Pain and Therapy最新文献

{"title":"The Importance of Image Guidance in Common Spine Interventional Procedures for Pain Management: A Comprehensive Narrative Review.","authors":"Martina Rekatsina, Philip W H Peng","doi":"10.1007/s40122-025-00731-9","DOIUrl":"https://doi.org/10.1007/s40122-025-00731-9","url":null,"abstract":"<p><strong>Introduction: </strong>Image-guided spinal injections are commonly performed by pain physicians and supported by literature. A recent survey showed that half of the Canadian providers still perform landmark-guided injections. This comprehensive review aims to describe the evidence supporting imaging modalities (fluoroscopy, computed tomography (CT) and ultrasound) in improving the accuracy and safety in several commonly performed spine injections. Relevant anatomy and pitfalls of landmark-guided injections are also discussed.</p><p><strong>Methods: </strong>An extensive literature search was conducted in PubMed, Medline and Embase databases, complemented by a manual search. Search terms included all spine interventions and imaging modalities.</p><p><strong>Results: </strong>Literature shows that incorrect needle placement without imaging guidance can reach 50% in caudal, 30.4% in lumbar interlaminar and 53% in cervical interlaminar epidural steroid injections. Lumbar and cervical transforaminal steroid injections require imaging to identify intravascular or intradiscal needle placement; misplacement rates can be as high as 20% at cervical, 8% at thoracic, 6-15% at lumbar and 16.5-21% at sacral levels. Imaging techniques for sacroiliac joint steroid injections are superior to non-imaging techniques, while medial branch blocks and facet joint injections require image guidance.</p><p><strong>Conclusion: </strong>Image guidance is a mandatory requirement when performing spinal procedures for pain management. Fluoroscopy enhances the safety and accuracy of spinal injections, with stored images benefiting patient records. Ultrasound also has an increasingly important role either alone or with fluoroscopy. CT is also effective but with limited accessibility.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764598","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":"Evaluating the Real-World Use of Topical Diclofenac Sodium Gel 1% Using US Longitudinal Electronic Health Records Database: A study supporting OTC switch.","authors":"Nicholas M Sicignano, Frédérique Bariguian Revel, Richard Petruschke, Francis P Barbone, Karin Nicholson, Jess D Edison","doi":"10.1007/s40122-025-00723-9","DOIUrl":"https://doi.org/10.1007/s40122-025-00723-9","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal conditions are a significant health challenge and second leading cause of disability worldwide. Diclofenac sodium topical gel 1% (DSG1%) provides effective relief of arthritis pain. While clinical studies show that DSG1% is safe and well-tolerated, long-term safety and tolerability in real-world settings are limited. This study aimed to profile users and prescribers of DSG1% and to evaluate its safety and tolerability over a screening period of 8.5 years with an average follow-up of nearly 1 year. The focus was on patients with risk factors and comorbidities, especially those taking concomitant medication in addition to topical nonsteroidal anti-inflammatory drugs (NSAIDs).</p><p><strong>Methods: </strong>This retrospective, longitudinal cohort study used the US Department of Defense (DoD) electronic health records (EHR) database. The database included 521,593 individuals with ≥ 1 prescription for DSG1% for either indicated or non-indicated conditions with mean (standard deviation; SD) follow-up of 348.4 (562.4) days. The primary outcome measure assessed the incidence of predefined events of interest (EOIs), including gastrointestinal, hepatic, renal diseases, cardiovascular events, hypertension, skin reaction, misuse, abuse, and death (all-cause mortality).</p><p><strong>Results: </strong>The average age of subjects was 56.7 years (SD = 18.1), with women comprising 60.4% of population. During study-period, 74.2% of subjects experienced no adverse EOIs after initiating treatment with DSG1%. Among the remaining 25.8%, average time to first EOI was 244.0 (SD = 368.6) days. Notably, the frequency of reported EOIs increased with age. Additionally, subjects with conditions such as rheumatoid arthritis, systemic lupus erythematosus, or diabetes had a higher incidence of cardiovascular EOIs.</p><p><strong>Conclusions: </strong>The study results indicate that DSG demonstrated a favorable safety profile, particularly for patients with comorbidities and high-risk factors and when used with other medications. Despite an older population and high baseline risk factors (93%), only 26% DSG1% users experienced a predefined EOI, observed on average 244.0 (368.6) days from index date. These findings confirm the long-term tolerability of topical DSG1% for musculoskeletal disorders.