Pain Practice最新文献

{"title":"Wearable, noninvasive, pulsed shortwave (radiofrequency) therapy for postoperative analgesia: A randomized, double-masked, sham-controlled pilot study.","authors":"Brian M Ilfeld, John J Finneran, Engy T Said, Scott T Ball, Anne M Wallace, Ryan C Broderick, Bryan J Sandler, Jay J Doucet, Sandy R Hu, Brannon J Cha, Adhithi Narayana Murthy, Baharin Abdullah","doi":"10.1111/papr.70007","DOIUrl":"10.1111/papr.70007","url":null,"abstract":"<p><strong>Background: </strong>Nonthermal, pulsed shortwave (radiofrequency) therapy (PSWT) is a nonpharmacologic, noninvasive modality that limited evidence suggests provides analgesia. Its potential favorable risk-benefit ratio stems from its lack of side effects and significant medical risks, applicability to any anatomic location, long treatment duration, and ease of application by simply affixing it with tape. Even with a relatively small treatment effect, PSWT might contribute to a multimodal analgesic regimen, similar to acetaminophen. However, widespread clinical use is hindered by a lack of systematic evidence. The current randomized, controlled pilot study was undertaken to determine the feasibility and optimize the protocol for a subsequent definitive investigation and estimate the treatment effect of PSWT on postoperative pain and opioid consumption.</p><p><strong>Methods: </strong>Within the recovery room following primary knee and hip arthroplasty, cholecystectomy, hernia repair, and non-mastectomy breast surgery, we applied 1-3 PSWT devices (Model 088, BioElectronics Corporation, Frederick, Maryland) over the surgical bandages. Participants were randomized to 28 days of either active or sham treatment in a double-masked fashion. The outcomes of primary interest were the cumulative opioid consumption and the mean of the \"average\" and \"worst\" daily pain measured with the Numeric Rating Scale over the first 7 postoperative days.</p><p><strong>Results: </strong>During the first 7 postoperative days, oxycodone consumption in participants given active treatment (n = 55) was a mean (SD) of 21 mg (24) versus 17 mg (26) in patients given sham (n = 57): difference 4 (95% CI, -5 to 13), p = 0.376. During this same period, the \"average\" daily pain intensity in patients given active treatment was 2.4 (1.6) versus 2.6 (1.7) in sham: difference -0.2 (95% CI -0.8 to 0.5), p = 0.597. Concurrently, the worst/maximum pain for the active group was 4.6 (2.0) versus 4.7 (2.1) in sham: difference -0.1 (95% CI -0.8 to 0.7), p = 0.888. No device-related systemic side effects or serious adverse events were identified.</p><p><strong>Conclusions: </strong>Pulsed shortwave (radiofrequency) therapy did not reduce pain scores and opioid requirements to a statistically significant or clinically relevant degree during the initial postoperative week in this pilot study. These results must be replicated with a subsequent study before being considered definitive. Data from this preliminary study may be used to help plan future trials.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"25 2","pages":"e70007"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009884","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":"The comparison of spread of methylene blue after the Pericapsular Nerve Group block and a double injection selectively targeting the articular branches to the anterior hip capsule in human cadavers.","authors":"Rachel J H Smits, Edward C T H Tan, Luuk R van den Bersselaar, Anne de Bruijn, Eva Hendriksen, Kris C P Vissers, Kim T E Olde Dubbelink, Selina E I van der Wal","doi":"10.1111/papr.70002","DOIUrl":"10.1111/papr.70002","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, the spread of methylene blue was compared between an ultrasound-guided Pericapsular Nerve Group (PENG) block and a double injection technique, where the approach towards the inferomedial acetabulum was added to the latter.</p><p><strong>Methods: </strong>The two techniques were performed in 11 fresh frozen cadavers. The spread was measured after anatomical dissection in which the supplying femoral and obturator nerves were identified.</p><p><strong>Results and conclusion: </strong>Our study demonstrates adequate staining of the iliac bone with comparable distal and medial spread in both techniques, indicating that the PENG block with a single injection is adequate in blocking the hip capsule with 10 mL local anesthetics. Staining of the femoral nerve occurred in 2/6 specimens after the PENG block, and staining of the obturator nerve in 1 specimen in each group.