Pain Medicine最新文献

{"title":"Impact of GLP-1 Receptor Agonists on Chronic Low Back Pain in Patients with Obesity: A Prospective Pilot Cohort Study.","authors":"Braeden Benedict, Dyan White-Gilliam, Aryan Pradhan, Salim Yakdan, Ahmad Hammo, Lucas Budd, Faraz Arkam, Simon Y Tang, Kenneth B Schechtman, Abby L Cheng, Susan Robinson Reeds, Burel R Goodin, Jacob K Greenberg","doi":"10.1093/pm/pnag121","DOIUrl":"10.1093/pm/pnag121","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977658","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 Multidimensional Assessment of Central Sensitization and Pain in Lipedema: Associations with Sleep and Quality of Life in a Case-Control Study.","authors":"Berna Orhan, Aslı Turan, Sibel Unsal Delialioglu, Oyku Isik, Meltem Dalyan","doi":"10.1093/pm/pnag120","DOIUrl":"https://doi.org/10.1093/pm/pnag120","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively characterize pain in women with lipedema and evaluate its relationship with central sensitization, neuropathic pain characteristics, pain sensitivity, sleep quality, and quality of life.</p><p><strong>Design: </strong>: A cross-sectional controlled study.</p><p><strong>Setting: </strong>Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital.</p><p><strong>Subjects: </strong>59 women with Type 2-3, Stage 1-3 lipedema and 59 age-matched healthy controls.</p><p><strong>Methods: </strong>Pain intensity, neuropathic pain characteristics, symptoms related to central sensitization, pain catastrophizing, sleep quality, health-related quality of life, and pressure pain thresholds were assessed using validated questionnaires and pressure algometry.</p><p><strong>Results: </strong>Compared with healthy controls, women with lipedema had significantly higher pain intensity, painDETECT, Central Sensitization Inventory, pain catastrophizing, and sleep disturbance scores, whereas pressure pain thresholds and all Short Form-36 domain scores were significantly lower (all p < 0.001). Clinically significant symptoms related to central sensitization (Central Sensitization Inventory ≥40) were present in 78.0% of patients versus 8.5% of controls. These associations remained significant after adjustment for age and body mass index. Although pain intensity, painDETECT scores, and pressure pain thresholds were associated with disease stage, Central Sensitization Inventory scores were not.</p><p><strong>Conclusions: </strong>Pain in lipedema extends beyond local adipose tissue changes and is associated with widespread pain sensitivity, symptoms related to central sensitization, impaired sleep, pain catastrophizing, and reduced quality of life. These findings support a multidimensional approach to pain assessment in lipedema.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970423","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":"Facial pain in patients with hemifacial spasm: A prospective cohort study.","authors":"Miriam Carvalho Soares, Mariana de Almeida Cruz Silva, Clélia Maria Ribeiro Franco, Pedro Augusto Sampaio Rocha-Filho","doi":"10.1093/pm/pnag119","DOIUrl":"https://doi.org/10.1093/pm/pnag119","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and clinical characteristics of facial pain in patients with primary hemifacial spasm (HFS), identify factors associated with its occurrence, and evaluate its longitudinal course following botulinum toxin type A (BoNT-A) treatment.</p><p><strong>Design: </strong>Prospective cohort study with 4 months of follow-up.</p><p><strong>Setting: </strong>Tertiary public referral center.</p><p><strong>Subjects: </strong>Eighty-seven adults with primary HFS receiving BoNT-A treatment. Median age was 66 years, 71.3% were women, and median disease duration was 13 years (IQR 8-20).</p><p><strong>Methods: </strong>Participants underwent standardized assessment using a semi-structured questionnaire, Visual Analog Scale, McGill Pain Questionnaire, facial pain diary, Hospital Anxiety and Depression Scale, and Hemifacial Spasm Grading Questionnaire. Clinical characteristics and factors associated with facial pain were analyzed, and pain outcomes were assessed longitudinally following BoNT-A treatment.</p><p><strong>Results: </strong>Facial pain was present in 40.2% of patients, predominantly involving the periorbital region (77.1%) and occurring ipsilateral to the spasm (85.7%). Median pain frequency was 5 days/month (IQR 3-15), intensity 6/10 (IQR 5-8), and duration 5 hours (IQR 1-20). In multivariable analysis, facial pain was independently associated with female sex (OR 3.47, 95% CI 1.00-11.97; p = 0.049) and greater subjective disease burden, measured by the HFS Global Subjective score (OR 1.01, 95% CI 1.00-1.03; p = 0.034), but not with objective motor severity. Although 88.2% of patients reported subjective improvement after BoNT-A, objective pain measures remained unchanged during follow-up.</p><p><strong>Conclusions: </strong>Facial pain is a frequent non-motor manifestation of HFS, affecting approximately 40% of patients. Its association with greater subjective disease burden, but not objective motor severity, suggests that pain represents a clinically relevant dimension of HFS not captured by motor assessment alone. Routine assessment of facial pain should therefore be incorporated into the comprehensive clinical evaluation of patients with HFS.