British Journal of Pain最新文献

{"title":"A cross-sectional study of the prevalence and correlates of post-traumatic stress among people attending acceptance and commitment therapy for chronic pain.","authors":"Kezia Kadri, Cara Keating, Madeleine Anderson, David Novelli, Emily McBride, Whitney Scott","doi":"10.1177/20494637261497966","DOIUrl":"10.1177/20494637261497966","url":null,"abstract":"<p><strong>Objective: </strong>Experiences of trauma are common among people with chronic pain, although estimates of comorbid post-traumatic stress vary widely across contexts. Acceptance and commitment therapy (ACT), which targets psychological flexibility to improve pain-related functioning, is increasingly delivered for people with pain. To inform treatment delivery, understanding of the prevalence and correlates of post-traumatic stress among those attending ACT-based treatment for pain is needed. This study aimed to identify the prevalence of post-traumatic stress and its associations with key pain-related outcomes and other relevant psychosocial factors at the start of an ACT-based treatment.</p><p><strong>Methods: </strong>This was a cross-sectional study using data collected within routine clinical care at a speciality pain management service in the UK. Four hundred and fifty-one participants completed standardized self-report questionnaires of post-traumatic stress symptoms (PTSS), pain-related outcomes (pain intensity and interference, work and social adjustment, and depression symptoms), psychological flexibility/inflexibility, and stigma at the start of an interdisciplinary ACT-based treatment for chronic pain.</p><p><strong>Results: </strong>Forty-seven percent of patients (<i>n</i> = 213) reported a traumatic exposure and 30% of the sample reported clinically meaningful PTSS. Greater severity of PTSS and probable post-traumatic stress disorder (PTSD) were associated with significantly worse pain-related outcomes, psychological flexibility/inflexibility, and stigma in bivariate analyses. PTSS severity and probable PTSD showed significant unique associations with poorer pain outcomes in regression models controlling for covariates and psychological flexibility/inflexibility.</p><p><strong>Conclusions: </strong>Post-traumatic stress is common among people engaging in ACT-based treatment for pain and associated with adverse pain outcomes. Trauma-informed practice is therefore important when providing ACT-based treatment for pain.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261497966"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216898","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":"Pathophysiology of pain in acute pancreatitis: A narrative review.","authors":"Patrice Forget, Urszula Brzuchalska, Sören Marsmann, Sara Brophy, Brittany Chimsuk, Brooke Irvine, Conor Logan, Sophie Macdonald, Andrew Mands, Sharon Vivienne Mathews, Mark Mcmillan, Sneha Prothasis, Emma Thomson, Asbjørn Mohr Drewes, Sanjay Pandanaboyana, Esther Pogatzki-Zahn","doi":"10.1177/20494637261496489","DOIUrl":"10.1177/20494637261496489","url":null,"abstract":"<p><strong>Background and objective: </strong>Pain affects between 80 and 95% of patients with acute pancreatitis (AP). However, despite its importance and severity, the pathophysiological mechanisms are not well understood. This narrative review aims to review current knowledge about the pathophysiological mechanisms of pain in AP.</p><p><strong>Methods databases and data treatment: </strong>A search of electronic databases (PubMed/MEDLINE, Embase, and Cochrane) was conducted from January 31 2024 to July 25 2025. Inclusion criteria included any study on acute pancreatitis and pain (management). Exclusion criteria included the absence of relevant content or specific information about pain in AP.</p><p><strong>Results: </strong>We identified 11 studies. Two potential pain pathways were identified, categorised as nociceptive and neuropathic. Nociceptive signals are enhanced through the release of inflammatory mediators, such as nuclear factor-kappa B, nitric oxide and interleukin-6, in response to tissue damage. Furthermore, the characteristic visceral and referred pain is likely attributed to high levels of overlap of primary sensory afferent fibre activation and neuronal convergence. Damage of the central and peripheral nervous system through the upregulation of voltage-gated ion channels, vanilloid receptors and transmembrane proteins may cause neuropathic-like pain. This triggers neurogenic inflammation and further release of neuropeptides, inducing an auto-amplification loop between neurogenic inflammation and neuropathic pain, with one positively reinforcing the other.</p><p><strong>Conclusions: </strong>Diagnostic approaches in AP should consider nociceptive and neuropathic mechanisms, which should guide specific pain management. However, the knowledge gap remains significant, for example, for specific biomarkers and mechanisms enabling the development of target-specific personalised treatments for pain in AP in the future.