Scandinavian Journal of Pain最新文献

{"title":"Exploring the relationship between pain intensity and psychological distress: a parallel mediator, cross-sectional, registry study of >6,400 patients in Sweden.","authors":"Emmanuel Bäckryd, Björn Gerdle, Marcelo Rivano Fischer, Sophia Åkerblom, Anna Trulsson Schouenborg, Elena Dragioti, Huan-Ji Dong, Åsa Ringqvist","doi":"10.1515/sjpain-2026-0030","DOIUrl":"https://doi.org/10.1515/sjpain-2026-0030","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain is associated with an increased prevalence of anxiety and depression. However, correlations between pain intensity and psychological distress are generally weak, suggesting a more complex relationship. Although evidence indicates a bidirectional association, the role of potential mediators warrants further study. The aim of this cross-sectional registry study was to explore mediators of the relationship between pain intensity and psychological distress, and vice versa, among individuals with chronic pain.</p><p><strong>Methods: </strong>This cross-sectional cohort study included 6,497 adult chronic non-cancer pain patients from the Swedish Quality Registry for Pain Rehabilitation (SQRP) with Patient-Reported Outcome Measures (PROMs) data (2008-2016). Five potential mediators - catastrophizing, fear-avoidance, physical activity level, acceptance and insomnia - were examined in the bidirectional relationship between pain intensity and psychological distress using Partial Least Squares Structural Equation Modelling (PLS-SEM).</p><p><strong>Results: </strong>The direct paths (i.e., correlations) between pain intensity and psychological distress in both directions became non-significant when controlling for the five mediators. Insomnia and catastrophizing emerged as the most important mediators, each with medium effect sizes, followed by acceptance, which showed a small effect size. Fear-avoidance demonstrated little to no influence. Physical activity showed no substantial mediating effect in any model.</p><p><strong>Conclusions: </strong>This study supports the idea that the clinically observed association between pain intensity and psychological distress is more accurately explained by the influence of mediators, specifically catastrophizing, insomnia, and acceptance, rather than a direct effect between the two. These findings suggest that clinical assessments and interventions for patients with chronic pain should prioritize addressing catastrophizing, insomnia, and acceptance.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pain severity on each EQ-5D-5L dimension of quality of life in patients with neuropathic pain associated with chronic low back or cervical pain: an ad hoc analysis.","authors":"Toshihiko Taguchi, Ryo Ishii, Yusuke Karasawa, Shigeki Zeniya, Tatsunori Murata, Kazutaka Nozawa","doi":"10.1515/sjpain-2026-0024","DOIUrl":"https://doi.org/10.1515/sjpain-2026-0024","url":null,"abstract":"<p><strong>Objectives: </strong>Clinical guidelines for patients with neuropathic pain (NeP) recommend setting achievable treatment goals relevant to their daily lives. We therefore evaluated the associations of the EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) with reduced quality of life (QoL) in patients with chronic low back pain with NeP (CLBP-NeP) or chronic cervical pain with NeP (CCP-NeP) to help inform the setting of such treatment goals.</p><p><strong>Methods: </strong>Secondary data were analyzed from two observational studies of patients with CLBP-NeP or CCP-NeP. The associations of each EQ-5D-5L dimension (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) with reduced QoL (defined as the ratio of each dimension to the increase in disutility) of patients with CLBP-NeP or CCP-NeP by change in pain Numeric Rating Scale (NRS) were calculated.</p><p><strong>Results: </strong>In patients with CLBP-NeP, mobility and pain/discomfort were associated with reduced QoL at lower pain levels, which was maintained at higher pain levels for mobility, but not for pain/discomfort. Anxiety/depression and self-care were associated with reduced QoL at higher pain levels. Usual activity was associated with reduced QoL across pain levels. In patients with CCP-NeP, an association of pain/discomfort with reduced QoL was observed across pain levels, increasing at higher pain levels. Usual activity was associated with reduced QoL at lower pain levels, with this association decreasing at higher levels. Self-care was associated with reduced QoL across pain levels, and mobility was more strongly associated at higher levels. Anxiety/depression was associated with reduced QoL across pain levels.</p><p><strong>Conclusions: </strong>These results indicate that factors associated with reduced QoL in patients with CLBP-NeP or CCP-NeP may differ depending on pain level. Focusing on mobility at lower pain levels and on psychological aspects at higher levels in CLBP-NeP, and on usual activities and pain/discomfort in CCP-NeP, may help set more effective treatment goals. An individualized approach may also help to improve patients' QoL of patients with NeP.