Clinical Journal of Pain最新文献

{"title":"A Description of Healthcare Utilization in Young Adults with Chronic Overlapping Pain.","authors":"Alberto Herrero Babiloni, Courtney Brown, Peyton Ash, Carly Conway, Christopher D King, Ian Andres Boggero","doi":"10.1097/AJP.0000000000001384","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001384","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic overlapping pain conditions (COPCs) affect young adults and pose significant challenges in medical care. This study aimed to describe the types and number of current and past medical providers and medications used by young adults with COPCs and to explore associations between healthcare utilization, clinical pain, and psychosocial factors.</p><p><strong>Methods: </strong>Fifty young adults (mean age 27.16 years) with COPCs were recruited and completed online questionnaires assessing demographics, pain intensity and interference, number of pain conditions, healthcare providers consulted, medication use, and psychosocial characteristics. Relationships among healthcare utilization, clinical pain measures, and psychosocial variables were analyzed using Pearson correlations and linear regression models.</p><p><strong>Results: </strong>Participants reported an average of 4.40 COPCs, with fibromyalgia, chronic low back pain, and chronic fatigue syndrome being the most common. Most (72%) were currently receiving medical treatment, with primary care physicians being the most frequently consulted providers. The average number of current providers was 2.82, while the number of past providers was 4.28. Despite extensive healthcare engagement, 77.7% reported no improvement or worsening of their condition. No significant associations were found between the number of providers or medications and clinical or psychosocial outcomes.</p><p><strong>Discussion: </strong>The findings highlight gaps in the effectiveness of healthcare utilization for young adults with COPCs. The high prevalence of provider visits and medication use without substantial symptom improvement suggests a need for more integrated, multidisciplinary care approaches. Future research should focus on optimizing treatment strategies and identifying opportunities for early intervention.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596156","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":"Using Multi-Informant Qualitative Data to Inform Adaptations to Mindfulness-Based Interventions for Adolescents With Chronic Migraine.","authors":"Michelle A Clementi, Michelle Harmon, Emily F Law, Sarah D E Perzow, Lauren B Shomaker, Talia Thompson","doi":"10.1097/AJP.0000000000001354","DOIUrl":"10.1097/AJP.0000000000001354","url":null,"abstract":"<p><strong>Objectives: </strong>Adolescents with chronic migraine face increased risk for comorbid anxiety and depression that, can hinder migraine self-management and coping. Mindfulness-based interventions may reduce anxiety/depression to improve migraine outcomes, yet require tailoring to increase acceptability and engagement among this distinct population. The current study used qualitative methods to explore multi-informant perspectives on the illness experience and unique intervention content/delivery needs, with the goal of informing adaptations to mindfulness-based interventions for adolescents with chronic migraine.</p><p><strong>Materials and methods: </strong>Fifteen interest holders, representing adolescents with chronic migraine, their parents, and health care providers, completed semi-structured interviews assessing experiences with chronic migraine, the role of stress and emotions, attitudes toward mindfulness, and perspectives on a telehealth group mindfulness-based program. Interviews were transcribed and coded using a team-based thematic approach.</p><p><strong>Results: </strong>Data revealed 4 major themes informing adaptations to mindfulness-based interventions for adolescents with chronic migraine: supporting engagement in mindfulness in the context of migraine pain, incorporating lived experience in intervention content, facilitating peer connections, and providing opportunities for parental involvement. Qualitative results were integrated with content expert input to develop specific adaptation recommendations for mindfulness-based interventions for adolescents with chronic migraine.</p><p><strong>Discussion: </strong>Acknowledging and addressing the challenges of practicing mindfulness in the context of pain and targeting the isolating experience of chronic migraine by offering peer connection via group intervention delivery may offer unique ways to tailor mindfulness-based interventions for adolescents with chronic migraine. Adaptations may improve intervention fit, acceptability, and retention and should be tested in future clinical trials.