Current Pain and Headache Reports最新文献

{"title":"Notalgia Paresthetica: An Updated Review of Pathophysiology, Diagnosis, and Treatment Approaches.","authors":"Parker Nguyen, Seema Parikh, Caitlyn Ko, Grace Nguyen, Alan D Kaye, Ivan Urits, Jamal Hasoon","doi":"10.1007/s11916-025-01402-2","DOIUrl":"10.1007/s11916-025-01402-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Notalgia paresthetica (NP) is a chronic sensory neuropathy characterized by localized pruritus and dysesthesia, most commonly affecting the upper back. Despite being a relatively common condition, it remains underdiagnosed and frequently mismanaged. This review covers the pathophysiology, clinical presentation, diagnostic evaluation, and treatment approaches for NP.</p><p><strong>Recent findings: </strong>Recent studies support a multifactorial pathogenesis for NP, with compression or irritation of the dorsal rami of thoracic spinal nerves playing a central role. Imaging and electromyography have shown variable utility in diagnosis, while histological findings often lack specificity. Although there is no universally effective treatment, advances in topical medications, systemic oral medications, and interventional therapies may be considered. Physical therapy and postural correction remain important non-pharmacologic strategies. NP is a neuropathic condition with evolving diagnostic and therapeutic approaches. Early recognition, multidisciplinary evaluation, and individualized treatment plans are essential for improving patient outcomes. Further research is needed to establish standardized diagnostic criteria and long-term treatment efficacy.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"87"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112735","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 Application of Artificial Intelligence to Enhance Spinal Cord Stimulation Efficacy for Chronic Pain Management: Current Evidence and Future Directions.","authors":"John V Prunskis, Tadas Masys, Stephen T Pyles, Alaa Abd-Elsayed, Timothy R Deer, Douglas P Beall, Ramis Gheith, Sheel Patel, Dawood Sayed, Hadi Moten, Todd Hagle, Chadi I Yaacoub, Leon Anijar, Mayank Gupta, Terri Dallas-Prunskis","doi":"10.1007/s11916-025-01400-4","DOIUrl":"10.1007/s11916-025-01400-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic pain significantly impacts quality of life for millions globally, with spinal cord stimulation (SCS) as an established treatment for refractory chronic pain. However, traditional SCS therapies face limitations including inconsistent patient outcomes, challenges in patient selection, and difficulties in sustaining therapeutic efficacy. This review examines how artificial intelligence (AI) can enhance the efficacy and personalization of SCS therapy by optimizing patient selection, refining stimulation parameters, and enabling real-time adaptive adjustments.</p><p><strong>Recent findings: </strong>Recent advances demonstrate that integrating AI with SCS significantly improves patient outcomes through predictive modeling for patient selection and real-time adaptive stimulation. Predictive analytics utilizing machine learning algorithms have successfully identified patient cohorts most likely to benefit from SCS therapy, enhancing response rates and reducing suboptimal outcomes. Closed-loop AI systems incorporating physiological feedback, such as evoked compound action potentials (ECAPs), dynamically optimize stimulation parameters, resulting in sustained pain relief, decreased programming burden, and improved device longevity. Despite these promising results, critical challenges persist, particularly related to data standardization, ethical considerations, and regulatory compliance. AI holds transformative potential for spinal cord stimulation, offering increased precision, personalization, and therapeutic efficiency in managing chronic pain. Although early results are encouraging, comprehensive clinical validation and multidisciplinary collaboration remain essential. Addressing ethical, regulatory, and data management challenges will be critical for widespread adoption of AI-enhanced SCS therapies in routine clinical practice.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"85"},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111498","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":"Burden of Emotional Stress in Chronic Pain Care: A Wake-up Call for the Care Team.","authors":"Grace Kao, Jason Parmar, Saba Javed","doi":"10.1007/s11916-025-01399-8","DOIUrl":"10.1007/s11916-025-01399-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic pain management presents significant emotional challenges for clinicians due to the complex and prolonged nature of the conditions they treat. This editorial aims to explore how emotional stressors, such as compassion fatigue, emotional labor, and ethical dilemmas, impact both clinician well-being and patient outcomes. It also emphasizes the need for effective strategies to address clinician stress and enhance overall care quality.