Pain physician最新文献

{"title":"Comments on \"The Effects of Ultrasound-Guided Genicular Nerve Blocks Used with Local Anesthetics Alone or in Combination with Corticosteroids on Patients with Knee Osteoarthritis\".","authors":"Ming-Hui Hung, Shu-Yueh Cheng","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"E445-E446"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670073","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":"Modulation of Pain Perception Through Identifying Emotionally with Music Feedback During Physical Exercise for Patients with Chronic Pain: A Randomized Trial.","authors":"Lydia Schneider, Cornelia Exner, Alida Wulfson, Jutta Geidel, Michael Schenk, Thomas Hans Fritz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The emotional modulation of pain can be achieved through interventions in the form of music, which may therefore be valuable in regulating emotions and perceived pain during physical activity.</p><p><strong>Objectives: </strong>The present study aimed to investigate the effects of music feedback during physical exercise on chronic pain patients' emotional states, motivation, and pain levels during an acute clinic stay.</p><p><strong>Study design: </strong>A crossover design was used to test the effects of music feedback during an ergometer training (active condition) vs. music listening during an ergometer training (passive condition) on 43 patients with different chronic pain conditions during their acute clinical stay.</p><p><strong>Setting: </strong>An acute clinic specializing in pain medicine.</p><p><strong>Methods: </strong>Patients were recruited by clinical staff and randomly assigned to perform both conditions in different orders. The music was selected from 4 genres, and the same songs were used in the training sessions for both types of conditions.</p><p><strong>Results: </strong>The results showed that patients' motivation to exercise was stronger during the active condition than during the passive condition, as measured by active engagement during the training interval (t(39) = 3.013, P = 0.006; 95% CI: 0.0104; .0529). Those findings matched with patients' individual ratings of their motivation. For both conditions, anxiety levels decreased significantly from baseline (active condition: Z = -4.213; P < 0.001; passive condition: Z = -3.864; P < 0.001). The pain levels did not differ between conditions (Z = -0.137, P = 0.45). Interestingly, the reported match/congruency of the patients' moods and emotions expressed by the chosen music pieces correlated with changes in pain perception (r = -0.438, P = 0.007), and the match of the patients' own emotional state with the music was significantly higher during the active condition (Mdn = 7.7) than during the passive condition (Mdn = 6.35; Z = -3.429; P < 0.001). No significant correlation between changes in pain intensity and changes in heart rate variability were observed (r = 0.15, P = 0.952).</p><p><strong>Limitations: </strong>The rather heterogeneous patient sample limits specific conclusions about effects on certain pain conditions, and the focus on immediate effects precludes conclusions about long-term outcomes.</p><p><strong>Conclusion: </strong>Music feedback during physical exercise may be beneficial in increasing motivation in patients with chronic pain. A stronger match of emotions expressed by music feedback and the patient's own emotional state seems to influence pain perception.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"317-326"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670248","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":"Ultrasound- Versus Landmark-Guided Corticosteroid Injections for Shoulder Pain: Evaluating the Overlapping Meta-Analyses of Randomized Controlled Trials.","authors":"Ying Du, Bowen Shi, Zhendong Xu, Bo Qian, Zhiwei Jia, Tianlin Wen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Shoulder pain is frequently treated with corticosteroid injections administered via ultrasound-guided (USG) or landmark-guided (LMG) approaches. Despite the widespread use of these injections, consensus on their comparative efficacy is lacking due to conflicting results reported in prior meta-analyses.</p><p><strong>Objective: </strong>To compare overlapping meta-analyses of USG to those of LMG injections in order to resolve current discrepancies, determine the highest-quality evidence, and offer clear recommendations for clinical practice.</p><p><strong>Study design: </strong>A cross-sectional analysis.</p><p><strong>Setting: </strong>English-language systematic reviews and meta-analyses searched in PubMed, Embase, and Cochrane Library up to February 12, 2025, regarding USG management of shoulder pain.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted to identify meta-analyses of randomized controlled trials (RCTs) that assessed USG and LMG corticosteroid injections in the treatment of shoulder pain. Methodological quality of the included meta-analyses was assessed, and the Assessment of Multiple Systematic Reviews (AMSTAR) scores were calculated. The Jadad decision algorithm was applied to determine the highest-quality evidence.</p><p><strong>Results: </strong>The analysis encompassed 9 meta-analyses, the AMSTAR ratings of which ranged between 5 and 9. Through the Jadad algorithm, one high-quality study was identified. Its findings indicated that USG injections did not significantly outperform LMG injections in terms of pain relief or functional outcomes for subacromial bursa and glenohumeral joint targets. However, for injections involving the brachial bicipital groove, the USG approach demonstrated greater efficacy in alleviating pain.</p><p><strong>Limitations: </strong>First, the restriction to English-language literature might have introduced language bias by excluding relevant non-Anglophone studies. Second, the included studies provided only Level II evidence, so this analysis could not establish clinical recommendations grounded in the highest tier (Level I) of empirical support.