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Sensory Testing Following Orthopedic Trauma: A Longitudinal Multisite Feasibility Study.","authors":"Rachel V Aaron, Fenan S Rassu, Kristin R Archer, Amanda L Stone, Amanda Priest, Kavya Bhattiprolu, Stephen Bruehl, Greg Osgood, Renan C Castillo, Stephen T Wegener, Claudia M Campbell","doi":"10.1097/AJP.0000000000001357","DOIUrl":"10.1097/AJP.0000000000001357","url":null,"abstract":"<p><strong>Objectives: </strong>Orthopedic trauma is a major cause of disability worldwide; around half of the people who sustain orthopedic trauma develop chronic pain. Quantitative Sensory Testing (QST) is a standardized method of assessing pain sensitivity, which may be useful in characterizing pain after injury and predicting chronic pain. This primary aim of this project was to test the feasibility of a portable QST battery, administered to adults 6-weeks post major orthopedic trauma and surgery.</p><p><strong>Methods: </strong>Twenty-nine participants (62% male; 52% black) who sustained major orthopedic trauma and surgery completed QST testing (including static measures, conditioned pain modulation, and mechanical temporal summation) at their 6-week postoperative visit and were invited to complete a 6-month follow-up survey. We examined feasibility and acceptability indices and explored associations between QST and clinical pain ratings.</p><p><strong>Results: </strong>Of all eligible patients, 77% were recruited. QST procedures were feasible and tolerable. No participant declined participation, withdrew for reasons related to study procedures, or discontinued QST due to discomfort. No patient experienced increased clinical pain after QST. Exploratory analyses identified a positive association between static QST and pain interference at T1. Feasibility challenges included poor 6-month retention (57%) and difficulty administering QST to patients with upper extremity injuries. High rates of analgesic use before testing (38%) poses an additional barrier for future QST studies in this population.</p><p><strong>Discussion: </strong>QST was acceptable and partially feasible; challenges included poor retention, high rates of analgesic use, and logistical barriers to accessing injury sites for testing. We pose several potential solutions for future research.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12846631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Liposomal Bupivacaine for Postoperative Analgesia After Thoracic Surgery: A Propensity Score-Matched Retrospective Study.","authors":"Shiyou Wei, Dandan Ling, Rui Chang, Junyi Huang, Lihua Wang, Yuxuan Xin, Hang Liu, Yiming Yang, Xin Lv, Jiong Song","doi":"10.1097/AJP.0000000000001383","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001383","url":null,"abstract":"<p><strong>Objective: </strong>Given that liposomal bupivacaine (LB) is not currently approved for thoracic surgery, this study evaluated postoperative analgesia after thoracic procedures.</p><p><strong>Methods: </strong>This retrospective cohort study with propensity score matching yielded 99 matched pairs. Patients were grouped by receipt of a postoperative ultrasound-guided serratus anterior plane block with LB plus standard care versus standard care alone. The primary outcome was the area under the curve (AUC) for pain scores over the first 0-72 postoperative hours. Secondary endpoints included verbal response scale pain scores, opioid consumption, quality of recovery, and hospital length of stay. Statistical significance was defined as P < 0.05.</p><p><strong>Results: </strong>Baseline characteristics were well balanced after matching. The LB group had a lower 0-72 hour pain AUC (110 ± 48 vs. 185 ± 67; P < 0.01), exceeding the prespecified threshold for clinical relevance (at least a 10% reduction), and lower early postoperative pain scores. Opioid consumption was reduced at 24 and 48 hours (both P < 0.01). Quality of recovery scores were higher at 24, 48, and 72 hours, with the 24-hour difference meeting the minimal clinically important difference. Postoperative nausea and vomiting was less frequent from 6 to 24 hours; length of stay did not differ.</p><p><strong>Conclusions: </strong>Perioperative regional block with LB was associated with reduced pain burden and opioid use after thoracic surgery. Prospective, multicenter randomized trials with longer follow-up and health economic evaluations are needed.