Pain physician最新文献

{"title":"Sympathetic and Parasympathetic Ganglion Blocks for Treatment of Long COVID-19 Symptoms: A Scoping Review.","authors":"Abhay Tyagi, Khushboo Singh, Preet Mohinder Singh, Frederic J Gerges","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Long COVID-19 affects approximately 10-30% of individuals who are infected with SARS-CoV-2 and is associated with persistent functional impairment and reduced quality of life. The heterogeneous, multisystemic nature and nonspecific symptomatology of long COVID-19 makes its treatment challenging. This scoping review evaluates existing evidence on sympathetic and parasympathetic ganglion blocks as potential interventions for patients suffering from long COVID-19.</p><p><strong>Objective: </strong>Our primary objective was to assess the effectiveness of sympathetic and parasympathetic ganglion blocks in treating patients with long COVID-19 by identifying the most commonly reported symptoms, symptom response to different block regimens, and any adverse effects associated with these interventions.</p><p><strong>Study design: </strong>A scoping review.</p><p><strong>Setting: </strong>Outpatient clinics where patients received sympathetic blocks or parasympathetic blocks.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Embase, Cochrane CENTRAL, Web of Science, Google Scholar, and ClinicalTrials.gov using MeSH and free-text terms related to \"long COVID-19,\" \"post-COVID-19 syndrome,\" and \"sympathetic ganglion blocks\" and \"parasympathetic blocks.\" Only English-language articles were included. Pre-print repositories and reference lists were also manually screened.</p><p><strong>Results: </strong>A total of 22 articles covering 505 patients were included in this review. The most frequently studied symptoms were olfactory dysfunction, fatigue, headache, and cognitive disturbances. The most commonly utilized intervention was the stellate ganglion block. The available evidence suggests that the stellate ganglion block could be an effective treatment for dysautonomia symptoms and cognitive dysfunction related to long COVID-19. Sphenopalatine ganglion block may be an effective option to treat headaches in long COVID-19 patients who are refractory to other treatments.</p><p><strong>Limitations: </strong>The significant existing variations in treatment regimens precluded our ability to do a quantitative analysis. Reporting bias from case reports and small observational studies should also be considered.</p><p><strong>Conclusions: </strong>Stellate ganglion blocks may offer therapeutic benefit for the dysautonomia and cognitive dysfunction associated with long COVID-19. Sphenopalatine ganglion blocks have shown promise in managing refractory headache symptoms in this population. Further well-designed, placebo-controlled randomized studies that employ validated outcome measures are required to establish the efficacy of sympathetic ganglion blocks in the treatment of long COVID-19.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"E151-E161"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Errata.","authors":"Asipp","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"299"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness and Safety of Percutaneous Balloon Compression Versus Conventional Radiofrequency Thermocoagulation for Classic Trigeminal Neuralgia: A Randomized Clinical Trial.","authors":"Anurag Agarwal, Neha Singh, Shivani Rastogi, Anuj Jain, Ajai Kumar Singh, Vikram Singh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is a debilitating facial pain syndrome. Percutaneous balloon compression (PBC) and conventional radiofrequency thermocoagulation (CRF) are widely used for drug-refractory TN, but randomized evidence comparing their efficacy and safety remains limited.</p><p><strong>Objectives: </strong>To compare the efficacy, safety, and mechanistic correlates of PBC vs CRF in patients with primary TN.</p><p><strong>Study design: </strong>Prospective, randomized, single-blind, controlled trial.</p><p><strong>Setting: </strong>The Pain Medicine Unit, Department of Anesthesiology, at a tertiary care medical institute in the Republic of India.</p><p><strong>Methods: </strong>Sixty adults with primary TN refractory to ≥ 2 medications were randomized 1:1 to PBC or CRF, stratified by age (< 60 or ≥ 60 years). PBC was performed via the Hartel approach with 0.8 mL contrast inflation and 90-second compression; CRF involved fluoroscopy-guided, electromyography-confirmed lesioning at 65°C and 70°C for 60 seconds. Independent blinded assessors recorded Numeric Rating Scale pain scores at baseline, and at postprocedure days 7, 30, 60, 90, and 180. Secondary outcomes included the Barrow Neurological Institute Pain Intensity Score, Brief Pain Inventory (BPI), Douleur Neuropathique 4 Questionnaire (DN4Q), the Pain Catastrophizing Scale (PCS), and safety measures. Correlations between balloon pressures at the beginning (P1) and end of compression (P2) or nerve division involvement and outcomes were analyzed.