</p><p><strong>Recent findings: </strong>Healthcare professionals working in chronic pain management are particularly susceptible to emotional stress, which can lead to burnout, job dissatisfaction, and poor mental health. Research highlights the prevalence of stressors such as compassion fatigue, emotional labor, heavy workloads, and time pressures. These stressors contribute to a decline in clinician well-being, which in turn negatively impacts patient care quality. Many studies also point to the interconnection between clinician burnout and compromised patient outcomes, emphasizing the importance of addressing these issues. Addressing the emotional stress faced by clinicians in chronic pain care is crucial for improving both clinician satisfaction and patient outcomes. Effective strategies, including mindfulness practices, self-compassion, wellness programs, and flexible work schedules, have been identified as potential solutions to mitigate burnout and enhance clinician resilience. By implementing these strategies, healthcare systems can improve clinician well-being and ultimately provide higher-quality care to patients.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"86"},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112734","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":"Pecto-Intercostal Fascial Plane Block for Pain Management after Cardiothoracic Surgery.","authors":"Alan D Kaye, Christopher A Vuong, Alison M Hawkins, Macie A Serio, Drew R Dethloff, Alex V Hollander, Shahab Ahmadzadeh, Kimberly L Skidmore, Zachary R Palowsky, Sahar Shekoohi","doi":"10.1007/s11916-025-01398-9","DOIUrl":"https://doi.org/10.1007/s11916-025-01398-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiac surgery is associated with significant postoperative pain. Compared to traditional analgesics, regional nerve blocks target specific anatomical areas to improve analgesia and to reduce postoperative opioid consumption.</p><p><strong>Recent findings: </strong>Pecto-intercostal fascial plane block (PIFB) is a novel analgesic technique that involves ultrasound-guided injection of anesthetic between pectoralis major and external intercostal muscles. Since PIFB is a relatively underexplored method of analgesia, to date, few manuscripts have reviewed and synthesized current literature related to PIFB.</p><p><strong>Conclusion: </strong>The present investigation focuses on relevant anatomy and physiology behind the PIFB, compares this novel technique with other traditional and novel methods of analgesia, and describes indications and contraindications for PIFB in cardiac surgery and other surgeries.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"84"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081536","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":"Epidural Contrast Patterns and Clinical Implications: An Educational Review.","authors":"Giuliano Lo Bianco, Barnabas T Shiferaw, Max Y Jin, Alaa Abd-Elsayed","doi":"10.1007/s11916-025-01396-x","DOIUrl":"https://doi.org/10.1007/s11916-025-01396-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this educational review is to describe the contrast spread patterns that indicate accurate needle placement in the epidural space and spread patterns associated with erroneous needle insertion.</p><p><strong>Recent findings: </strong>Epidural injections are minimally invasive and commonly used for patients with acute and chronic back pain that does not respond to conservative management. Imaging with contrast is frequently used during this procedure to improve accuracy and reduce adverse events. Contrast spread patterns are an important tool that can help identify where the needle is placed and whether the placement is accurate. Despite this, there may be discrepancies in the interpretation of spread patterns which ultimately reduce the utility of contrast. Inaccurate needle placement may result in intrathecal/subarachnoid, subdural, fascial, or retrodural space of Okada injections. The correct interpretation of contrast spread patterns on imaging is crucial for confirming accurate epidural needle placement. Furthermore, understanding contrast patterns of improper needle placement can prevent adverse events that result from injection outside of the epidural space.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"83"},"PeriodicalIF":3.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080704","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":"Atypical Applications of Neuromodulation for Non-Painful Conditions.","authors":"Ashlyn Brown, Loc Lam, Billy Huh, Ryan S D'Souza, Saba Javed","doi":"10.1007/s11916-025-01389-w","DOIUrl":"https://doi.org/10.1007/s11916-025-01389-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This narrative review explores the expanding applications of neuromodulation beyond pain management, focusing on its use in treating non-painful conditions such as heart failure, renal failure, spinal cord injuries, overactive bladder syndrome, and cognitive impairment in neurodegenerative diseases.