Current Pain and Headache Reports最新文献

{"title":"Fasting and Headache.","authors":"Patrick T Ebbert, Lauren R Natbony","doi":"10.1007/s11916-024-01326-3","DOIUrl":"https://doi.org/10.1007/s11916-024-01326-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review synthesizes the latest updates in the literature on the connection between fasting and migraine, examining both clinical outcomes and underlying pathophysiological mechanisms.</p><p><strong>Recent findings: </strong>Although no studies have specifically explored fasting as a therapeutic intervention for migraine, various retrospective analyses suggest that fasting might worsen migraine symptoms in the short term. On the other hand, recent investigations, including several randomized controlled trials, have shown that ketogenic diets significantly reduce the number of migraine days and decrease inflammation markers. Additional research has shown improvements in disability assessments, as indicated by VAS, MIDAS, and HIT-6 scores. These benefits are not replicated by merely administering ketone bodies. Furthermore, genetic studies have found a link between glycemic processing and the occurrence of migraine. There is accumulating evidence that ketogenesis can reduce both the frequency and disability associated with migraine, likely through the reduction of systemic inflammatory markers and diminished cortical excitability. However, the potential benefits of intermittent fasting on migraine prevention remain underexplored and warrant further investigation.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"67"},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Mixed Pain Research Over Three Decades (1993-2024): A Bibliometric Analysis.","authors":"Matteo Luigi Giuseppe Leoni, Marco Mercieri, Roberto Gazzeri, Marco Cascella, Martina Rekatsina, Omar Viswanath, Alberto Pasqualucci, Giustino Varrassi","doi":"10.1007/s11916-025-01371-6","DOIUrl":"10.1007/s11916-025-01371-6","url":null,"abstract":"<p><strong>Background: </strong>The term \"mixed pain\" is frequently used in clinical practice to describe the coexistence of nociceptive, neuropathic, and nociplastic pain mechanisms. However, its inconsistent use and lack of a formal definition warrant further investigation. This bibliometric analysis aims to explore publication trends, research networks, and key themes in mixed pain literature.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science Core Collection. The search was performed in February 2024, with journal rankings obtained from Journal Citation Reports™ 2022 (Clarivate Analytics). Extracted data included publication trends, citation analysis, co-authorship networks, and keyword mapping.</p><p><strong>Results: </strong>A total of 229 publications were identified, demonstrating an increasing trend in both publication volume and citations. Most studies were published in high-ranking Q1 journals as research (77%) and review articles (19%). The USA (21%), Italy (15%), and Germany (12%) were the leading contributors, yet global collaboration was weak, with limited co-authorship connections except within the USA. The keyword analysis revealed five major research clusters, with \"neuropathic pain,\" \"management,\" and \"quality of life\" emerging as central themes.</p><p><strong>Conclusions: </strong>Despite the progressive increase in mixed pain articles in highly ranked journals, this bibliometric analysis highlighted the absence of a well-structured collaborative network among authors and a lack of clear connections between keywords. Given the critical clinical implications of mixed pain, further high-quality studies on this topic and enhanced international collaborations are recommended.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"65"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Guided Genicular Nerve Blocks for Pain Management Following Total Knee Replacement: A Narrative Review.","authors":"Alan D Kaye, William C Upshaw, Joseph P Tassin, Jacob M Corrent, James V D'Antoni, Mark V Frolov, Shahab Ahmadzadeh, Hirni Patel, Catherine J Armstrong, Raju Behara, Shilpadevi Patil, Saurabh Kataria, Sahar Shekoohi","doi":"10.1007/s11916-025-01382-3","DOIUrl":"https://doi.org/10.1007/s11916-025-01382-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Total knee replacement (TKR) is a common procedure to alleviate pain in patients with severe osteoarthritis of the knee after failed conservative treatment. While generally safe, postoperative pain is a significant issue many patients experience following surgery.