Pain management最新文献

{"title":"Evaluation of the Gigstride wearable device for pain reduction and functional outcomes in patients with lower extremity mobility deficits: a single-arm pilot feasibility study.","authors":"Ahmed Khawer, Johnny Dang, Alejandra Rojas-Cardenas, Daniel Khokhar, Ankur Jain, Brandon J Goodwin, Justin Crane, Michael Crimmins, Eric Muneio, Akhil Chhatre","doi":"10.1080/17581869.2026.2664763","DOIUrl":"https://doi.org/10.1080/17581869.2026.2664763","url":null,"abstract":"<p><strong>Background: </strong>Mobility deficits are the most common form of disability in the United States and can significantly impair function and activities of daily living. Assistive devices have the potential to reduce physical limitations and support functional independence. This pilot study evaluated the Gigstride wearable device for its effects on pain reduction and gait-related outcomes.</p><p><strong>Methods: </strong>This prospective, single-arm feasibility study was conducted at a tertiary academic center and included adults ≥18 years with lower extremity deficits. The primary outcome was pain, measured by the Numeric Rating Scale (NRS) during level ambulation and stair climbing. Secondary outcomes included performance on the modified 10-meter walk test with return and the Timed Up and Go (TUG) test. Patient-reported experience and the practicality of implementing the device in a larger-scale study were also assessed.</p><p><strong>Results: </strong>A total of forty-four patients were enrolled (mean age 66 years; 57% female). Gigstride use significantly reduced pain during level ambulation and stair climbing, with no significant changes in secondary outcomes. Median walking pain decreased by 1 NRS point (<i>p</i> = 0.00032), and stair-related pain decreased by 0.5 NRS points (<i>p</i> = 0.00025).</p><p><strong>Conclusion: </strong>Gigstride wearable device use appears feasible and may provide modest reductions in mobility-related pain. However, the limited magnitude of pain reduction and absence of functional improvement in this study highlights the need for larger, controlled studies.</p><p><strong>Clinical trial registration: </strong>The www.ClinicalTrials.gov identifier is NCT06548087.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of transcutaneous electrical nerve stimulation associated to exercise for pain in Parkinson's disease: a randomized crossover clinical trial.","authors":"P A Garcez, B M DeJesus, L R Oliveira, L V Lima, J M DeSantana","doi":"10.1080/17581869.2026.2660894","DOIUrl":"https://doi.org/10.1080/17581869.2026.2660894","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) causes debilitating motor and non-motor symptoms, including chronic pain. While TENS and exercise are potential treatments, their combined effects require investigation.</p><p><strong>Objective: </strong>To assess the effect of TENS added to an exercise program on pain intensity (primary outcome), fatigue, temporal summation, pain catastrophizing, skin sensitivity, and depression in PD.</p><p><strong>Methods: </strong>This randomized, double-blind, crossover trial included 13 patients (Hoehn & Yahr II-III). Participants received active or placebo TENS (1:1 ratio) followed by the reverse order after a 7-day washout. Both phases included a 20-minute exercise program. Active TENS (100 Hz, 100 μs) was applied to thoracic and lumbar regions at motor threshold. Outcome assessors and participants were blinded to the intervention.</p><p><strong>Results: </strong>All 13 participants completed both phases (<i>n</i> = 26). Compared to placebo, the active TENS group showed significant improvements in primary outcome of pain intensity (<i>p</i> = 0.006). Significant improvements were also observed in temporal summation (<i>p</i> = 0.004) and cutaneous sensibility (thoracic right (<i>p</i> = 0.002), left (<i>p</i> = 0.041). No adverse events were reported during the interventions.</p><p><strong>Conclusions: </strong>TENS combined with exercise is effective for reducing pain intensity, temporal summation, and fatigue, as well as improving cutaneous sensibility in patients with PD.</p><p><strong>Clinical trial registration: </strong>ReBEC identifier is RBR-4bvwxq (UTN: U1111-1159-1101).</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectus sheath block a retrospective review of a novel adjunct for treatment of the injection site pain associated with treprostinil subcutaneous infusion in pulmonary hypertension case series.","authors":"Moustafa Moustafa, Hari Gopal, Caitriona Minnock, Sean Gaine, Conor Hearty","doi":"10.1080/17581869.2026.2641557","DOIUrl":"10.1080/17581869.2026.2641557","url":null,"abstract":"<p><strong>Introduction: </strong>Subcutaneous (SC) treprostinil is an effective treatment for severe pulmonary arterial hypertension (PAH). 