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920626","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":"Assessment and Treatment of Acute Low Back Pain: A Multidisciplinary Clinical Practice Guideline.","authors":"Andrea C Skelly, Devan Kansagara, Jessica Oswald, Roger Chou","doi":"10.1093/pm/pnag110","DOIUrl":"https://doi.org/10.1093/pm/pnag110","url":null,"abstract":"<p><strong>Purpose: </strong>To create an evidence-based guideline for the evaluation and management of acute low back pain.</p><p><strong>Methods: </strong>A multidisciplinary guideline development group formulated recommendations based on systematic review (PROSPERO Registration 537276) of evidence and using a protocol based on the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) working group methodology.</p><p><strong>Intended users and settings: </strong>Clinicians providing care to individuals presenting with acute low back pain (<6 weeks duration) with or without radiculopathy in outpatient settings.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881195","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":"Does the National Resident Matching Program Rank List Predict Accreditation College of Graduate Medical Education Trainee Performance Among Multispecialty Pain Medicine Fellows? A Multicenter Study.","authors":"Steven P Cohen, Oludare O Olatoye, Peter Schumaker, Dalia Elmofty, Heejung Choi, Bhavana Yalamuru, Lynn R Kohan","doi":"10.1093/pm/pnag117","DOIUrl":"https://doi.org/10.1093/pm/pnag117","url":null,"abstract":"<p><strong>Background: </strong>Training programs seek to match fellows who will perform well during training. The National Resident Matching Program (NRMP) allows programs to choose the most capable trainees, with higher ranked applicants expected to perform better. Pain medicine is one of the most popular non-internal medicine fellowships in the U.S., and multiple specialty pathways for entry make selecting candidates challenging.</p><p><strong>Objective: </strong>The aim of this study is to correlate fellow rank order and match number with academic performance.</p><p><strong>Methods: </strong>Match information and fellow performance from 4 highly-ranked multispecialty pain programs was obtained with performance evaluated based on the 6 final Accreditation Council for Graduate Medical Education (ACGME) core competencies. The primary analysis correlated each fellow's relative rank-list position with relative subsequent ACGME performance within the same institution and fellowship cohort using cohort-relative percentile ranks, Spearman correlation, stratified permutation testing, and stratified bootstrap confidence intervals. Sensitivity and exploratory analyses used absolute/converted match-number fixed-effects regression, Kendall Tau-B, sex stratification, and domain-specific correlations with false discovery rate adjustment.</p><p><strong>Results: </strong>The primary analysis included 93 fellows across 20 institution/cohort strata. Rank-list standing was not significantly associated with ACGME performance (Spearman r = 0.06; 95% CI, -0.19 to 0.32; p = 0.63), and sensitivity, sex-stratified, and domain-specific analyses were also nonsignificant. When stratified according to top-, middle- and bottom-ranked applicants, all domains were significant with bottom-ranked fellows faring worse than other groups.</p><p><strong>Conclusions: </strong>Pain medicine rank lists correlate poorly with fellowship performance, though a weak association was noted wherein bottom-ranked applicants performed worse. This suggests that either the metrics used to rank pain medicine applicants and/or those used to measure performance require modification.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875365","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":"Cost savings and quality-of-life gains associated with the use of an AI-powered digital tool for self-management of chronic pain based on a multicenter cohort study.","authors":"Sara Olofsson, Maria L Rosén Klement, Antje M Barreveld, Neel Mehta, Ulf Persson, Carl A K Borrebaeck","doi":"10.1093/pm/pnag061","DOIUrl":"10.1093/pm/pnag061","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a highly prevalent disease, leading to high health care costs, impaired productivity, and decreased quality of life. An artificial intelligence (AI)-powered digital tool for self-management (PaindrainerTM) has been shown to be an effective treatment in chronic pain and could have potential to reduce the burden on costs and quality of life.</p><p><strong>Objective: </strong>The objective of this study was to estimate the cost savings and quality-of-life gains associated with the use of an AI-powered digital tool for self-management of chronic pain. The study is a subsequent health economic analysis of previously published data.</p><p><strong>Method: </strong>Resource use and quality-of-life data were derived from a 1-arm, multicenter study in the United States. Differences between baseline and follow-up (6 and 12 weeks) were translated to an annual monetary estimate by using published literature, national statistics, and accepted threshold values for a quality-adjusted life year (QALY).