Pain Medicine最新文献

{"title":"Correlates of mental defeat in individuals with chronic non-cancer pain on long-term opioid therapy.","authors":"Yoonjae Lee, Nicholas A Giordano, Peggy A Compton, Nicole K Y Tang, Rosemary C Polomano, Martin D Cheatle","doi":"10.1093/pm/pnaf055","DOIUrl":"10.1093/pm/pnaf055","url":null,"abstract":"<p><strong>Background: </strong>Individuals with chronic non-cancer pain (CNCP) often present with significant challenges that can impact physical, psychological, and social well-being. Mental defeat is a critical consequence of CNCP being a known predictor of suicidality. This study examines the relationships between specific psychological and coping factors and mental defeat among individuals with CNCP on long-term opioid therapy (LTOT).</p><p><strong>Design: </strong>A cross-sectional study of secondary data.</p><p><strong>Setting: </strong>Primary care, pain, and substance abuse clinics in Pennsylvania, Washington, and Utah.</p><p><strong>Subjects: </strong>744 adults with CNCP receiving LTOT (≥ 6 months).</p><p><strong>Methods: </strong>Anxiety and depression symptoms and pain coping strategies were examined with hierarchical multiple linear regression analysis to describe their relationship to mental defeat. In an exploratory analysis, we also stratified the sample by the presence of opioid use disorder (OUD) to determine if the associations were differently represented.</p><p><strong>Results: </strong>After controlling for covariates, anxiety (β = 7.07, P < .001) and depression symptoms (β = 14.17, P < .001) were statistically significant correlates of increased mental defeat. Diverting attention (β = 0.31, P < .05), coping self-statements (β = -0.30, P < .05), and catastrophizing (β = 1.47, P < .001) were significant correlates, explaining 51% of the variance in mental defeat (P < .001). Exploratory analysis revealed subgroup differences, such that while depression symptoms and catastrophizing were significant correlates of mental defeat in persons with and without OUD, anxiety and diverting attention were significant only in persons without OUD.</p><p><strong>Conclusions: </strong>These findings identify key psychological and coping correlates of mental defeat in persons with CNCP on LTOT, informing the development of interventions to mitigate it, and thereby reducing the risk of suicide in this vulnerable population.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"576-582"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018135","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":"Retraction and Replacement of: Aftersensations and Lingering Pain After Examination in Patients with Fibromyalgia Syndrome.","authors":"","doi":"10.1093/pm/pnaf079","DOIUrl":"10.1093/pm/pnaf079","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"617"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837283","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":"Lowering pain and inflammation drug costs: evaluating the impact of a cost plus drug company model.","authors":"Kaylyn Rowsey, Adam Khan, Jillian Brassfield, Matthew Rashid, Jacob Duncan, Matt Vassar","doi":"10.1093/pm/pnaf034","DOIUrl":"10.1093/pm/pnaf034","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"607-610"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730853","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":"Painless lower limb complex regional pain syndrome: a problem-based learning discussion.","authors":"Annie M Cho, Christopher L Robinson, Robert Jason Yong, Samuel P Ang","doi":"10.1093/pm/pnaf024","DOIUrl":"10.1093/pm/pnaf024","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"596-599"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634165","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":"Concordance of International Classification of Diseases, Tenth Edition diagnostic codes for chronic migraine without aura with International Classification of Headache Disorders, Third Edition diagnoses at a tertiary headache center: a retrospective analysis.","authors":"Rishita Patlolla, Leon S Moskatel","doi":"10.1093/pm/pnaf038","DOIUrl":"10.1093/pm/pnaf038","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"600-602"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753772","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":"Discrimination and wellbeing are differentially related to pain severity for the racially marginalized.","authors":"Annwesha Dasgupta, Destiny M B Printz Pereira, Sergio R Pérez Rosal, Sonya C Faber, Monnica T Williams","doi":"10.1093/pm/pnaf039","DOIUrl":"10.1093/pm/pnaf039","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the relationship between racial discrimination and physical pain outcomes.