</p><p><strong>Results: </strong>Baseline characteristics were comparable. Both the groups achieved significant pain relief at 6months, but PBC yielded superior outcomes in Numeric Rating Scale scores (mean ± SD) (1.4 ± 0.98 vs 2.35 ± 1.09; P = 0.002) and BNI (1.75 ± 0.91 vs 2.28 ± 0.76; P = 0.01). Improvement in BPI, DN4Q and PCS were similar. Safety was excellent; transient mild masseter weakness was more common with PBC at day 7 (30% vs 3.3%, P = 0.005) but resolved by day 30. Corneal sensation and other cranial nerve functions were preserved. Balloon pressures showed weak, nonsignificant correlations with 6-month outcomes; nerve division involvement had no correlation with the outcome.</p><p><strong>Limitations: </strong>Single-center design and short 6-month follow-up.</p><p><strong>Conclusions: </strong>PBC provided superior 6-month pain and functional outcomes compared with CRF, with comparable long-term safety. These results support PBC as the preferred percutaneous intervention for appropriately selected patients with classic TN.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"E193-E199"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Voltage Fluoroscopic Guided Pulsed Radiofrequency Compared to Standard-Voltage Pulsed Radiofrequency on the Dorsal Root Ganglion for Chronic Lumbosacral Radicular Pain: A Double-Blinded, Randomized Controlled Trial.","authors":"Engi Yousry Hashem, Mina Nabil Habib, Sahar Elkaradawy, Mohamed Hamdy El Lakani","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lumbosacral radicular pain (LRP) results from the ectopic activation of nociceptive afferent fibers in a spinal nerve or its roots. Lumbar disc prolapse is the most prevalent cause of LRP. This condition significantly impacts patients' quality of life and is deemed a burden on communities and health care facilities alike. The utilization of pulsed radiofrequency (PRF) in dorsal root ganglion stimulation (DRG-S) has demonstrated efficacy with a wide applicability across various conditions. However, whether elevating the voltage of PRF to between 55-75 volts could augment its clinical efficacy remains uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The primary measure of outcome was the Numeric Rating Scale (NRS) score between the 2 groups . The secondary outcomes included functional outcomes as evaluated on the Oswestry Low Back Disability Questionnaire and intra- or post-intervention complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A prospective, double-blinded, randomized controlled study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The study was carried out at the Medical Research Institute of Alexandria University.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study included 96 patients with lumbosacral radicular pain caused by disc prolapse. They were randomly divided into 2 equal groups to receive high-voltage pulsed radiofrequency (HV-PRF) (Group I) or standard-voltage PRF (Group II) adjacent to the DRG corresponding to the affected dermatome. Scores on the NRS and Oswestry Low Back Disability Questionnaire were evaluated at one week and one, 2, 3, and 6 months after the intervention. The complications of the intervention were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In both groups, NRS scores decreased significantly from the pre-intervention ratings at all post-intervention studied times (P ≤ 0.001). However, this decline was significantly more observable in Group I than in Group II (P ≤ 0.001). The percentage of patients reporting NRS reductions ≥ 50.0% was significantly higher in Group I than Group II at one, 2, 3, and 6 months after the intervention (P ≤ 0.001). Similarly, when compared to the pre-intervention ratings, Oswestry Low Back Disability scores decreased significantly in both groups at all studied post-intervention times (P ≤ 0.001), but this reduction was significantly greater in Group I than in Group II (P ≤ 0.001). The percentage of patients who reported Oswestry Low Back Disability score reductions ≥ 50.0% was also significantly higher in Group I (37.5%, 66.7%, 75% and 81.3% of patients at one, 2, 3, and 6 months, respectively, post-intervention) than in Group II (no patients at one and 2 months, 8.3% and 14.6% at 3 and 6 months, respectively, post-intervention) (P ≤ 0.001). No major complications were recorded for either of the studied groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Short study period, single-centre study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;High- and standard-voltage PRF administered in an area a","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"259-267"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Two Doses of Hyaluronidase with Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block for Post Cesarean Delivery Pain: A Randomized Trial.","authors":"Samar Rafik Amin, Mohamed Said Elmeligy, Mohamed Fouad Elmeliegy, Shaimaa Ezzat Amin, Eman Mohamed Elafifi, Ibrahim Ezat Mostafa, Elsayed M Abdelzaam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A transversus abdominis plane block provides reliable abdominal wall analgesia, but which adjuvants best sustain its effect remains debated. By facilitating diffusion of local anesthetics, hyaluronidase may improve block quality.