Current Pain and Headache Reports最新文献

{"title":"Efficacy of Transcutaneous Electrical Nerve Stimulation in Management of Cancer Pain: a Meta Analysis.","authors":"Alan D Kaye, Kaitlyn E Allen, Shivam S Shah, Summer A Smith, Taylor R Plaisance, Amy E Brouillette, Dani'elle J Despanie, Tayler D Payton, Ross Rieger, Naina Singh, Shahab Ahmadzadeh, Sonja Gennuso, Sahar Shekoohi","doi":"10.1007/s11916-024-01337-0","DOIUrl":"10.1007/s11916-024-01337-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The present investigation assesses efficacy of transcutaneous electrical nerve stimulation (TENS) on relief of cancer or chemotherapy-related pain. Patients with cancer experience a relatively high prevalence of pain that is reportedly undertreated. Therefore, this analysis is pertinent to determine if TENS is a useful complementary therapy considering its increase in accessibility and minimal side effect profile.</p><p><strong>Recent findings: </strong>A systematic search for eligible studies from PubMed, Google Scholar, Cochrane, and Embase was performed. The present investigation elucidated any significant differences between change in numeric rating scale of average and maximum pain scores between a TENS and non-TENS group. A nonsignificant difference was reported between TENS and non-TENS, with a mean difference of - 0.393 (95% CI - 1.780, 0.993; P = 0.578). For change in maximum pain reported, a nonsignificant difference was also found, with a mean difference of 0.128 (95% CI - 1.158, 1.414; P = 0.845).</p><p><strong>Conclusion: </strong>Related to various limitations of this meta-analysis, no definitive conclusions could be concluded regarding efficacy of TENS in the treatment of cancer or chemotherapy-related pain. Additional randomized primary studies with standardized treatment protocols and pain measurements are needed for future meta-analysis and recommendations for clinical practice.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"5"},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928692","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":"Efficacy, Indications, and Safety of Intrathecal Baclofen Pump: A Narrative Review.","authors":"Alan D Kaye, Se Yun Cheon, Morgan H Roque, Caroline Gibbs, Karlee R Mott, Alex M Wandler, Syeda T Munir, Junyu Lin, Shahab Ahmadzadeh, Harish Siddaiah, Sarah H Myers, Kristin Nicole Bembenick, Sahar Shekoohi","doi":"10.1007/s11916-024-01310-x","DOIUrl":"10.1007/s11916-024-01310-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Baclofen, a muscle relaxant that reduces the release of excitatory neurotransmitters in the pre-synaptic neurons stimulating inhibitory neuronal signals in post-synaptic neurons, has been around for over 5 decades. Baclofen is used primarily for spasticity and since 1982, has had a role as an intrathecal agent. In the present investigation, we review research trends and updates on safety and efficacy of intrathecal baclofen (ITB) pumps.</p><p><strong>Recent findings: </strong>Evaluation of safety and efficacy of ITB pumps in spasticity and relevant conditions was evaluated in the present investigation. PubMed and ClinicalTrials.gov were used to review appropriate related literature. Commonly reported aspects regarding ITB efficacy include comparison with alternative treatments, maintenance efficacy, and long-term outcomes. Safety considerations and risk factors associated with ITB include postoperative complications, withdrawal symptoms, tolerance issues, long-term management, and contraindications. In summary, the present investigation reveals that ITB is efficacious for muscle spasticity; however, efforts should be made to enhance safety and efficacy by providing improved best practice guidelines on maximum safe dose with the least amount of risk with individualized treatments.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"9"},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928707","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":"Efficacy of Immunotherapy for Complex Regional Pain Syndrome: A Narrative Review.","authors":"Alan D Kaye, Angela Nguyen, Jolie Boullion, Mary-Elizabeth F Blue, Dillion W Hopson Allen, Rucha A Kelkar, Aya Mouhaffel, Andrew T Ro, Shahab Ahmadzadeh, Sahar Shekoohi, Christopher L Robinson","doi":"10.1007/s11916-024-01329-0","DOIUrl":"10.1007/s11916-024-01329-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Complex regional pain syndrome (CRPS) is a chronic condition characterized by disproportional pain typically affecting an extremity. Management of CRPS is centered around specific symptomatology, which tends to be a combination of autonomic dysfunction, nociceptive sensitization, chronic inflammation, and/or motor dysfunction. Targeting the autoimmune component of CRPS provides a way to both symptomatically treat as well as minimize progression of CRPS.