</p><p><strong>Significance statement: </strong>In 2023, the James Lind Alliance priority-setting partnership in pancreatitis indicated that the number one priority for AP is establishing more effective ways to manage pain.¹ Therefore, a complete comprehensive understanding of the pathophysiology of pain in AP should be obtained, to advise specific pain management guidelines in AP. This review is the first of its kind, attempting to synthesise the collective knowledge on pathophysiology of pain in AP.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261496489"},"PeriodicalIF":2.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216913","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":"Somatosensory processing is altered in people with hip osteoarthritis compared to controls: A cross-sectional study.","authors":"Andrea B Mosler, Ebonie K Rio, Benedict M Wand, Molly E Coventry, Gordon S Waddington, Myles C Murphy","doi":"10.1177/20494637261491934","DOIUrl":"https://doi.org/10.1177/20494637261491934","url":null,"abstract":"<p><strong>Background: </strong>With knee osteoarthritis (OA), measures of mechanical and thermal pain sensitivity relate to both pain severity and treatment outcomes, and lower limb left/right judgement is impaired. However, little is known about these somatosensory variables in people with hip OA.</p><p><strong>Objectives: </strong>Our cross-sectional study aimed to explore the differences in sensitivity to noxious mechanical and thermal stimuli, and lower limb left/right judgement, in people with hip OA compared to matched controls without hip OA.</p><p><strong>Methods: </strong>Demographic variables and self-reported hip-related disability were collected using an online survey, while physical function was assessed in person using standardised procedures. Quantitative sensory testing was conducted using mechanical (pressure) and thermal pain thresholds. Left/right judgement was assessed through a lower limb left/right judgement task on an online application. Generalised linear regressions were used to analyse differences between groups and explore associations between the demographic variables and the somatosensory measures.</p><p><strong>Results: </strong>15 participants with hip osteoarthritis and 15 controls were included. Mean (SD) age was 62.1 (11.2) years, median (IQR) BMI 26.2 (4.4) kg/m², and 21/30 (70%) were female. Pressure pain thresholds were lower in people with hip OA at both the hip (p = .049) and the ipsilateral elbow (p = .046). There were no differences detected between groups for thermal pain thresholds (p > .05). Left/right judgement accuracy was lower in controls compared to people with hip OA (p = .038). Associations between the somatosensory measures and demographic variables (sex, age, and BMI) varied across outcomes.</p><p><strong>Conclusions: </strong>Increased mechanical, but not thermal, pain sensitivity was found in people with hip OA compared to controls. Demographic variables are associated with somatosensory measures and require consideration in any analyses using these measures.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261491934"},"PeriodicalIF":2.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168069","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":"Trigeminal neuralgia management: What are patients saying?","authors":"Paige Grafton, Kylie Lew, Carlotta Ranalli, Krish Sharma, Marisa DiMarzio, Julie G Pilitsis","doi":"10.1177/20494637261496487","DOIUrl":"https://doi.org/10.1177/20494637261496487","url":null,"abstract":"<p><strong>Objective: </strong>Social media offers a window into how patients with trigeminal neuralgia (TN) discuss and interpret information about treatment. We performed a qualitative analysis of publicly available posts from Reddit to characterize patient perspectives on the platform and identify potential educational gaps in TN management.</p><p><strong>Methods: </strong>Posts published between September 2, 2020, and August 15, 2025, were collected using the Python Reddit API Wrapper and coded manually for treatment, purpose (question or informational), topic, poster perspective (patient or caregiver, pre- or post-treatment), and sentiment.