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764589","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":"Small Fibre Pathology in Fibromyalgia: A review.","authors":"Anne Marshall, Mohamed Elshafei, Frank G Preston, Jamie Burgess, Nicola Goodson, Nicholas Fallon, Bernhard Frank, Sizheng Steven Zhao, Uazman Alam","doi":"10.1007/s40122-024-00696-1","DOIUrl":"10.1007/s40122-024-00696-1","url":null,"abstract":"<p><p>Fibromyalgia syndrome (FMS) presents a complex and challenging disorder in both the diagnosis and treatment, with emerging evidence suggesting a role of small fibre pathology (SFP) in its pathophysiology. The significance of the role of SFP in FMS remains unclear; however, recent evidence suggests degeneration and dysfunction of the peripheral nervous system, particularly small unmyelinated fibres, which may influence pathophysiology and underlying phenotype. Both skin biopsy and corneal confocal microscopy (CCM) have consistently demonstrated that ~ 50% of people with FMS have SFP. CCM, a non-invasive measure of small nerve fibres has detected small fibre loss, correlating with neuropathic pain descriptors. Additionally, quantitative sensory testing has shown abnormalities, primarily in pain pressure/mechanical pain thresholds. This narrative review provides a comprehensive understanding of the pathophysiological dimensions of FMS with a clear focus on small nerve fibres and the peripheral nervous system, offering a roadmap for future research.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"461-478"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Pain and Obsessive-Compulsive Disorder: A Scoping Review.","authors":"Chad Sloley, Caroline Bell, Edward A Shipton, Jonathan Williman, Joanne L Jarvis","doi":"10.1007/s40122-024-00704-4","DOIUrl":"10.1007/s40122-024-00704-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The aim of this study was to map the association between Chronic Pain (CP) and Obsessive-Compulsive Disorder (OCD) in the present literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review was conducted with a comprehensive search of literature in peer-reviewed journals. Search parameters included articles written in English, published at any time, and including terms associated with both CP and OCD. Databases searched for purposes of this study included Psychinfo, Medline, Embase, Emcare, CINAHL, Scopus, Web of Science, Cochrane, and Google Scholar.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The review included 87 records, comprising 49 primary research and 38 secondary research records. Extracted information from these were grouped into four broad classifications. The Prevalence and Severity classification included information from 39 records which comprised: (1) primary research detailing current OCD prevalence rates in CP conditions (differentiated between general population and Pain/Medical/Hospital clinics); (2) primary research detailing lifetime OCD prevalence rates in CP conditions; (3) primary research detailing CP prevalence rates in OCD; (4) primary research detailing relationships between OCD and CP through psychometric measures; and (5) secondary research relating to prevalence rates. The Neurobiology classification included information from 28 records (primary and secondary research) detailing convergent and divergent neurobiological/neurophysiological aspects as reported for both OCD and CP. The Psychological Models/Factors classification included information from 7 records (primary and secondary research) detailing pain-related anxiety, neuropsychological measures, catastrophic thinking, preservative thinking, early maladaptive schemas, schema modes, childhood trauma experiences, and conditional associative learning, as reported for OCD and CP. The Intervention classification included information from 32 records which comprised: (1) primary research on neurosurgical, medication, and psychotherapeutic interventions; (2) secondary research on Deep Brain Stimulation; (3) secondary research on Medication; (4) secondary research on lesion, cingulotomy, and other surgical procedures; and (5) secondary research on other interventional procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While there has been considerable and growing research in the fields of both OCD and CP over the years, focused research into their potential association has been limited and potentially overlooked. The results of this review, however, suggest a complex relationship between CP and OCD. Prevalence rates between the two conditions vary widely across different populations, although the underlying reason for this remains unclear at this stage. There are commonalities in terms of alterations in pain processing, the dysregulation of certain brain regions, and the abnormalities in neurotransmitter systems in both conditions. In their