysis revealed that the VAS pain score [β (95% confidence interval [CI])=1.72 (0.90-2.55), P < .001], FIQ-R [β (95% CI)=5.62 (0.14-11.09), P < .001] and uric acid/creatinine ratio [β (95% CI)=0.21 (-0.10 to 0.52), P < .001] were positively associated with the DII after adjustments for body mass index (BMI), body fat, fat free mass, cholesterol, fiber, caroten, iron, magnesium, vitamine C reported by the patients with FM.</p><p><strong>Conclusions: </strong>A pro-inflammatory diet was associated with higher pain, disease severity and uric acid/creatinine ratio in patients with FM.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"131-139"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681039","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":"The intersectionality of chronic pain stigma and racial discrimination in Black and White adults with chronic low back pain.","authors":"Jenna M Wilson, Staja Q Booker, Burel R Goodin, Pavithra A Thomas, Robert E Sorge, Tammie L Quinn, Matthew C Morris, Edwin N Aroke, Samantha M Meints","doi":"10.1093/pm/pnae114","DOIUrl":"10.1093/pm/pnae114","url":null,"abstract":"<p><strong>Objective: </strong>We examined the intersection between chronic pain stigma and racial discrimination, separately among Black and White US adults with chronic low back pain.</p><p><strong>Methods: </strong>Participants completed measures of chronic pain stigma, lifetime experiences of racial discrimination, pain severity and interference. A composite variable representing the intersectionality of stigma and discrimination was created, and Black and White participants were separately categorized into 4 groups. Black participants were categorized as: (1) high discrimination/high stigma, (2) high discrimination/low stigma, (3) low discrimination/high stigma, and (4) low discrimination/low stigma. White participants were categorized as: (1) any discrimination/high stigma, (2) any discrimination/low stigma, (3) no discrimination/high stigma, and (4) no discrimination/low stigma.</p><p><strong>Results: </strong>Black participants reported more frequent experiences of racial discrimination than White participants (P < .05), but there was not a racial difference in chronic pain stigma (P > .05). Among Black participants, those in the high discrimination/high stigma and low discrimination/high stigma groups reported greater pain severity and interference than those in the high discrimination/low stigma and low discrimination/low stigma groups (P < .05). Among White participants, those in the any discrimination/high stigma group reported greater pain severity and interference than those in the no discrimination/low stigma group (P < .05), but there were no differences in pain severity or interference between the any discrimination/no stigma and no discrimination/high stigma groups (P > .05).</p><p><strong>Conclusion: </strong>Our findings suggest that the relationship of intersectional chronic pain stigma and racial discrimination with pain is nuanced and differs across racial groups.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"156-165"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625672","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":"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":"https://doi.org/10.1093/pm/pnaf018","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","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}