Current Pain and Headache Reports最新文献

{"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}

{"title":"Does Chemotherapy-Induced Peripheral Neuropathy Fall Within the Spectrum of Complex Regional Pain Syndrome? A Narrative Review.","authors":"Aila Malik, Saba Javed","doi":"10.1007/s11916-025-01390-3","DOIUrl":"https://doi.org/10.1007/s11916-025-01390-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Peripheral neuropathies and complex regional pain syndrome (CRPS) result in a similar clinical picture including shared sudomotor and vasomotor symptomatology. Chemotherapeutic agents can precipitate chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients akin to development of CRPS following trauma. Below we review the areas of overlap between CRPS and CIPN including their shared pathophysiology, clinical presentation, diagnostics, and treatment options.</p><p><strong>Recent findings: </strong>The features of autonomic dysfunction, motor impairment, and reduced proprioception observed in both CRPS and CIPN may result from shared mechanisms include inflammatory reactions, immune dysregulation, autonomic changes, as well as central and peripheral sensitization. Both conditions are a clinical diagnosis of exclusion, and demand a personalized, multidisciplinary therapeutic approach inclusive of psychosocial interventions to reduce deleterious effects on an individual's quality of life. CIPN is recognized as a separate clinical entity albeit sharing a similar underlying pathology and clinical presentation with CRPS. It may be plausible to include CIPN on the CRPS clinical spectrum as our mechanistic understanding of its development and progression evolves.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"77"},"PeriodicalIF":3.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024468","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":"SCS for CRPS: A Review of Cost-Effectiveness Models.","authors":"Daniel R Briggi, James Reilly, Josiel Garcia, Wyatt Kupperman","doi":"10.1007/s11916-025-01388-x","DOIUrl":"https://doi.org/10.1007/s11916-025-01388-x","url":null,"abstract":"<p><strong>Purposeof review: </strong>The provision of a review of current literature on the cost-effectiveness of employing SCS in the treatment of CRPS.</p><p><strong>Recent findings: </strong>Four studies were included in this review, with authorship in the United States, Canada, Europe, and Australia. Each study individually supported the cost-effectiveness of SCS in the treatment of CRPS, with the incremental cost of one quality-adjusted life year found to be AUD 2,321 - USD 22,084, all below a willingness to pay estimated at USD 50,000. One of the four studies was rated American Academy of Neurology (AAN) Grade II, three of the four studies were rated AAN Grade III, and an overall Class C evaluation was assigned to this evidence. SCS can be cost-effective in the treatment of patients with CRPS when considering a time horizon of at least ten years. Current evidence, however, remains weak and less invasive options remain first-line.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"75"},"PeriodicalIF":3.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059880","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 and Safety of Posterior Minimally Invasive Sacroiliac Joint Fusion: A Narrative Review of Recent Evidence.","authors":"Macie A Serio, Madelyn C Aucoin, Jacqueline Davis, Sahar Shekoohi, Alan D Kaye","doi":"10.1007/s11916-025-01392-1","DOIUrl":"https://doi.org/10.1007/s11916-025-01392-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic low back pain is one of the top three causes of diminished quality of life in well-developed countries. There are many etiologies of lower back pain, and sometimes, the pain is of true spinal pathology. However, this is not always the case, and sacroiliac joint (SIJ) pain has been described as an etiology in 15-30% or more of patients who are experiencing low back pain. Overlooking SIJ dysfunction as the cause of low back pain has considerable consequences on the patient's quality of life and healthcare-associated costs. SIJ dysfunction has been gaining recognition through well-described algorithms and reports on how to diagnose and differentiate types of low back pain.</p><p><strong>Recent findings: </strong>When conservative management fails in patients with SIJ dysfunction, fusion of the SIJ is a possibility. SIJ fusion was introduced as an open procedure but was often seen as a \"last resort\" related to the high complication rates and intensity of the procedure consistent with long operative time, high blood loss, and extended hospital stays. Minimally invasive surgical techniques for SIJ fusion were developed and have produced quality relief for some patients. Most minimally invasive SIJ fusion procedures are performed through a lateral approach. However, newer studies have shown evidence of a posterior or posterior oblique approach that may be more desirable for patients. The posterior approach to SIJ fusion has demonstrated a shorter operative time, smaller incision, and quicker return to activities of daily living. This narrative review aims to highlight up to date evidence on the efficacy and safety posterior minimally invasive SIJ fusion.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"76"},"PeriodicalIF":3.