Clinical Journal of Pain最新文献

{"title":"How Does the Helping Alliance Relate to Treatment Satisfaction? Dyadic Analyses in Pediatric Pain Patients, Caregivers, and Healthcare Professionals.","authors":"Amelie Florentine Schmidt, Lisa-Marie Rau, Julia Wager, Kay Brauer","doi":"10.1097/AJP.0000000000001313","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001313","url":null,"abstract":"<p><strong>Objectives: </strong>Preliminary evidence suggests that children and adolescents with high impact chronic primary pain benefit from intensive interdisciplinary pain treatment involving both patients and their caregivers. While it is important for patients and caregivers to be satisfied with the treatment, previous studies have not observed an association between treatment satisfaction and other treatment outcomes, such as pain symptoms. We hypothesized that the helping alliance - both between patients and healthcare professionals (HCPs) and between caregivers and HCPs - plays a role in treatment satisfaction.</p><p><strong>Methods: </strong>We computed two actor-partner interdependence models to analyze the dyadic associations between the predictor helping alliance and the outcome treatment satisfaction. Analyses were based on data from n = 205 patients, n = 191 caregivers, and n = 197 HCPs.</p><p><strong>Results: </strong>Findings revealed that patients' and caregivers' treatment satisfaction was positively associated with the quality of their respective helping alliance with their HCP. Notably, patients' perceptions of their alliance with HCPs were positively associated with caregiver treatment satisfaction, and caregivers' perceptions of their alliance with HCPs were linked to patients' treatment satisfaction.</p><p><strong>Discussion: </strong>These findings highlight the importance of viewing pediatric pain patients, caregivers, and HCPs as an interdependent network. Future studies may extend our findings to other clinical settings and longitudinally.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interdisciplinary Multimodal Pain Treatment for Patients with Chronic Musculoskeletal, Neuropathic, Primary Chronic, and tumor-related Pain at an University Outpatient Clinic - two Years follow-up in Four Symptom Domains.","authors":"Rupert Hölzl, Boo-Young Chung, Justus Benrath","doi":"10.1097/AJP.0000000000001312","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001312","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with chronic pain should receive specialist treatment in outpatient, day-care or inpatient clinics by \"interdisciplinary multimodal pain therapy\" recommended by scientific pain associations. Existing structural requirements, however, can often not support a full IMPT program for diverse indications. We report on a modified IMPT program implemented at the Pain Center of the University Hospital Mannheim which is readily adaptable for other regional pain centers seeing a similar broad spectrum of pain diagnoses and variable chronicities.</p><p><strong>Methods: </strong>The retrospective study on 106 day-care patients with chronic pain investigated the effects on four major pain domains, i.e., pain characteristics, function and impairment, well-being and quality of life, and mental health including depression two years after program entry. Patients were categorized according to referral ICD-10 diagnoses into musculoskeletal, neuropathic and persistent pain with psychosocial factors plus a small group with tumor-related pain.</p><p><strong>Results: </strong>Most markers of the major pain domains had significantly improved including function and well-being. The improvements were reproduced in the major pain clusters with best results for specific neuropathic and tumor pain and lesser but significant effects on musculoskeletal pain. Patients with persistent pain disorders responded least.</p><p><strong>Discussion: </strong>The results show that an individualized IMPT can be put in effect in an outpatient clinic seeing a diversity of chronic pain diagnoses. The success and failure rates for different pain pictures delineate the scope and the limits of generic IMPTs.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Correlates of Physical Activity among Young Adults with Chronic Pain.","authors":"Laura E Laumann, Katherine E Gnall, Sinead M Sinnott, Crystal L Park, Dean G Cruess","doi":"10.1097/AJP.0000000000001314","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001314","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain affects an estimated 8.5% of young adults in the United States. Physical activity is a promising strategy for behavioral pain management, yet research characterizing prevalence and correlates of physical activity among young adults with chronic pain is scant. The present study sought to characterize physical activity patterns and identify psychosocial predictors of physical activity in this population.