85% of the treated patients experience challenging infusion site pain with limited effective options.</p><p><strong>Patient and methods: </strong>We retrospectively reviewed 11 patients who underwent 23 RSB before treprostinil SC infusion. The collected data included the type of PAH, demographics, treprostinil infusion rate, pain scores, pain therapies, block details, and the patients' perspective. Paired within-patient analyses assessed the effect of RSB on pain scores and opioid requirement during the first week.</p><p><strong>Results: </strong>Pain reduction was most notable during Days 1-5, with significantly lower visual analogue scale (VAS) scores on Day 1 (<i>p</i> = 0.007), Day 3 (<i>p</i> = 0.011), and day 5 (<i>p</i> = 0.014) compared with sites managed without block. Peak pain occurred on Day 5 with the median highest VAS significantly lower with RSB (3.5 [IQR 1-5] vs 5.5 [IQR 4-9.25]). A transient reduction in opioid requirement was observed on Day 1, but it was not sustained afterwards.</p><p><strong>Conclusion: </strong>RSB may be a useful adjuvant on the initial days of treprostinil SC infusion. Given the small sample size and retrospective, within-patient observational design, these findings are exploratory and require confirmation in prospective controlled studies.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"397-403"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of a moderate versus high intensity training program on central pain processing: a pilot feasibility study.","authors":"Amber Billens, Toon Hamelink, Mira Meeus, Jessica Van Oosterwijck","doi":"10.1080/17581869.2026.2626256","DOIUrl":"10.1080/17581869.2026.2626256","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the feasibility of two minimally equipped, blended supervised and tele-supported exercise programs, a moderate intensity training (MIT) and high intensity training (HIT) program, in healthy sedentary adults, and explored signals of efficacy on central pain processing.</p><p><strong>Methods: </strong>Participants were randomized to a 10-week MIT or HIT program, each comprising one supervised group session and two tele-supported home-based sessions per week. MIT involved a Start-to-Run protocol at 60-70% of heart rate reserve, while HIT involved strength exercises at > 80% of predicted maximum heart rate. Feasibility outcomes included recruitment, retention, adherence, and acceptability. Quantitative sensory testing (QST) assessed central pain processing pre- and post-intervention.</p><p><strong>Results: </strong>Eighteen participants were enrolled (8 MIT, 10 HIT). Retention was lower in the MIT group (5 completed) than the HIT group (11 completed), with high adherence in both. Participants appreciated the blended format but noted challenges with digital tools, and suggested refinements. No significant differences in QST outcomes were observed, likely due to small sample size and inter-individual variability. Individual responses suggested reduced pain inhibition following MIT and enhanced inhibition after HIT.</p><p><strong>Conclusions: </strong>Both programs were feasible, supporting a larger-scale study to optimize implementation and confirm effects.</p><p><strong>Clinical trial registration: </strong>ClinicalTrails.gov (ID: NCT06207422).</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"445-459"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine for acute and chronic pain: beyond anaesthesia.","authors":"Hao G Duong, Tariq G Pulskamp, Daniel J Berlau","doi":"10.1080/17581869.2026.2627884","DOIUrl":"10.1080/17581869.2026.2627884","url":null,"abstract":"<p><p>Ketamine's clinical role has expanded beyond anesthesia into a mechanism-based, non-opioid analgesic used across acute, perioperative, and chronic pain settings. As a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine attenuates central sensitization, modulates opioid tolerance, and enhances descending inhibitory control. At subanaesthetic doses (0.1-0.5 mg/kg), it consistently reduces pain scores and postoperative opioid consumption while maintaining hemodynamic and respiratory stability. In acute and perioperative care, analgesic efficacy is comparable to opioids, though clear superiority has not been demonstrated. In chronic pain, particularly complex regional pain syndrome (CRPS), multi-day infusions provide temporary relief, but durability remains limited. In cancer-related pain, ketamine offers adjuvant benefits for opioid-refractory syndromes with variable outcomes. Short-term adverse effects such as dizziness and mild dysphoria are common, whereas psychomimetic symptoms, hepatobiliary injury, and cystitis restrict prolonged use. Overall, ketamine provides context-dependent, opioid-sparing analgesia with defined but specific clinical utility. Its evolving role in pain management will likely remain targeted, emphasizing patient selection, standardized dosing, and realistic expectations for benefit.