British Journal of Pain最新文献

{"title":"Pain catastrophising predicts optimal improvement in pain following genicular arterial embolisation for the treatment of mild and moderate knee osteoarthritis.","authors":"Richard Harrison, Tim V Salomons, Sarah MacGill, Mark W Little","doi":"10.1177/20494637251358334","DOIUrl":"10.1177/20494637251358334","url":null,"abstract":"<p><p><b>Background:</b> Knee osteoarthritis (OA) is the most common form of OA. Patients with mild-to-moderate OA, who do not respond to conservative treatment or yet warrant joint replacement, represent a significant clinical challenge. Genicular Arterial Embolisation (GAE) is a promising interventional radiological technique for OA. However, data highlight a consistent subset of patients that do not respond to GAE, despite a successful procedure. Pain Catastrophising (PC) represents a set of cognitive/affective biases to pain, linked to maladaptations in the descending pain modulatory system and has been frequently identified as a predictor of clinical outcomes. <b>Purpose:</b> This study aimed to investigate whether baseline pain catastrophising is associated with treatment outcomes following GAE, and to explore its neural correlates using resting-state functional magnetic resonance imaging (rs-fMRI). <b>Research Design:</b> A prospective, longitudinal cohort design was employed for this study. <b>Study Sample:</b> Thirty patients with mild-to-moderate knee OA scheduled for GAE completed a presurgical assessment including psychometric profiling and quantitative sensory testing. A neuroimaging subset of 17 patients, who met MRI safety criteria, also completed rs-fMRI. <b>Data Collection:</b> Participants completed outcome assessments at 6 weeks, 3 months, and 12 months post-GAE. Pain Catastrophising Scale (PCS) scores were analysed in relation to treatment outcomes and to whole-brain voxel-wise functional connectivity using the dorsolateral prefrontal cortex (DLPFC) as a seed region. PCS scores were included as regressors in rs-fMRI analyses. <b>Results:</b> Pain Catastrophising was associated with a myriad of psychological/lifestyle baseline variables, such as depression, anxiety and poor sleep. Surprisingly, high pain catastrophisers demonstrated the best improvements, with PC scores predicting higher reductions in pain at 6-weeks (R² = .18, p = .024), 3-months (R² = .37, p < .001) and 1-year (R² = .18, p = .027). Resting-state analyses revealed that catastrophising was associated with higher connectivity between the DLPFC and areas of the brain associated with pain processing, suggesting more frequent engagement of top-down modulatory processes. <b>Conclusions:</b> These results highlight that, interestingly, patients who catastrophise may benefit most from GAE. Potential explanations for this are discussed within. Overall, this data indicates GAE is an effective treatment for knee OA, and may be valuable at managing pain for high catastrophisers, who often fare worse in more invasive surgical procedures.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251358334"},"PeriodicalIF":1.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627328","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":"Pain, palliative care, and the politics of dying: Rethinking suffering in the assisted suicide debate.","authors":"Ilora Gillian Finlay","doi":"10.1177/20494637251356813","DOIUrl":"10.1177/20494637251356813","url":null,"abstract":"<p><p>Pain is cited as a fundamental rationale behind the campaign for 'assisted dying' (assisted suicide and euthanasia). However, current legislative proposals for England and Wales before the Westminster Parliament are silent on pain and on suffering. For patients to have real choice, they must be able to access the care they need, not feel coerced into viewing an early death as their only option. Yet current palliative care provision is dependent on voluntary donations, with severe deficits in some areas that urgently need to be addressed.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251356813"},"PeriodicalIF":1.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576618","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":"Repetitive transcranial magnetic stimulation for musculoskeletal pain: A systematic review and meta-analysis.","authors":"Yanan Liang, Shuangyang Niu, Yonghui Wang","doi":"10.1177/20494637251356812","DOIUrl":"10.1177/20494637251356812","url":null,"abstract":"<p><strong>Objective: </strong>In this study, a meta-analysis was conducted to characterize the therapeutic benefits of repetitive transcranial magnetic stimulation (rTMS) on musculoskeletal (MSK) pain and potential factors affecting the effect.</p><p><strong>Methods: </strong>A comprehensive search was performed in PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov for randomized and sham-controlled trials published from inception to 13 March 2024. We conducted this meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Based on the heterogeneity among studies, fixed effects or random-effects model was used for the effective analysis of rTMS on pain, quality of life, and depression.