Current Pain and Headache Reports最新文献

{"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}

{"title":"Episodic Migraine in the Pediatric Population: Behavioral Therapies and other Non-Pharmacological Treatment Options.","authors":"Parisa Gazerani","doi":"10.1007/s11916-025-01366-3","DOIUrl":"10.1007/s11916-025-01366-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to present current evidence on the multifaceted approach required for managing pediatric migraine. This includes identifying migraine triggers, managing acute pain episodes, and implementing preventive strategies. The review focuses on non-pharmacological interventions, such as behavioral and lifestyle modifications. By exploring these aspects, the review seeks to provide a comprehensive understanding of effective migraine management in children and adolescents.</p><p><strong>Recent findings: </strong>Non-pharmacological treatments like cognitive-behavioral therapy (CBT), relaxation techniques, and biofeedback are effective alternatives to medication. Nutraceuticals and dietary considerations, including ketogenic diet, alongside education and regular follow-ups, optimize outcomes. Integrating tools for tracking migraine patterns and training for clinicians, parents, and patients enhances treatment effectiveness. Engaging adolescents and their families through education and active participation is essential for improving their quality of life. This review presents available evidence of non-pharmacological strategies for managing episodic migraine in pediatrics. CBT and lifestyle modification are documented for their effect. Future research is required to create evidence-based, comprehensive treatment plans including these and other non-pharmacological strategies tailored to individual needs.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"57"},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544396","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":"Artificial Intelligence and Predictive Modeling in the Management and Treatment of Episodic Migraine.","authors":"Aniket Natekar, Fred Cohen","doi":"10.1007/s11916-025-01364-5","DOIUrl":"https://doi.org/10.1007/s11916-025-01364-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial intelligence (AI) has impacted different aspects of headache medicine, from history taking and diagnosis to drug development. AI has been shown to have predictive modeling in helping diagnose migraine and assist with patient care. Additionally, this technology has been adapted to help non-headache specialists with headache management. Similar practices have expanded to help diagnose cluster headache. AI has also been used to help streamline patient visits, and identify new drug targets.</p><p><strong>Recent findings: </strong>Various forms of AI models have been implemented in headache medicine; these have ranged from diagnosis engines to models helping track headache triggers. Additionally, AI has been used to assist in clinical trials and to help predict placebo responses to different medications. There are still several limitations with AI in setting of headache medicine. AI and diagnosis models have a role to play in headache medicine. However, technology is still in its infancy and limitations do exist.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"56"},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505756","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":"Review: An Update on CGRP Monoclonal Antibodies for the Preventive Treatment of Episodic Migraine.","authors":"Kelly S Nicol, John G Burkett","doi":"10.1007/s11916-025-01365-4","DOIUrl":"10.1007/s11916-025-01365-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>CGRP targeting therapies have revolutionized the migraine preventive space, introducing novel migraine-specific therapies to improve headache care. Four monoclonal antibodies (mAbs) are approved for use in prevention of episodic migraines. Erenumab (AMG334), fremanezumab (TEV48125), and galcanezumab (LY2951742) are monthly subcutaneous injections, while eptinezumab (ALD403) provides an intravenous infusion option. This review aims to examine the clinical evidence for the safety and efficacy of CGRP-targeted mAbs in the prevention of episodic migraines with a focus on recent studies (2023-2024).</p><p><strong>Recent findings: </strong>Long-term studies reveal ongoing safety and efficacy in recent literature for all 4 monoclonal antibodies. These investigations have built evidence for earlier access to CGRP treatment as they increase quality of life and reduce monthly migraine days while being better tolerated than non-specific migraine preventative therapies. These studies support the recent 2024 AHS consensus statement recommending CGRP monoclonal antibodies be considered as first-line preventive treatment in episodic migraine.