</p><p><strong>Methods: </strong>A geographically representative sample of 887 individuals was recruited online through CloudResearch from diverse racial backgrounds, including Black/African American, Latine/Hispanic American, Asian American, and White/European American adults. Participants completed measures on racial and ethnic discrimination, racial microaggressions, pain severity, depression symptoms, and coping styles. Statistical analyses included multiple regression and mediation models.</p><p><strong>Results: </strong>Our findings indicate that racialized participants experienced greater ethnic discrimination and racial microaggressions compared to their non-Hispanic White counterparts. Hispanic/Latine participants also reported greater pain severity than other groups. Lifetime experiences of discrimination, depression symptoms, avoidant coping style, and age emerged as significant predictors of pain severity, while mediation analyses revealed that lifetime discrimination partially mediated the relationship between race/ethnicity and pain severity for racially marginalized participants, compared to non-Hispanic White participants. Furthermore, greater reliance on avoidant coping combined with greater lifetime discrimination experiences was associated with increased severity of pain.</p><p><strong>Conclusions: </strong>The findings indicate how racism may result in worse pain outcomes in people of color, with potentially amplified adverse effects for those who engage in avoidant coping. While therapeutic interventions targeting avoidance may benefit racialized individuals, ultimately, the results highlight the critical need for large-scale policy interventions targeting racial discrimination to improve health equity and reduce the burden of pain among racialized populations.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"562-575"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764567","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":"Do difficult encounters affect pain treatment outcomes? A prospective cohort study.","authors":"Winnie L Liu, Evelien van Gelderen, Resham Mawalkar, Eric J Wang, Glenn Treisman, Steven P Cohen","doi":"10.1093/pm/pnaf027","DOIUrl":"10.1093/pm/pnaf027","url":null,"abstract":"<p><strong>Background: </strong>Difficult encounters represent an enormous burden and drain on resources in pain medicine, but their effect on outcomes has not been studied.</p><p><strong>Objective: </strong>To determine the effect of \"difficult\" encounters on chronic pain outcomes.</p><p><strong>Methods: </strong>In this prospective study, new chronic pain visits were rated by an attending physician and trainee on a 6-point Likert scale and stratified into \"difficult\" and \"non-difficult.\" The main outcome was successful treatment, defined as a ≥2-point reduction in average pain 4 weeks after initiation of pharmacological, integrative, or simple injection therapy, or 12 weeks after more invasive procedures. The secondary outcome was being lost to follow-up.</p><p><strong>Results: </strong>Among 428 patients seen for new-patient evaluations, 299 patients had follow-up, of whom 127 (42.5%) experienced a positive outcome. Patients involved in difficult encounters were less likely to experience a positive outcome (28% vs 46%; P = .02) than those not involved in difficult encounters. When stratified into quartiles, difficulty continued to be associated with an unsuccessful outcome, with the easiest encounters translating to a 53% success rate, versus 28% for patients involved in the most difficult encounters (P = .02). Difficult encounters were not associated with loss to follow-up. In multivariable analysis evaluating factors associated with difficultness, missing ≥10% of appointments (OR 0.69, 95% CI: 0.48-0.97; P = .04), non-organic signs (OR 0.42, 95% CI: 0.18-0.90; P = .03), visit taking longer than expected (OR 0.49, 95% CI: 0.25-0.96; P = .04), and refusal to try a treatment (OR 0.25, 95% CI: 0.08-0.70; P = .01) were associated with poor outcome.