</p><p><strong>Results: </strong>A total of 23 eligible randomized controlled trials (RCTs) comprising 1158 patients were included in our systematic search. The analysis showed effect sizes of -0.94 (95% CI: -1.30 to -0.59), indicating that real rTMS was better than sham stimulation in reducing pain (<i>p</i> < 0.01). Also, rTMS reduced depression scores and improved follow-up effects and the quality of life of MSK pain patients. In the subgroup analysis, stimulation frequency, intensity, and session frequency were important factors affecting the therapeutic effect.</p><p><strong>Conclusions: </strong>Our review demonstrated that rTMS had the potential to relieve pain and depression, enhance the quality of life for patients with MSK pain. Stimulation frequency, intensity, and session frequency were important factors affecting the therapeutic effect.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251356812"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561537","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":"Early detection of opioid-induced hyperalgesia after an ICU stay using quantified sensory testing: An observational cohort case-control study.","authors":"Paul Tarpin, Eric Serra, Yazine Mahjoub, Valéria Martinez","doi":"10.1177/20494637251356830","DOIUrl":"10.1177/20494637251356830","url":null,"abstract":"<p><strong>Background: </strong>Opioids can heighten sensitivity to noxious stimuli, leading to opioid-induced hyperalgesia (OIH). Despite the frequent use of high opioid doses in ICU settings, the presence of OIH following ICU stays remains undocumented.</p><p><strong>Methods: </strong>This prospective observational study aimed to assess OIH presence and its clinical implications in post-ICU patients. Adults with confirmed Sars-CoV-2 infection hospitalized in the ICU for over 48 h were included, with opioid dosage recorded. At ICU discharge, 11 quantitative sensory tests (QSTs) were conducted at two non-painful sites, and pain presence, intensity, and characteristics were assessed at discharge and 4 months later.</p><p><strong>Results: </strong>Analysis of 41 patients (20 opioid-treated, 21 controls) revealed significantly higher hyperalgesia levels in the opioid-treated group across six tests at both sites, including cold pain thresholds, heat and cold tolerance thresholds, duration of tolerance to a 47°C stimulus, and thermal and mechanical temporal summation.</p><p><strong>Conclusions: </strong>Our findings underscore the importance of QST in early OIH detection, identifying thermal tolerance thresholds and thermal/mechanical temporal summation tests as sensitive indicators. Subclinical hyperalgesia in ICU patients on opioids heightens susceptibility to chronic pain development, emphasizing the need for vigilant opioid monitoring and adjustment in ICU care.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251356830"},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555234","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":"Triple-target radiosurgery for intractable cancer pain of mixed origin: Two-centre experience in Central America.","authors":"Paola Del Cid, Liliana Aquino, Alejandra Moreira, Víctor Caceros, Carlos Tobar, Alejandro Blanco, Gabriel Carvajal, Luis Bermudez-Guzman, Eduardo E Lovo","doi":"10.1177/20494637251350331","DOIUrl":"10.1177/20494637251350331","url":null,"abstract":"<p><p>Cancer pain is one of the most severe components of the symptom burden among cancer patients, especially those with advanced or metastatic disease. Palliative interventions are necessary to alleviate cancer pain and reduce opioid-related side effects, thereby minimizing patient suffering. Radiosurgery has been effectively used to target the medial thalamus and the hypophysis for the treatment of chronic pain syndromes. These two areas are critical for pain modulation and control, and their precise targeting with radiosurgery and its non-invasive nature can provide relief for patients suffering from cancer-related intractable pain. Our previous work with single target irradiation of the hypophysis revealed promising pain relief in terminal cancer patients, albeit more suited for hormone-mediated tumours or bone-derived pain rather than complex mixed pain syndromes. Given that, we previously introduced the concept of triple-target irradiation (hypophysis + both thalami) in a small report of terminally ill cancer patients. Here, we report a larger case series of terminally ill patients (<i>n</i> = 8) with complex cancer pain treated with a triple-target approach, with radiation doses generally considered low or non-ablative (90 Gy), in contrast to the usual single-target, ablative approach comprising higher doses. We noted a substantial decrease in VAS scores and the medications needed to manage pain across all patients, experiencing minimal to no side effects. Our findings indicate that a minimally invasive triple-target method, utilising low radiation doses, effectively alleviates pain, lowers medication dependency, and enhances the quality of life with few side effects. Furthermore, additional research is essential to optimise pain relief and ensure long-term effectiveness.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251350331"},"PeriodicalIF":1.