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in health literacy following participation in a multidisciplinary primary care intervention for people with chronic pain: a longitudinal cohort study.","authors":"Kine Gjesdal, Svetlana Skurtveit, Ane Djuv, Aksel Paulsen, Gabriela Rolova, Cille Sevild, Torgeir Gilje Lid","doi":"10.1515/sjpain-2026-0034","DOIUrl":"10.1515/sjpain-2026-0034","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a global public health issue, severely affecting quality of life, functional capacity, and healthcare resources. Effective management requires adequate health literacy, yet limited health literacy is associated with greater pain burden and poorer outcomes. This underlines the need for interventions that can strengthen patients' health literacy skills. Thus, the aim of the present study was to investigate longitudinal changes in health literacy following participation in a multidisciplinary primary care pain management intervention.</p><p><strong>Methods: </strong>This longitudinal study reports health literacy outcomes from a multidisciplinary, personalized pain management intervention that was developed in accordance with the Medical Research Council framework. Forty-three participants with chronic non-cancer pain completed the full intervention. Health literacy was measured using the Norwegian version of the Health Literacy Questionnaire (HLQ) at baseline, midpoint, and post-intervention. Changes over time were analyzed using paired-sample t-tests.</p><p><strong>Results: </strong>Statistically significant improvements were observed in five HLQ domains from baseline to midpoint and in eight domains from baseline to post-intervention. \"Having sufficient information to manage my health\" showed the largest increase among Domains 1-5, whereas \"Navigating the healthcare system\" showed the largest increase among Domains 6-9 and improved significantly across all time-point comparisons.</p><p><strong>Conclusion: </strong>Participants demonstrated improvements in several dimensions of health literacy during participation in the intervention, particularly in domains related to having sufficient information to manage health and active self-management. These findings support further investigation of tailored, multidisciplinary approaches to strengthening health literacy among people with chronic pain.</p><p><strong>Trial registration: </strong>NCT05828121 Date: 04-25-2023.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic consumption after major lower extremity amputation - a Danish nationwide register-based study from 2010-2021.","authors":"Jeppe Marinus Mortensen, Anna Trier Heiberg Brix, Kristine Bollerup Arndt, Tine Nymark, Martin Lindberg-Larsen","doi":"10.1515/sjpain-2026-0028","DOIUrl":"https://doi.org/10.1515/sjpain-2026-0028","url":null,"abstract":"<p><strong>Objectives: </strong>Persistent pain after major lower extremity amputation (MLEA) is common. This study aimed to investigate opioid and non-opioid analgesic consumption, defined by drug group, one year before and after MLEA and to investigate risk factors for postoperative opioid use.</p><p><strong>Method: </strong>Through the Danish National Patient Registry, we identified 7,012 patients, ≥50 years, alive one year postoperatively, with first-time MLEA performed in 2010-2021, divided in below-knee (BKA) and above-knee amputations (AKA). Prescription redemptions were used as a proxy for analgesic use, which was analysed by drug class: Opioids, and non-opioids: NSAIDs, paracetamol, anticonvulsants, antidepressants, and other. Long-term opioid users were defined as patients with ≥1 redeemed opioid prescription in all four quarters post-amputation.</p><p><strong>Results: </strong>Opioid-use peaked in the quarter before MLEA (-Q1) at 93 % (CI 92-93 %) and remained higher one year after (37 %, CI 36-38 %) compared with one year before (25 %, CI 24-26 %). Long-term opioid use rose from 19 % (CI 18-20 %) to 28 % (CI 27-29 %). Paracetamol (93 %, CI 92-93 %), anticonvulsants (58 %, CI 57-60 %), and antidepressants (39 %, CI 38-40 %) peaked at - Q1, declining but exceeding baseline at one year. Female sex (OR 1.3, CI 1.2-1.5), AKA level (OR 1.5, CI 1.5-1.7), and long-term \"other\" analgesic use (OR 2.2, CI 1.6-3.0) were risk factors for new long-term opioid use.</p><p><strong>Conclusion: </strong>In conclusion, the use of opioids and non-opioid analgesics increased before MLEA, peaking before surgery. Postoperatively, the use declined but remained higher than in the pre-amputation year.