Pain managementPub Date : 2025-07-01Epub Date: 2025-06-10DOI: 10.1080/17581869.2025.2517523
Madhuli Bhide, P Emile Rossouw, Fawad Javed
{"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}
Pain managementPub Date : 2025-07-01Epub Date: 2025-06-19DOI: 10.1080/17581869.2025.2520148
Kira S Furie, Kaitlyn James, Ted J Kaptchuk, Mohammad Diab
{"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":1.5,"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}
Pain managementPub Date : 2025-07-01Epub Date: 2025-06-05DOI: 10.1080/17581869.2025.2515001
Christopher C Ballantyne, Karen L Stern
{"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}
Pain managementPub Date : 2025-07-01Epub Date: 2025-05-29DOI: 10.1080/17581869.2025.2513216
M Elena González-Álvarez, Giacomo Rossettini, Jorge Hugo Villafañe
{"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}
Pain managementPub Date : 2025-06-01Epub Date: 2025-05-16DOI: 10.1080/17581869.2025.2487406
Robert Croop, Peter J Goadsby, David A Stock, Charles M Conway, Micaela Forshaw, Elyse G Stock, Richard B Lipton
{"title":"Rimegepant orally disintegrating tablet for acute treatment of migraine: a plain language summary of a clinical study.","authors":"Robert Croop, Peter J Goadsby, David A Stock, Charles M Conway, Micaela Forshaw, Elyse G Stock, Richard B Lipton","doi":"10.1080/17581869.2025.2487406","DOIUrl":"10.1080/17581869.2025.2487406","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"301-309"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079543","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}
Pain managementPub Date : 2025-06-01Epub Date: 2025-05-14DOI: 10.1080/17581869.2025.2501521
Peter D Vu, Salahadin Abdi
{"title":"Post-acute sequelae SARS-CoV-2 infection and neuropathic pain: a narrative review of the literature and future directions.","authors":"Peter D Vu, Salahadin Abdi","doi":"10.1080/17581869.2025.2501521","DOIUrl":"10.1080/17581869.2025.2501521","url":null,"abstract":"<p><strong>Purpose of review: </strong>Neuropathic pain is a recognized and debilitating symptom of SARS-CoV-2 infection across acute, post-acute, and long-COVID phases. Initially emerging as acute or subacute symptoms, these neuropathic manifestations can evolve into chronic conditions, with approximately 10% of all SARS-CoV-2 cases (estimated 65 million individuals globally) developing post-acute SARS-CoV-2 (PASC) neuropathic sequalae. Given the limited literature specifically addressing neuropathic pain related to PASC, a deeper understanding is needed to improve management and reduce patient burden.</p><p><strong>Recent findings: </strong>PASC symptoms are associated with disease severity, elevated body mass indexes, preexisting psychological conditions, and addiction history. Sex differences appear to influence prevalence, and the multisystem nature of PASC complicates symptom presentation, with mood disorders, fatigue, and cognitive dysfunction contributing to altered pain perception. Proposed mechanisms include immune dysregulation, persistent viral protein effects, and neuroanatomical changes. Management typically involves a multimodal approach.</p><p><strong>Summary: </strong>This review examines SARS-CoV-2 neuropathic pain across the illness trajectory, examining its pathophysiology, prevalence, and treatment. It highlights the potential for subacute neuropathic symptoms to become chronic and calls for future research to refine long-term management strategies and assess broader healthcare implications.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"333-343"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009201","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}
Pain managementPub Date : 2025-06-01Epub Date: 2025-05-23DOI: 10.1080/17581869.2025.2507559
Komal Luthra, Melissa Schwartz, Darsha Krishnamurthi, Pranamya Suri, Scott Benkovic, Akhil Chhatre
{"title":"Baastrup's disease in a patient with multifactorial back pain: a case report.","authors":"Komal Luthra, Melissa Schwartz, Darsha Krishnamurthi, Pranamya Suri, Scott Benkovic, Akhil Chhatre","doi":"10.1080/17581869.2025.2507559","DOIUrl":"10.1080/17581869.2025.2507559","url":null,"abstract":"<p><p>Lower back pain is a common yet often misdiagnosed condition due to its multifactorial nature and presence of other underlying pathologies. Baastrup's disease is an underdiagnosed cause of lower back pain. We present a case of a 67-year-old female who initially presented with lower back pain and associated radiation to bilateral lower extremities. The patient's imaging revealed moderate spinal canal stenosis at L4-L5 due to grade 1 anterolisthesis, severe right L5-S1 neural foraminal stenosis, and a dorsal epidural cyst with interspinous bursitis possibly related to Baastrup's disease. The patient underwent L4-L5 interlaminar epidural steroid injection with cyst aspiration under fluoroscopic guidance and had temporary relief. Given the multifactorial nature of her pain, she subsequently underwent greater trochanter bursa steroid injections and bilateral L3-L5 medial branch blocks, resulting in significant pain relief. Our case demonstrates the multifactorial nature of lower back pain, where treatment of each underlying aspect, including identification of Baastrup's Disease with associated epidural cyst, resulted in pain relief. It also underscored the importance of considering the patient's history when using steroid injections in interventional procedures and determining when a patient is more appropriate for surgery.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"311-315"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128353","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}
Pain managementPub Date : 2025-06-01Epub Date: 2025-05-26DOI: 10.1080/17581869.2025.2511464
Tianhong Cai, Rong Zhang, Kai Chen, Ting Deng, Tenghui Zhan