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477172","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 complex relationship between neurocognition and chronic pain.","authors":"Christina Liossi","doi":"10.1177/20494637251347019","DOIUrl":"10.1177/20494637251347019","url":null,"abstract":"","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251347019"},"PeriodicalIF":1.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175293","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":"Clinical utility of digital pain drawings captured by people living with musculoskeletal pain conditions: a qualitative study.","authors":"Syed Mustafa Ali, Salma Elsayed, Rebecca R Lee, Jill Firth, David McCarthy, William G Dixon, Sabine N van der Veer","doi":"10.1177/20494637251343227","DOIUrl":"10.1177/20494637251343227","url":null,"abstract":"<p><strong>Background: </strong>Digital pain drawings are an emerging method for pain assessment, but it is still unclear how these could best support pain treatment and management decisions. Therefore, this study explored the potential clinical utility of digital pain drawings.</p><p><strong>Methods: </strong>We conducted a narrative study, involving qualitative interviews with healthcare professionals providing pain management services to people living with musculoskeletal pain conditions working across different disciplines and care levels in the healthcare system of the United Kingdom. We transcribed interviews, conducted thematic content analysis to identify themes and presented results using a framework approach.</p><p><strong>Results: </strong>We interviewed three general practitioners, five rheumatology healthcare professionals, four physiotherapists, two pain consultants and one rheumatology nurse. We identified four themes describing current pain assessment practices, potential advantages of digital pain drawings either alone or in combination with other pain information (e.g. perceived pain triggers and relieving factors) and outcome measures (e.g. quality of sleep, function and anxiety). Digital pain drawings provide an opportunity of enriching patient-provider communication, particularly for people with language barriers. Digital pain drawings may also support healthcare professionals across different disciplines and care levels (e.g. primary and secondary care) in decisions related to referrals, differential diagnosis, treatment planning, evaluating response to treatment and scheduling follow-up visits when combining pain drawings with other pain information, such as pain consequences and perceived causes.</p><p><strong>Conclusion: </strong>Digital pain drawings are clinically useful because of their potential to guide diagnosis, treatment and management choices in managing musculoskeletal chronic pain. Future research should investigate how these potential benefits are achieved by integrating digital pain drawings in clinical practice across different disciplines and care levels in the UK's healthcare system and beyond.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251343227"},"PeriodicalIF":1.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095389","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":"Group physical therapy improves outcomes for patients on an inpatient psychiatric pain service.","authors":"Kalen Pascal, Ryan Roemmich, Bingqing Ye, Kelly Daley, Glenn Treisman, Annette Lavezza, Rachel Reoli","doi":"10.1177/20494637251343553","DOIUrl":"10.1177/20494637251343553","url":null,"abstract":"<p><strong>Background: </strong>While physical therapists have provided group physical therapy interventions for patients admitted to inpatient psychiatric pain service lines, to date, it has not been assessed whether the patients' outcomes of pain and function have improved during their stay. Thus, our aim is to evaluate how group physical therapy, as part of an inpatient psychiatric rehabilitation team, impacts outcomes for patients receiving chronic pain treatment services.</p><p><strong>Methods: </strong>Data was retrospectively retrieved from patients who received group physical therapy during their inpatient psychiatric pain admission. At evaluation and discharge, PROMIS Pain Interference Scale tracked pain, while AM-PAC Basic Mobility Outpatient Short Form measured functional mobility. Paired samples statistics were used to evaluate outcomes.</p><p><strong>Results: </strong>Over a 6-month period, 25 patients (average age 40.28 +/- 15.93 years) received group physical therapy. All patients had the treatment diagnosis of chronic pain. The null hypothesis, that there was no difference between evaluation and discharge scores, was rejected for both the PROMIS Pain Interference Scale <i>t</i> (25) = 3.82, two-tailed <i>p</i> < .001 and the AM-PAC Mobility Score <i>t</i> (25) = -2.24, two-tailed <i>p</i> = .03.</p><p><strong>Conclusions: </strong>Group physical therapy, as part of an inpatient psychiatric pain management team, assists with improving patient outcomes of pain and mobility.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251343553"},"PeriodicalIF":1.