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"55"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494478","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":"Neuropsychological Instruments and Tasks for Dependence Behaviors in Medication-Overuse Headache.","authors":"Chi Ieong Lau, Yen-Feng Wang","doi":"10.1007/s11916-024-01334-3","DOIUrl":"https://doi.org/10.1007/s11916-024-01334-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to discuss about the potential roles of neuropsychological instruments and tasks in the evaluation of dependence behaviors shared by medication-overuse headache (MOH) and substance use disorders (SUDs).</p><p><strong>Recent findings: </strong>Recent studies utilizing criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM) for SUDs have revealed that MOH patients often exhibit impaired control over medication use, along with tolerance and withdrawal symptoms. In addition, dependence questionnaires such as the Leeds Dependence Questionnaire and the Severity of Dependence Scale have shown a strong correlation between MOH and higher dependence scores, with predictive value for treatment outcomes. Furthermore, investigations into decision-making processes with the Iowa Gambling Task have suggested potential parallels between MOH and SUDs. MOH patients exhibit biased decision-making, particularly in conditions of ambiguity, possibly predisposing them to favor immediate pain relief over long-term consequences. This suggests a potential mechanism involving emotional feedback processing in MOH. This review underscores the importance of recognizing dependence-like behaviors in MOH patients and highlights the potential utility of neuropsychological instruments and tasks in advancing the understanding of MOH pathophysiology. The findings suggest that MOH shares characteristics with substance dependence, emphasizing the need for tailored interventions in MOH management. Understanding the neurobehavioral aspects of MOH may lead to more effective therapeutic strategies aimed at mitigating dependence and improving long-term outcomes.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"54"},"PeriodicalIF":3.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477237","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 Steroid Facet Joint Injections for Axial Spinal Pain and Post Radiofrequency Ablation Neuritis: A Systematic Review.","authors":"Alan D Kaye, Amy E Brouillette, Cameron A Howe, Sheeza Wajid, Joseph R Archer, Rachael Bartolina, Jon D Hirsch, Jeffrey T Howard, Daniel Bass, Charles J Fox, Shahab Ahmadzadeh, Sahar Shekoohi, Laxmaiah Manchikanti","doi":"10.1007/s11916-025-01369-0","DOIUrl":"https://doi.org/10.1007/s11916-025-01369-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic axial spinal pain is a leading cause of disability and healthcare spending in the United States. A common source of axial spinal pain is the facet joint. Current treatments for facet joint-mediated pain include conservative treatments and interventions such as intra-articular facet joint injections (FJI), medial branch blocks (MBB), and radiofrequency ablation (RFA). While facet joint interventions are one of the most common spinal procedures, current scientific literature demonstrates conflicting results regarding the use of corticosteroids in these interventions.</p><p><strong>Recent findings: </strong>A systematic review was conducted to determine the efficacy of local corticosteroid usage in facet joint interventions for treating chronic axial spinal pain. Separate literature searches were performed using PubMed, Google Scholar, Embase, and Cochrane Library to evaluate the use of local corticosteroids in intra-articular FJI, MBB, and for the prevention of post-neurotomy neuritis (PNN). Inclusion criteria included a randomized clinical trial (RCT) or control trial while unique inclusion criteria was used for the differing uses of local corticosteroids. The exclusion criteria for studies included (i) studies written in a non-English language; (ii) articles without full-text access or abstract-only papers; (iii) and studies focused on non-human subjects. Final literature searches were conducted in August 2024. Two studies with 131 patients, four studies with 440 patients, and two studies with 203 patients were selected for the assessment of local corticosteroid use on intra-articular FJI, MBB, and PNN, respectively. A quality assessment tool recommended by The Cochrane Collaboration was used to assess bias risk in included studies. Results were synthesized through a meta-analysis to evaluate intra-articular FJI while a literature analysis was completed to investigate MBB and PNN. This study found that the use of corticosteroid intra-articular FJI and MBB provides significant improvement in pain relief and functionality from baseline for the treatment of lower back pain and chronic axial spinal pain, respectively. However, the use of corticosteroids post-RFA has not been proven to reduce the occurrence of PNN. Limitations to the studies used included blinding bias, absence of placebo groups, subjective inclusion criteria, limited generalizability and small sample sizes.