Pain management最新文献

{"title":"Sleep, inflammation, and pain in musculoskeletal rehabilitation: a structured integrative review of neurobiological mechanisms and non-pharmacological pain management strategies.","authors":"Eder Moreira de Freitas, Andressa Silva, Andrea Maculano Esteves","doi":"10.1080/17581869.2026.2748285","DOIUrl":"https://doi.org/10.1080/17581869.2026.2748285","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbance, inflammation, and persistent pain may reinforce one another, compromising musculoskeletal rehabilitation.</p><p><strong>Purpose: </strong>To synthesize evidence on mechanisms linking sleep, inflammation, and pain and identify relevant non-pharmacological interventions.</p><p><strong>Methods: </strong>This structured integrative review examined peer-reviewed studies published from January 2010 to December 2025, identified through PubMed, Scopus, PEDro, and SciELO. Reporting and synthesis were guided by SANRA and EQUATOR recommendations.</p><p><strong>Results: </strong>Fifty-seven studies were included: 24 experimental or observational studies, 17 systematic reviews or meta-analyses, and 16 narrative or integrative reviews. Sleep restriction was associated with changes in interleukin-6, tumor necrosis factor-α, and C-reactive protein, with responses varying across populations and protocols. Prostaglandins and bradykinin may promote nociceptive sensitization, while disrupted sleep may impair descending pain inhibition. Exercise, manual therapy, neuromuscular electrical stimulation, low-level laser therapy, and sleep-focused behavioral interventions showed mechanistic plausibility, although confirmatory trials remain limited.</p><p><strong>Conclusion: </strong>Sleep assessment and sleep-focused interventions should be considered within multimodal musculoskeletal pain management, while further controlled research clarifies clinical effectiveness.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228508","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":"Changes in functional outcomes following activity management training in individuals with chronic low back pain: associations with cognitive functions, body awareness, and fatigue.","authors":"Nilay Şahan, Ceyhun Türkmen, Tuğba Arslan, İlkem Ceren Sığırtmaç, Meltem Yazıcı Gülay","doi":"10.1080/17581869.2026.2748301","DOIUrl":"https://doi.org/10.1080/17581869.2026.2748301","url":null,"abstract":"<p><strong>Aims: </strong>This study investigated changes in activity patterns, cognitive functions, and fatigue following activity management training in individuals with chronic low back pain (CLBP).</p><p><strong>Patients and methods: </strong>Thirty-four individuals with CLBP completed a six-week training program covering ergonomics, pacing, energy conservation, and relaxation. Assessments included the Canadian Occupational Performance Measure (COPM), Body Awareness Questionnaire, Patterns of Activity Measure-Pain, Cognitive Failures Questionnaire (CFQ), Fatigue Severity Scale, Stroop Test, and selected Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) subtests.</p><p><strong>Results: </strong>Significant improvements were observed in COPM performance and satisfaction (<i>p</i> < 0.001). Body awareness and adaptive activity regulation behaviors increased, while pain-related avoidance behaviors decreased (<i>p</i> < 0.05). Cognitive performance also improved, as indicated by lower CFQ scores and better performance on selected Stroop and LOTCA measures (<i>p</i> < 0.05). Fatigue severity did not change significantly (<i>p</i> > 0.05). Regression models were significant for activity performance (R² = 0.366, <i>p</i> = 0.008) and satisfaction (R² = 0.347, <i>p</i> = 0.013). Body awareness and visuomotor organization were associated with activity performance, while fatigue was associated with activity satisfaction (<i>p</i> < 0.05).         .</p><p><strong>Conclusions: </strong>Activity management training may be considered a supportive approach for addressing activity-related difficulties in individuals with chronic low back pain.</p><p><strong>Clinicaltrials.gov identifier: </strong>www.clinicaltrials.gov identifier is NCT07061743.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183689","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":"OneRF radiofrequency ablation system for the minimally invasive treatment of trigeminal neuralgia: initial clinical experience.","authors":"Michael D Staudt, Theresa A Elder, Marshall T Holland, David P Darrow","doi":"10.1080/17581869.2026.2748288","DOIUrl":"https://doi.org/10.1080/17581869.2026.2748288","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous radiofrequency ablation is an established treatment for medically refractory trigeminal neuralgia (TN). Conventional systems use a single active tip and often require repeated repositioning. A multi-contact radiofrequency platform may permit contact-level interrogation and lesioning along a single fixed trajectory.