Pain physician最新文献

{"title":"In Response to Comment on \"Is Fibromyalgia a Nociplastic or a Mixed-pain Condition? International, Multidisciplinary Recommendations for Pain Phenotyping in Fibromyalgia Syndrome\".","authors":"Ismail Saracoglu, Esra Akin, Jo Nijs","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"E124-E125"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778113","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":"A Prospective, Multicenter, Double-Blinded, Randomized Controlled Trial Investigating the Effects of High-Frequency Stimulation at the Proximal Peripheral Nerves for Treating Chronic Back Pain with 36 Months of Follow-Up.","authors":"Bart Billet, Tony Van Havenbergh, Karel Hanssens, Pieter Van Looy, Roel Wynendaele, Niek E Vanquathem","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic back pain is a debilitating condition that significantly diminishes a patient's quality of life and imposes a substantial economic burden, driven by ongoing health care costs and lost workdays.</p><p><strong>Objectives: </strong>This trial aimed to assess the efficacy and safety of an externally powered neuromodulation system targeting the proximal peripheral nerves at the T9 dermatome for chronic back pain refractory to surgery or standard treatment by comparing sub-threshold active stimulation therapy to sham.</p><p><strong>Study design: </strong>This is a prospective, multicenter, double-blinded, randomized controlled trial. Adhering to the highest standards of methodological quality control, the 38 patients who completed the study had been randomized in a 1:1 ratio to receive either subthreshold active stimulation or sham stimulation using the same Freedom® (Curonix LLC) Peripheral Nerve Stimulator System.</p><p><strong>Setting: </strong>This is a randomized controlled trial conducted at 2 independent clinical sites representing distinct secondary and tertiary clinical settings.</p><p><strong>Methods: </strong>Both the patients and the assessors were fully blinded. All patients were implanted with 2 4-electrode neurostimulators over the proximal peripheral nerves at the T9 level, in a single-stage direct to permanent procedure. The primary endpoint assessed the difference (at least 50% overall relief or a return to 30 mm or less on the Visual Analog Scale) between subthreshold stimulation and sham stimulation. Patients who received the sham treatment were unblinded and were then given the active treatment throughout the different visits if they reported a lack of response. A per-protocol analysis was conducted at the one-month visit. Patients were followed for 36 months.</p><p><strong>Results: </strong>Thirty-eight (active: n = 19; sham: n = 19) patients completed the one-month primary endpoint. Superiority for the primary endpoint was confirmed for the active stimulation arm with a responder rate of 63% compared to the sham arm with only a 16% responder rate (P = 0.007). In addition, the active stimulation patients programmed with subthreshold frequencies experienced statistically and clinically significant improvements in Visual Analog Scale scores, the Oswestry Disability Index. the European Quality of Life Survey, the EuroQOL-5 Dimension Questionnaire, and the Patient Global Impression of Change compared to the sham group. Pain relief, improved functionality, and patient satisfaction were consistently reported throughout the study and were sustained through the 36-month follow-up.</p><p><strong>Limitations: </strong>While the study was rigorously designed and executed, residual confounding cannot be entirely excluded.</p><p><strong>Conclusion: </strong>This trial showed statistically or clinically significant reductions in low back pain in patients with both Persistent Spinal Pain Syndrome Type 1 (c","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"171-183"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778344","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 \"Could the Hanging Drop Technique Be an Alternative Method to Loss of Resistance in Cervical Epidural Injections?\"","authors":"Jeff Gudin, Danielle Bodzin Horn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"E132-E133"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777744","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":"Analgesic Effect of Cannabinoids for Fibromyalgia: A Systematic Review and Meta-Analysis.","authors":"Pui Ming Lam, Fengfeng Wang, Chung Hin Shing, Hung Chak Ho, Marc Russo, Stanley Sau Ching Wong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia is a kind of complex chronic pain syndrome that exerts a profound impact on patients' lives. Current pharmacological treatments for fibromyalgia often yield suboptimal results. Cannabinoids have emerged as a potential therapeutic alternative to these treatments.</p><p><strong>Objectives: </strong>Our study aimed to assess the analgesic efficacy of cannabinoids in treating fibromyalgia.</p><p><strong>Study design: </strong>A systematic review and meta-analysis.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search using PubMed (MEDLINE), EMBASE, ISI Web of Knowledge, Cochrane Library, and Clinicaltrials.gov to analyze randomized controlled trials and observational studies that investigated the analgesic efficacy of cannabinoids in individuals diagnosed with fibromyalgia. The primary outcome was the effect of cannabinoids on pain intensity, quantified by the standardized mean difference (SMD) in pain levels before and after the treatment. We registered our review protocol in PROSPERO (CRD42024495525). The quality of the evidence was evaluated using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) method.