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"25 2","pages":"e70002"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009882","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":"Triptan treatment is associated with a higher number of red wine-induced migraine episodes: An exploratory questionnaire-based survey.","authors":"Saad Masood, Muhammad Ahrar Bin Naeem, Muhammad Qasim, Javeeria Arshad","doi":"10.1111/papr.13412","DOIUrl":"10.1111/papr.13412","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":" ","pages":"e13412"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110806","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":"11. Cervicogenic headache and occipital neuralgia.","authors":"Nicole Lefel, Hans van Suijlekom, Steven P C Cohen, Jan Willem Kallewaard, Jan Van Zundert","doi":"10.1111/papr.13405","DOIUrl":"10.1111/papr.13405","url":null,"abstract":"<p><strong>Introduction: </strong>Cervicogenic headache (CEH) and occipital neuralgia (ON) are headaches originating in the occiput and that radiate to the vertex. Because of the intimate relationship between structures based in the occiput and those in the upper cervical region, there is significant overlap between the presentation of CEH and ON. Diagnosis starts with a headache history to assess for diagnostic criteria formulated by the International Headache Society. Physical examination evaluates range of motion of the neck and the presence of tender areas or pressure points.</p><p><strong>Methods: </strong>The literature for the diagnosis and treatment of CEH and ON was searched from 2015 through August 2022, retrieved, and summarized.</p><p><strong>Results: </strong>Conservative treatment includes pain education and self-care, analgesic medication, physical therapy (such as reducing secondary muscle tension and improving posture), the use of TENS (transcutaneous electrical nerve stimulation), or a combination of the aforementioned treatments. Injection at various anatomical locations with local anesthetic with or without corticosteroids can provide pain relief for a short period. Deep cervical plexus block can result in improved pain for less than 6 months. In both CEH and ON, an occipital nerve block can provide important diagnostic information and improve pain in some patients, with PRF providing greater long-term pain control. Radiofrequency ablation of the cervical facet joints can result in improvement for over 1 year. Occipital nerve stimulation (ONS) should be considered for the treatment of refractory ON.</p><p><strong>Conclusion: </strong>The treatment of CEH preferentially consists of radiofrequency treatment of the facet joints, while for ON, pulsed radiofrequency of the occipital nerves is indicated. For refractory cases, ONS may be considered.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":" ","pages":"e13405"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110804","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":"Diagnosing persistent spinal pain syndrome type 2.","authors":"Alaa Abd-Elsayed, Christopher Gilligan","doi":"10.1111/papr.13447","DOIUrl":"https://doi.org/10.1111/papr.13447","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":"25 1","pages":"e13447"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009792","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":"High-frequency spinal cord stimulation in treatment of phantom lower limb pain following spinal cord injury: A case report.","authors":"Rachel J Park, Tillman W Boesel, Antonio Di Ieva","doi":"10.1111/papr.13437","DOIUrl":"10.1111/papr.13437","url":null,"abstract":"<p><strong>Introduction: </strong>Pain management in patients with complete spinal cord injury is complex.</p><p><strong>Case report: </strong>We report a successful case of managing neuropathic, phantom limb, and back pain below the level of spinal cord injury (T5 American Spinal Injury Association [ASIA] A) using a 10 kHz high-frequency spinal cord stimulator (SCS) over a 6-month follow-up period.</p><p><strong>Conclusion: </strong>The effectiveness of this approach may be attributed to its ability to modulate supraspinal pain processing, allowing for targeted relief of various pain mechanisms below the level of injury.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":" ","pages":"e13437"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682437","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 influence of pain on community reintegration after spinal cord injury.","authors":"Valerie Henderson, Mokgadi Kholofelo Mashola","doi":"10.1111/papr.13439","DOIUrl":"10.1111/papr.13439","url":null,"abstract":"<p><strong>Background: </strong>Community reintegration is an important goal for people living with a spinal cord injury (SCI), and pain is suspected to limit reintegration due to its limitations in daily functioning, mood, and sleep.</p><p><strong>Objectives: </strong>To determine the influence of pain on community reintegration in manual wheelchair users with SCI.</p><p><strong>Methods: </strong>The Reintegration to Normal Living Index was used to determine community reintegration, while the DN4 and the Wheelchair User's Shoulder Pain Index were used to determine the presence of neuropathic and shoulder pain respectively. Associations and differences between the pain variables and participants with and without pain were analyzed with Spearman correlations and Mann-Whitney U-tests using SPSS v27 at 0.05 significance level and 95% confidence interval.