</p><p><strong>Conclusions: </strong>USG corticosteroid injections are recommended for targeting the brachial bicipital groove due to their superior efficacy in pain reduction, while LMG injections remain appropriate for the subacromial bursa or glenohumeral joint.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"377-387"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670351","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":"Peripheral Nerve Stimulation Is Medically Necessary and Clinically Validated and Can No Longer Be Deemed Experimental.","authors":"Peter S Staats, Timothy Deer, Sean Li, Konstantin Slavin, Sayed Wahezi, Miles Day, Paul Christo, Jason S Eldrige, Steven P Cohen, Jennifer Hah, David Dickerson, Hemant Kalia, Robert Levy, Alan D Kaye, Mahendra R Sanapati, Laxmaiah Manchikanti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Peripheral Nerve Stimulation (PNS) is a well-established neuromodulation therapy with decades of clinical use, a substantial body of clinically validated, peer-reviewed evidence, and endorsement in multiple evidence-based professional guidelines, including by the US Department of Defense. Despite this maturity, many commercial payers continue to deny coverage by categorizing PNS as \"investigational\" or \"experimental,\" often conflating it with fundamentally different, indirect electrical stimulation modalities. This misclassification is increasingly misaligned with current science, clinical practice, and health-economic data, and has become a primary barrier to patient access to medically necessary care for refractory chronic pain. Given this extensive evidence base, it is no longer appropriate or ethical for payors to deny patients access to such an impactful treatment that clinicians and patients rely upon for managing refractory chronic pain.The present position statement - peripheral nerve stimulation is medically necessary and clinically validated, is developed by consensus of multidisciplinary experts with deep expertise in the field of neuromodulation, chronic pain, and peripheral nerve stimulation. This position statement provides background and rationale showing the justification for the statement supported by literature research and clinical evidence.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"301-306"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670350","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":"Chronic Pain-Associated Mortality in the United States: A Population-Based Study, 1999-2023.","authors":"Ali Al-Salahat, Mittal Prajapati, Ali Bin Abdul Jabbar, Jyotsna Nagda, Peter S Staats, Laxmaiah Manchikanti","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is increasingly recognised as a disease with substantial morbidity, yet large-scale data on chronic pain-associated mortality trends and disparities are lacking.</p><p><strong>Objective: </strong>To examine nationwide temporal trends and demographic disparities in chronic pain-associated mortality in the US from 1999 to 2023.</p><p><strong>Methods: </strong>Death certificate data from the Centres for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999-2023) were extracted. All deaths with chronic pain listed as a contributing cause were included (n = 67,417), reporting chronic pain (ICD-10 codes R52.1 and R52.2). Age-adjusted mortality rates (AAMRs) per 1,000,000 population, standardized to the 2000 US population. Trends were analysed using Joinpoint regression and represented by annual percentage changes (APCs) with 95% confidence intervals.</p><p><strong>Results: </strong>Among 67,417 chronic pain-associated deaths (61.5% female), AAMR increased from 1.97 per 1,000,000 in 1999 to 10,72 per 1,000,000 in 2023 (average APC, +6.3%; 95% CI5.8% to 6.8%). Increases in AAMR were noted across both sexes (females; average APC, 6.1%; males: 6.6%), age groups (≥ 55 years: average APC, 6.5%; < 55 years: 4.7%), race/ethnicities (non-Hispanic White; average APC, 6.3%; non-Hispanic Black: 10.4% to 2019 then stable; Hispanic: similar acceleration), and regions (all average APCS, 5.3% to 6.3%). Females and those ≥ 55 years had higher AAMRS; the South had the highest burden (33.9% of deaths).</p><p><strong>Conclusion: </strong>These findings revealed a marked rise in chronic pain-associated mortality, disproportionately affecting females, older adults, non-Hispanic White individuals, and the South, signalling chronic pain as a public health concern. Enhanced documentation, interventions targeting comorbidities and disparity-focused policies are urgently needed to mitigate this burden.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"353-361"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669696","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":"Prolonging Peripheral Nerve Blocks in Adults: A Narrative Review of Adjunct Medications for Single-Injection Techniques.","authors":"Sachin Sunny Jha","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Single-injection peripheral nerve blocks (PNBs) are a cornerstone of multimodal perioperative analgesia. However, the duration of commonly used long-acting local anesthetics is finite; many patients experience abrupt and sometimes severe \"rebound pain\" as the block resolves. This phenomenon is particularly prominent after painful orthopedic procedures and may increase early opioid consumption and reduce patient satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To review the effectiveness and safety of pharmacologic adjuncts used to prolong adult single-injection PNBs and to provide practical, clinically oriented recommendations for their use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Narrative review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;I