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095391","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 association between chronic pain and deficits in attention: Is it mediated by disturbed sleep?","authors":"Giulia Zerbini, Cindy Strömel-Scheder, Anna Karmann, Philip Lang, Miriam Kunz, Stefan Lautenbacher","doi":"10.1177/20494637251342005","DOIUrl":"10.1177/20494637251342005","url":null,"abstract":"<p><strong>Objective: </strong>Persons with chronic pain suffer from additional symptoms and deficits that are directly or indirectly related to their condition. Attentional deficits are a common problem in these individuals. The same is true for sleep disturbances. It is well-known that night sleep affects attention the next day. Therefore, sleep disturbances might be responsible for the association between chronic pain and deficits in attention.</p><p><strong>Methods: </strong>We studied the gaze behaviour (absolute and relative fixation times, i.e., attentional biases) in patients with chronic musculoskeletal pain (<i>N</i> = 20) and pain-free individuals (<i>N</i> = 28). For that purpose, we used an eye-tracker to monitor gaze behaviour during the presentation of affective stimuli, that is, pictures of faces displaying joy, anger, pain, and neutral expressions. In addition, we assessed subjective/wellbeing parameters, as well as objective sleep parameters with a portable polysomnography (PSG) device during two nights at home, with the aim of testing the mediating role of sleep for the relationship between chronic pain and alterations of attention.</p><p><strong>Results: </strong>Patients with chronic pain exhibited overall shorter fixation times (on average ∼160 ms shorter fixation times). With respect to the attentional biases, all participants looked longer at the affective faces compared to the neutral ones, independent of group or type of affective stimulus. Several subjective sleep/wellbeing parameters, together with two PSG parameters (sleep efficiency and duration of awakenings), were significantly worse in patients with chronic pain. Despite this, only subjective sleep quality and sleep efficiency mediated the association of chronic pain and attentional processes.</p><p><strong>Conclusions: </strong>Our findings confirm previous studies showing attentional deficits and sleep disturbances in patients with chronic pain. However, our results only partially support the hypothesis that the relationship between chronic pain and altered attentional processes is due to disturbed sleep. Other mechanisms might be involved, highlighting the need for further studies.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251342005"},"PeriodicalIF":1.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062638","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":"Pain modulation in amputees: Exploring conditioned pain modulation and its influencing factors on amputated and non-amputated sides: A cross-sectional study.","authors":"Sara Barbosa Franco, Silvia Di-Bonaventura, Kevin Pacheco-Barrios, Andre Sugugawara, Marta Imamura, Leandro Heidy Yoshioka, Linamara Battistella, Felipe Fregni","doi":"10.1177/20494637251336359","DOIUrl":"https://doi.org/10.1177/20494637251336359","url":null,"abstract":"<p><strong>Background: </strong>Amputation leads to significant physical, psychological, and emotional challenges, with chronic pain being among the most debilitating outcomes. Conditioned Pain Modulation (CPM) is a key mechanism for understanding pain modulation reflecting the central nervous system's capacity to regulate pain.</p><p><strong>Objective: </strong>This study aimed to evaluate CPM in amputees, comparing CPM between the amputated and non-amputated sides, and to identify factors influencing CPM in this population.</p><p><strong>Method: </strong>Eighty-six amputees participated in the study. Sociodemographic and pain-related variables, including age, occupation, smoking status, pre-amputation pain duration, phantom limb pain, and pressure pain threshold, were assessed. Multiple linear regression models were performed to explore factors associated with CPM on both sides, with additional <i>t</i>-tests to compare CPM values between sides.</p><p><strong>Results: </strong>The multivariate model for the amputated side explained 26.3% of CPM variability, with significant associations found for pre-amputation pain duration and retirement status, as well as PPT mean of the amputated side, smoking, and phantom limb pain and age. In contrast, the non-amputated side model explained 26.5% (Adjusted R-squared) of the variability, with the following significant variables: duration of pre-amputation pain (negative correlation), smoking history, phantom limb pain (negative correlation), and frequency of telescoping sensation (negative correlation). There were no significant differences in CPM between amputated and non-amputated sides (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>The findings suggest that CPM on the amputated side is more influenced by pain experience and sociodemographic variables, while the non-amputated side shows less variability and is more resilient to these influences.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251336359"},"PeriodicalIF":1.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055823","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}