Pain Practice最新文献

{"title":"Women's Causal Beliefs About Their Pelvic Pain: A Systematic Review and Meta-Ethnography.","authors":"Grace A Ferencz, Amelia K Mardon, Alice M Mitchell, Saravana Kumar, K Jane Chalmers","doi":"10.1111/papr.70194","DOIUrl":"10.1111/papr.70194","url":null,"abstract":"<p><strong>Introduction: </strong>This study identified and synthesized the current qualitative literature on women's causal beliefs about their chronic pelvic pain.</p><p><strong>Methods: </strong>Academic databases and relevant gray literature sources were searched from their inception to August 2025 with an English language limiter. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) qualitative checklist. A meta-ethnography was used to synthesize findings.</p><p><strong>Results: </strong>Thirty studies including 1255 women from a range of countries were deemed eligible for inclusion. Seven studies fully met the CASP criteria and were deemed to have minimal risk of bias. The quality of reporting and demographic diversity of included studies were limited, often lacking consideration of researcher-participant relationships, and primarily including Caucasian, cis-gender, heterosexual women from Western countries. Four themes were generated: (1) It's happening to me because I'm a woman, (2) It's happening to me in my body, (3) It's happening to me due to my actions, and (4) It's happening to me due to my life. Women's pain attributions varied from siloed biological, psychological, or social explanations to combinations of these factors. Their perceptions of control also ranged from feeling entirely powerless to experiencing a sense of personal agency. A conceptual model was developed to represent the range of beliefs women hold about the cause of their pelvic pain.</p><p><strong>Conclusion: </strong>Understanding women's causal beliefs about their chronic pelvic pain may inform clinical assessment to provide a foundation for recovery. This study was unfunded and was preregistered on Open Science Framework (https://osf.io/wkc5v/) and PROSPERO (CRD42023444018).</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 7","pages":"e70194"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Identification and Management of Gluteus Medius Calcific Tendinopathy Showing a Flame-Like Pattern.","authors":"Zehra Duman Şahin, Selkin Yılmaz Muluk, Vedat Altuntaş, Tuğba Yalçın","doi":"10.1111/papr.70196","DOIUrl":"10.1111/papr.70196","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 7","pages":"e70196"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Spinal Neuromodulation for Chronic Pain in Pediatric Patients: A Scoping Review.","authors":"Puneet Gupta, Vibha Sastri, Antony Sharobim, Bobga Gang, Jevaughn Davis, Geet Paul, Sina Davari Farid","doi":"10.1111/papr.70180","DOIUrl":"10.1111/papr.70180","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pain affects up to 21% of pediatric patients and significantly impairs function and quality of life. Although spinal neuromodulation, including spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRG-S), has demonstrated efficacy in adults, evidence in children remains limited. This scoping review aims to systematically evaluate current evidence on spinal neuromodulation for pediatric chronic pain patients, focusing on clinical indications, outcomes, and safety.</p><p><strong>Methods: </strong>A structured scoping review was conducted using PubMed/MEDLINE and Scopus databases on June 8, 2025. Studies were included if they reported on patients under 21 years undergoing SCS or DRG-S for chronic pain. Two independent reviewers screened articles and extracted data on demographics, diagnoses, interventions, outcomes, and follow-up.</p><p><strong>Results: </strong>Out of 706 references, 17 studies met inclusion criteria. Of those, 16 reported on SCS and 1 reported on DRG-S. complex regional pain syndrome (CRPS) was the most common indication, with most patients reporting substantial pain reduction, improved functional outcomes, and decreased medication use. Erythromelalgia was another frequent diagnosis treated successfully with SCS, demonstrating significant reductions in pain, swelling, and erythema. Other conditions included recurrent tethered cord syndrome, neurogenic thoracic outlet syndrome, lymphangioma, postoperative neuropathic pain, and genetic syndromes. Overall, most patients experienced meaningful improvements in pain and daily functioning, with few major complications reported.</p><p><strong>Conclusions: </strong>Spinal neuromodulation, predominantly SCS, appears to be a promising adjunctive therapy for refractory chronic pain in pediatric patients, particularly for CRPS and erythromelalgia. Despite encouraging findings, the evidence remains limited to small series and case reports. High-quality prospective studies are needed to establish long-term safety, efficacy, and optimal patient selection in this vulnerable population.