</p><p><strong>Objectives: </strong>This study evaluated the safety and efficacy of 2 hyaluronidase doses added to bupivacaine for bilateral transversus abdominis plane blocks in patients having a cesarean delivery.</p><p><strong>Study design: </strong>A prospective, randomized, double-blind, controlled clinical trial.</p><p><strong>Setting: </strong>Benha University Hospital, Arab Republic of Egypt, from May 2023 through February 2024.</p><p><strong>Methods: </strong>A double-blind, controlled randomized trial was performed with 114 patients having elective cesarean delivery. The patients were allocated equally into 3 arms: Group I (bupivacaine alone), Group II (bupivacaine plus 750 IU hyaluronidase), and Group III (bupivacaine plus 1500 IU hyaluronidase). The time to first rescue analgesia served as the primary outcome. Secondary outcomes encompassed 24-hour morphine requirements, Visual Analog Scale pain score at rest and on coughing, patient satisfaction, hemodynamics, and adverse events. Analyses employed the appropriate statistical tests (parametric or nonparametric), with subsequent post hoc comparisons for significant findings.</p><p><strong>Results: </strong>Both hyaluronidase groups had significant prolonged analgesia (median 8.1 hours and 9.6 hours) compared to the control group (5.8 hours) (P < 0.001). Morphine requirements over the first postprocedure 24 hours diminished significantly (P < 0.001); Groups II and III had lower pain scores at rest and on coughing between postprocedure hours 2 and 12 (all P < 0.05). Patient satisfaction increased with hyaluronidase (P = 0.0039). No group differences were observed for adverse events, including postoperative nausea and vomiting or local anesthetic toxicity.</p><p><strong>Limitations: </strong>This single-center trial with 24-hour follow-up may restrict generalizability and long-term safety assessment; also only 2 hyaluronidase doses were examined.</p><p><strong>Conclusions: </strong>Adding hyaluronidase to bupivacaine for transversus abdominis plane block enhances analgesic duration and quality without compromising safety in patients having cesarean delivery. Both high and low doses appear equally effective, suggesting that even lower doses are sufficient for optimal effect.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"E209-E216"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ganglion Impar Neurolysis Enhances the Short-term Efficacy of Pudendal Nerve Pulsed Radiofrequency Treatment for Pudendal Neuralgia: A Retrospective Cohort Study.","authors":"Yiming Liu, Yifan Yang, Jun Li, Ou Wu, Shunan Xie, Tingjie Zhang, Yi Feng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pudendal neuralgia (PN) lacks specific treatments and severely affects patients' quality of life. Although pudendal nerve pulsed radiofrequency (PRF) can alleviate symptoms, its overall efficacy is not satisfactory. Ganglion impar neurolysis (GIN) has been widely employed for perineal pain management. We hypothesize that combining PRF with GIN may enhance therapeutic outcomes for PN compared to PRF monotherapy. To the best of our knowledge, no relevant reports have been found.</p><p><strong>Objective: </strong>To assess whether GIN improves PRF treatment efficacy for PN.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>This is a single-center retrospective study conducted at the Department of Pain Medicine, Peking University People's Hospital in Beijing, China.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 84 women patients with PN treated from January 2020 through February 2024. The patients were divided into 2 groups: PRF Group (n = 40) received only pudendal nerve PRF; PRF + GIN Group (n = 44) received PRF combined with GIN. We recorded the posttreatment differences in Visual Analog Scale (VAS) scores, Overall Improvement in Pain (OIP) values, Hospital Anxiety and Depression Scales scores (anxiety: HADS-A; depression: HADS-D), and Pain Catastrophizing Scale scores (PCS) of the 2 groups at time points up to posttreatment month 6.</p><p><strong>Results: </strong>At one, 2, 3, and 6 months posttreatment, the VAS scores in both groups were lower than pretreatment levels (P < 0.05). At 6 months posttreatment, the mean (SD) VAS score in the PRF+GIN Group (2.09 [1.38]) was lower than that in the PRF Group (3.81 [1.85]) (P < 0.05). The mean (SD) OIP value in the PRF+GIN group (73.72% [17.27%]) was higher than that in the PRF Group (56.13% [26.90%]) (P < 0.05). At 3 and 6 months posttreatment, the HAD scores and PCS scores in both groups were lower than pretreatment levels (P < 0.05). At 6 months posttreatment, the mean (SD) HADS-A and HADS-D scores in the PRF+GIN Group-3.91 (2.70) and 3.37 (2.18), respectively-were lower than those in the PRF group-6.54 (3.75) and 5.55 (3.25), respectively (P < 0.05); the mean (SD) PCS score in the PRF+GIN Group 12.16 (6.16) was lower than that in the PRF Group 19.52 (9.92) (P < 0.05). No severe complications were observed at any posttreatment time point.