</p><p><strong>Recent findings: </strong>Neuromodulation techniques, including dorsal root ganglion stimulation, sacral neurostimulation, and deep brain stimulation, have shown promising results in various non-painful medical conditions: Heart and Renal Failure: Dorsal root ganglion stimulation induces diuresis in diuretic-resistant patients, offering a novel approach to managing fluid overload. Spinal Cord Injuries: Epidural spinal cord stimulation and brain-spine interfaces have demonstrated the potential to restore motor function, enhancing mobility and quality of life for paralyzed individuals. Overactive Bladder Syndrome: Sacral neurostimulation and tibial nerve stimulation have proven effective in improving urinary continence and reducing symptoms in patients unresponsive to conventional treatments. Cognitive Impairment in Neurodegenerative Diseases: Techniques such as deep brain stimulation and transcranial magnetic stimulation are being investigated for their ability to enhance cognitive and motor functions in conditions like Parkinson's and Alzheimer's disease. The review highlights the transformative potential of neuromodulation in non-painful conditions, demonstrating its ability to address complex medical issues beyond its traditional scope. Continued research and optimization of these techniques may lead to broader therapeutic applications and improved patient outcomes.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"82"},"PeriodicalIF":3.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004327","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 Ganglia of the Head and Neck: Clinical Relevance for the Interventional Pain Physician.","authors":"Paul W Millhouse, Robert W Bloom, Jason N Beckstrand, Matthew L McClure, Maxim S Eckmann, Kristofer J Feeko, Jeffrey J Mojica","doi":"10.1007/s11916-025-01387-y","DOIUrl":"https://doi.org/10.1007/s11916-025-01387-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this article is to provide a comprehensive review of the ganglia of the head and neck and their role in the interventional management of chronic headaches and facial pain disorders.</p><p><strong>Recent findings: </strong>Interventions targeting the sphenopalatine, stellate and gasserian ganglia are well described in the literature for headaches and facial pain disorders. There is a growing body of evidence supporting use of these techniques for clinical conditions outside of pain such as post-traumatic stress disorder and Long COVID symptoms. These findings increase the potential applications of such procedures, making them more relevant to the interventional physician tasked with managing symptoms in difficult to treat medical conditions. Nerve blocks of the head and neck are used for diagnostic and therapeutic purposes in the management of headaches and facial pain disorders. Headaches, whether acute or chronic, are common pain conditions with a wide-range of etiologies and are often difficult to treat. Chronic facial pain can have a variety of underlying causes, including direct or indirect nerve damage, infection, inflammation, and muscle dysfunction. Traditional pain management strategies such as medications and physical therapy often fail or are associated with significant adverse effects. Interventions such as nerve blocks and neuroablative procedures have shown promise in managing headaches and facial pain by directly targeting the underlying causes. This review article summarizes the most recent evidence regarding the efficacy, safety, applications and limitations of these interventional pain management techniques.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"80"},"PeriodicalIF":3.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027225","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 Promising Route for Established Indications: A Systematic Review of Nebulized Ketamine in Pain.","authors":"Neveen A Kohaf, Tabia Imtiyaz Khan, Hamada Hamdy Elbana, Ro'a Azzam Hassouna, Mohamed Maher Abd Elfattah, Prashant Nasa, Sahar Shekoohi, Alan David Kaye, Islam Mohammad Shehata","doi":"10.1007/s11916-025-01394-z","DOIUrl":"10.1007/s11916-025-01394-z","url":null,"abstract":"<p><strong>Background: </strong>Nebulized ketamine, an innovative route of drug delivery, has gained interest for its potential effectiveness in challenging clinical scenarios. The objective of this systematic review is to provide insights into the safety and effectiveness of nebulized ketamine in pain management.</p><p><strong>Method: </strong>A systematic search was performed on online databases including WOS, Cochrane, Scopus, and PubMed, using a specific search strategy. Our review focused on primary studies about the utilization of nebulized ketamine in various contexts regarding pain management. Additionally, we incorporated relevant secondary research, such as reviews presenting diverse perspectives.</p><p><strong>Results: </strong>Nebulized ketamine in pain management included nine studies.