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 6","pages":"e70180"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Nerve Stimulation of the Sacral Lateral Branches for Sacroiliac Joint Pain: A Technical Report.","authors":"Victor M Silva-Ortiz, Alaa Abd-Elsayed, Anna Gisse Lopez-Uribe, Kenneth B Chapman","doi":"10.1111/papr.70188","DOIUrl":"https://doi.org/10.1111/papr.70188","url":null,"abstract":"<p><strong>Objective: </strong>To describe the use of peripheral nerve stimulation targeting the sacral lateral branches as a treatment for sacroiliac joint mediated low back pain refractory to conventional therapies.</p><p><strong>Methods: </strong>A 67-year-old female with chronic sacroiliac joint (SIJ)-mediated low back pain, refractory to conservative management and sacral lateral branch radiofrequency ablation, subsequently underwent a trial and implantation of peripheral nerve stimulation (PNS) targeting the sacral lateral branches.</p><p><strong>Results: </strong>The PNS trial achieved 60% pain reduction without adverse events. After permanent implantation, 12-month follow-up showed 70% sustained pain relief and ODI improvement from 68% to 28%.</p><p><strong>Conclusion: </strong>PNS of the sacral lateral branches, performed using a novel technique, appears to be a safe and effective treatment for SIJ-mediated low back pain refractory to standard therapies. Further studies are warranted to validate these findings.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 6","pages":"e70188"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Assessment of Adjacent Fracture Risks in Vertebroplasty, Kyphoplasty, and Bone-Tumor Radiofrequency Ablation.","authors":"Soun Sheen, Prit Hasan, Xiaowen Sun, Jian Wang, Claudio Tatsui, Kent Nouri, Saba Javed","doi":"10.1111/papr.70182","DOIUrl":"https://doi.org/10.1111/papr.70182","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous vertebral augmentation is widely used to provide symptom relief for patients with painful vertebral compression fractures (VCFs), but adjacent fractures remain a known complication. This retrospective study evaluated the risk of adjacent vertebral fractures following different percutaneous vertebral augmentation techniques.</p><p><strong>Methods: </strong>A total of 985 encounters from 878 patients who underwent vertebroplasty, kyphoplasty, or bone tumor radiofrequency ablation (BT-RFA) with cement augmentation were included. The primary outcome was incidence of postprocedural adjacent fractures. Associations with demographic and clinical factors including age, sex, BMI, pathologic fractures, bone density, imaging guidance, and number of treated levels were assessed. Statistical analyses included a generalized linear mixed model and Cox proportional hazards models clustered by patient.</p><p><strong>Results: </strong>Adjacent fracture occurred in 17.8% of encounters. BT-RFA was associated with a significantly lower risk of adjacent fractures compared with kyphoplasty (HR: 0.54, 95% CI:0.36-0.81; p = 0.003) and vertebroplasty (HR: 0.40, 95% CI: 0.27-0.60; p < 0.0001). Multilevel vertebral augmentations increased fracture risk by 1.42-fold, while pathologic fractures lowered the odds of adjacent fracture. No significant associations were found for age, BMI, sex, cement extravasation, or bone density.</p><p><strong>Conclusion: </strong>BT-RFA combined with cement augmentation significantly reduced the risk of adjacent fractures compared to kyphoplasty or vertebroplasty.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 6","pages":"e70182"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The False-Negative Paradox: Refining the Prognostic Value of Selective Nerve Root Blocks Before Pulsed Radiofrequency-A Comment on Van Ooijen Et al.","authors":"Minzhi Yang, Wenting Zhao, Qin Liu, Huan Du","doi":"10.1111/papr.70186","DOIUrl":"https://doi.org/10.1111/papr.70186","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 6","pages":"e70186"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Analgesia in Patients With Childhood Cancer: A Retrospective Cohort Study.","authors":"Erika A S Rouhento, Susanna A Vuorenoja, Maija-Liisa Kalliomäki, Sauli A Palmu","doi":"10.1111/papr.70185","DOIUrl":"10.1111/papr.70185","url":null,"abstract":"<p><strong>Background: </strong>Although modern medicine provides multimodal approaches to treating pain, pain remains undertreated in 30% of pediatric palliative patients.