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006462","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":"Acupuncture for the Management of Chronic Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Lei Lan, Li Wang, Behnam Sadeghirad, Juan Tang, Yunyu Liu, Rachel J Couban, Wenbin Ma, Jason W Busse","doi":"10.1007/s11916-025-01386-z","DOIUrl":"https://doi.org/10.1007/s11916-025-01386-z","url":null,"abstract":"<p><strong>Aim: </strong>Diabetic peripheral neuropathy (DPN) affects up to half of all patients with diabetes mellitus. Acupuncture is often used to manage chronic pain, but its' effects on DPN are uncertain. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) to assess the effectiveness of acupuncture for DPN.</p><p><strong>Methods: </strong>We searched databases from inception to September 30, 2024. Paired reviewers independently extracted data and assessed risk of bias. We used random effects models for all meta-analyses and the GRADE approach to assess the certainty of evidence.</p><p><strong>Results: </strong>We included 14 RCTs (1,169 participants, 45% female). Low certainty evidence suggests that, compared to sham, acupuncture may reduce pain (weighted mean difference [WMD] -1.44 cm on a 10 cm VAS, 95%CI -1.72 to -1.15; modelled risk difference [RD] for achieving the minimally important difference [MID] of 1.5 cm: 45%, 95%CI 35-54%). Comparted to sham or usual care, low certainty evidence suggests that acupuncture may reduce overall neurological symptom severity (WMD - 1.22 [95%CI -1.85, -0.59] on the 19-point Toronto Clinical Scoring System [TCSS]), and provide little to no difference in physical functioning, mental functioning, or adverse events. Low certainty evidence suggests that, compared to amitriptyline or pregabalin, acupuncture may reduce pain associated with DPN.</p><p><strong>Conclusions: </strong>Acupuncture for DPN may reduce pain when compared to sham acupuncture and may reduce neurologic symptom severity and result in little to no difference in physical functioning, mental functioning or adverse events, when compared with sham acupuncture or usual care.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"74"},"PeriodicalIF":3.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046407","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":"Neuropathic Pain: A Comprehensive Bibliometric Analysis of Research Trends, Contributions, and Future Directions.","authors":"Matteo Luigi Giuseppe Leoni, Marco Mercieri, Omar Viswanath, Marco Cascella, Martina Rekatsina, Alberto Pasqualucci, Annalisa Caruso, Giustino Varrassi","doi":"10.1007/s11916-025-01384-1","DOIUrl":"10.1007/s11916-025-01384-1","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain represents a significant public health concern due to its complex pathophysiology and the disability it can cause. Despite advancements in understanding its underlying mechanisms and potential treatments, challenges persist in achieving effective management. This bibliometric analysis aims to offer a comprehensive overview of research trends, key contributors, and existing gaps in the literature on neuropathic pain, providing valuable insights to guide future studies and enhance clinical approaches.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science Core Collection (WoSCC) database. Key metrics, including publication trends, citation patterns, co-authorship networks, and keyword co-occurrence, were evaluated. Statistical analyses included average annual percentage change (APC) assessments and trend forecasting with an Auto Regressive Integrated Moving Average (ARIMA) model.</p><p><strong>Results: </strong>A total of 9,974 studies published between 2005 and 2024 were included. Publications peaked between 2021 and 2022 but showed a slight decline thereafter, with forecasts predicting a steady increase from 2025 to 2030. Most papers were published in high-impact Q1 journals, reflecting the quality of research. Co-authorship analysis revealed central hubs of collaboration in the USA and China, with limited integration of smaller countries into the global research network. Keyword analysis identified multiple thematic clusters, including \"chronic pain,\" \"molecular mechanisms,\" and \"clinical management.\" Specific gaps were noted in understanding personalized therapeutic approaches, and non-pharmacological interventions.</p><p><strong>Conclusions: </strong>This analysis underscores the critical need for continued research to address gaps in diagnosis, treatment, and management of neuropathic pain. Strengthening international collaborations and fostering multidisciplinary efforts will be pivotal in advancing this field.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"73"},"PeriodicalIF":3.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781735","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":"Risks and Benefits of Cervical Transforaminal Epidural Steroid Injections: A Comprehensive Review.","authors":"Jamal Hasoon, Ashlyn Brown, Alexandra Moauro, Omar Viswanath, Alaa Abd-Elsayed","doi":"10.1007/s11916-025-01385-0","DOIUrl":"10.1007/s11916-025-01385-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cervical transforaminal epidural steroid injections (CTFESIs) are widely used for the treatment of radicular pain caused by cervical spine pathology, including disc herniations and foraminal stenosis. This review aims to analyze the risks and benefits of CTFESIs, address their efficacy and safety profile, improve clinical decision-making, and educate interventional pain medicine physicians.