</p><p><strong>Methods: </strong>Participants were 129 young adults with self-reported chronic pain. Fear-avoidance (experiential avoidance, kinesiophobia), mental health (depression, anxiety) and energy-related (sleep disturbance, fatigue) factors were examined as correlates and predictors of moderate-to-vigorous physical activity (MVPA), walking, and sedentary behavior using generalized linear models.</p><p><strong>Results: </strong>Participants reported an average of 51.0 (IQR=16.75, 100.75) minutes of MVPA and 90.0 (IQR=43, 153) minutes of walking per day. Nearly three-quarters (72.9%) of participants met recommended MVPA guidelines. At baseline, experiential avoidance (95% CI [-0.019, -0.007]), depression (95% CI [-0.100, -0.017]), and fatigue (95% CI [-0.042, -0.007]) were negatively associated with MVPA; depression (95% CI [1.37, 13.71]) was positively associated with sedentary behavior. Experiential avoidance at baseline predicted MVPA at two-week follow-up (95% CI [-0.015, -0.001]). No psychosocial factors were significantly associated with or predictive of walking.</p><p><strong>Discussion: </strong>On average, young adults with chronic pain in our sample met recommended physical activity guidelines. Experiential avoidance was associated with MVPA at baseline and predicted less MVPA two weeks later. Findings suggest that while pain itself may not prevent engagement in MVPA among this population, a desire to prevent discomfort may be prohibitive.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Combined Lidocaine Transdermal Patch and Lidocaine Subcutaneous Injection Versus Lidocaine Subcutaneous Injection Alone for Trans-distal Radial and Trans-Radial Arterial Access Pain and Cost-Effectiveness: A Single-Blind Randomized Study.","authors":"Arata Hagikura, Kazuki Moriwaki, Hayato Tanaka, Yu Kawai, Miko Hosoi, Maya Kashimoto, Yuki Satani, Shumpei Yao, Yutaro Nagase, Kana Nagasawa, Atsushi Miyajima, Naoto Inoue, Eitaro Umehara, Takanori Kusuyama, Daiju Fukuda","doi":"10.1097/AJP.0000000000001308","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001308","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal local anesthetic for trans-distal radial (TDRA) and trans-radial arterial (TRA) catheterization is unclear and not standardized. This study compared the efficacy and cost-effectiveness of adding a lidocaine patch to standard lidocaine subcutaneous lidocaine injection for TDRA and TRA procedures.</p><p><strong>Methods: </strong>This was a prospective, single-blind study conducted between September 2021 and December 2023. With written consent, consecutive patients undergoing TDRA or TRA catheterization in patients with ischemic heart and peripheral arterial disease were randomized to receive either a lidocaine patch (Lidocaine group, n=41) or a placebo patch (Placebo group, n=43) at the planned arterial access site at least 30 minutes before the procedure, followed by lidocaine subcutaneous anesthesia using a 27-gauge needle. The primary outcome was access site pain measured by visual analog scale (VAS) at predetermined three points. Secondary outcomes included drug-related costs.</p><p><strong>Results: </strong>VAS scores at all three points were comparable (Lidocaine vs. Placebo: at the point of lidocaine infusion 20 mm vs. 19 mm, P=0.55; during the procedure 17 mm vs. 14 mm, P=0.67; after the procedure 9 mm vs. 12 mm, P=0.71). The Lidocaine group incurred significantly higher costs, even when considering only the lidocaine patch (0.43 USD vs. 0.00 USD, P<0.001) and the total amount of lidocaine patch and lidocaine subcutaneous infusion (0.62 USD vs. 0.21 USD, P<0.001).</p><p><strong>Discussion: </strong>The addition of a lidocaine patch to standard lidocaine subcutaneous injection for TDRA or TRA catheterization did not improve pain relief or cost-effectiveness.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathic Pain in Female Patients with Fibromyalgia Syndrome: Clinical, Electrodiagnostic and Genetic Aspects.","authors":"Noha A Elsawy, Marwa Hassan, Rasha A Ghazala, Riham Hamed, Rehab Elnemr","doi":"10.1097/AJP.0000000000001311","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001311","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to explore the potential contribution of small fiber pathology (SFP) and COMT enzyme gene Val/158/Met functional polymorphism to neuropathic pain (NP) in FMS female patients.