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of chronic primary and secondary pain in a patient sample with psychiatric disorders.","authors":"Ina Løvås, Tormod Landmark, Tone Rustøen, Einar Vedul-Kjelsås, Stephen H Butler, Mari Glette, Astrid Woodhouse","doi":"10.1515/sjpain-2026-0025","DOIUrl":"https://doi.org/10.1515/sjpain-2026-0025","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain often coexists with psychiatric disorders, yet less is known about the specific types of chronic pain conditions that may co-occur. This study aimed to classify chronic pain according to ICD-11 categories and provide an overview of the types and frequency of these conditions in a patient sample with psychiatric disorders and coexisting chronic pain.</p><p><strong>Methods: </strong>This descriptive cross-sectional study consecutively recruited 151 patients (78.8 % females, mean age 36 years) from psychiatric outpatient units. Common psychiatric diagnoses included anxiety disorders (27.8 %), stress-related disorders (23.2 %), mood disorders (22.5 %), attention deficit disorders (10.6 %), personality disorders (9.3 %) and other psychiatric disorders (6.6 %). Chronic pain was assessed by structured interviews and comprehensive clinical examinations conducted by physicians and physiotherapists. Examination verified pain conditions were classified into subcategories of chronic primary and secondary pain (ICD-11). We used descriptive statistics to analyze the data.</p><p><strong>Results: </strong>Chronic primary pain was present in 99 % of the participants; most commonly musculoskeletal pain (94.0 %), e.g. low back pain and neck pain, headache and orofacial pain (80.8 %), e.g. tension-type headache and migraine, and visceral pain (31.8 %), e.g. irritable bowel syndrome. Chronic secondary pain affected 49 % of the participants; most frequently musculoskeletal pain (33.8 %), e.g. osteoarthritis and tendinitis, and neuropathic pain (11.3 %), e.g. sciatica. The distribution of primary and secondary pain conditions was quite similar across the subgroups of psychiatric disorders. Participants had on average 5.7 chronic pain conditions. Females had significantly more pain conditions, chronic widespread pain and primary visceral pain than males.</p><p><strong>Conclusions: </strong>This study indicates that chronic pain in patients with psychiatric disorders may include complex and multiple chronic primary and secondary pain conditions. Given such complexity, implementing pain assessment and management into routine psychiatric care as well as collaboration across different areas of medical expertise is warranted.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early multidisciplinary rehabilitation targeting severe functional impairments following meningitis caused by <i>Listeria monocytogenes</i>.","authors":"Aleksandra Skorupa-Strojna, Natalia Pszczoła, Agnieszka Ochocińska, Aneta Wieczorek, Małgorzata Kulesa-Mrowiecka","doi":"10.1515/sjpain-2026-0029","DOIUrl":"10.1515/sjpain-2026-0029","url":null,"abstract":"<p><strong>Objectives: </strong>The aim was to evaluate the outcomes of early, comprehensive rehabilitation in a 61-year-old patient with severe neurological and functional impairments following meningitis caused by <i>Listeria monocytogenes</i>.</p><p><strong>Methods: </strong>The patient underwent one month of multidisciplinary rehabilitation. The therapeutic program included functional physiotherapy with postural and verticalization training, respiratory interventions, and orofacial rehabilitation. Orofacial therapy focused on the masticatory and facial muscles and comprised soft tissue techniques, mandibular movement training, and neuromuscular re-education.</p><p><strong>Results: </strong>Improvements were observed in trunk control, tolerance of spontaneous breathing, maximum mouth opening, mouth closure, and mandibular mobility. A reduction in head and neck muscle pain was also noted.</p><p><strong>Conclusions: </strong>Early, comprehensive physiotherapy contributed to improvements in postural stability, respiratory function, and orofacial function, as well as to reduced head and neck muscle pain. These findings highlight the potential value of multidisciplinary rehabilitation in patients recovering from meningitis caused by <i>L. monocytogenes</i>.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic patterns and predictors of opioid consumption following epidural analgesia discontinuation after pancreatic cancer surgery.","authors":"Samuel Fredriksson, Christina Biörserud, Johanna Wennerblom, Jessica Komi, Natalie Svensson, Paulin Andréll, Adam Piasecki","doi":"10.1515/sjpain-2026-0027","DOIUrl":"https://doi.org/10.1515/sjpain-2026-0027","url":null,"abstract":"<p><strong>Introduction: </strong>Thoracic epidural analgesia (EDA) is recommended for multimodal perioperative pain management. However, increased pain and opioid consumption are frequently observed following EDA discontinuation. Risk factors for this transition phase remain poorly characterized after pancreatic surgery.