</p><p><strong>Results: </strong>Of the 122 participants, 85.2% reported current pain, with a 77.7% median for community reintegration. Neuropathic pain (53.3%) was more common and severe than nociceptive shoulder pain (14.8%). There was no significant difference in community reintegration between participants with and without pain, nor any correlation between the overall presence of pain and community reintegration. The severity of pain, particularly shoulder pain, was negatively associated with taking trips out of town (p < 0.01), and overall community reintegration (p < 0.05).</p><p><strong>Conclusion: </strong>It is not the mere presence of pain that influences community reintegration, but rather the severity and the location of pain. Shoulder care and pain management need to be included in the rehabilitation program, as these are important considerations when rehabilitating people with SCI back into their communities.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":" ","pages":"e13439"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668590","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":"Lead fracture in dorsal root ganglion stimulation.","authors":"Alaa Abd-Elsayed, Christopher Gilligan","doi":"10.1111/papr.13434","DOIUrl":"10.1111/papr.13434","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":" ","pages":"e13434"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569344","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":"UK medical cannabis registry: A clinical outcome analysis of medical cannabis therapy in chronic pain patients with and without co-morbid sleep impairment.","authors":"Ishita Datta, Simon Erridge, Carl Holvey, Ross Coomber, Rahul Guru, Wendy Holden, Alia Darweish Medniuk, Mohammed Sajad, Robert Searle, Azfer Usmani, Sanjay Varma, James J Rucker, Michael Platt, Mikael H Sodergren","doi":"10.1111/papr.13438","DOIUrl":"10.1111/papr.13438","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain (CP) affects 35.0%-51.3% of the UK population, with 67%-88% reporting sleep disturbances. Cannabis-based medicinal products (CBMPs) have shown therapeutic potential in managing CP. Evidence suggests poor sleep worsens pain perception; therefore, this study aimed to assess patient-reported outcome measures (PROMs) following CBMP treatment in CP patients with and without co-morbid sleep impairment.</p><p><strong>Methods: </strong>A prospective cohort study of CP patients from the UK Medical Cannabis Registry was conducted. Participants were separated by baseline single-item sleep quality scale (SQS) score into sleep impaired (SQS ≤3) and unimpaired (SQS ≥4) cohorts. The primary outcome assessed changes in PROMs from baseline to 1-, 3-, 6-, and 12-months. Participants completed the following: SQS, General Anxiety Disorder-7, EQ-5D-5L, Brief Pain Inventory (BPI), and Short-Form McGill Pain Questionnaire-2. Significance was defined as p < 0.050.</p><p><strong>Results: </strong>1139 participants met the inclusion criteria (sleep impaired: n = 517, 45.4%; sleep unimpaired: n = 622, 54.61%). The sleep impaired cohort showed improvements in all PROMs at each follow-up (p < 0.010). The sleep unimpaired cohort showed similar results (p < 0.050), except in SQS and ED-5Q-5L: self-care and anxiety/depression scores (p > 0.050). However, the sleep impaired cohort observed greater improvements in BPI pain severity (p < 0.050) and SQS (p < 0.001) than the sleep unimpaired cohort at all follow-ups. 2817 adverse events were self-reported between both cohorts (p = 0.197).</p><p><strong>Discussion: </strong>These findings align with literature that shows associated improvements in pain outcomes following CBMP administration. Sleep impaired individuals were more likely to experience greater pain severity improvements. However, this was not confirmed on multivariate logistic regression analysis and instead may be confounded by baseline pain severity.</p><p><strong>Conclusion: </strong>Whilst these results show promise for the effects of CBMPs on CP, they must be examined within the limitations of the study design. These findings provide further evidence to support the design of subsequent randomized controlled trials to verify causality between CBMPs and pain outcomes.</p>","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":" ","pages":"e13438"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625943","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":"Caudal epidural steroid injections: Is ultrasound guidance sufficient?","authors":"Tuba Tanyel Saraçoğlu, Fırat Akbaş, Mehmet Sacit Güleç","doi":"10.1111/papr.13433","DOIUrl":"10.1111/papr.13433","url":null,"abstract":"","PeriodicalId":19974,"journal":{"name":"Pain Practice","volume":" ","pages":"e13433"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505787","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}