</p><p><strong>Recent findings: </strong>Understanding the physiology of CRPS and strategies for treating and targeting immunophysiology behind CRPS allows examination of the efficacy of such treatments. IL-1 receptor antagonism, glucocorticoid administration, IVIG infusion, and TNFα inhibitors are treatments that target the immune response and decrease inflammation, thereby reducing pain and enhancing function in patients with CRPS. IL-1 receptor antagonism is thought to inhibit the inflammatory effects of IL-1, a key player in the inflammatory process in CRPS. Glucocorticoids have anti-inflammatory properties and can reduce inflammation in affected tissues. IVIG infusion involves administering immunoglobulins, which may modulate the immune response and reduce autoimmunity in CRPS. TNFα inhibitors block the action of TNFα, a pro-inflammatory cytokine associated with CRPS development. These therapies are further discussed at the extent of mechanism of action as well as advantages and limitations of such therapies. The present investigation provides a detailed summary of the mechanism of action, advantages, and limitations of novel immunomodulatory therapies and recent studies and trials that investigated these therapies for CRPS. Future studies are warranted related to the role of immunomodulators in the treatment of CRPS.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"4"},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928687","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":"Efficacy of Transversus Thoracic Plane Block for Pain Management in Cardiac Surgeries.","authors":"Alan D Kaye, Carliss M Sampognaro, Shivam S Shah, Drake P Duplechin, Grant C Curry, Victoria A Rodriguez, Shahab Ahmadzadeh, Jibin Mathew, Zachary R Palowsky, Sahar Shekoohi","doi":"10.1007/s11916-024-01357-w","DOIUrl":"https://doi.org/10.1007/s11916-024-01357-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Effective pain management in cardiac surgery presents as a continuous challenge related to the intensity of postoperative pain and reliance on opioid therapy. The dependance of opioid-based therapies is concerning, as these therapies carry risk future addiction and potential severe side effects. The transversus thoracic plane block (TTPB) has emerged as a promising regional anesthesia technique that blocks the anterior branches of the intercostal nerves in the chest wall, potentially providing improved analgesia for cardiac surgery patients. The present investigation evaluates the efficacy of TTPB in reducing opioid consumption, decreasing postoperative pain scores, and enhancing recovery outcomes in patients undergoing cardiac surgeries.</p><p><strong>Recent findings: </strong>Data from randomized controlled trials revealed that TTPB significantly reduced 24-hour opioid consumption, increased the time to first rescue analgesic, and lowered Visual Analog Scale (VAS) pain scores both at rest and with movement, particularly in the first 12 h post-surgery. Additional benefits include fewer opioid-related side effects, such as nausea and pruritus, and reductions in intensive care unit (ICU) length of stay. Studies also suggested that TTPB can support earlier extubation and accelerated recovery, contributing to higher patient satisfaction and overall improved postoperative outcomes.</p><p><strong>Conclusion: </strong>Despite these promising results, challenges in technique standardization and limited long-term data are still obstacles that prevent widespread adoption. Achieving consistent TTPB efficacy requires technical precision in ultrasound guidance, and there is little research on its effectiveness across diverse populations, such as pediatric and high-risk cardiac patients. Addressing these gaps through multi-center, long-term studies could help establish TTPB as a prominent pain management strategy in cardiac surgery to minimize opioid dependence and enhance patient comfort and recovery.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"8"},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928701","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":"Rhomboid Intercostal and Subserratus Plane Block for Acute Pain Management after Abdominal Surgeries: A Narrative Review.","authors":"Alan D Kaye, Alex V Hollander, Brianna N Rogers, Austin S Thomassen, Jolie A Boullion, Gianni H Ly, Bradley Dorius, Hirni Patel, Shahab Ahmadzadeh, Sahar Shekoohi, Christopher L Robinson","doi":"10.1007/s11916-024-01356-x","DOIUrl":"https://doi.org/10.1007/s11916-024-01356-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>The rhomboid intercostal and subserratus plane (RISS) block is an effective, safer alternative for managing postoperative acute pain following abdominal surgeries. The RISS block offers several advantages over traditional approaches, including reduced incidence of puncture-related complications, lower rates of systemic opioid consumption, and more consistent analgesic coverage of lower thoracic dermatomes.