{"title":"Safety and efficacy of intra-arterial lidocaine administration for pain control in uterine artery embolization for cesarean scar pregnancy.","authors":"Tianhong Cai, Rong Zhang, Kai Chen, Ting Deng, Tenghui Zhan","doi":"10.1080/17581869.2025.2511464","DOIUrl":"10.1080/17581869.2025.2511464","url":null,"abstract":"<p><strong>Background: </strong>Uterine artery embolization (UAE) for cesarean scar pregnancy (CSP) can cause significant pain.</p><p><strong>Objectives: </strong>To evaluate safety and efficacy of intra-arterial lidocaine during UAE for CSP.</p><p><strong>Methods: </strong>Retrospective study of 255 CSP patients: Control Group (184) without lidocaine; Study Group I (39) with unilateral lidocaine; Study Group II (32) with bilateral lidocaine. Outcomes included VAS pain scores and morphine usage.</p><p><strong>Results: </strong>Early postoperative VAS scores (0-2 hours) were significantly lower in study groups (<i>p</i> < 0.001). No differences in later VAS scores (4-24 hours), maximal VAS scores, morphine dosage, or safety indicators.</p><p><strong>Conclusion: </strong>Intra-arterial lidocaine during UAE for CSP provides effective analgesia immediately post-procedure but only for the first 2-4 hours, without reducing overall opioid requirements.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"325-332"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143119","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}
Pain managementPub Date : 2025-05-01Epub Date: 2025-05-08DOI: 10.1080/17581869.2025.2502311
Fanny Jogna, Adriana Graenicher A, Quentin Rey-Millet, Alexandra Groz, Jehanne De Grasset, Fabiola Stollar, Matteo Coen, Anna Faivre
{"title":"Pharmacological and non-pharmacological approaches to temporomandibular disorder chronic pain: a narrative review.","authors":"Fanny Jogna, Adriana Graenicher A, Quentin Rey-Millet, Alexandra Groz, Jehanne De Grasset, Fabiola Stollar, Matteo Coen, Anna Faivre","doi":"10.1080/17581869.2025.2502311","DOIUrl":"10.1080/17581869.2025.2502311","url":null,"abstract":"<p><p>Temporomandibular disorders (TMD) involve the temporomandibular joint and related structures, causing chronic pain, impaired jaw function, and reduced quality of life. TMD has multifactorial origins, including mechanical, neuromuscular, and inflammatory factors. Chronic TMD pain is difficult to manage due to its complex pathophysiology and the limited long-term effectiveness of existing treatments. A combination of pharmacological and non-pharmacological strategies is essential for optimal pain management. This narrative review provides an integrative overview of current treatments for TMD-associated chronic pain. Pharmacological options discussed include analgesics, muscle relaxants, antidepressants, anticonvulsants, and botulinum toxin injections. Non-pharmacological strategies include physical therapy, cognitive-behavioral therapy, acupuncture, and lifestyle modifications. A comprehensive literature search was conducted using PubMed, Embase.com, Cochrane, and Evidence Alerts databases through October 2024. We focused on original research articles, randomized controlled trials, narrative and systematic reviews, and meta-analyses. Effective management of chronic TMD pain requires a multidisciplinary approach tailored to individual needs. Evidence supports the integration of physical and psychological therapies into treatment plans. Future research should aim to develop targeted interventions that address underlying mechanisms of TMD pain and evaluate the long-term outcomes of noninvasive therapies.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"285-296"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011406","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}
Pain managementPub Date : 2025-05-01Epub Date: 2025-04-28DOI: 10.1080/17581869.2025.2494495
Mathieos Belayneh, Samar Hejazi, Bruno Gagnon, Philippa Hawley
{"title":"Methadone to treat chemotherapy-induced peripheral neuropathy (METACIN): study protocol.","authors":"Mathieos Belayneh, Samar Hejazi, Bruno Gagnon, Philippa Hawley","doi":"10.1080/17581869.2025.2494495","DOIUrl":"10.1080/17581869.2025.2494495","url":null,"abstract":"<p><strong>Rationale: </strong>Chronic chemotherapy-induced peripheral neuropathy (CIPN) affects 70% of cancer patients, causing neuropathic pain. Duloxetine is the most recommended treatment for CIPN per most guidelines. However, Methadone, an alternative and effective treatment for refractory neuropathic cancer pain has been under-recognized and under-studied in patients with CIPN.</p><p><strong>Participants: </strong>Adult patients with cancer and life expectancy greater than 12 weeks who have >grade 1 CIPN based on National Cancer Institute Common Toxicity Criteria for Adverse Events version 5.0 grading scale lasting ≥3 months beyond chemotherapy completion.</p><p><strong>Intervention: </strong>A triple-blind, double-dummy randomized controlled trial, participants randomized to either methadone or duloxetine, followed weekly over 5 weeks with dose titration.</p><p><strong>Outcomes: </strong>Primary outcome is the efficacy of methadone versus duloxetine in reducing average pain intensity from baseline to study end. Secondary outcomes include improvements in functional and quality-of-life interference. Exploratory outcomes include proportion of participants achieving ≥30% or ≥50% pain reduction, patient-reported global impression of change, incidence of adverse events, and methadone dose escalation over a 24-week follow up period.</p><p><strong>Anticipated impact: </strong>This study will determine if methadone is a viable treatment for CIPN; a very common, distressing, and debilitating condition that otherwise has limited treatment options.</p><p><strong>Clinical trial registration: </strong>www.clinicaltrials.gov identifier is NCT05786599.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"235-243"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048013","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}