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"523-533"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive functional therapy for persistent neck pain.","authors":"Siri Bjorland, John Bjørneboe, Cecilie Røe, Mirad Taso, Kaia Engebretsen, Sigrid Skatteboe, Hanne Krogstad Jenssen, Nina Skorge, Jens Ivar Brox","doi":"10.1080/17581869.2026.2625646","DOIUrl":"10.1080/17581869.2026.2625646","url":null,"abstract":"<p><strong>Aims: </strong>Persistent neck pain is a leading cause of years lived with disability. The aim of the current study is to describe and evaluate cognitive functional therapy for patients with persistent neck pain.</p><p><strong>Methods: </strong>We recruited 74 patients (73% women) aged 22-76 years, with persistent neck pain. The outcomes were neck pain at activity and rest measured by 11-point numeric rating scales (NRS), disability by Neck Disability Index (NDI) (0-100), Fear Avoidance Beliefs Questionnaire (FABQ), Hopkin Symptom Check List (HSCL-10) at baseline and post-treatment. The treatment program included 5 sessions and focused on cognitive strategies and exposure to physical activities.</p><p><strong>Results: </strong>Sixty (81%) patients had follow-ups. Neck pain during activity was reduced by a mean of 3.3 (95% Confidence interval (CI) 2.6 to 3.2) and 2.5 (95% CI 1.9 to 3.1) at rest. NDI was reduced by 16.3 (95% CI 12.0-20.5). Similar large improvements were observed for FABQ and HSCL-10. Ninety-eight percent of the participants reported that they would recommend the program to other patients.</p><p><strong>Conclusions: </strong>Clinically relevant improvements were observed in pain, disability, fear-avoidance beliefs, and emotional distress following CFT in patients with persistent neck pain.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"435-443"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosing trends for buprenorphine buccal film: a step in the wrong direction.","authors":"Amanda Zimmerman","doi":"10.1080/17581869.2025.2591475","DOIUrl":"10.1080/17581869.2025.2591475","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"387-388"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why should we assess and promote the decision-making autonomy of patients suffering from chronic pain? A perspective.","authors":"Marguerite d'Ussel, Anne Coutaux, Julien Nizard, Nathan Moreau, Guillaume Durand","doi":"10.1080/17581869.2026.2631510","DOIUrl":"10.1080/17581869.2026.2631510","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain exerts an enormous personal and economic burden, affecting around 30% of people worldwide yet both patients and providers report low satisfaction with chronic pain care. One of the potential causes stems from insufficient decision-making autonomy in chronic pain patients that hampers their ability to properly get involved in their treatment regimen. Improving said autonomy should thus allow better management in the clinical setting.</p><p><strong>Methods: </strong>Via a conceptual and philosophical exploration informed by targeted literature, this Perspective examines the role of decision‑making autonomy in the care of patients living with chronic pain, a specific subject that is scarcely addressed in the literature.</p><p><strong>Results: </strong>In chronic pain, patient autonomy is not only an ethical principle to be respected, but also a competence to foster. Promoting decision-making autonomy can improve pain management by fostering necessary patient empowerment and better involvement in one's treatment regimen.</p><p><strong>Discussion: </strong>Concepts and specific tools exist that can help clinicians better evaluate and promote patient decision-making autonomy in their pain practice. Future avenues for research are suggested to help ensure that autonomy is better assessed in the clinical setting.