</p><p><strong>Aim: </strong>The primary aim was to characterize analgesic strategies, including opioid consumption and use of non-opioid agents, following EDA discontinuation after pancreatic cancer surgery (days 0-2). The secondary aim was to determine predictors of increased opioid consumption on the day of EDA discontinuation (day 0).</p><p><strong>Methods: </strong>In this retrospective cohort study, adult patients who underwent pancreatic cancer surgery between 01 June 2021 and 31 June 2023 at Sahlgrenska University Hospital, Gothenburg, Sweden, and received postoperative EDA were identified using institutional electronic health records. Total daily opioid consumption (oral morphine equivalent daily dose, OMEDD) and non-opioid pharmacological treatments were characterized. Factors associated with opioid consumption on day 0 were determined using multivariable linear regression. Variable importance analysis based on R² decomposition (Lindeman-Merenda-Gold method) was performed.</p><p><strong>Results: </strong>A total of 194 patients were included. Median OMEDD (IQR) was 98 (60-142) mg on day 0, 75 (60-105) mg on day 1, and 60 (45-90) mg on day 2. EDA duration, age, epidural infusion rates, and preoperative opioid use were independently associated with opioid consumption at EDA discontinuation. Preoperatively confirmed malignancy and EDA analgesic failure showed potential associations. The final model explained 20.8 % of the variance in opioid consumption (adjusted R²=0.208).</p><p><strong>Conclusions: </strong>The transition from EDA to oral analgesia after pancreatic surgery is accompanied by high opioid consumption. In this cohort, longer EDA treatment, younger age, higher epidural infusion rates, and preoperative opioid use were associated with increased opioid consumption at EDA discontinuation, suggesting that patients at risk of high opioid usage may be identified in advance and could benefit from tailored, multimodal opioid-sparing strategies.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous chronic back pain >1 year and incident cardiovascular disease in elderly men: results from the ULSAM-study.","authors":"Magnus Peterson, Per Wändell, Ann-Sofie Rönnegård, Tessa Schillemans, Johan Ärnlöv","doi":"10.1515/sjpain-2026-0020","DOIUrl":"https://doi.org/10.1515/sjpain-2026-0020","url":null,"abstract":"<p><strong>Background: </strong>Chronic back pain is a major cause of disability and a socioeconomic burden. Previous studies on back pain have suggested a moderately increased risk for cardiovascular mortality in elderly women, but evidence in elderly men is lacking. We investigated the association between continuous chronic back pain for more than a year and incident cardiovascular events in a cohort of elderly men.</p><p><strong>Methods: </strong>The Uppsala Longitudinal Study of Adult Men (ULSAM), a community-based cohort of elderly men (mean age, 71 years; n=1,024), was used to investigate the association between continuous back pain lasting more than one year and incident cardiovascular events (defined as a composite of coronary heart disease, cerebrovascular disease or cardiovascular mortality).</p><p><strong>Results: </strong>During up to 20 years follow-up, 504 individuals developed a cardiovascular event. In Cox proportional-hazards models adjusted for a large number of established cardiovascular risk factors, socioeconomic factors, and lifestyle factors (age, systolic blood pressure, antihypertensive treatment, high- and low-density lipoprotein-cholesterol, triglycerides, lipid-lowering treatment, glomerular filtration rate, urinary albumin excretion, body mass index, diabetes, diabetes medication, insulin-sensitivity, C-reactive protein, educational level, smoking, physical activity) continuous chronic back pain was robustly associated with a more than 70 % increased risk for cardiovascular events (multivariable hazard ratio 1.71, 95 % confidence intervals 1.23-2.37, p<0.001).</p><p><strong>Conclusions: </strong>Continuous chronic back pain for more than a year is a risk factor for cardiovascular events in elderly men. Our findings confirm previous evidence, highlighting chronic pain as a clinically relevant and under-recognized risk factor for cardiovascular disease that warrants consideration in future clinical guidelines.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing pain during exercise with offset analgesia in young healthy adults.","authors":"Savannah B Gutsch, Robert T McChesney, Teresa N Brinkmann, Marie Hoeger Bement","doi":"10.1515/sjpain-2026-0022","DOIUrl":"10.1515/sjpain-2026-0022","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this study was to translate offset analgesia (OffA) to an exercise task to reduce pain and improve feelings towards exercise (affective valence).