</p><p><strong>Results: </strong>Twelve clinical studies, consisting of 2 randomized controlled trials and 10 observational studies, (14 comparisons, 1,248 patients) were selected. Cannabinoids reduced pain intensity with statistical significance (SMD = -1.41, 95% CI = -1.98 to -0.84, P < 0.001), which was associated with a low GRADE rating. Both short-term (< 3 months, SMD = -1.37, 95% CI = -2.32 to -0.43, P = 0.004) and longer-term (≥ 3 months, SMD = -1.43, 95% CI = -2.22 to -0.65, P < 0.001) follow-ups showed statistically significant pain score reduction. Patients also experienced statistically significant improvements in sleep quality, anxiety, depression and quality of life (P-values < 0.05). Common adverse effects included dizziness, dry mouth, and drowsiness, while serious adverse effects were rare.</p><p><strong>Limitations: </strong>Our analyses revealed that the results demonstrated considerable heterogeneity, which was attributed to variations in study designs, interventions, and outcome measurements across the included studies. These factors could potentially influence the validity of the findings. Thus, the results should be interpreted with these variations in mind.</p><p><strong>Conclusion: </strong>Cannabinoids may provide analgesic benefits for patients with fibromyalgia. Cannabinoid use was also associated with improvements in sleep, anxiety, depression and quality of life. However, the findings should be interpreted with caution due to the quality of the evidence, heterogeneity, and small amount of available data from randomized controlled trials.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"95-107"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777682","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 Response to Comments on \"Effects of Continuous Intercostal Nerve Block Versus Patient-Controlled Intravenous Analgesia on Postoperative Pain After Video-Assisted Thoracoscopic Surgery\".","authors":"Liu Shanling","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"E138"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778070","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":"Comment on \"Development of a Model for Predicting the Effectiveness of Low-Temperature Plasma on Zoster-Associated Pain\".","authors":"Mohammad Azizi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"E127-E128"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777700","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":"The Optimal Needle Placement to Access the S1 Dorsal Root Ganglion for Transforaminal Radiofrequency Treatment.","authors":"Abdul Veli Ismailoglu, Savas Sencan, Ahmet Sac, Serdar Kokar, Osman Hakan Gunduz, Umit Suleyman Sehirli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pulsed radiofrequency (PRF) treatment modulates the dorsal root ganglion (DRG), thereby blocking nociceptive signals. Its success depends on precise electrode placement adjacent to the target DRG. However, proper electrode placement for the S1-DRG is challenging due to uncertainty regarding the S1-DRG's precise location.</p><p><strong>Objective: </strong>Our study aimed to investigate the S1-DRG's location relative to the S1-dorsal foramen (DF) and to develop a technique to facilitate its targeting for PRF application.</p><p><strong>Study design: </strong>Human cadaver feasibility study.</p><p><strong>Setting: </strong>Cadaver laboratory.</p><p><strong>Methods: </strong>Twelve S1-DRGs were dissected. A percutaneous needle passing through the S1-DF targeting the \"belly\" of the S1-DRG was placed to establish the optimal needle trajectory. The optimal needle skin entry point relative to the posterior superior iliac spine and the needle's caudal and oblique angulations were measured.</p><p><strong>Results: </strong>In each study cadaver, the S1-DRG was located craniomedially to the S1-DF within the sacral canal. The optimal needle trajectory to the S1-DRG \"belly\" consistently passed through the inferolateral quadrant of the S1-DF.</p><p><strong>Limitations: </strong>Our study's findings are based on anatomical examinations of a limited number of human cadavers and may not fully represent living human anatomy.</p><p><strong>Conclusion: </strong>Approaching through the inferolateral quadrant of the S1-DF maximizes access to the S1-DRG. Placing the needle as described in our study can facilitate PRF treatment of the S1-DRG.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"E87-E91"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778094","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 2","pages":"203"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778135","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":"Experiment-Induced Nociception in Humans with Substance Use Disorders: A Review of Psychophysical Studies.","authors":"Hada Fong-Ha Ieong, Fu Gao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pain perception in individuals with substance use disorders (SUDs) is shaped by neuroadaptive changes in both peripheral and central nociceptive pathways. Accurate assessment of pain sensitivity in this population is essential for effective clinical management but remains challenging due to overlapping effects of drug use, tolerance, and withdrawal.