</p><p><strong>Conclusions: </strong>Difficult encounters can not only lead to administrative burdens, poor ratings, and lost revenue but also are associated with negative outcomes for chronic pain, a condition notoriously associated with difficult visits.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT05585619.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"554-561"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657950","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 design and rationale of the Biomarkers for Evaluating Spine Treatments trial: a sequential multiple assignment randomized trial.","authors":"Matthew C Mauck, Kelly S Barth, Kevin M Bell, Amber K Brooks, Andrea L Chadwick, Cameron A Gunn, Robert W Hurley, Anastasia Ivanova, Sara R Piva, Michael J Schneider, Jeannie F Bailey, Sarah Bagaason, Anna Batorsky, Jeffrey J Borckardt, Anton E Bowden, Timothy S Carey, Joel Castellanos, Lucy Chen, Brooke Chidgey, Diane Dalton, Jonathan S Dufour, Aaron J Fields, Julie M Fritz, Rachel West Goolsby, Carol M Greco, Richard E Harris, Steven Harte, Afton L Hassett, Anna Hoffmeyer, Sara Jones Berkeley, Chelsea Kaplan, Kelley M Kidwell, Gregory G Knapik, Michael R Kosorok, Gregorij Kurillo, Remy Lobo, Jeffrey C Lotz, Sean Mackey, Prasath Mageswaran, Sharmila Majumdar, Jianren Mao, William S Marras, Micah McCumber, Samuel A McLean, Wolf Mehling, Ulrike H Mitchell, Vitaly J Napadow, Conor O'Neill, Kushang V Patel, Scott Peltier, Matthew Psioda, Bryce Rowland, Sean D Rundell, Andrew Schrepf, John Sperger, Nam Vo, Mark S Wallace, Ajay D Wasan, Tristan E Weaver, Kenneth A Weber, David A Williams, Leslie Wilson, Fadel Zeidan, Beibo Zhao, Kevin J Anstrom, Daniel J Clauw, Gwendolyn A Sowa","doi":"10.1093/pm/pnaf032","DOIUrl":"10.1093/pm/pnaf032","url":null,"abstract":"<p><strong>Objective: </strong>Chronic low back pain (cLBP) is a common condition that impacts quality of life and function. There are many evidence-based treatments to address cLBP; however, treatment effects are modest, perhaps in part due to individual variation in treatment response. The Biomarkers for Evaluating Spine Treatments (BEST) trial was designed as the collaborative centerpiece of the Back Pain Consortium (BACPAC) research program. This consortium was sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) as part of the Helping to End Addiction Long-term (HEAL) Initiative.</p><p><strong>Design: </strong>The BEST trial was a sequential multiple assignment randomized trial (SMART) designed with the primary goal of identifying in whom different treatments show optimal response. The primary focus of the study was to use patient features, including biomarkers and phenotypic measures, to identify subsets of persons with cLBP who respond best to specific common treatments.</p><p><strong>Methods: </strong>Four interventions were chosen for the trial: Enhanced Self-Care, Acceptance and Commitment Therapy, Duloxetine, and Evidence-Based Exercise and Manual Therapy. Following a run-in period and baseline assessment, participants were randomized to 1 of the 4 treatments for the first 12-week intervention period. Participants were reassessed and based on their self-reported response to initial treatment, continued that initial treatment, were augmented with an additional randomly assigned treatment, or were switched to a new treatment.</p><p><strong>Conclusion: </strong>This trial was designed to deliver rich phenotypic data that will both potentially aid in the discovery of phenotypic characteristics that predict treatment response and provide a greater mechanistic understanding of cLBP.</p><p><strong>Clinical trial registration number: </strong>The Biomarkers for Evaluating Spine Treatments (BEST) trial is registered on ClinicalTrials.gov (Registration number: NCT05396014; https://clinicaltrials.gov/study/NCT05396014).</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"538-553"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036474","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":"Aftersensations and Lingering Pain After Examination in Patients with Fibromyalgia Syndrome.","authors":"Richard J Berwick, David A Andersson, Andreas Goebel, Andrew Marshall","doi":"10.1093/pm/pnaf080","DOIUrl":"10.1093/pm/pnaf080","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia syndrome (FMS) is a chronic widespread pain condition with mixed peripheral and central contributions. Patients display hypersensitivities to a spectrum of stimuli. Patients' blunt pressure pain thresholds are typically reduced, and sometimes (∼15%) gentle brushstroke induces allodynia. However, aftersensations after these stimuli have not, to our knowledge, been reported.