Pain Medicine最新文献

{"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}

{"title":"Diagnosis and Coding of Opioid Misuse: A Systematic Scoping Review and Implementation Framework.","authors":"Robert W Hurley, Khadijah T Bland, Mira D Chaskes, Elaine L Hill, Meredith C B Adams","doi":"10.1093/pm/pnaf019","DOIUrl":"10.1093/pm/pnaf019","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate current administrative coding practices for opioid misuse within the World Health Organization's International Classification of Diseases (ICD) framework and develop standardized documentation recommendations.</p><p><strong>Design: </strong>Systematic scoping review following PRISMA-ScR guidelines.</p><p><strong>Setting: </strong>Analysis of studies using administrative databases, including electronic health records, insurance claims, and national healthcare utilization databases.</p><p><strong>Subjects: </strong>Studies published in peer-reviewed journals examining administrative codes for opioid misuse, excluding those focused solely on illicit drugs, opioid use disorder, or using only natural language processing/qualitative methods.</p><p><strong>Methods: </strong>Comprehensive search of Embase, Medline, Google Scholar, and PubMed databases following PRISMA-S extension guidelines. Three independent reviewers screened articles and extracted data. Study quality was assessed using a modified Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Of 9,561 initial records, 19 studies met inclusion criteria. The use of ICD-10 code F11.9* (Opioid use) emerged as the most referenced method for documenting opioid misuse, distinguishing it from opioid use disorder methods (F11.1, opioid abuse; F11.2, opioid dependence). Studies demonstrated significant heterogeneity in coding practices, resulting in code-based definitions identifying only approximately 50% of cases compared to more comprehensive clinical assessment approaches.</p><p><strong>Conclusions: </strong>While ICD-10 code F11.9* can effectively document opioid misuse as distinct from opioid use disorder, successful implementation requires consensus on the clinical definition of opioid misuse and documentation in the form of clear clinical guidelines and operationalized through enhanced electronic health record integration. Future research should focus on validating these approaches across diverse healthcare settings.</p>","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":"143557466","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":"https://doi.org/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 lifetime. 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>35 patients with chronic shoulder pain 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 SSN, AN, and LPN. Treatment response was assessed using 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 post-cRFA. Patient characteristics were compared between responder and non-responder to cRFA treatment and correlation analyses were conducted to explore the relationship between pain relief and functional improvement.</p><p><strong>Results: </strong>NRS pain levels significant decreased at 1 month (Adj. P < 0.0001), 3 month (Adj. P < 0.0001) and 6 month (Adj. P = 0.0002) post-icRFA, respectively. ASES score improved at 1 months (Adj. P < 0.0001), 3 month (Adj. P < 0.0001), and 6 months (Adj. P < 0.0001) post-icRFA, respectively. Flexion AROM improved at 1 months (Adj. P < 0.0001), 3 months (Adj. P < 0.0001), and 6 months (Adj. P = 0.0139) post-icRFA, respectively. Abduction AROM improved at 1 months (Adj. P < 0.0001), 3 months (Adj. P < 0.0001), and 6 months (P < 0.0001) post-RFA, respectively.</p><p><strong>Conclusion: </strong>cRFA 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 shoulder for at least 6 months.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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 01/01/2010 and 30/06/2016, with a follow-up period of 3.5 years (data censoring on 31/12/2020) across Victoria. Trajectory modelling 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 (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":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/10.1093/pm/pnaf015","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","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}