Pain management最新文献

{"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}

{"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":"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":"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":"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":"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}

{"title":"Case series of CT-fusion and real-time US-guidance in percutaneous RF thermocoagulation for trigeminal rhizotomy.","authors":"Chia-Hong Guo, Yung-Chi Hsu, Wei-Chen Liao, Hao-Lun Kao, Wei-Chou Chang, Yi-Chih Hsu","doi":"10.1080/17581869.2025.2508683","DOIUrl":"10.1080/17581869.2025.2508683","url":null,"abstract":"<p><p>This case series evaluates the feasibility, safety, and efficacy of real-time computed tomography fusion with ultrasound guidance (CTF-USG) in percutaneous radiofrequency thermocoagulation (RFT) for trigeminal rhizotomy. Traditional imaging modalities such as CT and fluoroscopy lack real-time visualization, increasing the risk of vascular injury and reducing procedural precision. The CTF-USG technique integrates CT imaging with real-time ultrasound via electromagnetic tracking, enabling accurate needle navigation and anatomical confirmation. Six patients with refractory trigeminal neuralgia affecting the V2 or V3 divisions underwent RFT guided by CTF-USG. All procedures achieved first-attempt needle placement success with no immediate complications. Postoperative assessments demonstrated significant reductions in pain scores at one and three months. The real-time imaging capability facilitated avoidance of critical structures, enhanced procedural safety. In conclusion, CTF-USG offers real-time imaging superior to C-arm fluoroscopy or standard CT, reducing complications and improving procedural accuracy. Primary technique efficacy was 100%. These advantages support its adoption in treating refractory trigeminal neuralgia.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"317-323"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111705","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":"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}

{"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}