British Journal of Pain最新文献

{"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}

{"title":"An observational cohort study of factors associated with patients' reports of being offered lumbar spine surgery during orthopaedic spine consultations for chronic low back pain.","authors":"Kathrin Braeuninger-Weimer, Naffis Anjarwalla, Asef Al-Ani, Douglas Evans, Hanna Rooslien, Tamar Pincus","doi":"10.1177/20494637261472434","DOIUrl":"10.1177/20494637261472434","url":null,"abstract":"<p><strong>Background: </strong>Guidelines do not recommend lumbar spine surgery for people with chronic low back pain (CLBP). It remains unknown how these guidelines are implemented, and which factors affect the decision to offer surgery.</p><p><strong>Objectives: </strong>This study examined factors associated with patients reporting that lumbar spine surgery was recommended during specialist consultation for CLBP.</p><p><strong>Methods: </strong>Clinical, demographic and psychosocial factors were measured pre-consultation in people referred with CLBP for their first consultation with orthopaedic spine clinicians in secondary care in eight hospitals. Patients reporting leg pain, previous spinal surgery, or other specific spinal pathology were excluded. Data were analysed using binomial logistic regression. In addition, three surgeons independently rated a subsample of the MRI reports as suitable or unsuitable for lumbar spine surgery, blinded to clinical background of patients and to the consultation outcome.</p><p><strong>Results: </strong>A total of 424 patients were included in the analysis, of whom 96 reported being offered lumbar spine surgery. Patients were more likely to report being offered surgery if they were older, had a longer pain duration, had consulted more widely, and had stronger positive expectations of surgery. Pain intensity, disability, depression, and anxiety were not associated with the decision to offer surgery. The model correctly classified 80.6% of cases. In the subsample analysis based on MRI reports alone, the proportion judged as potentially suitable for lumbar spine surgery (20%) was similar to the actual consultations (22%), but concordance on who was offered surgery was poor (27%).</p><p><strong>Conclusion: </strong>In this cohort of people with CLBP without leg pain, patient perception that surgery was offered during the consultation was associated with a longer history of pain and a greater number of prior consultations. Surgical offer was patient-reported and surgeons' rationale was not captured. Subsample findings suggest that MRI findings alone should not drive surgical decision-making in CLBP.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261472434"},"PeriodicalIF":2.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674074","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":"OnabotulinumtoxinA in refractory postherpetic neuralgia: a case report.","authors":"Dominic Bertram, Georg Haber, Dina von Rohrscheidt, Thomas R Tölle","doi":"10.1177/20494637261471112","DOIUrl":"10.1177/20494637261471112","url":null,"abstract":"<p><strong>Background: </strong>Postherpetic neuralgia (PHN) is a chronic neuropathic pain condition following herpes zoster, occurring particularly in elderly or immunosuppressed individuals. It is often difficult to treat and may significantly impair quality of life.</p><p><strong>Case report: </strong>We report the single-blinded treatment of refractory thoracic PHN with onabotulinumtoxinA (BoNT/A). A total of 200 IU was injected into the affected area across 40 injection points (5 IU per site), while one corner of the affected area was injected with saline as an intra-individual blinded comparator. A remaining painful area was treated with a further 100 IU BoNT/A 24 days later.</p><p><strong>Results: </strong>Pain intensity decreased progressively from severe pain with attacks up to 10/10 on the numeric rating scale (NRS) to 5/10 in the BoNT/A-treated area, while the saline-injected area showed no noteworthy improvement. Following the second BoNT/A injection, the remaining painful area reduced further to a coin-sized spot. The clinical effect lasted approximately 3 months and repeated treatment stabilised substantial pain reduction for almost 1 year.</p><p><strong>Conclusion: </strong>BoNT/A may be an effective treatment option in selected patients with refractory focal PHN, particularly when established first- and second-line treatments are ineffective, poorly tolerated or contraindicated. Further controlled studies are required to clarify efficacy, duration of benefit and repeat-treatment strategies.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261471112"},"PeriodicalIF":2.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594003","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":"Cumulative adulthood trauma exposures and pain outcomes among older adults.","authors":"Yeonwoo Kim, Lisa S Panisch, Soeun Jang","doi":"10.1177/20494637261471088","DOIUrl":"10.1177/20494637261471088","url":null,"abstract":"<p><strong>Objective: </strong>The majority of research on connections between trauma exposure and adult pain focuses on childhood trauma. Trauma experienced during adulthood receives less attention, especially among middle-aged and older adults. This longitudinal study explores the relationships between adulthood trauma and the onset of pain over 6 years among middle-aged and older adults, after controlling for childhood trauma.</p><p><strong>Method: </strong>We analyze data from the Health and Retirement Study, a nationally representative longitudinal survey of adults aged 50+. Our analytic sample (<i>N</i> = 6724) consists of participants (<i>M</i> = 64.4 ± 10.8 years) with no reports of pain in the past 10 years. A multilevel mixed effects logistic regression analysis was performed with repeated measures of pain over a six-year period as an outcome, adulthood traumatic events as exposures, and demographic, childhood trauma, and health-related factors as covariates.