conducted a focused narrative review of randomized controlled trials, observational studies, and systematic reviews or meta-analyses evaluating adjunct medications administered with single-injection PNBs in adults. The agents considered were dexamethasone, dexmedetomidine, clonidine, morphine, fentanyl, buprenorphine, magnesium sulfate, midazolam, and ketamine. The outcomes of interest were sensory block duration and analgesia, postoperative opioid consumption, rebound pain, and adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Dexamethasone, given intravenously or perineurally, consistently prolongs analgesia by approximately 6-8 hours and reduces early opioid use. Buprenorphine, administered perineurally, often extends analgesia to 24-48 hours but increases postoperative nausea. Dexmedetomidine modestly prolongs a block's duration and improves a block's quality, but is associated with dose-dependent bradycardia, hypotension, and sedation. Clonidine yields smaller gains in a block's duration with similar hemodynamic and sedative concerns to dexmedetomidine. Magnesium sulfate and midazolam produce modest and more variable benefits. Ketamine has inconsistent effects on a block's duration but may help mitigate hyperalgesia in select patients. Conventional opioids (morphine, fentanyl) provide little incremental benefit as perineural adjuncts; they also increase opioid-typical adverse effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;This is a narrative rather than a systematic review; heterogeneity among studies in block type, local anesthetic formulation, dosing, and outcome definitions precludes pooled quantitative estimates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Dexamethasone and buprenorphine have the strongest and most consistent evidence for clinically meaningful prolongation of single-injection PNBs in adults and may be considered first-line adjuncts in appropriate patients. Dexmedetomidine, clonidine, magnesium, midazolam, and ketamine may be useful in some situations when their specific benefit-risk profiles are acceptable. Conventional opioids offer little advantage as perineural adjuncts and are not recommended for routine use. Evidence-based selection of adjuncts within a multimodal analges","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"307-315"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670394","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":"Absence of a Consistent Gut or Oral Microbial Signature in Fibromyalgia Under Strictly Controlled Clinical Conditions: A Multi-Compartment 16S rRNA Analysis.","authors":"Gozde Celik, Ece Yanik, Nurten Inan, Ayse Meltem Yalinay","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fibromyalgia (FM) has been increasingly studied in the context of gut-brain-immune interactions, and several reports have suggested an association between FM and alterations in gut or oral microbial communities. However, prior studies have often suffered from heterogeneous comorbidities, inconsistent sampling procedures, and limited control for environmental factors, making it unclear whether FM is associated with a reproducible, site-independent microbial signature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To determine whether women with FM exhibit consistent alterations in gut or oral microbiota when evaluated under strictly standardized physiological, clinical, and environmental conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A prospective, observational, case-control study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The Department of Pain Medicine and Department of Medical Microbiology at Gazi University, Türkiye.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The patient selection comprised 31 women (16 with FM; 15 healthy controls) who met rigorous inclusion and exclusion criteria, minimizing confounding from diet, metabolic disease, medications, hormonal status, and recent infections. No therapeutic intervention was performed; all patients provided paired oral mucosal and fecal samples during the follicular phase of the menstrual cycle. Sequencing of 16S rRNA V3-V4was performed on DNA extracted from all samples. Alpha and beta diversity metrics, taxonomic profiles, and differential abundance analyses (including LEfSe with FDR correction) were compared between groups. The clinical severity of FM was assessed using scores on the visual analog scale (VAS), Widespread Pain Index (WPI), and Symptom Severity Scale (SSS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No statistically significant differences were observed between FM patients and controls in fecal or oral alpha diversity (Shannon, Simpson, Chao1, Observed OTU indices, all P &gt; 0.05). Beta diversity analyses (Bray-Curtis PERMANOVA) revealed no between-group separation in either compartment (fecal R² = 0.032, P = 0.529; oral R² = 0.032, P = 0.464). Both groups displayed preserved core microbial communities in the gut, dominated by Firmicutes and Bacteroidota and, in the oral cavity, Streptococcus-enriched profiles. Minor genus-level variations were detected, but none remained significant after FDR correction. Cross-site analyses confirmed the expected ecological divergence between oral and fecal habitats but identified no FM-specific microbial pattern. Post hoc sensitivity analysis indicated that the study was powered to detect only moderate effect sizes (R² ≥ 0.11), suggesting that subtle differences might have remained undetected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;A modest sample size, a lack of quantitative dietary assessment, and reliance on 16S rRNA sequencing limited the detection of subtle or functional microbial alterations. Additionally, the cross-sectional design precludes causal infer","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"E407-E416"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670541","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":"Perioperative 24-Hour Lidocaine Infusion Does Not Prevent Chronic Postthoracotomy Pain: A Triple-Blinded Randomized Controlled Trial.","authors":"Jun Zheng, Danyang Pan, Shilang He, Xiangcai Ruan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Managing chronic postsurgical pain is challenging. Evidence supporting the use of perioperative lidocaine to prevent it is inconsistent, potentially due to insufficient infusion duration.