</p><p><strong>Recent findings: </strong>CTFESIs have demonstrated benefits such as pain relief, functional improvement, and the potential to avoid surgical interventions. However, their use is limited by safety concerns due to the proximity of vascular structures in the cervical spine. Complications, including neurological injuries, infections, and vascular injuries, though rare, can be severe. Recent studies emphasize the importance of using advanced procedural techniques, such as fluoroscopic guidance and non-particulate corticosteroids, to minimize risks. CTFESIs remain a valuable tool for managing cervical radiculopathy in selected patients. While they provide substantial therapeutic and diagnostic benefits, careful patient selection and adherence to safety protocols are crucial to minimizing serious complications. This review compiles current evidence to assist clinicians in evaluating the risks and benefits of CTFESIs in clinical practice.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"72"},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765701","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":"Epidemiology of Pediatric Chronic Pain: An Overview of Systematic Reviews.","authors":"Alessio Lo Cascio, Miriam Cascino, Marcella Dabbene, Antonella Paladini, Omar Viswanath, Giustino Varrassi, Roberto Latina","doi":"10.1007/s11916-025-01380-5","DOIUrl":"10.1007/s11916-025-01380-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic non-cancer pain in children and adolescents represents a significant public health issue, affecting physical, psychological, and social well-being. Defined as pain persisting for over three months, this condition is influenced by developmental, socioeconomic, and cultural factors. However, its prevalence remains uncertain and debated. A comprehensive literature search was conducted across electronic databases, including Medline, Embase, CINAHL, PsycINFO, and the Cochrane Library. Eligible systematic reviews were critically appraised using the AMSTAR-2 tool to assess methodological quality. This overview synthesises evidence from existing systematic reviews to provide an updated understanding of the epidemiology and burden of paediatric non-cancer chronic pain.</p><p><strong>Recent findings: </strong>Findings revealed substantial variability in the reported prevalence of specific pain types: headaches (4-83%), abdominal pain (4-53%), musculoskeletal pain (4-40%), and back/low-back pain (14-24%). Prevalence was generally lower in low- and middle-income countries, likely due to barriers in healthcare access. Methodological heterogeneity was observed across studies, and AMSTAR-2 assessment identified critical limitations in some systematic reviews, impacting the reliability of findings. This overview highlights the urgent need for standardised research methodologies to accurately monitor the prevalence of paediatric non-cancer chronic pain. Standardisation is essential for informing policies aimed at mitigating the long-term impact of chronic pain in children and adolescents. Addressing these issues, particularly in resource-limited settings, is crucial for improving health outcomes and reducing societal and economic burdens.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"71"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755746","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":"Prophylactic Fibrin Glue Application for Immediate Management of Dural Puncture during Spinal Cord Stimulation Lead Placement: a Simple and Effective Technique.","authors":"Roberto Gazzeri, Marcelo Galarza, Felice Occhigrossi, Omar Viswanath, Giustino Varrassi, Matteo Luigi Giuseppe Leoni","doi":"10.1007/s11916-025-01381-4","DOIUrl":"10.1007/s11916-025-01381-4","url":null,"abstract":"<p><strong>Background: </strong>Accidental dural puncture during epidural lead insertion for Spinal Cord Stimulation (SCS) is a recognized surgical complication that may lead to cerebrospinal fluid (CSF) leakage and subsequent postdural puncture headache (PDPH). The optimal technical approach to prevent CSF leakage remains controversial. This study aimed to evaluate a simple and efficient intraoperative technique for managing accidental dural puncture during SCS lead placement.</p><p><strong>Materials and methods: </strong>A retrospective review was conducted of the medical records and imaging studies of all patients who underwent SCS procedures between January 2020 and April 2024. Signs or symptoms associated with dural puncture were recorded, including subcutaneous fluid collections, pseudomeningocele formation, PDPH, wound infection, and meningitis.</p><p><strong>Results: </strong>Among 107 patients who underwent SCS implantation, involving a total of 194 lead insertions, 4 cases (3.7%) of intraoperative CSF leakage due to iatrogenic dural puncture were identified. Each case was managed by injecting fibrin glue through the introducer needle into the epidural space, directly over the dural lesion.</p><p><strong>Conclusions: </strong>Prophylactic application of fibrin glue following dural puncture appears to be highly effective in sealing the damage and preventing CSF leakage. This technique offers a valuable intraoperative solution for surgeons to immediately address dural injuries during SCS lead placement, potentially minimizing postoperative complications and improving patient outcomes.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"29 1","pages":"70"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711970","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}