Pain management最新文献

{"title":"Effect of diamagnetic therapy to manage a patient with degenerative cervical myelopathy and drug's intolerance.","authors":"Vincenzo Rania, Gianmarco Marcianò, Cristina Vocca, Caterina Palleria, Lucia Muraca, Pietro Romeo, Felipe Torres, Luca Gallelli","doi":"10.1080/17581869.2025.2523729","DOIUrl":"10.1080/17581869.2025.2523729","url":null,"abstract":"<p><p>Degenerative cervical myelopathy (DCM) is a common condition with a prevalence of 24.2% in the healthy population, and 35.3% in patients older than 60 years. The management of this clinical condition is difficult and implies chronic management of patients. The risk of drug abuse is very high and may lead to important long-term consequences. Finding a therapeutic option capable to reduce the number of prescribed drugs and with few side effects is very important in DCM. We report a 44-year-old Caucasian woman who was diagnosed with DCM. Her medical history revealed that despite using multiple medications, she did not show any signs of improvement. She declined the surgical treatment as well. Following clinical assessment, a diamagnetic pump treatment with pulsed electromagnetic fields for 3 months (once-twice weekly for 30 min, magnetic flux density 86 mt at the site of treatment) resulted in a clinical improvement. The benefits of diamagnetic therapy were three-faced including pain improvement, functional status, and imaging (magnetic resonance imaging (MRI) showing bone marrow edema reduction and myelopathy improvement). This is the first case report in our knowledge to prove the effectiveness of diamagnetic therapy in DCM, alongside imaging and functional improvement.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"373-378"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369136","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":"Efficacy of intra-articular opioid injections for managing temporomandibular joint nociception: a systematic review.","authors":"Madhuli Bhide, P Emile Rossouw, Fawad Javed","doi":"10.1080/17581869.2025.2517523","DOIUrl":"10.1080/17581869.2025.2517523","url":null,"abstract":"<p><strong>Aim: </strong>This systematic review evaluated randomized controlled trials (RCTs) investigating the effectiveness of intra-articular opioid injections for managing temporomandibular joint (TMJ) pain.</p><p><strong>Methods: </strong>A comprehensive search of indexed databases and Google Scholar was conducted following PRISMA guidelines. Included studies assessed self-reported TMJ pain and maximum mouth opening (MMO) as primary and secondary outcomes, respectively. Risk of bias (RoB) was evaluated using the Cochrane tool, and evidence certainty was rated using the GRADE framework.</p><p><strong>Results: </strong>Ten RCTs met the inclusion criteria, with follow-up periods ranging from 30 minutes to 6 months. Six trials demonstrated significant pain reduction after opioid injections, while one reported no difference following morphine use. Another study found mepivacaine more effective than morphine or saline. Regarding MMO, one trial showed no effect of morphine, whereas two trials found that 1 mg morphine or 1 ml buprenorphine led to greater improvements than 0.1 mg morphine. In three trials, opioids enhanced MMO more than sodium hyaluronate. All studies exhibited low RoB. Certainty of evidence was moderate in six RCTs and low in three.</p><p><strong>Conclusion: </strong>There is no credible evidence for the benefit of intra-articular opioid-injections for managing TMJ nociception.</p><p><strong>Protocol registration: </strong>www.crd.tork.ac.uk/prospero identified is CRD42024598035.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"441-447"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267015","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":"Postoperative pain management after ureteroscopy: focused approaches to reducing opiate dependence.","authors":"Christopher C Ballantyne, Karen L Stern","doi":"10.1080/17581869.2025.2515001","DOIUrl":"10.1080/17581869.2025.2515001","url":null,"abstract":"<p><p>Ureteroscopy (URS) is a common urological procedure performed to treat nephrolithiasis, but postoperative pain often leads to patient inquires, unplanned emergency department visits, or readmissions. Effective pain management is essential for improving recovery, reducing adverse symptoms, and enhancing patient satisfaction. Due to concern for opioid dependency, urologists have increasingly focused on alternative methods for pain relief, emphasizing multimodal analgesia. This narrative review, based on a PubMED search from January 2025-February 2025, examines alternative strategies for pain management. Recent studies show benefits of combining medications like nonsteroidal anti-inflammatory (NSAIDS), alpha-blockers, and anticholinergics to reduce opioid dependence. Identifying the most appropriate analgesics following URS remains a challenge, with the primary goal to optimize recovery to improve patient outcomes and satisfaction.