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"53"},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469955","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 Suprainguinal Fascia Iliaca Block for Pain Management in Hip Surgeries: A Narrative Review.","authors":"Alan D Kaye, Trevor P Giles, Emily O'Brien, Allison M Picou, Austin Thomassen, Nicholas L Thomas, Shahab Ahmadzadeh, Jeffrey Sterritt, Matthew A Slitzky, Prabandh Reddy Buchhanolla, Sahar Shekoohi","doi":"10.1007/s11916-025-01368-1","DOIUrl":"https://doi.org/10.1007/s11916-025-01368-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Hip surgeries are commonly associated with significant postoperative pain, which can hinder early mobilization, prolong hospital stays, and increase healthcare costs. Effective pain management in this patient population is crucial to improving outcomes and reducing complications.</p><p><strong>Recent findings: </strong>Traditional pain control methods, such as systemic opioids, are often associated with adverse effects, including respiratory depression, nausea, and delayed recovery. Regional anesthesia techniques, particularly the suprainguinal fascia iliaca block (SFIB), have gained attention for the potential to provide targeted, long-lasting analgesia with fewer systemic side effects.</p><p><strong>Conclusion: </strong>This narrative review evaluates efficacy of the SFIB, an effective and safe technique for postoperative pain management in hip surgeries. The fascia iliaca block, initially described as a low-volume alternative to the lumbar plexus block, has evolved, with the suprainguinal approach demonstrating particular promise. By accessing the lumbar plexus and blocking the femoral, obturator, and lateral femoral cutaneous nerves, the SIFIB provides broad analgesia to the hip region. Recent studies have highlighted that, compared to traditional infrainguinal approaches, the suprainguinal technique offers superior spread and more consistent pain control related to its targeted proximity to the inguinal ligament. Consequently, this technique may optimize perioperative pain management and improve functional recovery in patients undergoing hip surgeries.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"52"},"PeriodicalIF":3.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460437","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":"Psychological Support for Chronic Low Back Pain: A Systematic Review on the Validity of a Growing Remote Approach.","authors":"Anna Anselmo, Maria Pagano, Irene Cappadona, Davide Cardile, Rocco Salvatore Calabrò, Francesco Corallo","doi":"10.1007/s11916-024-01340-5","DOIUrl":"https://doi.org/10.1007/s11916-024-01340-5","url":null,"abstract":"<p><strong>Background and objective: </strong>Low back pain (LBP) is one of the main health problems imposing a significant burden both personally and socially. It is estimated that 70-85% of people experience LBP during their lifetime, with nearly 20% of cases becoming chronic (CLBP). Interest in psychosocial factors and their correlations with the onset and outcome of low back pain has increased in recent years. The primary objective of this study is to demonstrate the validity and promote the adoption of psychological therapies delivered through remote platforms for the treatment and management of chronic pain related to LBP.</p><p><strong>Methods: </strong>The clinical studies we reviewed in our research were identified from the PubMed, Web of Science, Scopus, and Cochrane Library databases. Out of the initial 11,859 studies, only 20 met the inclusion criteria.</p><p><strong>Results: </strong>The results of our study confirm the effectiveness of psychological therapy delivered remotely in the treatment and management of chronic pain caused by low back pain. This highlights the importance of psychological intervention to improve the quality of life for these patients. Remote therapy can indeed facilitate treatment adherence and patient empowerment.</p><p><strong>Conclusion: </strong>Living with a chronic illness requires continuous support and the development of personalized interventions where the patient is accompanied and supported daily through active intervention. This underscores the importance of expanding the availability of traditionally available psychological strategies to remote delivery to support a growing number of people affected by CLBP.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"51"},"PeriodicalIF":3.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460539","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}