</p><p><strong>Limitations: </strong>This single-center study has a small sample size, a short follow-up period, and lacks patients who are men.</p><p><strong>Conclusions: </strong>GIN enhances short-term pudendal nerve PRF efficacy for PN, with no significant adverse reactions.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"289-297"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated Analysis of Continued Decline of Utilization Patterns of Facet Joint Interventions in Managing Spinal Pain in the Traditional Medicare Population: From 2000 to 2024.","authors":"Laxmaiah Manchikanti, Vidyasagar Pampati, Mahendra Sanapati, Mittal S Prajapati, Vinita Singh, Nebojsa Nick Knezevic, Alan D Kaye, Amol Soin, Alaa Abd-Elsayed, Joshua A Hirsch","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of facet joint interventions for spinal pain management increased rapidly between 2000 and 2010, followed by slower growth from 2010 to 2019. Post-COVID analyses demonstrated a marked decline in facet joint interventions despite an increasing prevalence of chronic pain among traditional Medicare beneficiaries after 2019, together with multiple contributing factors over time, including enactment of the Affordable Care Act, COVID-19, the Inflation Reduction Act, and other influences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to update and analyze utilization patterns of facet joint interventions for chronic pain management in the U.S. traditional Medicare population across multiple periods from 2000 to 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A retrospective cohort study evaluating utilization trends and influencing factors for facet joint interventions in the fee-for-service (FFS) traditional Medicare population in the United States from 2000 to 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were derived from the Centers for Medicare & Medicaid Services (CMS) physician/supplier procedure summary database (2000-2024). Utilization rates per 100,000 Medicare beneficiaries, percentage of change, and geometric average changes were calculated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Facet joint intervention utilization increased rapidly from 2000 to 2010 (15.5% annually), slowed from 2010 to 2019 (4.2% annually), and declined from 2019 to 2024 (-6.1% annually). Episodes followed similar patterns but declined less steeply than procedures (-6.7% vs. -27.1%). By 2024, service rates had returned to approximately 2012 levels (5,016 vs 5,046 per 100,000 beneficiaries). From 2000 to 2010, lumbar and cervical/thoracic facet joint blocks and radiofrequency ablation procedures increased substantially (13.5%-24.6% annually), followed by slower growth from 2010 to 2019 (2.8%-11.0%), a sharp pandemic-related decline from 2019 to 2020 (10.6%-17.4%), and partial recovery with modest growth or stabilization through 2024. Between 2019 and 2024, the episode ratio of facet joint nerve blocks to radiofrequency ablation declined from 1.9 to 1.7 for lumbar procedures and from 2.4 to 2.0 for cervical procedures, attributed to the mandatory radiofrequency policy. Interventional pain-related specialties accounted for the majority of facet joint procedures, increasing their share from 87.3% in 2010 to 95% by 2024, while surgical specialties declined from 4.8% to 2.0%. During the same period, the site of service shifted modestly from office settings (50.7% to 48.8%) and hospital outpatient departments (HOPD) (declining to 20.5%) toward ambulatory surgery centers (ASCs) (25.6% to 30.6%). These findings reflect increasing specialization, recent reductions in treatment intensity, and the influence of policy changes, Medicare Advantage shifts, and broader system pressures on pain management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The analysis was li","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"E163-E181"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors of Chemotherapy-Induced Painful Peripheral Neuropathy: A Retrospective Study from A Single Cancer Center.","authors":"Ashlyn Brown, Angela Nwankwo, Eliana Ege, Jian Wang, Xiaowen Sun, Jay Karri, Patrick M Dougherty, Salahadin Abdi, Billy Huh, Ryan S Souza, Saba Javed","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) affects approximately 50% of patients who receive chemotherapy. CIPN often results in dose reductions, therapy discontinuation, and long-term neurological impairment. Despite existing studies, identifying high-risk populations remains challenging, particularly in patients with diabetes, diabetic neuropathy, and those undergoing corticosteroid therapy.