</p><p><strong>Methods: </strong>We performed a retrospective review of patients with medically refractory TN treated with a multi-contact thin-film radiofrequency probe. Demographics, operative details, Barrow Neurological Institute (BNI) pain scores, medication use, and complications were reviewed. Contact-level localization was performed intraoperatively, including low-temperature thermal interrogation, followed by definitive lesioning.</p><p><strong>Results: </strong>Fifteen patients (mean age 66.5 years; 12 women) underwent treatment. Most had classical or idiopathic TN, purely paroxysmal involving the V2-V3 distribution. Contact-level mapping was successfully achieved in all cases with definitive lesioning along a fixed trajectory. At mean follow-up of 6.0 months, all patients had a good outcome (BNI I-IIIB), and most had reduced or discontinued pain medications. No off-target lesioning was observed.</p><p><strong>Conclusions: </strong>This early clinical series suggests that a multi-contact radiofrequency platform can facilitate contact-level mapping and lesioning of trigeminal distributions along a single trajectory without repeated probe repositioning. Initial pain outcomes were favorable, although larger cohorts and longer follow-up are needed to define durability and comparative effectiveness.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183722","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":"Same trials, different answers: reconciling four meta-analyses of anti-CGRP antibodies in cluster headache.","authors":"Hiba Mustafa, Bayan Ayman Barawi, Carlo Baraldi, Lanfranco Pellesi","doi":"10.1080/17581869.2026.2744714","DOIUrl":"https://doi.org/10.1080/17581869.2026.2744714","url":null,"abstract":"<p><strong>Introduction: </strong>Monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway have been tested in cluster headache with mixed results, and four systematic reviews and meta-analyses reached different conclusions, leaving clinicians without a clear answer on whether, and in whom, to use these drugs.</p><p><strong>Areas covered: </strong>PubMed and Google Scholar were searched up to June 2026. We re-express the placebo-controlled evidence as the number needed to treat (NNT) for a ≥ 50% reduction in attacks, separately by subtype and by agent, summarize the pooled safety data, and translate the findings into a concrete framework for everyday practice.</p><p><strong>Expert opinion: </strong>Only galcanezumab in episodic disease met its primary endpoint (the reduction in weekly attacks). Its ≥50% responder rate translates into an NNT of 5, though this estimate derives from a single trial and should be interpreted cautiously. Eptinezumab missed both its primary and key secondary endpoints and was stopped for futility. A concordant ≥50% responder signal emerged only in exploratory, non-multiplicity-controlled analyses (nominal NNT = 6). No agent shows a measurable benefit in the chronic form. These antibodies are best regarded as a second-line option in selected patients with episodic cluster headache, after standard prevention has been optimized.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148822","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":"Erector spinae plane block for postoperative analgesia after hip surgery: a systematic review and meta-analysis of randomized controlled trials.","authors":"Mashour Ibrahim A Alsherie, Rashed K Alrashed, Saad Khalid Alsaleh, Khalid A Rifadah, Bassam Khalifah S Alkhalifah, Omar Abdulilah O Binmadi, Abdulaziz Ibrahim Almughamis, Yahya Saeed B Alqahtani, Naser Bader Alenezi, Khaled Al Khaledi, Abdullah AlGhaith, Abdullah Altamimi","doi":"10.1080/17581869.2026.2738427","DOIUrl":"https://doi.org/10.1080/17581869.2026.2738427","url":null,"abstract":"<p><strong>Background: </strong>Erector spinae plane block (ESPB) has been evaluated for postoperative analgesia after hip surgery, but its comparative value relative to established regional techniques remains uncertain. This systematic review and meta-analysis of randomized controlled trials (RCTs) assessed postoperative pain and opioid use with ESPB versus no regional block/standard care and versus active regional analgesic techniques.</p><p><strong>Methods: </strong>PubMed, Scopus and Web of Science were searched from database inception to January 2026. Two reviewers independently screened records, extracted data and assessed risk of bias using the revised Cochrane Risk of Bias 2 tool. Comparator-stratified random-effects meta-analyses used standardized mean differences (SMDs) for pain and opioid outcomes using R software (v. 4.5.2). Certainty was assessed with GRADE.