</p><p><strong>Methods: </strong>This case-control study was conducted on 60 women with FMS and 60 matched healthy women. All patients were subjected to detailed clinical assessment. Sympathetic skin response (SSR) and cutaneous silent period (CSP) were performed to assess small fiber neuropathy (SFN). Catechol-Omethyl-transferase (COMT) SNP, rs4680 (A/G, missense158Val/Met),) were genotyped for all studied subjects.</p><p><strong>Results: </strong>FMS patients had significantly longer latency and lower amplitude of foot and hand SSR (P<0.001), with seven patients having unobtainable foot SSR. Also, they had significantly earlier onset latency, longer duration, and more delayed offset latency of CSP (P<0.001, from most of them). Regarding the relation between COMT genotypes and different disease characteristics, patients with A/A genotypes had a statistically significant increase in pain severity scores compared to those with G/G genotypes (P=0.013 for McGill and 0.019 for the visual analogue scale). Moreover, there was a significant increase in NP scores (P=0.004 and 0.001, for pain DETEDT and SFNL, respectively) of A/A and A/G compared to G/G genotypes.</p><p><strong>Conclusion: </strong>It can be concluded that moderate to severe neuropathic pain was experienced by all the studied patients with fibromyalgia syndrome, and small fiber pathology was suggested to be a significant contributor to neuropathic pain. Moreover, the COMT A/A genotype was found to be associated with the NP as well as pain severity.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to the Editor Regarding Hyperbaric Oxygen Therapy (HBOT) for Management of Complex Regional Pain Syndrome.","authors":"Joon Cha, Gerardo Bosco, Richard E Moon, Giorgio Melloni, Enrico M Camporesi","doi":"10.1097/AJP.0000000000001309","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001309","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Hyperbaric Oxygen.","authors":"Andreas Goebel, Michael Ferraro","doi":"10.1097/AJP.0000000000001310","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001310","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attrition from Pediatric Interdisciplinary Chronic Pain Clinics: Utilizing the \"Paediatric Electronic Persistent Pain Outcomes Collaboration (PaedePPOC) Database\".","authors":"Kristen Tiong, Andrew Gorrie, Greta M Palmer, David Sainsbury, Tiina Jaaniste","doi":"10.1097/AJP.0000000000001302","DOIUrl":"10.1097/AJP.0000000000001302","url":null,"abstract":"<p><strong>Objectives: </strong>Attrition from pediatric chronic pain clinics limits patients from receiving maximum benefit from evidence-based interventions, with likely persistence of chronic pain, functional and psychosocial impairments. We aimed to determine attrition prevalence from interdisciplinary pediatric outpatient chronic pain clinics and identify any associated patient and caregiver factors.</p><p><strong>Methods: </strong>A retrospective analysis was performed of longitudinal data from patients and caregivers attending 10 interdisciplinary pediatric outpatient chronic pain clinics in Australia or New Zealand contributing to the Paediatric electronic Persistent Pain Outcomes Collaboration (PaedePPOC) database. Data was retrieved for patient attrition, patient and caregiver factors at treatment commencement and subsequent documentation of the episode end for treatment completers and non-completers. Statistical associations with patient attrition were assessed using logistic regression analyses.</p><p><strong>Results: </strong>The prevalence of patient attrition was 19.3% in the PaedePPOC cohort (N =1051 ), occurring steadily over 11 months. Patients ending their treatment prematurely presented with longer pain duration (>12 mos) (χ 2 ( 1 , n = 879)=8.23, P=0.004 ) than treatment completers. In the regression model, only older patient age ( P=0.010 ) and higher caregiver psychosocial burden ( P=0.025 ) at treatment commencement were associated with attrition. While pain intensity, patient physical and psychosocial functioning scores and caregiver partner status were not.</p><p><strong>Discussion: </strong>One in five patients commencing an interdisciplinary pediatric outpatient chronic pain clinic intervention did not complete it. Identifying patients at pre-intervention screening with longer pain duration, older in age and from families with greater reported caregiver burden and providing tailored supports may minimize attrition, therefore optimizing efficiency of service provision.