</p><p><strong>Result: </strong>At 12 weeks, the use of an AI-powered digital tool was associated with a reduction in health care costs of $127 per user and an increase in annual productivity of $930 per user. In addition, the intervention was associated with an increase in health of 0.0275 QALYs, corresponding to a monetized value of $1375.</p><p><strong>Conclusion: </strong>The analysis of cost savings and quality-of-life gains associated with the use of an AI-powered digital tool for pain self-management demonstrates significant potential improvements in measured parameters of up to $2432 per person in total ($7380 per year, assuming 70% compliance), supporting this as an important treatment alternative.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1056-1063"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841350","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":"Prediction of post-cesarean outpatient opioid use based on euphoric opioid responses and negative affect.","authors":"Amelie Pham, Daniel B Larach, Amanda L Stone, Sarah S Osmundson, Alex Pedowitz, Laura L Sorabella, Stephen Bruehl","doi":"10.1093/pm/pnag047","DOIUrl":"10.1093/pm/pnag047","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1076-1078"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609535","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 safety and effectiveness of lumbar transforaminal injection of sterile amniotic fluid filtrate compared to steroid for lumbosacral radicular pain due to spinal stenosis: a phase I/II double-blinded randomized trial.","authors":"Zachary L McCormick, Hasan Sen, Amanda N Cooper, Aaron M Conger, Alexandra E Fogarty, Allison Glinka Przybysz, Taylor Burnham, Richard Kendall, Graham Wagner, Pamela A Hansen, Jan Pierce, Brooke Hashimoto, Daniel M Cushman, Brook I Martin","doi":"10.1093/pm/pnag048","DOIUrl":"10.1093/pm/pnag048","url":null,"abstract":"<p><strong>Background: </strong>Radicular symptoms from lumbosacral spinal stenosis (LSS) are commonly managed with conservative measures, including transforaminal epidural steroid injection (TFESI). However, repeated use may cause systemic side effects in some patients. Human amniotic fluid filtrate (hAF), containing anti-inflammatory, neuroprotective, and regenerative factors, has shown therapeutic potential in pre-clinical models and other medical conditions.</p><p><strong>Objectives: </strong>Compare the safety and effectiveness of transforaminal epidural injections with hAF versus dexamethasone for treating radicular pain from LSS.</p><p><strong>Design: </strong>Double-blinded, prospective, randomized comparative trial.</p><p><strong>Methods: </strong>Fifty-eight participants were included, with outcomes assessed at 3 weeks, 6 weeks, 3 months (primary endpoint), and 6 months. Primary outcomes were adverse events (AEs) and proportions of participants reporting ≥50% numerical pain rating scale (NPRS) back and leg pain reductions at 3 months. Secondary outcomes included Oswestry Disability Index (ODI), Swiss Spinal Stenosis Questionnaire (SSSQ), and PROMIS Physical Health Summary (PHS). Linear mixed-effects models evaluated between-group differences while accounting for repeated measures.</p><p><strong>Results: </strong>At 3 months, a significantly greater proportion of participants receiving dexamethasone achieved ≥50% reductions in back pain (45.8% [95%CI = 27.9%-64.9%] vs. 15.0% [95%CI = 5.2%-36.0%]; P = .050) and leg pain (60.0% [95%CI = 40.7%-76.6%] vs. 25.0% [95%CI = 11.2%-46.9%]; P = .034) compared with hAF. Secondary outcome trends similarly favored dexamethasone at 3 months. Mixed-effects models showed greater improvements to 6-week pain and function scores with dexamethasone relative to hAF. Group AE rates were comparable, and no serious intervention-related AEs occurred.</p><p><strong>Conclusion: </strong>Dexamethasone demonstrated significantly greater short- and intermediate-term benefits over hAF across multiple clinical outcome domains for radicular pain due to LSS, prompting early trial discontinuation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT04537026); September 3, 2020.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"972-988"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581445","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":"Response to Letter to the Editor titled \"Genicular nerve radiofrequency ablation for persistent pain after knee arthroplasty: what is the challenge?\"","authors":"Roy Madrid, Napatpaphan Kanjanapanang, Paul Abboud, Peter Lin, Amanda Cooper, Hasan Sen, Sherwin Thiyagarajan, Kai-Hua Chang, Henry Luo, Aaron Conger, Zachary L McCormick, Reza Ehsanian","doi":"10.1093/pm/pnag063","DOIUrl":"10.1093/pm/pnag063","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1085-1086"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043299","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":"Image-guided combined ultrasound and fluoroscopy technique for stellate ganglion blocks.","authors":"Simon Yang, Ratan K Banik","doi":"10.1093/pm/pnag062","DOIUrl":"10.1093/pm/pnag062","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1072-1075"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841441","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}