</p><p><strong>Results: </strong>Systematic search identified 23 RCTs (<i>n</i> = 1401). Versus no block/standard care, ESPB was associated with statistically lower pain at 2 h (SMD = -1.08, 95% CI: -1.91 to -0.24; I² = 84.4%), 4 h (SMD = -2.72, 95% CI: -4.30 to -1.14; I² = 93.5%), 6 h (SMD = -1.19, 95% CI: -1.73 to -0.65; I² = 85.2%) and 48 h (SMD = -0.58, 95% CI: -1.04 to -0.12; I² = 63.5%), but not at 12 or 24 h. The 48-h finding was leave-one-out sensitive. Head-to-head effects were predominantly non-significant and selected timepoints favored active comparators. At 24 h, opioid consumption was lower versus no block (SMD = -1.30, 95% CI: -2.16 to -0.45; I² = 91.9%), but marked Doi-plot asymmetry was present. Postoperative nausea and vomiting were less frequent (RR = 0.55, 95% CI: 0.35 to 0.88; I² = 0%), although the result was sensitivity-analysis fragile. Certainty was generally low or very low.</p><p><strong>Conclusion: </strong>Current randomized evidence suggests that ESPB may improve early postoperative pain scores compared with no regional block, but pooled estimates are limited by marked clinical and statistical heterogeneity. No consistent superiority over established regional techniques has been demonstrated. ESPB is therefore best considered a possible alternative within multimodal analgesia rather than a replacement for targeted hip blocks.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/prospero/ identifier CRD420261372476.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138047","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":"Integrating culture, religion, and clinical practice of pain experience.","authors":"G Shankar Ganesh","doi":"10.1080/17581869.2026.2744709","DOIUrl":"https://doi.org/10.1080/17581869.2026.2744709","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128206","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":"Fasting-induced headache in Ramadan: a scoping review with implications for clinical practice.","authors":"Ghina Makki, Thien Phu Do, Lanfranco Pellesi","doi":"10.1080/17581869.2026.2744716","DOIUrl":"https://doi.org/10.1080/17581869.2026.2744716","url":null,"abstract":"<p><strong>Introduction: </strong>Headache attributed to fasting is a recognized secondary headache in the International Classification of Headache Disorders, 3rd edition (ICHD-3), defined as a diffuse, non-pulsating headache developing during fasting and relieved after eating. It is especially relevant during Ramadan, when large populations undergo predictable daily periods of food and fluid abstinence lasting up to 20 hours. Despite the high number of individuals potentially affected, the evidence on fasting-induced headache during Ramadan remains fragmented and has never been systematically summarized.</p><p><strong>Areas covered: </strong>This scoping review maps the current literature on fasting-induced headache during Ramadan based on structured searches in PubMed and Embase. Twenty studies were included, comprising observational studies, surveys, case reports and a small number of clinical trials. Findings were organized thematically.</p><p><strong>Expert opinion: </strong>Ramadan fasting reproducibly worsens migraine and triggers fasting headache, with dehydration, caffeine withdrawal, hypoglycemia, disrupted sleep and eating habits as the main proposed mechanisms. Worsening tends to be most pronounced in the early days of fasting and to attenuate thereafter. Preemptive pharmacological prevention is promising: pre-fasting etoricoxib has a preliminary evidence, while rimegepant shows a positive signal in migraine patients that awaits confirmation. Pharmacological interventions may offer the greatest benefit during the first week of Ramadan.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128147","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":"Quality of life outcomes in neuropathic orofacial pain: an umbrella review of therapeutic interventions.","authors":"Javier Basualdo Allende, Gilbert Jorquera, Vanessa Campos-Bijit, Constanza Morales-Gómez, Leonardo Díaz, Alfredo Von Marttens, Liliann Abarza, Víctor Beltrán, Eduardo Fernández","doi":"10.1080/17581869.2026.2688376","DOIUrl":"10.1080/17581869.2026.2688376","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic orofacial pain comprises chronic conditions that severely affect daily function, psychological well-being, and quality of life, yet no umbrella review has synthesized how available treatments influence quality-of-life outcomes.</p><p><strong>Objective: </strong>To critically summarize evidence from systematic reviews and meta-analyses evaluating the impact of therapeutic interventions on quality-of-life-related outcomes in neuropathic orofacial pain.</p><p><strong>Methods: </strong>This umbrella review followed Joanna Briggs Institute methodology and PRISMA 2020. PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from inception to 2 January 2026. Eligible studies were systematic reviews/meta-analyses of therapeutic interventions for neuropathic orofacial pain reporting quality-of-life or patient-reported outcomes. Quality was assessed with AMSTAR 2 and ConQual.