</p><p><strong>Results: </strong>Among 3,627 posts, 39.3% (<i>n</i> = 1,424) discussed medications and 60.7% (<i>n</i> = 2,203) addressed surgical treatment. Surgical discussions focused on microvascular decompression (53.3%) and stereotactic radiosurgery (26.7%), with percutaneous procedures rarely mentioned (8.5%). Carbamazepine (50.4%), oxcarbazepine (16.2%), and gabapentinoids (gabapentin 14.3%; pregabalin 10.8%) were the most frequently referenced medications. Overall, 1,019 posts were questions, primarily about surgery (<i>n</i> = 703) and commonly by patients prior to intervention (44.2%) inquiring about outcomes (57.6%) and candidacy (28.6%). Medication questions (<i>n</i> = 316) were typically from users already receiving treatment (71.2%) and most often addressed side effects (40.8%) or use (32%), including dosage and drug interactions. Sentiment differed significantly between treatment types, with surgical-related posts having a higher proportion of positive sentiment (χ² ₂ = 328.1, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Overall, patients use social media throughout the course of TN treatment to seek guidance, share experiences, and clarify management options. Limited discussion of percutaneous procedures suggests gaps in public awareness, while uncertainty about surgical eligibility highlights opportunities for improved patient education. Additionally, the predominance of negative sentiment toward medications compared with surgery on social media forums may influence treatment preferences.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261496487"},"PeriodicalIF":2.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170771","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 feasibility report on a non-invasive dynamic neuromodulation device for chronic pain.","authors":"Melvin T Franken, Lirios Dueñas, Vesna Skul, Maarten Gijssel","doi":"10.1177/20494637261487986","DOIUrl":"10.1177/20494637261487986","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive dynamic neuromodulation (NIDN) automatically modulates stimulation frequency using real-time skin-impedance feedback. This study evaluated the feasibility, safety and exploratory clinical outcomes of NIDN in adults with chronic non-specific low back pain.</p><p><strong>Methods: </strong>This single-arm feasibility study enrolled 45 adults, with eight 30-minute NIDN sessions scheduled over five weeks. Feasibility outcomes included recruitment, intervention adherence, retention and adverse events. Average pain intensity over the preceding week and disability were assessed using a 100-mm visual analogue scale and the Quebec Back Pain Disability Scale, respectively, at baseline and one and six weeks after treatment.</p><p><strong>Results: </strong>Forty-five participants were recruited, 43 completed all sessions and 42 completed follow-up. No serious adverse events occurred. Median pain intensity decreased from 71 mm (IQR 58-77) at baseline to 29 mm (IQR 19-48) one week after treatment and 22.5 mm (IQR 12.5-38.8) at six weeks; 64% achieved a reduction of at least 50% at six weeks. Median disability improvement at six weeks was 31 points (IQR 19.3-49.0), with 86% exceeding the minimal detectable change of 15.8 points.</p><p><strong>Conclusions: </strong>High adherence and retention support progression to a pilot randomised controlled trial incorporating a standard transcutaneous electrical nerve stimulation comparator and longer follow-up. The uncontrolled design and short follow-up preclude conclusions about efficacy or sustained benefit.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261487986"},"PeriodicalIF":2.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008614","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":"Baseline symptom severity profiles and response to physiotherapy treatment in chronic musculoskeletal pain: A cluster analysis in primary care.","authors":"Juan Manuel González-Flores, Luis Espejo-Antúnez, María de Los Ángeles Cardero-Durán, Josefa Costillo-Rodríguez, Carlos Fernández-Morales","doi":"10.1177/20494637261487995","DOIUrl":"10.1177/20494637261487995","url":null,"abstract":"<p><strong>Background: </strong>Chronic musculoskeletal pain (CMP) is a heterogeneous condition in which overall treatment effects may obscure differences across patient subgroups.</p><p><strong>Objective: </strong>To identify distinct baseline symptom profiles and examine their association with baseline-adjusted post-treatment outcomes, responder status, exploratory multidomain negative change, and response trajectorie<b>s</b> following a structured active pain coping program in primary care.</p><p><strong>Methods: </strong>This was a prospective observational cohort study (<i>n</i> = 169). Participants were enrolled in a 12-week physical therapy program combining pain neuroscience education (PNE) and therapeutic exercise. Two-step cluster analysis identified baseline profiles from pain catastrophizing (PCS), kinesiophobia (TSK-11), disability (RMDQ), and central sensitization (CSI). Pre-post changes, ANCOVA-adjusted endpoints, responder rates, and K-means response trajectories were examined.