</p><p><strong>Objective: </strong>This review synthesizes findings on pain sensitivity in individuals with SUDs, focusing on experimentally induced nociception-specifically thresholds, tolerance, and perceived intensity of pain.</p><p><strong>Study design: </strong>A systematic narrative review.</p><p><strong>Setting: </strong>Clinical studies that involve patients with opioid, alcohol, and stimulant use disorders and compare their pain responses to those of healthy controls.</p><p><strong>Methods: </strong>The protocol for this review was registered on Open Science Framework (ID# XYPE6). A comprehensive PubMed search identified studies assessing nociception in SUD populations, focusing on pain threshold, tolerance, and intensity.</p><p><strong>Results: </strong>Of 348 publications, 14 studies were included. Thermal stimuli (cold and heat) were used most frequently, followed by pressure, electrical, and chemical modalities. Findings indicate changes in pain thresholds and increased pain sensitivity in association with SUDs, with evidence of dysesthesia notably in patients with alcohol, stimulant, and tobacco use disorders, as well as in chronic pain patients receiving opioids.</p><p><strong>Limitations: </strong>This review is limited by the scarcity of clinical psychophysical pain studies in SUD populations, since most existing research is based on animal models. Additionally, heterogeneous testing protocols across studies constrain comprehensive synthesis.</p><p><strong>Conclusion: </strong>Changes in experimentally induced nociception among individuals with SUDs are measurable and extend beyond preclinical findings. Psychophysical assessments during specific withdrawal stages can reliably quantify nociception in this population. Further research using standardized methodologies is needed to bridge preclinical and clinical evidence and thus enhance pain management strategies for individuals with SUDs.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"109-122"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778137","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":"The Effects of Ultrasound-Guided Genicular Nerve Blocks Used with Local Anesthetics Alone or in Combination with Corticosteroids on Patients with Knee Osteoarthritis: A Placebo-Controlled Randomized Clinical Trial.","authors":"Claudia de la Fuente-Escudero, Carla Sofia Den Heijer, Fatima N Bebea Zamorano, Elia Perez-Fernandez, Mariano Tomas Florez-Garcia, Jose Martel Viliiagran, Javier Martinez Martin, Cristina Duran-Carretero","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The genicular nerve block (GNB) is an emerging minimally invasive treatment for knee osteoarthritis (OA) pain. While corticosteroids are often combined with local anesthetics in GNBs, the added clinical value of this combination remains unclear.</p><p><strong>Objective: </strong>To evaluate the efficacy of the GNB with local anesthetics alone versus local anesthetics plus corticosteroids and a placebo for patients with knee OA.</p><p><strong>Study design: </strong>A prospective, randomized, double-blind, placebo-controlled trial with 3 parallel groups.</p><p><strong>Setting: </strong>Outpatient rehabilitation and orthopedic clinics at a tertiary care hospital.</p><p><strong>Methods: </strong>Adults with symptomatic knee OA were randomized to receive an ultrasound-guided GNB that used one of the following substances: (1) 0.5% bupivacaine plus 20 mg triamcinolone (BC group), (2) 0.5% bupivacaine alone (B group), or (3) 2.5 mL saline placebo (S group). The primary outcome was pain intensity, measured using the numeric rating scale (NRS) and the ) pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC at 4, 12, and 24 weeks. Secondary outcomes included scores on the WOMAC function and stiffness subscales, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Kujala score, and mood as measured on the Escala de Valoración del Estado de Ánimo (EVEA).</p><p><strong>Results: </strong>A total of 102 patients completed the study (BC: n = 33; B: n = 35; S: n = 34). Both the BC and B groups achieved greater pain reduction than did the placebo group (interaction P = 0.001). At 4 weeks, the mean NRS pain reduction was 2.24 (95% CI: 0.93-3.55) in the BC group, 2.94 (95% CI: 1.67-4.21) in the B group, and 1.29 (95% CI: 0-2.58) in the S group. These effects were maintained at 24 weeks. Scores on the WOMAC pain and function subscales saw significantly greater improvement in the BC and B groups than did the placebo group (interaction P < 0.05). No significant differences were observed in KOOS, Kujala, or mood scores. No serious adverse events occurred.</p><p><strong>Limitations: </strong>This study was a single-center trial with a modest sample size. Some secondary outcomes may have been too underpowered to detect group differences.</p><p><strong>Conclusions: </strong>GNBs with bupivacaine provide effective and sustained pain relief for knee OA. The addition of corticosteroids did not yield additional benefits, suggesting that the use of local anesthetics alone may be a safer and sufficient option.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 2","pages":"143-153"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778148","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}