</p><p><strong>Recent findings: </strong>Despite a favorable safety profile, the RISS block carries potential risks, such as pneumothorax and local anesthetic systemic toxicity, particularly when long-acting anesthetics such as bupivacaine or ropivacaine are used. Careful administration with ultrasound guidance minimizes these risks, enhancing patient safety. Compared to epidural and paravertebral blocks, RISS is associated with fewer instances of nerve damage, hemodynamic instability, and bleeding. Research suggests that RISS not only improves postoperative pain scores, but also extends duration of analgesic effect, reducing total opioid use by nearly 40%.</p><p><strong>Conclusion: </strong>Future directions include clinical trials to validate efficacy across diverse patient populations, comparative studies with other regional blocks, and evaluations of long-term outcomes. Expanding our understanding of RISS block application may help advance multimodal pain management protocols, underscoring potential to improve recovery, reduce opioid dependency, and elevate patient quality of life in postoperative settings.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"7"},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928708","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":"Traumatic Brain Injury in Intimate Partner Violence.","authors":"Cali C M Callaway, Judy H Ch'ang","doi":"10.1007/s11916-024-01324-5","DOIUrl":"https://doi.org/10.1007/s11916-024-01324-5","url":null,"abstract":"<p><strong>Purposeof review: </strong>In this article, we explore the current literature on traumatic brain injury (TBI) in survivors of intimate partner violence (IPV) and evaluate the barriers to studying this vulnerable population.</p><p><strong>Recent findings: </strong>Research on TBI and IPV is limited by multiple factors including mistrust of the healthcare system by survivors, lack of awareness by community advocates, and insufficient funding by public entities. As such, most investigations are small population, retrospective, and qualitative. Quantitative research addressing the scope of TBI in IPV found reported rates ranging from 19 to 100% of survivors experiencing neurological injury at the hands of a violent partner. The principals of trauma-informed healthcare should guide both neurological care for survivors as well as future studies on TBI and IPV, with an emphasis on community-based participatory research.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"6"},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928709","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":"Spinal Cord Stimulation for Low Back Pain: A Systematic Review.","authors":"Alan D Kaye, Joseph R Archer, Shivam Shah, Coplen D Johnson, Lexa R Herron, Amy E Brouillette, Catherine J Armstrong, Peyton Moore, Shahab Ahmadzadeh, Sahar Shekoohi, Azem A Chami","doi":"10.1007/s11916-024-01336-1","DOIUrl":"https://doi.org/10.1007/s11916-024-01336-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic low back pain (LBP) is a prevalent and debilitating condition affecting millions worldwide. Among emerging interventions, spinal cord stimulation (SCS) has gained attention as a potential alternative for managing chronic LBP, particularly when alternative approaches fail to provide adequate relief.</p><p><strong>Recent findings: </strong>This systematic review focuses on both residual pain levels and ability to perform daily tasks after treatment with SCS. The present investigation includes a systematic search for studies from PubMed, Google Scholar, and Cochrane, and Embase. Sources were eligible for inclusion in the review if they were published from 2010 to present (May 1, 2024). 8 studies involving a total of 1,172 patients were evaluated. This systematic review demonstrated that SCS is superior to conventional medical management (CMM) for both short and long-term pain relief, functionality, psychological well-being, and opioid dependency. Furthermore, newer SCS approaches, such as high frequency (HF), differential target multiplexed (DTM), and multiphase SCS all demonstrated improved efficacy over traditional SCS for pain relief and functionality scores. Adverse event rates for all trials were low and represent the safety of SCS treatments. The present investigation provides insight into the capabilities of both traditional SCS and HF SCS, DTM SCS, and multiphase SCS as compared to baseline pain and functionality as well as conventional medical management (CMM). This review grants physicians a broader picture of the applicability of SCS, its safety profile, and the opportunities it offers for pain reduction and functionality over CMM.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"2"},"PeriodicalIF":3.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923914","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 Dual Burden of Post-Traumatic Headache: Health Consequences and Economic Impact.","authors":"Fred Cohen","doi":"10.1007/s11916-024-01347-y","DOIUrl":"10.1007/s11916-024-01347-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the history and impact and burden of post-traumatic headache (PTH).