</p><p><strong>Recent findings: </strong>To control postoperative pain, numerous treatments may be administered which may be given preoperatively, intraoperatively, or postoperatively. These treatments include medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and opioids. Additionally, peripheral nerve blocks (PNB) may be performed prior to total knee replacement to limit pain after the surgery. A specific type of PNB done prior to total knee replacement is the genicular nerve block (GNB) which targets five genicular nerves that innervate different parts of the knee joint. This type of block is designed to prevent pain impulses from being sent to the central nervous system from the knee without affecting movement of the lower extremity by sparing efferent nerves innervating muscles. PubMed was used to identify the studies found in this review that are less than 5 years old using the search term \"genicular nerve block clinical studies.\" Most studies compared GNB alone compared to other blocks, however some used GNB in combination with other blocks, most at a maximum of 48 h postoperative. GNB is typically performed by anesthesiologists under ultrasound guidance to ensure accurate placement of the block. Clinical studies have shown that GNB is effective in controlling pain following TKR leading to lower pain scores following surgery as well as a reduced level of opioid consumption. Additionally, GNB has shown reduced motor weakness following TKR compared to other types of PNBs allowing earlier mobilization of patients. However, more studies are needed to further investigate the efficacy of GNB compared to other PNBs to treat postoperative pain following TKR.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"66"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current Status and Future Prospects of Intra-articular Injection Therapy for Hip Osteoarthritis: A Review.","authors":"Li Li, Xiaofan Dou, Xueliang Song, Fengxian Wang","doi":"10.1007/s11916-025-01378-z","DOIUrl":"10.1007/s11916-025-01378-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Hip osteoarthritis constitutes a prevalent condition among individuals aged 55 and above, serving as one of the primary triggers for joint discomfort and impairment, and marking a substantial origin of chronic pain particularly affecting the elderly population. Our article provides an exhaustive summary of the mechanisms of action, therapeutic efficacy, and potential adverse consequences associated with novel therapeutic modalities including glucocorticoids, hyaluronic acid, platelet-rich plasma, mesenchymal stem cells, and stromal vascular fraction. Concurrently, we conducted a comprehensive evaluation of the clinical efficacy and potential applications of various medications.</p><p><strong>Recent findings: </strong>In comparison to physical therapy, oral analgesics, and other nonsurgical modalities, intra-articular injection therapy is characterized by enhanced safety and greater efficacy. Moreover, when contrasted with surgical intervention, intra-articular injection demonstrates a lower degree of invasiveness and incurs fewer adverse reactions. Intra-articular treatments have shown excellent local efficacy while significantly minimizing adverse reactions in patients. These methods hold significant potential for development but require comprehensive research and thorough discussion within the academic community.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"64"},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Pain Management for Major Limb Amputation - A Systematic-Narrative Hybrid Review.","authors":"Floris V Raasveld, Seamus P Caragher, Nicolas Kumar, Carla H Lehle, Ahish Chitneni, Ian L Valerio, Kyle R Eberlin, David Hao","doi":"10.1007/s11916-025-01379-y","DOIUrl":"https://doi.org/10.1007/s11916-025-01379-y","url":null,"abstract":"<p><strong>Introduction: </strong>Post-amputation pain, including residual limb pain (RLP) and phantom limb pain (PLP), can affect the outcome of surgery and have an impact on quality of life. Effective management of acute post-amputation pain requires a multidisciplinary approach with collaboration among the surgical and anesthesia teams to optimize pain management. A systematic-narrative hybrid review was conducted to assess and report the effectiveness of various interventions in perioperative pain management for amputation surgery.</p><p><strong>Methods: </strong>MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov databases were searched for studies evaluating interventional and/or pharmacological approaches to managing perioperative pain in major extremity amputation surgery. The data collected included treatment options, average dosage and/or duration of treatments, and reported pain outcomes.