</p><p><strong>Results: </strong>Two profiles emerged: Moderate (57.4%) and Severe (42.6%). Participants in both profiles improved significantly, with larger absolute reductions in the Severe profile (PCS responders: 77.6% vs 47.8%). After adjusting for baseline values, between-group differences were non-significant (<i>p</i> ≥ 0.05) across all domains, with similar adjusted endpoint levels in both profiles. The exploratory multidomain negative-change criterion was met by 21.6% of participants and was concentrated in the Moderate profile (88%; OR = 3.99, 95% CI: 1.36-11.70). Response-pattern analysis identified three trajectories: Global Responders (broad improvement across domains; 7.1%), Limited Responders (modest symptom change with worsening mental health; 45.9%), and Moderate Responders (intermediate improvements; 46.9%); the distribution of these trajectories was significantly associated with baseline profile. Only 31.0% of participants met the prespecified ideal responder criterion (simultaneous improvement in symptoms and quality of life).</p><p><strong>Conclusion: </strong>Both profiles converged toward comparable functional endpoints, making baseline severity a poor gatekeeping criterion for access to this care. Nonetheless, exploratory multidomain negative change was more frequent in the Moderate profile, and concurrent symptom and quality-of-life recovery was uncommon, underscoring the need for systematic mid-treatment monitoring and outcome definitions that extend beyond symptom scores.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261487995"},"PeriodicalIF":2.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963777","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":"Machine learning-based modeling of response patterns to transcranial direct current stimulation in women with fibromyalgia.","authors":"Michele de Moura Gonçalves, Stefany Vilani Gomes, João Pedro Ferreira Zanatta, Leonardo Henrique Rocha, Giovana Mendes Wolf Viegas, Isabela de Souza Santos, Ariana Mendes Freire, Gisele da Silva Peixoto Zandona, Eduardo Henrique Loreti","doi":"10.1177/20494637261487997","DOIUrl":"10.1177/20494637261487997","url":null,"abstract":"<p><strong>Background: </strong>Clinical heterogeneity in fibromyalgia (FM) results in highly variable therapeutic responses to transcranial direct current stimulation (tDCS). Identifying predictors and temporal response patterns is crucial to transform personalized neuromodulation strategies. This secondary analysis integrated supervised prediction, pain-trajectory modeling, and causal inference to characterize individual response profiles to anodal tDCS in women with FM.</p><p><strong>Methods: </strong>Secondary analysis of a randomized, controlled, triple-blind clinical trial including 35 women allocated to active anodal M1 tDCS (2 mA, 20 min, 10 sessions) or sham stimulation. Pain (VAS) was assessed at baseline, D10, D30, and D90; functional, fatigue, mood, and QoL measures at baseline and D30. Six supervised algorithms were trained toclassify responders (≥30% VAS reduction). Pain-trajectory clusters were derived using Dynamic Time Warping with k-means. A T-learner framework estimated Conditional Average Treatment Effects (CATE) to detect treatment-effect modifiers. The Research Ethics Committee of the Centro Universitário da Grande Dourados under registration number Certificado de Apresentação de Apreciação Ética approved this research:36444920.5.0000.5159. The study was registered in The Brazilian Registry of Clinical Trials with the identifier RBR-8wc8rjq.</p><p><strong>Results: </strong>Active tDCS elicited greater pain reduction than sham at D10, D30, and D90 (<i>p</i> < .001). Predictive models demonstrated stable discrimination (AUC 0.78-0.84). WHOQOL-Physical and WHOQOL-Psychological domains were the strongest positive predictors, while higher FIQ and antidepressant use lowered response probability. Three exclusive pain-trajectory phenotypes were identified-rapid responders, progressive responders, and non-responders-with distinct sustainability at D90. CATE analyses indicated higher treatment advantage among participants with higher psychological QoL, moderate baseline VAS (6-8), and no antidepressant use.</p><p><strong>Conclusion: </strong>The integration of machine-learning models, longitudinal trajectory analysis, and causal estimation revealed heterogeneous response dynamics and specific clinical profiles with higher likelihood of therapeutic gain from tDCS. These findings may support refinement of personalized stimulation protocols, early monitoring strategies, and targeted candidate selection in FM.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261487997"},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921226","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":"Novel interventions but familiar problems in delivering non-medical interventions for chronic pain patients.","authors":"Roxaneh Zarnegar","doi":"10.1177/20494637261487660","DOIUrl":"10.1177/20494637261487660","url":null,"abstract":"","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261487660"},"PeriodicalIF":2.