treatmen","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"513-587"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Noninvasive Pulsed Electromagnetic Field Therapy for Joint and Soft Tissue Pain Management: A Prospective, Multi-center, Randomized Clinical Trial.","authors":"Joshua G Hackel, James M Paci, Sunny Gupta, David A Maravelas, Taylor J North, Adelina Paunescu","doi":"10.1007/s40122-025-00711-z","DOIUrl":"10.1007/s40122-025-00711-z","url":null,"abstract":"<p><strong>Introduction: </strong>Strategies to reduce pharmacologic use for pain are needed. Pulsed electromagnetic field (PEMF) therapy is a noninvasive, nonpharmacologic treatment for pain that modifies nitric oxide signaling to improve healing. This study examined whether PEMF decreased pain and pharmacologic use vs. standard-of-care (SOC) treatment for joint and soft tissue pain.</p><p><strong>Methods: </strong>This prospective, randomized controlled trial enrolled 120 patients presenting with joint or soft tissue pain at five orthopedic clinic sites. The PEMF group self-administered daily therapy from a commercially available device and the SOC group received standard treatment daily as prescribed by the clinician. Patients recorded their pain level, pharmacologic usage, and adverse events daily for 14 days. After 14 days, patients in the SOC group were given the option to crossover to PEMF therapy and continue for 16 days. The study was overseen by an independent clinical research organization. It was hypothesized that PEMF would be superior to SOC for pain management.</p><p><strong>Results: </strong>PEMF treatment provided significant analgesic benefits compared to SOC. Complete data was collected for 91 patients, 48 from the PEMF group and 43 from the SOC group. The least squares mean pain score change from baseline was - 1.8 (a 36% reduction) for the PEMF group, significantly surpassing - 0.46 (a 10% reduction) for the SOC group (p < 0.0001). Pharmacologic usage decreased from 40 to 18% for the PEMF group (a 55% reduction), while the SOC group decreased from 40 to 35% (a 12% reduction). In the crossover subgroup, patients experienced an additional 18% decrease in pain score and 63% decrease in pharmacologic use after switching from SOC to PEMF treatment.</p><p><strong>Conclusions: </strong>PEMF was significantly more effective than SOC at managing pain and reducing pharmacologic use. PEMF therapy should be considered for noninvasive, nonpharmacologic management of joint and soft tissue pain.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID NCT05244187.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"723-735"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bayesian Network Meta-Analysis of Postoperative Analgesic Techniques in Thoracoscopic Lung Resection Patients.","authors":"Fang Yue, Yongye Xie, Xiangdong Chen, Ruifen Xu, Hui Wang, Ning Bai, Minna Hou, Jiao Guo","doi":"10.1007/s40122-025-00712-y","DOIUrl":"10.1007/s40122-025-00712-y","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative analgesia in thoracoscopic lung resection is crucial, with several nerve block techniques-including thoracic epidural anesthesia (TEA), paravertebral block (PVB), erector spinae plane block (ESPB), intercostal nerve block (INB), and serratus anterior plane block (SAPB)-commonly employed. However, there remains ongoing debate regarding the optimal technique.</p><p><strong>Methods: </strong>To evaluate and compare the effectiveness of these analgesia methods, a systematic review was conducted across multiple databases, including PubMed, Embase, Web of Science, and the Cochrane Library, identifying relevant randomized clinical trials (RCTs). A Bayesian network meta-analysis was performed to assess postoperative pain management, with subgroup analyses and meta-regression conducted to examine key factors influencing outcomes, such as the risk of bias, continuous catheter analgesia, and patient-controlled analgesia (PCA).</p><p><strong>Results: </strong>The results revealed that for 12-h resting visual analog scale (VAS) scores, the surface under the cumulative ranking curve (SUCRA) ranking was TEA > PVB > ESPB > control > INB > SAPB, whereas at 24 h, it shifted to PVB > TEA > ESPB > INB > control > SAPB. For 12-h coughing VAS scores, TEA ranked highest, followed by PVB, SAPB, ESPB, and control. At 24 h, PVB ranked highest, followed by TEA, ESPB, SAPB, INB, and control. The inconsistency test showed good consistency, with minimal publication bias, and meta-regression revealed that neither study quality nor local anesthetic infiltration at the incision site significantly impacted the outcomes. Excluding studies without PCA did not change the SUCRA rankings. PVB consistently ranked highest for 24-h resting and coughing VAS scores. Clustered ranking plots indicated that PVB and ESPB were the most suitable techniques for postoperative analgesia.