Pain Medicine最新文献

{"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}

{"title":"Real world treatment patterns among patients with painful diabetic peripheral neuropathy in the United States.","authors":"Nathaniel M Schuster, Sushanth Jeyakumar, Ann M Menzie, Moeen Panni, Nicole Princic, Meghan Moynihan, Charles E Argoff","doi":"10.1093/pm/pnag055","DOIUrl":"10.1093/pm/pnag055","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzes real-world treatment patterns among patients newly initiating treatment for painful diabetic peripheral neuropathy using a contemporary dataset in the United States.</p><p><strong>Methods: </strong>A retrospective study using the MarketScan database (January 1, 2016, to June 30, 2023) identified adults newly prescribed pain medication(s) used to treat neuropathic pain within 60 days of a diabetic peripheral neuropathy diagnosis. Patients with prior medication, conditions with similar treatment indications, cancer, or major surgery were excluded. Treatment patterns over a 12-month period and variable-length follow-up (four sequential treatment episodes) were captured, including treatment type, dosage, adherence, discontinuation (≥90-day gap), and switching.</p><p><strong>Results: </strong>Among 22 955 patients identified, 98.5% initiated monotherapy treatment for painful diabetic peripheral neuropathy. The majority initiated treatment with gabapentinoids (gabapentin 59.0%; pregabalin 5.3%), followed by opioids (tramadol 15.1%, oxycodone 7.0%), and antidepressants (duloxetine 5.2%). Among patients initiating gabapentin, pregabalin, or duloxetine, most were prescribed daily doses below recommended levels (79% gabapentin, 91% pregabalin, 61% duloxetine), and the majority (81%-96%) did not increase their dose. Adherence was low. Over 50% discontinued their initial treatment within 3 months, and approximately 75% discontinued in the 12-month follow-up period, with fewer than 25% switching to another medication. When evaluating treatment patterns across sequential treatment episodes, almost 65% discontinued all pain medications and did not receive subsequent treatment by the fourth treatment episode.</p><p><strong>Conclusions: </strong>High rates of treatment discontinuation and suboptimal adherence likely indicate challenges with tolerability and insufficient pain relief associated with current therapies for painful diabetic neuropathy. These findings emphasize the limitations of existing treatment options and highlight the unmet need for more effective and better-tolerated treatments for these patients.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1027-1039"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777881","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":"Scrambler Therapy (delivered via the Calmare® device) in refractory complex regional pain syndrome in an adolescent: a practical solution to a complex clinical problem (Resident and Fellow Forum).","authors":"Alfredo Bravo-Vidal, Diana Carolina Correa-Sandoval, Ximena Guzman-Manzur, Fernando Cantu-Flores","doi":"10.1093/pm/pnag054","DOIUrl":"10.1093/pm/pnag054","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1064-1068"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675724","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":"Response to LTE: CMS proposed restrictions on peripheral nerve blocks and procedures for chronic pain: clinical, ethical, and policy implications for millions of Americans.","authors":"Priyanka Singla, Alexandra Adler, James R Babington, Zachary L McCormick, Michael D Osborne, Nathaniel M Schuster, Antje M Barreveld","doi":"10.1093/pm/pnag051","DOIUrl":"10.1093/pm/pnag051","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1089-1090"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675716","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":"Comparing low and high recovery expectations among those with lumbar spinal stenosis: a network analysis.","authors":"Adam Babitts, Annie T Chen, Dawn M Ehde, Adam P Goode, Jeffrey G Jarvik, Amy M Cizik, Eric N Meier, Janna L Friedly, Maggie E Horn, Pradeep Suri, Colleen A Burke, Sandra K Johnston, Sean D Rundell","doi":"10.1093/pm/pnag059","DOIUrl":"10.1093/pm/pnag059","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to (1) compare networks of factors for patients with low and high recovery expectations in individuals with lumbar spinal stenosis (LSS) using biopsychosocial measures and duration of symptoms and (2) identify the most influential factors within each group.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using baseline data from 598 patients with LSS. Participants were recruited through Duke University and the University of Washington spine clinics between 2021 and 2024. Recovery expectations were assessed using a 0 (lowest) to 10 (highest) numerical rating scale. We stratified participants into low and high expectation groups. Network analysis was used to assess relationships among factors for each group. Networks included chronicity and PROMIS-29 + 2 Profile. Partial correlations, centralities, network comparison measures, and network stabilities were calculated.</p><p><strong>Results: </strong>There were 226 participants with low and 108 with high recovery expectations. The 2 networks did not have significant structural differences, and strength centralities were stable. Chronicity was not significantly associated with other factors in both networks. Pain Interference and Fatigue strength centralities show greater importance in both networks. Anxiety had significantly higher strength in the low expectation group, suggesting greater relevance for individuals with low expectations.