</p><p><strong>Procedure: </strong>In this single center retrospective cohort study, our aim was to ascertain how pediatric palliative phase pain was managed at a tertiary university hospital during the years 2013-2022. The medical records of patients with childhood cancer were reviewed for palliative diagnosis, demographics, duration of palliative period, pain medication or other treatment modality, effects and adverse effects, pain assessment, and death location.</p><p><strong>Results: </strong>We identified 35 patients aged 1 to 19 years (median 9.0 years), of which 24 were female. Twenty-three patients had the ICD10 diagnosis for palliative care in their diagnoses. The palliative phase lasted from 1 to 491 days and took place at home in 15 cases. Fifteen patients had tumors of the central nervous system. Other diagnoses included sarcoma, neuroblastoma, acute lymphoblastic leukemia, and hepatocellular cancer. All patients were given acetaminophen and opioids. Non-steroidal anti-inflammatory drugs were given to 24 patients, anticonvulsants to 14, tricyclic antidepressants to 9, corticosteroids to 21, interventional pain procedures to 3, radiation therapy for analgesia to 10, and 5 patients underwent a procedure to alleviate pain and discomfort. Thirty-one patients used patient-controlled analgesia.</p><p><strong>Conclusions: </strong>Patient data concerning analgesics' effects and adverse effects were heterogeneous. We followed the WHO analgesic ladder during palliative care. Use of opioids was beneficial; the outcome for other classes of drugs was uncertain based on our limited data.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 6","pages":"e70185"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"17. Cancer Pain: Part I: Cordotomy for Unilateral Pain due to Cancer.","authors":"Bregje Huisman, Martine Puylaert, Liong Liem, Manohar Sharma, Johannes C F Ket, Steven P Cohen, Kris Vissers, Monique Steegers","doi":"10.1111/papr.70184","DOIUrl":"10.1111/papr.70184","url":null,"abstract":"<p><strong>Introduction: </strong>Despite advancements in pharmacological and intrathecal treatment of oncological pain, it remains a significant challenge, affecting 44.5% of patients with cancer, with 30.6% experiencing moderate-to-severe pain.</p><p><strong>Methods: </strong>This scoping review provides a summary of the literature from 2016 to 2024, focusing on percutaneous cordotomy techniques and clinical outcomes for the treatment of unilateral pain in patients with cancer. A literature search (in Medline and Embase) was performed from inception up to September 9, 2024, in collaboration with a medical information specialist.</p><p><strong>Results: </strong>A comprehensive multidimensional assessment is essential when considering cordotomy. Ideal candidates have unilateral pain unresponsive to more conservative measures, localized below the C4 level. A detailed neurological examination is crucial for intra-procedural assessment and to evaluate potential post-procedural muscle weakness and sensory deficits. Our search identified 18 studies, half of which were retrospective and half prospective, including 596 patients in total. Studies varied regarding imaging technique and included fluoroscopy, CT-guided, or via microendoscopy. Excellent immediate pain relief was reported in between 86% and 98% of patients. Of patients surviving 6 months, the majority still experienced sustained pain relief. There is no consensus regarding optimal lesion temperature and duration. The reported rate of permanent complications such as paresis is low. The reported incidence of mirror pain is highly variable.</p><p><strong>Conclusions: </strong>Cancer pain should ideally be managed in a multidisciplinary and multimodal manner. When conservative treatment fails, a percutaneous cordotomy can be considered for refractory unilateral pain.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 6","pages":"e70184"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effectiveness and Safety of Dorsal Root Ganglion Stimulation for Persistent Spinal Pain Syndrome: Results From an Expanded Prospective Registry.","authors":"Pedram Tabatabaei, Maria Eriksson, Amar Awad, Johan Vänman","doi":"10.1111/papr.70183","DOIUrl":"10.1111/papr.70183","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Persistent spinal pain syndrome (PSPS) with predominant low-back pain (LBP) is difficult to manage when conservative and surgical treatments fail. Dorsal root ganglion stimulation (DRG-S) offers segmental, focal neuromodulation that may be particularly suited for managing axial LBP, yet long-term evidence from real-world practice remains limited. This study evaluated the effectiveness, safety, and impact on medication use of bilateral T12 DRG-S in patients with