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"479-485"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of chronic pain patients at a multidisciplinary spine center.","authors":"Lisa R Witkin, Jessica Kim, Jacky Choi, Silis Y Jiang, Jonathan N Tobin","doi":"10.1080/17581869.2026.2625647","DOIUrl":"10.1080/17581869.2026.2625647","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective is to characterize patients presenting to a multidisciplinary spine center to understand sociodemographic features, pain characteristics, and functional status across diagnoses. The secondary objective is to identify factors associated with worse outcomes in radiculopathy patients.</p><p><strong>Methods: </strong>In this retrospective, registry-based cohort study, we extracted questionnaire and EHR data for 10,069 patients. Baseline sociodemographic, clinical, and pain-related were examined across the top 10 diagnostic categories. Thereafter, we performed an analysis of radiculopathy patients (<i>n</i> = 653) using GLMM with random intercepts to identify baseline factors associated with changes in NRS and PROMIS-PI.</p><p><strong>Results: </strong>At presentation, patients had moderate pain intensity (mean NRS:5.1, SD:2.1), significant impairment in PROMIS-PI (mean:64.6, SD:7.9), and PROMIS-PF (mean:37.7, SD:8.9), regardless of the diagnosis. Longitudinal analysis of radiculopathy patients identified multiple statistically significant factors (<i>p</i> < 0.05) associated with worse outcomes, including sleep interference, depression/anxiety, smoking, BMI, and being female, Black/African American, or Asian race.</p><p><strong>Conclusions: </strong>This study explores predictors of poor outcomes that may identify opportunities for interventions targeting modifiable risk factors and highlights the need for further research into how health disparities influence treatment outcomes. Identifying non-responders could improve selecting effective treatments through precision care, ultimately reducing costs and disability associated with chronic pain.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"405-418"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in human assumed central sensitization between patients with radiating and non-radiating chronic low back pain: a cross-sectional observational study with special attention to sex.","authors":"Ingrid Schuttert, Jone Ansuategui Echeita, Thom Eshuis, Rienk Dekker, Henrica Rosalien Schiphorst Preuper, Kristian Kjær-Staal Petersen, Lars Arendt-Nielsen, Michiel Felix Reneman, André Wolff, Hans Timmerman","doi":"10.1080/17581869.2026.2629228","DOIUrl":"10.1080/17581869.2026.2629228","url":null,"abstract":"<p><strong>Objectives: </strong>Radiating chronic low back pain (CLBP-r) is linked to more pain, more disability, and a lower quality of life than non-radiating chronic low back pain (CLBP-nr). Female patients experience higher pain intensity and greater incidence of pain-related conditions compared to males. The objectives are to compare clinical manifestations potentially associated with human assumed central sensitization (HACS) between: (1) patients with CLBP-r and CLBP-nr and (2) female and male patients.</p><p><strong>Methods: </strong>In this cross-sectional observational study, 142 patients with CLBP underwent quantitative sensory testing (QST), including mechanical detection thresholds, mechanical pain thresholds, pressure pain thresholds, wind-up ratio, conditioned pain modulation, and the central sensitization inventory (CSI) to assess HACS.</p><p><strong>Results: </strong>Patients with CLBP-r based on radiculopathy, radicular pain, or segmental pain showed a higher mechanical detection threshold (8.0 [2.0-16.0] vs. 4.0 [1.0-8.0]; <i>p</i> < 0.001) and mechanical pain threshold (64.0 [16.0-128.0] vs.16 [8.0-64.0]; <i>p</i> = 0.001) and lower CSI score (34.2 ± 13.7 vs. 40.6 ± 12.4; <i>p</i> = 0.005) compared to patients with CLBP-nr. Female patients showed lower mechanical pain threshold (32.0 [8.0-64.0]) vs. (96.0 [32.0-128.0]; <i>p</i> < 0.001) and pressure pain threshold (36.0 [24.5-51.8] vs. 65.5 [40.2-83.0]; <i>p</i> < 0.001) than males.</p><p><strong>Discussion: </strong>Radiating pain and sex appears to influence clinical expressions attributed to HACS. Patients with CLBP-r showed higher mechanical thresholds and female patients presented lower mechanical and pressure pain thresholds. Interpretation should consider the cross-sectional design, the use of two data sets and unresolved clinical relevance.</p><p><strong>Clinical trial registration: </strong>https://trialsearch.who.int/ identifiers are NL-OMON24108 and NL-OMON24502.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"419-434"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}