</p><p><strong>Conclusion: </strong>PVB and ESPB emerged as the most suitable analgesic techniques for thoracoscopic lung resection. While PVB showed superior analgesic efficacy, ESPB offered fewer side effects, providing a safety advantage. TEA was considered less suitable due to its excessive side effects.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"617-637"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Long-Term Retrospective Observational Clinical Study Evaluating the Efficacy of Plasma Rich in Growth Factors (PRGF) in the Treatment of Back Pain.","authors":"Eduardo Anitua, Isidro Milani, Àlex Martínez, Freddy Cabello, Roberto Prado, Sabino Padilla, Luis Sanado","doi":"10.1007/s40122-024-00699-y","DOIUrl":"10.1007/s40122-024-00699-y","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic back pain is a long-lasting disorder that is significantly associated with a reduction in the quality of life. Previously, the efficacy of intradiscal and epidural injections of plasma rich in growth factors (PRGF) was demonstrated at 6 months. The objective of this study was to retrospectively examine the medical records of these patients in order to determine whether the observed improvement at the 6-month follow-up was sustained over time.</p><p><strong>Methods: </strong>PRGF efficacy was evaluated using validated questionnaires: Core Outcome Measure Index (COMI) Pain score, COMI Disability score, COMI total score, and Oswestry Disability Index (ODI). Furthermore, an evaluation was conducted to determine whether the patients had undergone additional treatments.</p><p><strong>Results: </strong>the results demonstrated that 85.2% of the 27 patients who were enrolled exhibited sustained improvement across all scales over a median follow-up period of 24 months. The results of all questionnaires administered at 24 months exhibited statistically significant differences when compared to the baseline data (p < 0.01). Furthermore, there were no statistically significant differences between the results reported at 6 months and those at 24 months (p > 0.05).</p><p><strong>Conclusions: </strong>the results of this retrospective study demonstrate that treatment of chronic back pain with PRGF was effective in maintaining pain reduction and improving function for at least 24 months after the end of treatment.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"675-690"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Antibiotic Administration Incidents Involving Neuraxial Routes: Clinical Analysis, Contributing Factors and Prevention Approaches.","authors":"Santosh Patel","doi":"10.1007/s40122-024-00701-7","DOIUrl":"10.1007/s40122-024-00701-7","url":null,"abstract":"<p><strong>Introduction: </strong>This review aimed to investigate the inadvertent administration of antibiotics via epidural and intrathecal routes. The secondary objective was to identify the contributing human and systemic factors.</p><p><strong>Methods: </strong>PubMed, Scopus and Google Scholar databases were searched for the last five decades (1973-2023). The author recorded the antibiotics involved, the route of administration, clinical details and consequences in a standardised format. The author utilized the Human Factors Analysis Classification System (HFACS) framework to identify contributing factors.</p><p><strong>Results: </strong>Twenty publications reported neuraxial administration of antibiotics (adults, 19, paediatric, three patients). Fifteen (of 22) incidents happened in the post-surgical or post-chronic pain procedure period. Most errors (14 of 22) occurred via the epidural route. Cefazolin (six) and gentamicin (five) were the most common among 13 antibiotics involved. Intrathecal cephalosporin incidents (n = 6) were associated with devastating consequences (death, one, permanent residual neurological deficits, three). In the unsafe act category of the HFACS, the perceptual error contributing to occurrences of neuraxial antibiotics administration errors was due to IV-neuraxial device (e.g. intrathecal drain or catheter, epidural catheter) confusion (eight patients) or syringe/infusion bag swap (nine patients).</p><p><strong>Conclusions: </strong>Intrathecal cephalosporins and gentamicin administration are associated with devastating consequences. Prevention of neuraxial antibiotic administration requires improvements in clinical deficiencies and the implementation of supporting technological tools to prepare and administer antibiotics correctly, thereby ensuring patient safety.