</p><p><strong>Objectives: </strong>We sought to evaluate the key risk factors associated with CIPN by analyzing patient demographics, comorbidities, and chemotherapy regimens, with a specific focus on diabetes-related variables in order to inform early identification and prevention strategies.</p><p><strong>Study design: </strong>Retrospective, single-center, observational cohort study.</p><p><strong>Setting: </strong>Academic tertiary care cancer center.</p><p><strong>Methods: </strong>Adult patients who received chemotherapy between January 2016 and December 2023 were identified through electronic medical records. Patients with CIPN were defined by the International Classification of Disease, Tenth Revision G62.0 diagnosis code (drug-induced polyneuropathy) and an associated diagnosis of \"painful peripheral neuropathy.\" Extracted data included demographics (age, body mass index [kg/m2], race/ethnicity), clinical variables (alcohol use, corticosteroid use, diabetes-related factors), and chemotherapy regimen details. Descriptive statistics, Wilcoxon rank sum, c2/Fisher's exact tests, and multivariable logistic regression were performed. Institutional review board (IRB) approval was obtained (IRB exemption #2024-0139).</p><p><strong>Results: </strong>Among 36,949 patients, significant CIPN risk factors included older age (40-80 years, P < 0.0001), women (odds ratio [OR] 1.89; P < 0.0001), non-Hispanic/non-Latino ethnicity (OR 1.29; P < 0.0001), and corticosteroid use (OR 2.01; P < 0.0001). African American patients had lower odds of CIPN than White patients (OR 0.78; P < 0.0001). Diabetic neuropathy was strongly associated with increased CIPN risk (OR 5.35; P < 0.0001). Alcohol use was inversely associated with CIPN (OR 0.75; P < 0.0001). Several chemotherapy agents also showed significant associations.</p><p><strong>Limitations: </strong>Our study is limited by its retrospective design, potential misclassification bias in CIPN diagnosis, and reliance on electronic medical records. Alcohol use data were frequently missing or unspecified, limiting interpretation.</p><p><strong>Conclusions: </strong>Key CIPN risk factors include age, race/ethnicity, corticosteroid use, and diabetic neuropathy. Alcohol use appeared inversely associated with CIPN, though causality remains unclear. Individualized patient assessments and proactive management strategies may help reduce CIPN incidence and improve outcomes in patients with cancer who are receiving chemotherapy.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 3","pages":"269-279"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Supplementation in the Management of Painful Diabetic Peripheral Neuropathy: A Narrative Review.","authors":"Seoyon Yang, Dong Soon Jang, Min Cheol Chang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Painful diabetic peripheral neuropathy (DPN), a debilitating complication of diabetes mellitus (DM), significantly reduces quality of life. Vitamin D deficiency is common in patients with DM and has been associated with both the presence and severity of DPN.</p><p><strong>Objectives: </strong>This systematic review aims to investigate whether vitamin D supplementation improves neuropathic symptoms in patients with painful DPN.</p><p><strong>Study design: </strong>A narrative review.</p><p><strong>Methods: </strong>A systematic literature search was conducted in MEDLINE (PubMed), the Cochrane Library, Embase, Scopus, and the Web of Science for English-language articles published through August 7, 2025. Studies were included if they evaluated the effects of vitamin D supplementation in patients with painful DPN.</p><p><strong>Results: </strong>Overall, 50 articles were identified through the database search. After screening titles and abstracts, 39 articles were excluded for not meeting the inclusion criteria. The remaining 11 articles were assessed for full-text eligibility. Finally, 7 studies were included in this review. Most of those studies reported improvements in pain scores, quality of life, and serum 25(OH)D levels following vitamin D supplementation. The findings suggest that vitamin D alleviates neuropathic pain by modulating inflammatory responses, promoting nerve regeneration, and enhancing the expression of neurotrophic factors.</p><p><strong>Limitations: </strong>Further randomized controlled trials are needed to confirm the therapeutic efficacy of vitamin D supplementation and to establish the optimal dosage, frequency, and treatment duration associated with it.</p><p><strong>Conclusion: </strong>The findings support the consideration of vitamin D supplementation as a potential adjunctive strategy for managing painful DPN.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"E67-E74"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Lumbar Medial Branch Cryoneurolysis Improves Pain and Function Versus Radiofrequency Ablation for Chronic Low Back Pain: 12-Month Randomized Pilot Study\".","authors":"Shahin Azizov","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"E129"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}