</p><p><strong>Results: </strong>Seven systematic reviews were included. Overlap was slight (CCA = 2.14%) and disappeared after adjustment (CCA = 0%). Repetitive transcranial magnetic stimulation improved selected patient-reported domains (MD -9.23; 95% CI-11.91 to -6.54). Microvascular decompression showed sustained pain relief, with benefits inferred from satisfaction and functional recovery. Pulsed radiofrequency improved short-term pain/sleep outcomes. Botulinum toxin type A reduced pain but not broader quality-of-life domains.</p><p><strong>Conclusions: </strong>These interventions may improve quality-of-life-related outcomes when pain control is sustained, but evidence remains indirect and methodologically limited.</p><p><strong>Protocol registration: </strong>PROSPERO, http://www.crd.york.ac.uk/prospero, identifier CRD420251276623.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1183-1196"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dronabinol for chronic low back pain in Veterans: protocol for a randomized, double-blind, placebo-controlled, parallel-group trial.","authors":"Michael Strayhorn, Adetola Vaughan, JeTaury Davis, Grace Lo, Christopher D Verrico","doi":"10.1080/17581869.2026.2685608","DOIUrl":"10.1080/17581869.2026.2685608","url":null,"abstract":"<p><p>Chronic low back pain is common, disabling, and often inadequately controlled with current pharmacologic options, underscoring the need for safer non-opioid treatments. Dronabinol, a synthetic formulation of Δ9-tetrahydrocannabinol, has analgesic potential but has not been rigorously evaluated for chronic low back pain. This article describes a phase IIa, single-site, randomized, double-blind, placebo-controlled, parallel-group trial in Veterans with chronic low back pain. Seventy-five participants will be randomized 2:1 to oral dronabinol or matching placebo for 8 weeks following a screening period of up to 4 weeks. The primary objective is to evaluate safety and tolerability. Primary outcomes include treatment-emergent adverse events, serious adverse events, laboratory findings, vital signs, and electrocardiogram results. Secondary outcomes are exploratory and include pain intensity, physical functioning, emotional functioning, global improvement, analgesic use, and medication adherence. This study is designed to generate safety data and preliminary estimates of variance and effect size to inform a future confirmatory trial; it is not powered to test efficacy hypotheses.Clinical trial registration: http://www.clinicaltrials.gov identifier is NCT06454669.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1073-1081"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebound pain after patient-controlled epidural analgesia for major abdominal surgery : a retrospective study.","authors":"Didier Delbrouck, Vincent Garcia, Nathalie Leroux-Bromberg, Clémence Leguilette, Houssein El Hajj","doi":"10.1080/17581869.2026.2688375","DOIUrl":"10.1080/17581869.2026.2688375","url":null,"abstract":"<p><strong>Background: </strong>Rebound pain (RP) is recognized after locoregional analgesia, yet its incidence and determinants remain insufficiently characterized in major abdominal oncologic surgery patients managed with patient-controlled epidural analgesia (PCEA).</p><p><strong>Methods: </strong>We conducted a retrospective single-center study of patients undergoing major abdominal oncologic surgery with PCEA (<i>n</i> = 199). Maximal Daily Pain Scores (MDPS) were recorded during and after PCEA withdrawal. RP was defined as an increase of ≥3 points on the 11-point Numeric Rating Scale within 8 hours of discontinuation. Data on timing, modality, and prescriptions of systemic relay analgesics were collected. Descriptive, univariate, and multivariate logistic regression analyses evaluated risk factors for RP.</p><p><strong>Results: </strong>Of 199 patients, 92(46%) developed RP within 8 hours after PCEA withdrawal. Median PCEA duration was shorter in RP patients (93.3 h) compared with non-RP patients (112.5 h); <i>p</i> = 0.001, despite most receiving anticipatory relay prescriptions. Longer PCEA duration remained independently associated with a lower risk of RP in multivariate analysis (OR 0.81 per 12-hour increase; 95%CI,0.70-0.92; <i>p</i> = 0.002). The choice of relay analgesia was significantly associated with pain intensity during the two days before PCEA discontinuation, suggesting possible confounding by indication.</p><p><strong>Conclusion: </strong>RP affected nearly half of patients after PCEA withdrawal. Extended PCEA duration significantly reduced its incidence.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1113-1121"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}