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"445-460"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autologous Peripheral Blood-Derived Orthobiologics for the Management of Elbow Disorders: A Review of Current Clinical Evidence.","authors":"Ashim Gupta, Filippo Migliorini, Tommaso Bardazzi, Nicola Maffulli","doi":"10.1007/s40122-025-00707-9","DOIUrl":"10.1007/s40122-025-00707-9","url":null,"abstract":"<p><strong>Introduction: </strong>Elbow ailments are common, but conventional treatment modalities have shortcomings, offering only interim pain relief rather than targeting the underlying pathophysiology. The last two decades have seen a marked increase in the use of autologous peripheral blood-derived orthobiologics (APBOs), such as platelet-rich plasma (PRP), to manage elbow disorders. Platelet-rich plasma (PRP) is the most widely used APBO, but its efficacy remains debatable. Consequently, other APBOs, such as platelet lysate (PL), autologous conditioned serum (ACS), gold-induced cytokine (GOLDIC), plasma rich in growth factors (PRGF), autologous protein solution (APS), and hyperacute serum (HS), have been considered. Only a few reviews summarize the results of clinical studies investigating the efficacy of these APBOs in elbow disorders. This review documents the results of clinical studies involving APBOs in managing elbow disorders and summarizes the ongoing clinical studies on different clinical trial protocol repositories comprising these APBOs to manage elbow disorders.</p><p><strong>Methods: </strong>This systematic review adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. In December 2024, PubMed, Embase, and Web of Science were accessed with no additional filters or time constraints. All available clinical studies published in English, French, Spanish, German, or Italian concerning the management of elbow disorders by means of APBOs were considered.</p><p><strong>Results: </strong>Only three clinical studies met our predefined search and inclusion criteria. In particular, two and one studies involving the use of PL and ACS, respectively, were included in this review. Data from 99 patients were obtained. Of them, 57.6% (57 of 99 patients) were women. The mean length of follow-up was 11.9 ± 0.6 months, and the mean age was 42.0 ± 3.5 years. No complications were reported in any of the studies included. The included studies have low to medium risk of bias, and a very low score on methodological quality. Finally, no clinical studies involving the use of GOLDIC, PRGF, APS or HS were identified, and only one ongoing clinical study involving the use of PL was registered.</p><p><strong>Conclusions: </strong>The current peer-reviewed published studies demonstrated that administering APBOs, including PL and ACS, might be safe and effective in reducing pain and improving function in patients with elbow disorders. Further, high-quality studies are required.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"497-511"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Different Acupuncture Techniques for Pain and Dysfunction in Patients with Knee Osteoarthritis: A Randomized Controlled Trial.","authors":"Jing Sun, Yi Liang, Kai-Tao Luo, Xiao-Mei Shao, Ming-Qi Tu, Xiao-Ting Wu, Fang Liu, Xin-Wei Li, Yi-Dan Chen, Qi-Fei Zhang, Cong-Hua Ji, Rong-Rong Li, Xiao-Yu Li, Fu Xu, Jian-Qiao Fang","doi":"10.1007/s40122-025-00713-x","DOIUrl":"10.1007/s40122-025-00713-x","url":null,"abstract":"<p><strong>Introduction: </strong>Various acupuncture techniques are widely applied in clinics for pain control and dysfunction relief in patients with knee osteoarthritis (KOA). The purpose of this trial was to investigate whether the different acupuncture techniques were more effective in treating joint pain and dysfunction than were sham acupuncture or drug treatment in patients with KOA and to determine the differences in efficacy among them.</p><p><strong>Methods: </strong>In this multi-center, single-blind, randomized, controlled trial, participants were randomly assigned to the manual acupuncture (MA), electroacupuncture (EA), warm-needling acupuncture (WA), mild moxibustion (MM), sham acupuncture (SA), or drug treatment (Celebrex) groups. Each participant in the above groups received individual treatments for 4 consecutive weeks. The primary outcome measures included the visual analog scale score (VAS) and the physical function score of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).</p><p><strong>Results: </strong>Compared with the SA group, the acupuncture technique groups (MA, EA, WA, and MM) had markedly lower patient VAS scores (- 0.61; 95% CI - 1.09 to - 0.13; P = 0.01) and lower WOMAC physical function scores (- 13.84; 95% CI - 21.14 to - 6.54; P < 0.01). Compared with Celebrex, EA had a significant advantage in reducing the VAS score (1.14; 95% CI 0.55 to 1.72; P < 0.01) and WOMAC physical function score (14.81; 95% CI 5.69 to 23.93; P < 0.01).</p><p><strong>Conclusions: </strong>The observed acupuncture techniques effectively relieve pain and ameliorate knee joint dysfunction in patients with KOA. EA is the most effective method of alleviating pain intensity in treating KOA.</p><p><strong>Trial registration: </strong>The trial was registered on ClinicalTrials.gov (NCT03563690).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"737-751"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}