</p><p><strong>Conclusion: </strong>Pain Interference and Fatigue were influential for both groups, while Anxiety was more influential for those with low expectations. Future research and patient management should consider the influence of anxiety for those with low recovery expectations and pain interference and fatigue for all individuals with LSS on other associated factors.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"962-971"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777887","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":"Letter to the Editor: In response to Singla et al.","authors":"Brandon Tan Zhiming, Cormac Francis Mullins","doi":"10.1093/pm/pnag053","DOIUrl":"10.1093/pm/pnag053","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1087-1088"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675721","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":"Genicular nerve radiofrequency ablation for persistent pain after knee arthroplasty: what is the challenge?","authors":"Mauricio Forero, Philip Peng","doi":"10.1093/pm/pnag056","DOIUrl":"10.1093/pm/pnag056","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"1083-1084"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056071","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":"Mixed-duration basivertebral nerve ablation for vertebrogenic low back pain: lesion strategies and clinical outcomes in a multicenter retrospective cohort study.","authors":"Charles A Odonkor, Eric Poole, Eric T Nguyen, Aileen Padilla, Muhammad Uzair Siddique, Cameron Harris, Selaiman Noori, Jack Diep, Anthony Giuffrida, Daniel A Jiménez, Pratik J Gandhi, David E Gutierrez, Peter G Whang, David W Lee","doi":"10.1093/pm/pnag057","DOIUrl":"10.1093/pm/pnag057","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether lesion duration, aka \"burn time\" is associated with clinical outcomes following basivertebral nerve ablation (BVNA).</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Setting: </strong>Seven United States pain management and spine care centers including academic, community, and private practice settings.</p><p><strong>Subjects: </strong>: 359 adults with vertebrogenic low back pain (LBP) of at least 6 months' duration with magnetic resonance imaging evidence of Modic Type I or Type II vertebral endplate changes who underwent BVNA between 2022 and 2025.</p><p><strong>Methods: </strong>Patients were categorized into 3 groups according to radiofrequency lesion duration: Uniform 7-minute lesions (n = 202), uniform 15-minute lesions (n = 59), or mixed-duration lesions combining 7- and 15-minute applications (n = 98). Pain intensity was assessed using the Numeric Rating Scale at baseline and at 1, 3, and 6 months. The primary outcome was ≥50% pain reduction at 6 months. Secondary outcomes included ≥30% and ≥80% improvement and continuous pain change. Multivariable analyses incorporated propensity score-based inverse probability of treatment weighting (IPTW) to adjust for baseline demographic, clinical, and anatomical covariates. Sensitivity analyses included complete-case and worst-case scenarios, as well as alternative IMMPACT-aligned responder thresholds.</p><p><strong>Results: </strong>Responder rates differed across groups, with 54.0% in the 7-minute group, 59.3% in the 15-minute group, and 73.5% in the mixed-duration group (P = .005). In propensity-weighted analyses, mixed-duration lesioning showed higher odds of ≥50% response compared with uniform 15-minute lesions, but this difference did not reach statistical significance (OR 2.01; 95% CI, 0.88-4.59; P = .098), while 15-minute lesioning showed no clear advantage over 7-minute lesions. Continuous measures of pain improvement did not differ across groups. Male sex was associated with lower response, whereas baseline pain severity, symptom duration, and number of treated levels were not. Findings were consistent across sensitivity analyses and alternative responder thresholds.</p><p><strong>Conclusions: </strong>In this multicenter cohort, mixed-duration BVNA was associated with higher responder rates than uniform lesion strategies, but no statistically significant differences in outcomes were observed across 7-, 15-minutes, or mixed duration strategies after adjustment. The observed variation in lesion strategies underscores the need for prospective studies to evaluate tailored lesioning approaches.</p><p><strong>Clinical trial registration: </strong>This study was a retrospective observational cohort study and was not registered in a clinical trials registry.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"989-1003"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777912","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":"Improving the contextual use of GRADE (Grading of Recommendations Assessment, Development, and Evaluation) for interventional pain procedures: bridging evidence certainty and clinical reality.","authors":"Priyanka Singla, Aaron M Conger, Zachary L McCormick","doi":"10.1093/pm/pnag052","DOIUrl":"10.1093/pm/pnag052","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"959-961"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675727","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}