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"401-411"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226272","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":"Effectiveness of conditioning + open-label placebo for post-operative pain management in adolescent idiopathic scoliosis.","authors":"Kira S Furie, Kaitlyn James, Ted J Kaptchuk, Mohammad Diab","doi":"10.1080/17581869.2025.2520148","DOIUrl":"10.1080/17581869.2025.2520148","url":null,"abstract":"<p><p>The vast majority of placebos are administered with concealment or deception. Most clinicians and researchers believe that either deception or concealment is necessary to achieve a placebo response; however, recent studies with open-label placebo (OLP), conditioning, and conditioning + OLP (COLP) have shown that placebos can be effective even when patients know they are receiving a placebo. To date, no studies have examined COLP in a pediatric surgical population, which is vulnerable to developing opioid dependence. COLP may assist in lowering opioid doses administered and quicker tapering off opioids. This study investigates the effectiveness of COLP on postoperative treatment of patients ages 10 through 17 undergoing posterior fusion for adolescent idiopathic scoliosis (AIS). It is a randomized controlled trial of 64 AIS patients assigned to one of the two arms: COLP + treatment as usual (TAU) and TAU control. Randomization and baseline assessments occur at the preoperative visit. Opioid consumption is recorded weekly after hospitalization until the first in-person postoperative visit at 6 weeks. The primary outcome measure is postoperative opioid consumption, both amount and duration. Secondary outcomes include pain, functional ability, and mental health scores.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"363-371"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326546","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":"A multimodal intervention of manual therapy, exercise, and psychological management for painful diabetic neuropathy: intervention development and feasibility trial protocol.","authors":"David Hohenschurz-Schmidt, Sasha Smith, Annina B Schmid, Philip Bright, Jerry Draper-Rodi, Matthew C Evans, Harriet Kemp, Nuno Koch Esteves, Elizabeth Pigott, Whitney Scott, Jan Vollert, Esther Williamson, Esther M Pogatzki-Zahn, Steven Vogel","doi":"10.1080/17581869.2025.2515010","DOIUrl":"10.1080/17581869.2025.2515010","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic options for people experiencing neuropathic pain from diabetic peripheral neuropathy are limited, and impact can be severe. Physical and psychological interventions remain under-explored but may offer promise, especially in multimodal combination programs.</p><p><strong>Objectives and methods: </strong>To address this gap, an intervention was developed according to the Medical Research Council's framework for complex interventions, including research expert and stakeholder input. This will be tested for acceptability and feasibility in a trial.</p><p><strong>Results: </strong>NeuOst (Neuropathy Optimisation through Self-management and Therapy) is a manual therapy-based intervention, incorporating exercise, psychologically informed training, and education. The protocol for a single-site, parallel, three-arm, partially participant-blinded, randomized controlled trial is presented. The experimental treatment is a 5-week course of NeuOst as adjunct to patients' usual care. Comparators are a control intervention that lacks pre-specified components of interest as adjunct to usual care and usual care only in adults with painful diabetic peripheral neuropathy. The follow-up period is 16 weeks. Primary outcomes are feasibility measures such as recruitment, eligibility, and consent rates, retention, blinding, fidelity, acceptability, and safety. Secondary and exploratory outcomes involve clinical measures and qualitative feedback. A protocol was prospectively registered (NCT06423391).</p><p><strong>Conclusion: </strong>After initial intervention development, a feasibility trial will inform intervention refinement and future research steps.</p><p><strong>Clinical trial registration: </strong>www.clinicaltrials.gov identifier is NCT06423391.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"387-399"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267013","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":"Fibromyalgia, more than \"just pain\".","authors":"M Elena González-Álvarez, Giacomo Rossettini, Jorge Hugo Villafañe","doi":"10.1080/17581869.2025.2513216","DOIUrl":"10.1080/17581869.2025.2513216","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"359-361"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174453","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":"Opioid deprescribing: rethinking policies to facilitate better patient outcomes.","authors":"Aili V Langford, Kellia Chiu","doi":"10.1080/17581869.2025.2516409","DOIUrl":"10.1080/17581869.2025.2516409","url":null,"abstract":"<p><p>Deprescribing, the patient-centered process of reducing or stopping a medication when the potential harms outweigh the likely benefits, has emerged as a promising strategy to mitigate opioid-related harm. Typically, opioid deprescribing occurs at the individual level, however, adopting a policy-driven approach could expand its reach and impact. To date, prescription opioid control policies that have been implemented with the intention of reducing opioid use and harm have often resulted in unintended consequences. In this article we discuss whether and how the concept of opioid deprescribing can be operationalized at a policy level. We review the goals, challenges and consequences of opioid control policies, explore how they intersect with system-level factors, and propose pathways for developing and implementing future opioid deprescribing policies. We argue that the development and implementation of patient-centered opioid deprescribing policies are both essential and feasible, if key challenges such as structural stigma and the complex interplay between pain and opioid use disorder are recognized and addressed. Robust evaluation frameworks will also be critical for monitoring outcomes and refining interventions. By prioritizing patient and provider needs, and carefully considering pertinent system-level factors, policymakers may be able to foster more effective and compassionate opioid management and reduce opioid-related harm.