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900544","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 photobiomodulation associated with exercise in patients with fibromyalgia: A systematic review and meta-analysis.","authors":"Ruth Ludimila Macena, Viviana Thomazzoni Barbosa, Dernival Bertoncello, Márcia Rosângela Buzanello, Gladson Ricardo Flor Bertolini","doi":"10.1177/20494637261471068","DOIUrl":"10.1177/20494637261471068","url":null,"abstract":"<p><strong>Purpose: </strong>To conduct a literature review on the effects of photobiomodulation associated with exercise in patients with fibromyalgia.</p><p><strong>Methods: </strong>The databases included were PubMed, Cochrane Library, the Physiotherapy Evidence Database (PEDro), Scopus, Web of Science, Embase and LILACS. Grey literature: Google Scholar, Open Grey and ProQuest. The risk of bias was assessed using the Cochrane RoB 2 tool. Outcomes of pressure pain threshold, pain intensity, functional capacity, symptoms of depression and quality of life were analysed.</p><p><strong>Results: </strong>No statistically significant effects were observed in any of the outcomes studied: pressure pain threshold (MD = -0.36; 95% CI: -1.50 to 0.79; <i>p</i> = 0.54; I² = 80%); pain intensity (MD = 1.07; 95% CI: -1.02 to 3.16; <i>p</i> = 0.32; I² = 95%); objective functional capacity measured by the TUG (MD = 0.26; 95% CI: -0.13 to 0.65; <i>p</i> = 0.20) and the 6MWT (MD = -81.92; 95% CI: -236.21 to 72.37; <i>p</i> = 0.30; I² = 93%). Similarly, subjective functional capacity (FIQ: SMD = 0.41; 95% CI: -1.36 to 2.18; <i>p</i> = 0.65; I² = 0%), symptoms of depression (BDI: MD = 1.06; 95% CI: -6.29 to 8.42; <i>p</i> = 0.78; I² = 53%) and quality of life (SF-36: MD = 6.29; 95% CI: -8.40 to 20.98; <i>p</i> = 0.40; I² = 86%). Very low certainty means that the true effect is likely to be substantially different from the estimate.</p><p><strong>Conclusion: </strong>Based on very low certainty evidence (GRADE), this systematic review and meta-analysis found no statistically significant additional benefits of photobiomodulation combined with exercise compared to exercise alone for pain, function, depression, or quality of life. However, due to substantial heterogeneity, small sample sizes, and methodological limitations, the current evidence is insufficient to either confirm or definitively exclude a clinically meaningful additional effect. Further high-quality, adequately powered trials are needed.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261471068"},"PeriodicalIF":2.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819909","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, non-opioid, and non-pharmacological pain management in patients with a history of cancer.","authors":"May Z Gao, Nosayaba Osazuwa-Peters, Justin M Barnes, Eric Adjei Boakye, Trinitia Y Cannon, Tammara L Watts, Tomi Akinyemiju, Oyomoare L Osazuwa-Peters","doi":"10.1177/20494637261475190","DOIUrl":"10.1177/20494637261475190","url":null,"abstract":"<p><p>Pain management is a critical component of cancer care, yet the influence of sociodemographic and clinical factors on prescribing patterns for opioids, non-opioid medications, and non-pharmacological interventions remains underexplored. This cross-sectional study using the 2018-2020 Medical Expenditure Panel Survey (MEPS) characterizes clinical and sociodemographic factors associated with opioid, non-opioid, and non-pharmacological pain management in individuals with a history of cancer. Adults aged ≥18 years with a self-reported cancer diagnosis (N = 7,035) were characterized by sociodemographic factors, including race/ethnicity, income, insurance type, and English proficiency, and clinical variables such as cancer type, comorbidities, and depression were surveyed. Main outcomes included receipt of prescription opioids, non-opioid pain medications, and non-pharmacological pain interventions. Adjusted relative risks (aRR) for pain management approaches were estimated using quasi-Poisson regression. Among 7,035 participants, 19.99% received opioids, 51.15% non-opioid medications, and 20.73% non-pharmacological interventions. Opioid prescription was significantly lower among Asian participants (aRR 0.18, 95% CI 0.05, 0.67) and those with limited English proficiency (aRR 0.22; 95% CI 0.11, 0.43). Depression was associated with increased use of opioids (aRR 1.26, 95% CI 1.09, 1.46) and non-opioid medications (aRR 1.26, 95% CI 1.18, 1.34). Non-opioid and non-pharmacological interventions were more likely among females (aRR 1.21 and 1.49, respectively) but less frequent among individuals with lower income and education. Significant differences in cancer pain management were found based on sociodemographic and clinical factors. Further research is needed to determine whether disparities in opioid and non-opioid prescribing persist across race, sex, English language proficiency, and mental health comorbidities.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261475190"},"PeriodicalIF":2.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689964","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}