</p><p><strong>Results: </strong>Of the 27 studies evaluating interventions, 8 addressed neuraxial or perineural analgesia, 16 focused on peripheral nerve blocks (PNB), 2 examined peripheral nerve stimulators (PNS), and 1 investigated transcutaneous electrical nerve stimulation. Preoperative epidural analgesia was associated with a reduced incidence of postoperative pain. PNS, PNB, and catheter-based infusions were found to be effective in managing postoperative pain. The role of ketamine in treating post-amputation pain yielded mixed results, while other pharmacological agents, such as valproic acid and gabapentin, demonstrated limited efficacy.</p><p><strong>Conclusions: </strong>While numerous pain interventions are available, no single approach has been shown to be superior. A multimodal strategy, incorporating PNBs, preoperative pain control, and potentially ketamine, appears to provide the most comprehensive pain management strategy. Further long-term prospective studies are required to refine and optimize pain management techniques for major extremity amputation surgery.</p><p><strong>Level of evidence: </strong>III-Systematic reviews.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"62"},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Sacroiliac Joint Injections of Platelet-Rich Plasma (Prp) and Stem Cells.","authors":"Laxmaiah Manchikanti, Alan D Kaye, Alaa Abd-Elsayed, Mahendra R Sanapati, Vidyasagar Pampati, Sahar Shekoohi, Joshua A Hirsch","doi":"10.1007/s11916-025-01377-0","DOIUrl":"https://doi.org/10.1007/s11916-025-01377-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review evaluates the effectiveness of sacroiliac joint injections of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) for treating low back and lower extremity pain. A systematic analysis was conducted to assess the impact of PRP and MSC injections on managing these conditions.</p><p><strong>Recent findings: </strong>In recent years, several cell-based therapies, including the injection of MSCs and PRP into the sacroiliac joints, have been proposed for the management of low back pain. Emerging clinical evidence supporting their use appears promising. The present systematic review identified 2 randomized controlled trials (RCTs) and 3 observational studies that met inclusion criteria based on strict methodological quality and bias assessments. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and qualitative analysis synthesis determined evidence levels as IV (limited) with a weak recommendation.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"63"},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Radiation Therapy on Intrathecal Drug Delivery System Functioning and Safety.","authors":"David Hao, Donghwan Lee, Shivam S Shah, Sahar Shekoohi, Alan D Kaye","doi":"10.1007/s11916-025-01375-2","DOIUrl":"https://doi.org/10.1007/s11916-025-01375-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Intrathecal drug delivery systems (IDDS) are integral to managing chronic pain and spasticity, especially in oncology patients who may also require radiation therapy (RT). Concerns regarding the potential effects of ionizing radiation on IDDS functionality have been raised, with limited but growing evidence on device resilience. This review summarizes the current literature on radiation-induced IDDS malfunctions, identifies key risk factors, and discusses mitigation strategies.</p><p><strong>Recent findings: </strong>Although most IDDS remain functional during RT, isolated cases of radiation-induced pump failure have been reported. Factors such as radiation dose, proximity to the treatment field, and shielding methods influence device susceptibility to failure. Case studies and retrospective reviews have suggested that cumulative doses above 10 Gy may increase malfunction risks, though some devices have withstood doses as high as 36 Gy without failure. Advances in RT, including proton therapy and stereotactic techniques, may reduce exposure to IDDS. Current recommendations emphasize preemptive planning, shielding strategies, and close post-radiation monitoring to mitigate these potential risks. RT presents unique challenges for patients with IDDS, requiring a multidisciplinary approach to balance cancer treatment efficacy with device integrity. While modern IDDS demonstrate resilience to radiation exposure, careful consideration of radiation dose thresholds, device placement, and shielding is needed. Given the lack of standardized guidelines, more research is needed to establish evidence-based protocols to optimize patient safety and device performance during RT.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"60"},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Regenerative Medicine Therapies for Axial Spine Pain of Facet Joint Origin.","authors":"Laxmaiah Manchikanti, Alaa Abd-Elsayed, Alan D Kaye, Mahendra R Sanapati, Vidyasagar Pampati, Sahar Shekoohi, Joshua A Hirsch","doi":"10.1007/s11916-025-01376-1","DOIUrl":"https://doi.org/10.1007/s11916-025-01376-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to assess the effectiveness of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) injections in treating axial spinal pain originating from the facet joints. A systematic evaluation of available evidence on these biological therapies was conducted to determine their clinical utility.