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"413-423"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249153","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":"Comparative efficacy of memantine and vitamin C in postoperative pain management: a randomized clinical trial.","authors":"Masoud Saadat Fakhr, Amirhasan Mohajeri, Bahar Amini, Reza Shah Hosseini, Fatemeh Rafizadeh, Elham Esmaeili, Mahnaz Narimani Zamanabadi","doi":"10.1080/17581869.2025.2516415","DOIUrl":"10.1080/17581869.2025.2516415","url":null,"abstract":"<p><strong>Aim: </strong>Acute postoperative pain affects most surgical patients, often delaying recovery. Memantine (Namenda®), an N-methyl-D-aspartate (NMDA) receptor antagonist, offers potential for effective pain relief with minimal adverse effects. This study examines memantine's effectiveness in reducing acute postoperative pain and opioid consumption compared to vitamin C, which served as an active comparator.</p><p><strong>Patients and methods: </strong>This double-blind randomized clinical trial was conducted in 2021 at a single tertiary-care hospital (Boali, Amirul Mominin, and Farhikhtegan Hospital). Patients aged 15-75 undergoing elective abdominal surgery were randomized to receive either memantine (<i>n</i> = 17) or vitamin C (<i>n</i> = 17). Pain was assessed using the visual analogue scale (VAS) at 0, 6, 12, and 24 hours postoperatively, with pethidine rescue analgesia (VAS >V). Statistical analyses included the Mann-Whitney test (non-normally distributed data), repeated-measures ANOVA (time effects), and Fisher's exact test (categorical variables).</p><p><strong>Results: </strong>Memantine significantly reduced postoperative pain at all intervals compared to vitamin C (<i>p</i> < 0.05), with the largest difference at 24 hours (3.2 ± 0.2 vs. 4.7 ± 0.1, <i>p</i> < 0.001). Narcotic use was lower in the memantine group (31.7 ± 2.5 mg vs. 42.9 ± 4.1 mg, <i>p</i> = 0.81). Pain intensity declined over time in both groups, but the reduction was greater with memantine (group-by-time interaction, <i>p</i> = 0.034).</p><p><strong>Conclusions: </strong>Memantine was more effective than vitamin C (active comparator) in reducing acute postoperative pain and opioid requirements following elective abdominal surgery. These findings support memantine's potential as a non-opioid adjunct for pain management in this population. However, limitations include a small sample size, single-center design, and short follow-up period. Further multicenter trials with larger cohorts and extended observation are warranted to confirm these results and optimize dosing strategies.</p><p><strong>Clinicaltrialregistration: </strong>https://irct.behdasht.gov.ir/trial/80349 is: IRCTID: IRCT20240120060739N1).</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"379-385"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267014","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":"The role of liposomal bupivacaine in pain management after the NOPAIN act.","authors":"Yash Shah, Anthony Barisano, Eric Ly, Vendhan Ramanujam","doi":"10.1080/17581869.2025.2525740","DOIUrl":"https://doi.org/10.1080/17581869.2025.2525740","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-3"},"PeriodicalIF":1.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507522","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":"Ankylosing spondylitis management: a narrative review of radiofrequency ablation and naproxen.","authors":"Akash Patel, Dev Patel, John DesRochers, Abdullah Noory, Brandon Goodwin, Don D Shamilov, David F Lo, Richard Jermyn","doi":"10.1080/17581869.2025.2518046","DOIUrl":"https://doi.org/10.1080/17581869.2025.2518046","url":null,"abstract":"<p><p>Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, causing pain, stiffness, and reduced mobility. Its pathophysiology remains unclear, complicating treatment development. Management aims to alleviate symptoms and control inflammation, but targeted strategies are lacking. This study compared the efficacy of radiofrequency ablation (RFA) and naproxen in axSpA treatment. A PubMed search was conducted on 14 March 2023 and 27 May 2025. RFA is a minimally invasive procedure that targets nerve endings to block pain signals, while naproxen is a non-steroidal anti-inflammatory drug (NSAID) that reduces inflammation. We conducted a narrative review of axSpA patients treated with either RFA or naproxen, assessing pain relief, functional improvement, and quality of life. Results showed that RFA was significantly more effective than naproxen in managing chronic pain. Patients receiving RFA reported greater pain reduction and better functional outcomes compared to those on naproxen. RFA provided prolonged relief, while naproxen's effectiveness diminished over time, limiting its long-term benefit. These findings suggest that RFA should be considered a preferred treatment for axSpA patients seeking long-term pain relief and improved quality of life. This study supports RFA's role in managing inflammatory spinal conditions and informs optimal axSpA treatment strategies.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-8"},"PeriodicalIF":1.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275642","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}