</p><p><strong>Methods: </strong>We examined the perception of blunt pressure and \"pleasant touch\" in FMS. Patients were first interviewed and completed standard psychometric questionnaires. We then measured their sensitivity to blunt pressure and perception of pleasant touch, including aftersensations; patients were followed up for 5 days to evaluate lingering pain from blunt pressure.</p><p><strong>Results: </strong>We recruited 51 patients with FMS and 16 pain-free healthy controls (HCs) at a UK Pain Management Centre. Forty-four patients completed the aftersensation protocol. Most patients reported pain after the application of less mechanical pressure than the level of pressure at which HCs reported pain; median arm and leg thresholds for the patients with FMS were 167 kPa and 233 kPa, respectively. Eighty-four percent (31/37) of patients reported ongoing pain at the site of pressure application 1 day after testing, and 49% (18/37) still perceived pain at 5 days. Aftersensations after brushstroke were common in the FMS group, reported by 77% (34/44) of patients with FMS vs 25% (4/16) of HCs; 34% (15/44) of patients, but no HCs, perceived these aftersensations as uncomfortable. For patients with FMS who experienced aftersensations, brushstroke pleasantness ratings were reduced, and the skin was often an important site of pain.</p><p><strong>Conclusion: </strong>Pain after blunt pressure assessment typically lingers for several days. Aftersensations after brushstroke stimulation are a previously unreported FMS phenomenon. They are associated with tactile anhedonia and might identify a clinically distinct subgroup.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"618-627"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837280","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":"Therapist Delivered Massage for Veterans with Chronic Neck Pain: A Randomized Control Trial.","authors":"Niki Munk, Joanne K Daggy, James E Slaven, Trevor Foote, Mikayla Garner, Erica Evans, Brian V Laws, Marianne S Matthias, Matthew J Bair","doi":"10.1093/pm/pnaf118","DOIUrl":"https://doi.org/10.1093/pm/pnaf118","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic neck pain is challenging to treat in Veterans. Massage therapy benefit evidence for musculoskeletal pain is building and massage is now included in Veteran health benefits. This randomized control trial compared therapist-delivered massage (TT-M) versus waitlist control for Veterans with chronic neck pain.</p><p><strong>Methods: </strong>TT-M involved twice-weekly massage therapist-delivered 60-minute standardized sessions for 12-weeks. The Neck Disability Index and Brief Pain Inventory measured neck disability and pain severity at baseline, 1-, 3-, and 6-months. Linear mixed-model approach examined primary analysis at 3 months; responsiveness analysis examined clinically meaningful change, ≥5 point improvement in neck disability and ≥30% decrease in pain severity.</p><p><strong>Results: </strong>Participants (N = 290; n = 145/group) were aged 55.8 ± 14 years, 71% White, and 15% Female. Compared to control, TT-M participants had statistically significant reductions in pain-related disability at 1-month (-2.2; p = 0.007) and 3-months (-3.1; p < 0.001) and pain severity at 1-month (-0.8; p = 0.001), 3-months (-1.3; p < 0.001), and 6-months (-0.8; p = 0.003), respectively. TT-M participants were more likely to experience clinically meaningful benefits in neck disability at 3-months (35% v 16%; p = 0.003) and pain severity at 1-month (27% v 14%; p = 0.021), 3-months (43% v 15%; p < 0.001), and 6-months (36% v 16%; p = 0.005).</p><p><strong>Conclusion: </strong>Therapist applied massage led to greater clinical benefits and reductions in neck disability and pain severity compared to waitlist control. Less robust outcomes at 6-months may suggest longer treatment windows or booster sessions are needed to maintain benefits. Engaging Veterans with massage therapy as part of their health benefits for chronic neck pain can provide an effective, non-pharmacological approach to pain management.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963833","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}