</p><p><strong>Conclusion: </strong>The advantages of nebulized ketamine over other forms of administration include its rapid absorption and effective delivery. The smaller volume required for nebulization can result in fewer side effects and enhanced patient compliance thereby facilitating efficient drug delivery while minimizing the systematic impact. Emerging evidence supports the administration of nebulized ketamine as a safe and efficacious treatment for acute pain. However, further investigations are needed for a better understanding of its pharmacokinetics, optimal dosing and efficacy across different populations.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"81"},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055997","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 Erector Spinae Plane Block for Pain Management after Hip Surgery: A Narrative Review.","authors":"Alan D Kaye, Angela Nguyen, Austin S Thomassen, Allison M Picou, Nicholas L Thomas, Coplen D Johnson, Charles J Fox, Shahab Ahmadzadeh, Yair Lopez Torres, Julian Kim, Sahar Shekoohi","doi":"10.1007/s11916-025-01393-0","DOIUrl":"https://doi.org/10.1007/s11916-025-01393-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Managing pain after hip surgery can be challenging, especially with the need to balance effective relief and early movement. Traditional pain management methods, such as opioids and nerve blocks, have been demonstrated to be efficacious but come with risks, including side effects, potential for opioid dependency, and the possibility of delays in mobility.</p><p><strong>Recent findings: </strong>The erector spinae plane block (ESPB) has recently gained attention as a newer option that may offer unique benefits. ESPB is an ultrasound-guided technique targeting nerves along the spine, providing broad and long-lasting pain relief without significant muscle weakness. This allows patients to start moving sooner, which is critical to recovery. Studies suggest ESPB can reduce opioid use and maintain motor strength better than other approaches, although more research is needed to confirm these findings across larger groups.</p><p><strong>Conclusion: </strong>ESPB's technique, however, still needs standardization to ensure consistent results, as variations in dosage and application can impact its effectiveness. Further research focusing on larger, controlled studies could better clarify ESPB's role compared to traditional methods, especially regarding long-term recovery and quality of life. As more evidence accumulates, ESPB may become a valuable addition to pain management plans for hip surgery, especially for patients needing effective, low-risk analgesia.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"79"},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052225","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":"Optimization of Postoperative Opioids Use Following Spine Surgery.","authors":"Alan D Kaye, Victoria T Tong, Rahib K Islam, Ivan Nguyen, Brennan M Abbott, Chandni Patel, Luke Muiznieks, Daniel Bass, Jon D Hirsch, Richard D Urman, Shahab Ahmadzadeh, Varsha Allampalli, Sahar Shekoohi","doi":"10.1007/s11916-025-01391-2","DOIUrl":"https://doi.org/10.1007/s11916-025-01391-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>The present investigation evaluated the use of opioids for postoperative pain relief in spinal surgery patients.</p><p><strong>Recent findings: </strong>Pain management is a crucial component of postoperative care that greatly impacts patient outcomes. Postoperative pain management has been shown to allow for earlier mobility, discharge, and return to normal life. Opioids are the standard treatment for postoperative pharmacologic pain relief, but they are associated with the same adverse effects that pain management strives to mitigate. Opioids are associated with a large side effect profile, including a higher risk of various postoperative complications. Opioids are potentially highly addictive and postoperative use is associated with dependence, tolerance, and the current opioid epidemic. Some studies indicate that there are similar surgical outcomes amongst patients independent of whether opioids were prescribed opioids for pain relief.</p><p><strong>Conclusion: </strong>Opioids should only be recommended for postoperative pain management under strict guidance and supervision from physicians. All 50 states have acute pain guidelines in place limiting opioid prescribing. One of the strategies of reducing postoperative opioid consumption is the emphasis on opioid alternatives that should be actively considered and explored prior to resorting to opioids. There are pharmacological and non-pharmacological options available for pain relief that can provide similar levels of analgesia as prescription opioid without unwanted effects such as tolerance and dependency. Proper assessment of patient history and risk factors can aid physicians in tailoring a pain management regimen that is appropriate for each individual patient. More research into efficacy and safety of alternative treatments to opioids is warranted.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"78"},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048615","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}