</p><p><strong>Objectives: </strong>To determine the effect of extending lidocaine infusion to 24 hours for treating chronic postsurgical pain in patients undergoing video-assisted thoracoscopic surgery.</p><p><strong>Study design: </strong>Triple-blind, controlled randomized trial.</p><p><strong>Setting: </strong>A tertiary center in a university hospital.</p><p><strong>Methods: </strong>Seventy-one patients undergoing elective video-assisted thoracoscopic surgery were randomized 1:1 to receive either 2% lidocaine or placebo infusion at a speed of 4 mL/h started after anesthesia induction and continued for 24 hours. Primary outcomes were chronic postsurgical pain at 3 months defined as present pain score > 0 on an 11-point Numeric Rating Scale. Secondary outcomes included acute pain and opioid use during the first postsurgical 48 hours, and chronic postsurgical pain for up to 6 months.</p><p><strong>Results: </strong>The incidences of chronic postsurgical pain at either 3 or 6 months did not differ significantly between the placebo and lidocaine groups (50% vs 50%, P = 1.0; 27% vs 32%, P = 0.63, respectively). There were no significant differences in acute pain scores or opioid consumption between the groups. Dizziness was more frequent during lidocaine infusion (47% vs 14% in the placebo group, P < 0.01). No serious adverse events were reported.</p><p><strong>Limitations: </strong>The follow-up period was limited to 6 months and there was a small number of patients.</p><p><strong>Conclusions: </strong>A perioperative lidocaine infusion for 24 hours added to multimodal analgesia did not prevent chronic postthoracotomy pain.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"345-352"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670287","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":"Long-Term Effectiveness of Repeated, Single-Day Intravenous Ketamine Infusions for Severe Arthritis: A Retrospective Cohort Study.","authors":"Leonardo Kapural, Ishan Viradia, Sofia Korunda, Simran Dua, Neil Poddar, Carmen Bekavac, Kunal Poddar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ketamine, either adminstered as an infusion or orally as an analgesic, was considered only to be a drug for neuropathic pain. More recently it has been speculated to be efficacious for other types of pain, including nociceptive pain.</p><p><strong>Objectives: </strong>We aimed to examine the long-term effects of single-day ketamine infusions for treating diffuse chronic pain caused by rheumatoid arthritis, osteoarthritis, or psoriatic arthritis.</p><p><strong>Study design: </strong>Our study analyzed the records of a cohort of 38 consecutive patients treated with repeated single-day intravenous ketamine infusions for chronic arthritis pain.</p><p><strong>Setting: </strong>Outpatient private practice.</p><p><strong>Methods: </strong>Outcome data on patients treated from January 2019 through December of 2024 in our clinic were collected from our electronic medical records and analyzed. It included numeric pain scores and opioid usage. All procedures were completed under conscious sedation using a vitals monitoring protocol. Ketamine was administered at about 1-1.5 mg/kg/h during a 3 hour session. The sessions were repeated as needed at approximately every 3-12 months (median 6 months). Dosing was decided based on a patient's comorbidities. Patients with advanced cardiovascular issues, sleep apnea, or a history of substance abuse were not considered for an infusion.</p><p><strong>Results: </strong>A total of 38 patients-35 women and 3 men, aged from 21-73 years (median 58) with a median body mass index (BMI [kg/m2]) of 33 received repeated ketamine infusions (300-500 mg per session) for control of their chronic arthritis pain. They averaged 3 sources of chronic pain in their body. Of the 38 study patients, 18 were on opioids with a median morphine milligram equivalent of 45. Their baseline pain score was 8 and decreased at 3 months follow-up to 4 which was maintained at 4 at 24 months. Nineteen patients had more than 50% pain relief at 3 months and 20 patients at 24 months. Pain relief was maintained through 24 months after the initial infusion. Eight patients received minimal or no benefit from infusions. The number of patients on opioids decreased from 18 to 10 at 24 months with a median morphine milligram equivalent of 30.</p><p><strong>Limitations: </strong>This was a retrospective study.</p><p><strong>Conclusions: </strong>Ketamine infusion provided substantial and lasting pain relief in the majority of patients with arthritis. Repeated ketamine infusions provided consistent pain relief throughout 24 months. Opioid usage somewhat decreased in those patients on opioid medications.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"363-368"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670292","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 \"Comparing the Safety and Effectiveness of Radiofrequency Thermocoagulation on Genicular Nerve, Intraarticular Pulsed Radiofrequency with Steroid Injection in the Pain Management of Knee Osteoarthritis\".","authors":"Mert Sancar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 5","pages":"E455"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669971","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}