</p><p><strong>Methods: </strong>Forty-nine young healthy adults (24 women; 21.8 ± 2.0 years, 25 men; 23.4 ± 5.7 years) completed two research sessions, with one randomized exercise task in each session (control or offset). Thermal and exercise OffA were assessed using individualized test temperature or exercise intensity, assessing pain during the following time points: moderate painful temperature or exercise stimulus for 5 s (T1), increase in temperature or exercise intensity for 10 s (T2), and decrease to original temperature or exercise intensity for 10 s (T3). For thermal OffA, noxious heat was applied to the forearm at an individualized test temperature that caused moderate pain (T1), increased by 1 °C (T2), and then returned to the test temperature (T3). For exercise OffA, an isometric knee extension was held by the right leg at 25 % of a maximal voluntary contraction (MVC) until moderate pain was reported (T1), increased to 50 % MVC (T2), and then returned to 25 % MVC (T3). With both heat and exercise testing, a control task was conducted whereby noxious stimulus intensity remained constant. Pain was reported during T1, T2, and T3 for all thermal and exercise protocols. Affective valence was reported during exercise only.</p><p><strong>Results: </strong>OffA occurred with both thermal and exercise tasks: pain increased when temperature or exercise intensity increased (T2), and dropped significantly following (T3), resulting in a clinically meaningful pain reduction regardless of noxious stimulus type (painful heat or exercise). Affective valence at the end of exercise was more positive during the offset task than the control task (p<0.001).</p><p><strong>Conclusions: </strong>OffA can be translated into exercise prescription to reduce pain and improve feelings during isometric exercise in young healthy adults. [Marquette University Institutional Review Board (#4434)].</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transversal ultrasound-guided approach to the popliteal ssciatic nerve block in the supine position: feasibility, effectiveness, and safety in lower-limb surgery.","authors":"Mario Germán Orozco Sandoval, Miguel A Pinzon, Harold A Sandoval, Edwin A Guarnizo, Luis F Lasso, Andres F Velasquez, Natalia Escobar","doi":"10.1515/sjpain-2026-0023","DOIUrl":"10.1515/sjpain-2026-0023","url":null,"abstract":"<p><strong>Background: </strong>The popliteal sciatic nerve block is an established technique to provide anesthesia and analgesia for surgical procedures below the knee. Classical approaches require the prone or lateral position, which can be uncomfortable for the patient, demand additional personnel, and entail risks in patients under general anesthesia. Ultrasound guidance has enabled the development of alternative techniques such as the transversal approach in the supine position, which may optimize logistics and patient comfort without compromising effectiveness or safety.</p><p><strong>Methods: </strong>We conducted an observational, descriptive, cross-sectional study between September and December 2024 at Fundación San José de Buga (Colombia). Adult patients undergoing lower limb surgery under ultrasound-guided popliteal sciatic nerve block using a transversal approach were included. Sociodemographic, clinical, surgical, and technical variables were recorded, along with associated medications, operator subjective evaluation, analgesic effectiveness (VAS at different time points), and safety (immediate and 24-h adverse events). The analysis included descriptive and bivariate statistics according to the technique used, with a significance level set at p<0.05.</p><p><strong>Results: </strong>Data from 50 patients were analyzed. The median age was 58.5 years (IQR, 41-69), with male predominance (66 %). Ninety-four percent received a block via the transversal technique, achieving an optimal ultrasound window in all cases and without the need for additional mobilization. The median depth of the sciatic nerve was 3.5 cm (IQR, 3.0-4.0). The anesthetic volume used was 15 mL of levobupivacaine in all cases. The transversal approach was highly rated by operators: 94 % considered it comfortable, easy to perform, and associated with excellent image quality. Analgesia was effective, with VAS 0 in 100 % of patients immediately postoperatively and at 6 h, and in 90 % at 24 h; no patient required rescue analgesia or opioids. No cardiovascular or respiratory adverse events, or immediate or 24-h complications, were reported.</p><p><strong>Conclusions: </strong>The ultrasound-guided transversal approach to the popliteal sciatic nerve block in the supine position is a feasible, safe, and effective technique that provides logistical and comfort advantages for both patient and operator. Its safety and efficacy profile make it an attractive alternative to classical approaches, particularly in scenarios where patient mobilization is limited or risky. Future comparative studies with larger sample sizes are needed to confirm these findings and assess its applicability in ambulatory surgery.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"26 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}