</p><p><strong>Results: </strong>Exposure to 2+ adulthood traumatic events was significantly related to a higher risk of pain onset (OR = 1.34; 95% CI: 1.04, 1.71), when controlling for demographic and health-related factors. After adjusting for childhood trauma, this relationship attenuated slightly, but remained statistically significant (OR = 1.28; 95% CI: 1.00, 1.64).</p><p><strong>Conclusions and implications: </strong>Our results indicate that trauma exposure at multiple life stages independently contributes to pain outcomes in older adults. Notably, the negative impact of adulthood trauma persists even among those with a history of childhood trauma. We encourage future research exploring these underlying biopsychosocial mechanisms linking life-course trauma to pain in later life.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261471088"},"PeriodicalIF":2.8,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585497","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":"Mapping the gaps: Multi-disciplinary chronic pain service provision for cancer-related pain across England.","authors":"Julie Armoogum, Alison Llewellyn, Fiona Cramp, Alice Berry, Candida McCabe","doi":"10.1177/20494637261465816","DOIUrl":"10.1177/20494637261465816","url":null,"abstract":"<p><strong>Introduction: </strong>Prevalence rates for cancer-related pain are 40-50%. Provision of multi-disciplinary chronic pain services for those with cancer-related pain is poorly understood.</p><p><strong>Aim: </strong>To identify provision of multi-disciplinary chronic pain services for those with cancer-related pain across England.</p><p><strong>Methods: </strong>Acute/Hospital and Community NHS Trusts in England (<i>n</i> = 190) were sent Freedom of Information requests asking if a multi-disciplinary chronic pain service was provided by the Trust, and numbers of people seen in previous 24 months with (a) tumour-related pain and (b) cancer-related late effects pain or pain caused by cancer treatments. Demographic information was requested. If no response was received within 10 weeks, a follow up request was sent. Quantitative data were analysed using descriptive statistics.</p><p><strong>Results: </strong>In total, 171 NHS Trusts responded. Almost half, (<i>n</i> = 74, 43.3%) reported providing a multi-disciplinary chronic pain service. Of these, 17 (23.0%) were able to provide attendance data for people with tumour-related pain and eight (10.8%) with late effects pain. Demographic information could be provided by seven (9.5%) Trusts for those with tumour-related pain and four (5.4%) for late effects pain. The main reason Trusts could not provide demographic information was because such data were not routinely collected.</p><p><strong>Conclusions: </strong>People with cancer-related pain appear to have limited access to multi-disciplinary chronic pain support in England. However, lack of standardised methods of coding and recording cancer-related pain as reasons for attending multi-disciplinary chronic pain services mean reporting accurate figures is challenging. It is essential that there is an accurate reporting system so the scale of cancer-related pain can be understood to help guide the provision and development of services, education and research.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261465816"},"PeriodicalIF":2.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521205","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":"Developing \"De-stress pain,\" an intervention to reduce chronic pain-related distress: Proof of concept and qualitative assessment of acceptability.","authors":"Stephanie Hughes, Tamar Pincus, Adam W A Geraghty, Carolyn A Chew-Graham, Beth Stuart, Paul Little, Michael Moore, Hollie Birkinshaw","doi":"10.1177/20494637261464804","DOIUrl":"10.1177/20494637261464804","url":null,"abstract":"<p><strong>Introduction: </strong>People with persistent musculoskeletal (MSK) pain often experience distress, distinct from depression. Current referral pathways and interventions are suboptimal for this group. We developed and tested the acceptability and proof of concept of <i>De-Stress Pain</i>, an intervention to reduce pain-related distress.</p><p><strong>Methods: </strong>Guided by principles from Acceptance and Commitment Therapy, behavioural activation, and the Person-Based Approach (PBA) De-<i>Stress Pain</i> provided 4-6 social prescriber sessions over 12 weeks, plus access to a mental wellbeing website promoting engagement in meaningful and pleasurable activities. Acceptability of the intervention and study procedures was assessed qualitatively using semi-structured interviews with participants and social prescribers before and after the intervention programme.</p><p><strong>Results: </strong>Sixteen participants were recruited and 11 completed the intervention alongside four social prescribers. Participants described the intervention as acceptable and valued the combination of social prescriber support, accountability, and encouragement to re-engage in meaningful and pleasurable activities. Social prescribers reported that the intervention was acceptable to deliver and aligned with their existing practice, although limited appointment time and participants' financial constraints could affect engagement. Some participants initially viewed pleasurable activities as indulgent, which acted as a barrier to engagement. Findings also suggested that future iterations may benefit from refining eligibility criteria to better identify individuals experiencing sufficient pain-related distress. Improvements in mood measures and participant reports of increased hope, activity, and wellbeing suggested the intervention showed promise for supporting people with pain-related distress.