</p><p><strong>Recent findings: </strong>PTH is a prevalent headache disorder that many healthcare providers encounter. Unlike more extensively researched primary headache disorders like migraines, PTH has not been as thoroughly studied, and there are fewer treatments specifically tested for it. A significant obstacle to conducting detailed population studies on PTH is the need for the headache to occur shortly after a traumatic event. Despite these challenges, PTH is recognized as a disabling condition with considerable effects on quality of life and economic impact. PTH is a distressing and debilitating condition. Although there have been efforts to evaluate its personal and economic effects, these studies are limited compared to the more extensive research conducted on other primary headache disorders. More comprehensive epidemiological studies are needed.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"3"},"PeriodicalIF":3.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923915","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":"Overview and Comparison of Interscalene Block Techniques for Brachial Plexus Pain Management.","authors":"Alan D Kaye, William C Upshaw, Caroline Holley, Paris D Bailey, Joseph P Tassin, Mark V Frolov, Sanjana Sudini, Benjamin C Miller, Zachary R Palowsky, Saurabh Kataria, Shahab Ahmadzadeh, Sahar Shekoohi, Christopher L Robinson","doi":"10.1007/s11916-024-01346-z","DOIUrl":"https://doi.org/10.1007/s11916-024-01346-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Peripheral nerve blocks are performed using local anesthetics that are commonly performed prior to surgery to either be the sole anesthetic and/or for postoperative pain management. Interscalene blocks are a specific type of nerve block that targets the superior and middle trunks of the brachial plexus inhibiting transmission of pain signals from the upper extremities to the central nervous system making them useful in mitigating pain following surgeries involving the shoulder, upper arm, and elbow.</p><p><strong>Recent findings: </strong>Previously, interscalene blocks were performed with a nerve stimulator, which is an instrument designed to generate a twitch in surrounding muscles to verify the anesthetic block was placed in the correct location. However, this approach with a nerve stimulator alone is being done less frequently as physicians now often employ ultrasound either by itself or in conjunction with a nerve stimulator to in the block. Several clinical studies have shown that the use of ultrasound leads to improved safety and effectiveness of the interscalene block as compared to performing the block using a nerve stimulator alone. Clinical studies comparing interscalene blocks done with ultrasound versus ultrasound in conjunction with a nerve stimulator have shown the combination to be slightly safer and more efficacious with reduced side effects, though the difference in these metrics between the two is small. Interscalene blocks are highly effective for postoperative pain related to shoulder and upper extremity surgeries. Ultrasound guided blocks are more effective with reduced adverse effects when compared to nerve stimulation alone. The combination of both ultrasound and nerve stimulation allows for increased efficacy and decreaed side effects in limited clinical investigations. Therefore, more studies are needed to further compare and determine best practice interscalene techniques for shoulder and upper extremity surgeries.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"1"},"PeriodicalIF":3.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911058","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":"Mechanism of Action of Temporary Peripheral Nerve Stimulation.","authors":"Alaa Abd-Elsayed, Sumedha Attanti, Meredith Anderson, Tyler Dunn, Jillian Maloney, Natalie Strand","doi":"10.1007/s11916-023-01184-5","DOIUrl":"10.1007/s11916-023-01184-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Peripheral nerve stimulation (PNS) refers to the technique of utilizing electrical stimulation of peripheral nerves to inhibit the transmission of pain signals. PNS is used to treat chronic intractable pain and post-surgical or post-traumatic pain alongside a variety of other pain conditions, including headaches, facial pain, pelvic and urogenital pain, chest wall pain, residual limb or phantom limb pain, and back pain.</p><p><strong>Recent findings: </strong>More recently, PNS has been used temporarily for periods of time less than 60 days to treat acute post-surgical pain. Peripheral nerve stimulation is believed to be effective due to its effects on both central and peripheral pathways. Centrally, it is proposed that the electrical pulses of PNS inhibit alpha-delta and C fibers, which decreases pain signaling in the higher centers of the central nervous system. Peripherally, gate theory is applied as it is theorized that PNS downregulates inflammatory mediators, endorphins, and neurotransmitters associated with pain signaling to decrease the transmission of efferent nociception and reduce pain sensations.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":" ","pages":"1219-1224"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54232020","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}