</p><p><strong>Recent findings: </strong>Recent studies emphasize the therapeutic promise of intraarticular biologics, including MSCs, PRP, and alpha-2-macroglobulin, in managing facet joint-related axial spinal pain. Emerging evidence suggests improvements in pain relief, physical function, and quality of life following these treatments. Based on our search criteria, 20 publications were identified and considered for inclusion. Of these, 4 randomized controlled trials (RCTs) and 6 observational studies met the inclusion criteria. Among the RCTs, 3 trials involved lumbar facet joints, and one trial involved cervical facet joints using PRP. Among the observational studies, 4 studies used PRP, with 3 focusing on the lumbar spine and one study, with 2 publications, on the cervical spine, and only 2 studies evaluated stem cell treatments. The summary of evidence utilizing various criteria, including Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) evidence synthesis, the evidence for PRP injections in facet joints is Level II, or moderate, and Level IV, or limited, overall, with low certainty. For PRP, the recommendation is moderate, and for MSCs, the recommendation is weak.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"61"},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating a Framework for Minimizing Opioid Consumption after Office Based Surgery.","authors":"Austin A Skinner, Vikranth R Chinthareddy, Richard D Urman, Fred Shapiro","doi":"10.1007/s11916-025-01372-5","DOIUrl":"https://doi.org/10.1007/s11916-025-01372-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Herein we review recent trends in opioid prescribing, the rise in office-based surgeries, and propose a framework to minimize opioid consumption following such procedures.</p><p><strong>Recent findings: </strong>Outpatient surgical procedures are increasing year over year in the United States. This observed increase is expected to continue due to the financial incentives to perform outpatient procedures. Office-based surgery is a setting that is expected to have tremendous growth. Still, currently there are scant safety guidelines concerning how to manage perioperative pain related to surgeries in this setting safely and effectively. Opioid abuse is rampant across the United States, and we anticipate that an increase in outpatient procedures will create a rise in opioid prescribing without appropriate discourse and planning. There are a variety of systematic factors in play to minimize opioid consumption after office-based surgery that must be considered at each operative phase. Careful planning and consideration of the multitude of factors can increase patient satisfaction while minimizing opioid prescriptions.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"59"},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurosurgical Interventions in Chronic Pain Management: A Review of Emerging Technologies and Accessibility.","authors":"Lucas de Oliveira Woehl, Emanuel Schumacher Pereira","doi":"10.1007/s11916-025-01374-3","DOIUrl":"https://doi.org/10.1007/s11916-025-01374-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic pain affects millions worldwide, reducing quality of life and posing a major healthcare challenge. This review aims to explore advancements in neurosurgical interventions for managing chronic pain, focusing on the latest neuromodulation techniques, and addressing how these innovations may offer alternative solutions for these patients.</p><p><strong>Recent findings: </strong>We reviewed advances in high-frequency spinal cord stimulation, dorsal root ganglion stimulation, and closed-loop neuromodulation systems, which optimize precision in pain control and reduce adverse effects. Improvements in targeted drug delivery enabled more accurate and sustained management of pain, with fewer unfavorable effects than traditional therapies. Additionally, we discussed emerging technologies, including artificial intelligence for personalized treatment adjustment, and gene therapy for addressing pain at a molecular level, innovations that also hold promise for future applications. Neurosurgical techniques have the potential to transform chronic pain management, offering improved control with fewer complications. However, challenges remain regarding accessibility, cost, and long-term efficacy. Further research is needed to refine, expand access, and enhance effectiveness.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"58"},"PeriodicalIF":3.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}