</p><p><strong>Conclusions: </strong>This study demonstrates that De-Stress Pain was acceptable to both participants and social prescribers and feasible to deliver within social prescribing services. The findings identified several factors requiring consideration in future iterations, including participant selection, time constraints, and financial barriers to engagement. De-Stress Pain is, to our knowledge, among the few pain-related interventions specifically designed for delivery by social prescribers within primary care settings.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261464804"},"PeriodicalIF":2.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391947","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":"Reliability and standard error of measurement of pressure pain thresholds at articular landmarks.","authors":"Fabian Tomschi, Thomas Hilberg","doi":"10.1177/20494637261463704","DOIUrl":"10.1177/20494637261463704","url":null,"abstract":"<p><strong>Background: </strong>Pressure pain threshold (PPT) testing is a widely used quantitative sensory testing method to assess mechanical pain sensitivity. While reference values for PPT at articular-/joint-related and osseous landmarks are available, data on measurement reliability remain limited. This study aimed to determine the intra- and inter-rater reliability of PPT measurements and to report the standard error of measurement (SEM) for joint PPT.</p><p><strong>Methods: </strong>Healthy participants aged 18-40 years were included in a two-part study. In Part A (<i>N</i> = 40), intra-rater reliability was assessed through three repeated PPT measurements by the same examiner. In Part B (<i>N</i> = 40), inter-rater reliability was evaluated with two different examiners. PPT was measured at joints (elbow, knee, ankle) and reference landmarks (sternum, forehead) using a digital algometer. ICCs (2,k model) and SEM were calculated for each landmark.</p><p><strong>Results: </strong>Intra-rater reliability was excellent at all landmarks (ICCs ≥ 0.926) except the elbow with a good reliability (ICC = 0.848). Inter-rater reliability was excellent at the sternum (ICC = 0.950) and good at the ankle, knee, elbow, and forehead (ICCs ≥ 0.813). SEM values varied across landmarks, with lowest values observed at reference landmarks sites (e.g., sternum and forehead). ICCs are similar between sexes.</p><p><strong>Conclusions: </strong>PPT measurements at articular (joints) and bony reference landmarks show good to excellent reliability. These findings support the use of joint PPT in standardized pain sensitivity assessments and provide a basis for clinical and research applications. However, findings are limited to pain-free participants and should be replicated in broader populations.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261463704"},"PeriodicalIF":2.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346482","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 human being does not cease to exist at death. It is change, not destruction, which takes place.\" (Florence Nightingale).","authors":"Patrice Forget, Roxaneh Zarnegar, Christina Liossi","doi":"10.1177/20494637261463940","DOIUrl":"https://doi.org/10.1177/20494637261463940","url":null,"abstract":"","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261463940"},"PeriodicalIF":2.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333546","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":"Disease burden of low back pain in middle-aged and older women (≥55 years) attributable to three factors: A comparative analysis from GBD 2023.","authors":"Jingwen Jia, Yuxuan Bai, Mingtao Zhang, Mingdong Ma, Shuanhu Lei, Xuewen Kang","doi":"10.1177/20494637261459558","DOIUrl":"https://doi.org/10.1177/20494637261459558","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is a leading cause of global disability, with a heavier burden in low and low-middle Socio-Demographic Index (SDI) regions. Women aged ≥55 years are vulnerable due to dual labor loads, yet LBP burden attributed to occupational ergonomic factors, smoking, and high Body Mass Index (BMI) in this subgroup remains understudied.</p><p><strong>Objective: </strong>This study analyzed the 30-year LBP burden and its drivers in this population to inform targeted prevention.</p><p><strong>Method: </strong>Using Global Burden of Diseases (GBD) 2023 data (1992-2023), we employed Joinpoint regression, decomposition, and frontier analyses to assess LBP-related disability-adjusted life years (DALYs) across low/low-middle SDI regions.</p><p><strong>Result: </strong>Absolute DALYs increased consistently across all risk factors; age-standardized DALY rates (ASDR) declined with age, peaking at 55-59 years. Population growth was the primary driver which contributed >100%. High BMI-associated LBP grew most prominently with 579% in low-middle SDI regions, and ASDR rises in low SDI regions. Decomposition and frontier analyses revealed unique regional contribution patterns and intercountry disparities.</p><p><strong>Conclusion: </strong>This study indicates that the burden of LBP attributable to three factors may be increasing in low and low-middle SDI regions, with population growth and aging likely acting as primary drivers. Occupational ergonomic factors emerge as the most pressing risk factors, while high BMI is potentially the fastest-growing contributor. Notable intercountry disparities within each SDI tier underscore both challenges and opportunities for targeted prevention.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637261459558"},"PeriodicalIF":1.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228664","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}