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Acceptance in Adolescent Chronic Pain: Do Body Mindsets Play a Role?","authors":"Emily J Dowling, Laura E Simons, Alia J Crum, Joshua Pate, Joseph Chilcot, Helen C Laycock, Whitney Scott, Lauren C Heathcote","doi":"10.1097/AJP.0000000000001307","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001307","url":null,"abstract":"<p><strong>Objective: </strong>Pain acceptance predicts better quality of life, physical functioning, and treatment outcomes in youth with chronic pain. However, we know little about the factors that promote pain acceptance in youth. This study investigated body mindsets and their associations with facets of pain acceptance, specifically pain willingness and activity engagement, in adolescents with chronic pain.</p><p><strong>Methods: </strong>The sample comprised 102 adolescents with chronic musculoskeletal pain (aged 8-17; 72.3% female, 49.5% Caucasian/White) attending a tertiary pain clinic. Hierarchical linear regression analyses examined associations of body mindsets with pain acceptance controlling for demographic factors, pain and mental health symptoms, and basic functioning.</p><p><strong>Results: </strong>There was significant variation in the mindsets that adolescents with chronic pain held about their bodies - some endorsed the mindset that their Body is an Adversary, others endorsed the mindsets that their Body is Responsive or Body is Capable. Hierarchical linear regression analyses indicated that endorsing the mindset that their Body is an Adversary was associated with lower willingness to experience pain, while endorsing the mindset that their Body is Capable was associated with greater engagement in valued activities despite pain, even after accounting for demographic factors, pain characteristics, and basic functioning. Together, all three mindsets explained 6.6-26.8% unique variance in pain acceptance.</p><p><strong>Discussion: </strong>Body mindsets are significantly associated with pain acceptance in youth with chronic pain even after controlling for pain characteristics and basic functioning. Experimental research should investigate whether body mindsets are modifiable in this population and whether they could represent interventional targets fostering pain acceptance.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence of Neuropathic-Like Symptoms in Individuals With Painful Tendinopathy/Overuse Injuries: A Systematic Review and Meta-Analysis.","authors":"Ignacio Cancela-Cilleruelo, Jorge Rodríguez-Jiménez, José L Arias-Buría, Marcos J Navarro-Santana, Lars Arendt-Nielsen, César Fernández-de-Las-Peñas","doi":"10.1097/AJP.0000000000001292","DOIUrl":"10.1097/AJP.0000000000001292","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis evaluated the prevalence of neuropathic-like symptoms in individuals with painful tendinopathies/overuse injuries.</p><p><strong>Methods: </strong>Electronic literature searches on MEDLINE, CINAHL, PubMed, SCOPUS, and Web of Science databases were conducted up to January 20th, 2025. Studies reporting the prevalence of neuropathic-like symptoms in painful tendinopathy/overuse injury were included. The methodological quality was assessed with the Newcastle-Ottawa Quality Assessment Scale in cohort/case-control studies or the Physiotherapy Evidence Database (PEDro) in clinical trials. Random-effects models were used for meta-analytical pooled prevalence of neuropathic-like symptoms.</p><p><strong>Results: </strong>From 1285 studies identified, 8 (1 case-control, 5 cohorts, and 2 clinical trials) met inclusion criteria. The sample included 920 participants with painful tendinopathy/overuse injury (47.6% female, age: 51, SD: 12.5 y). All studies included self-reported questionnaires for evaluating neuropathic-like symptomatology. The methodological quality was moderate-high. The overall prevalence of neuropathic-like symptoms in painful tendinopathies was 30% (95% CI: 22%-38%, n=8, I2 =79%). The prevalence by each tendinopathy was: plantar heel pain (44%, 95% CI: 17%-75%, n=2, I2 =96%), lateral epicondylalgia (42%, 95% CI: 30%-56%, n=2, I2 =30%), insertional Achilles tendinopathy (38%, 95% CI: 20%-60%, n=2, I2 = 71%), greater trochanteric pain syndrome (32%, 95% CI: 26%-39%, n=2, I2 =0%), patellar-quadricipital tendinopathy (16%, 95% CI: 5%-41%, n=3, I2 =29%), noninsertional Achilles tendinopathy (11%, 95% CI: 2%-41%, n=5, I2 =86%).</p><p><strong>Conclusion: </strong>The results of this meta-analysis suggests the presence of neuropathic-like symptoms in 30% of participants with painful tendinopathy, although this prevalence rate depends on specific condition. Identification of neuropathic symptoms in musculoskeletal pain conditions is important for diagnosis as it impacts its management.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}