intractable LBP, using prospectively collected registry data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Of 33 consecutive patients with chronic LBP assessed for DRG-S, 20 underwent trial stimulation after multidisciplinary evaluation. Eighteen (90%) proceeded to permanent implantation following ≥ 50% pain reduction during trial. Patients were followed via a digital platform at 3, 6, 12, and 24 months. Outcomes included pain intensity (NRS), quality of life (PROMIS-29), pain catastrophizing (PCS), satisfaction, medication use, and adverse events. Statistical comparisons were made between baseline and follow-up time points using paired tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Pain intensity decreased substantially and significantly across all follow-up assessments: mean NRS declined from 8.0 ± 1.8 at baseline to 3.6 ± 1.6 at 3 months, 3.2 ± 1.8 at 6 months, 3.6 ± 1.7 at 12 months, and 2.9 ± 1.6 at 24 months (all p &lt; 0.001). At 24 months, 100% of patients achieved ≥ 30% pain reduction and 70% achieved ≥ 50% reduction. Patient-reported outcomes demonstrated broad improvements. PROMIS-29 domains showed significant gains in physical function, pain interference, fatigue, and sleep disturbance, with consistent improvements also observed in anxiety and depression. Pain catastrophizing (PCS) scores decreased markedly, with total scores reduced by 47%-62% across follow-ups (all p &lt; 0.001), reflecting improvements across helplessness, magnification, and rumination subdomains. Medication use declined over time. Mean opioid dose fell from 27 mg/day at baseline to 11.25 mg/day at 1 year and 4.44 mg/day at 2 years (p = 0.019 and 0.011, respectively). Paracetamol use also decreased significantly, whereas gabapentinoid use remained variable. Seven hardware-related complications were recorded (lead migration n = 3, lead fracture/damage n = 4), all successfully managed with revision surgery. Kaplan-Meier analysis estimated mean time to complication at 1080 days. Two patients discontinued therapy (EOT), both for reasons unrelated to device failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this prospective registry, bilateral T12 DRG-S provided durable reduction in pain intensity, improved physical, psychosocial, and cognitive outcomes, and facilitated meaningful opioid-sparing effects over 2 years. Complications were limited to correctable hardware issues, and therapy discontinuation was rare. Although larger multicentre studies are warranted, these findings add important real-world evidenc","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 6","pages":"e70183"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Efficacy of Transdermal Buprenorphine in Chronic Low Back Pain: A Meta-Analysis of Randomized Clinical Trials.","authors":"Anna Karla do Nascimento Souza, Eduardo Silva Reis Barreto, César Romero Antunes Júnior, Gabriel Teles de Oliveira Piñeiro, Durval Campos Kraychete","doi":"10.1111/papr.70155","DOIUrl":"10.1111/papr.70155","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of transdermal buprenorphine for treating pain in patients with chronic low back pain (CLBP), with additional assessment of sleep quality and adverse events.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Scopus, Embase, and Cochrane CENTRAL up to June 2025. Randomized controlled trials (RCTs) comparing transdermal buprenorphine with placebo in adults with CLBP were included. Pain intensity was the primary outcome; secondary outcomes were sleep quality and adverse events. This review followed PRISMA guidelines and was registered in PROSPERO (CRD42024629751).</p><p><strong>Results: </strong>Six RCTs, including 698 patients, were analyzed. Transdermal buprenorphine did not significantly reduce pain intensity compared to placebo (Mean Difference = -0.32; 95% CI: -1.04 to 0.40; p = 0.380; I² = 77.4%). However, a small but statistically significant improvement in sleep quality was found (Standardized Mean Difference = -0.24; 95% CI: -0.37 to -0.10; p < 0.001; I² = 28%). Adverse events were more frequent in the buprenorphine group, although not statistically significant for total adverse events (RR = 1.98; 95% CI: 0.97 to 4.02; p = 0.060).</p><p><strong>Conclusion: </strong>These findings suggest a limited benefit of transdermal buprenorphine for pain relief in CLBP. While sleep quality may improve slightly, the potential for increased adverse events must be considered. Current evidence does not support the routine use of transdermal buprenorphine for CLBP due to insufficient analgesic effect and possible safety concerns.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"26 5","pages":"e70155"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}