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596097","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":"Impaired Conditioned Pain Modulation and Peripheral Sensitization in Chronic Postsurgical Pain After Total Knee Arthroplasty.","authors":"Marc Terradas-Monllor, Marga Ullastre-Pujal, Christian Dürsteler, Raquel Roca-Ribera, Anna Roca-Esteban, Clara Garcia Del Sol, Maria Cueta-Casas, Eduard Minobes-Molina, Rosa Terre-Boliart, Carles Parés-Martínez, Mirari Ochandorena-Acha","doi":"10.1097/AJP.0000000000001387","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001387","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic postsurgical pain (CPSP) is a common complication following total knee arthroplasty (TKA), affecting up to 30% of patients. Altered nociceptive processing may underlie CPSP mechanisms. The study aimed to compare conditioned pain modulation (CPM), local and widespread sensitization between patients with and without CPSP.</p><p><strong>Methods: </strong>A prospective case-control study was conducted among 117 patients undergoing TKA due to primary knee osteoarthritis. Participants were classified as CPSP or non-CPSP based on pain intensity (≥30 mm on the visual analog scale) at 3 months postoperatively. Quantitative sensory testing assessed CPM, local pressure pain thresholds (PPTs), and remote PPTs at tibial and forearm locations. Measures were taken at 3 and 6 months after surgery. Group comparisons and linear mixed-effects models were applied.</p><p><strong>Results: </strong>Patients with CPSP (n=53) exhibited significantly lower CPM responses at both local and remote sites compared to non-CPSP patients (n=64), with differences persisting over time. Local PPTs were significantly reduced in the CPSP group across all periarticular sites, suggesting enhanced peripheral sensitization. At remote locations, lower PPTs were observed at both tibiae and at the ipsilateral forearm at 3 months; at 6 months, group differences were restricted to the ipsilateral tibia, indicating spatially selective alterations in pain modulation rather than generalized hypersensitivity.</p><p><strong>Discussion: </strong>CPSP following TKA is associated with persistent differences in descending pain inhibition and increased local pressure sensitivity. These findings suggest that persistent dysfunction in descending inhibitory pathways and localized peripheral sensitization are associated with pain persistence beyond the expected healing period.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581926","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":"Ketamine's Immediate Analgesia and Opioid-Sparing Benefits in Laparoscopic Cholecystectomy: A Meta-Analysis of Time Points, Anesthesia Protocols, and Bolus/Infusion Strategies.","authors":"Mohamed Abo Zeid, Amr M Abou Elezz, Kareem Khalefa, Ahmed W Abbas, Habiba Tariq Saeed, Amr Alaa Azzouz Elkelany, Habiba Abdelhameed Elrefaey, Mohamed Samir Ahmed Zaki, Lamees Taman","doi":"10.1097/AJP.0000000000001382","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001382","url":null,"abstract":"<p><strong>Objectives: </strong>Laparoscopic cholecystectomy (LC), though minimally invasive, sometimes leads to significant postoperative pain. Ketamine has shown potential in alleviating it, but small sample sizes and administration protocols variability limit prior findings generalizability. This study evaluates ketamine's effectiveness in reducing postoperative pain across multiple time points.</p><p><strong>Methods: </strong>A thorough search of multiple databases was conducted, covering publications up to January 2025. Data from eligible randomized controlled trials (RCTs) were extracted and pooled to calculate mean differences (MDs) for postoperative pain scores at 30 minutes, 1 hour, 2 hours, 4 hours, and 12 hours, alongside opioid consumption (morphine and tramadol) and adverse events.</p><p><strong>Results: </strong>The analysis included 22 RCTs with 1,163 participants. Ketamine significantly reduced postoperative pain compared to placebo (MD=-0.37, 95% CI [-0.56 to -0.17], P=0.0002). Subgroup analyses at 30 minutes showed significant pain reduction in bolus + infusion (MD=-0.70, 95% CI [-1.33 to -0.07], P=0.03), bolus alone (MD=-1.28, 95% CI [-2.29 to -0.27], P=0.01), and propofol-based maintenance (MD=-0.89, 95% CI [-1.44 to -0.34], P=0.002). Additionally, ketamine significantly reduced morphine (MD=-0.46, 95% CI [-0.91 to -0.02], P=0.04) and tramadol consumption (MD=-1.03, 95% CI [-1.86 to -0.21], P=0.01).</p><p><strong>Discussion: </strong>Ketamine reduced opioid use and postoperative pain at 30 minutes, with efficacy varying by administration method. Future RCTs should standardize dosage, anesthesia protocols, and pain management strategies to enhance evidence consistency.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488268","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":"A Systematic Review and Meta-Analysis of Pharmacological and Physical Interventions Directed at the Injection Site for Reducing Distress during Vaccine Injections.","authors":"Anna Taddio, Vibhuti Shah, C Meghan McMurtry, Eddy Lang, Noni E MacDonald, Kaytlin Constantin, Charlotte Logeman, Elizabeth Uleryk","doi":"10.1097/AJP.0000000000001374","DOIUrl":"10.1097/AJP.0000000000001374","url":null,"abstract":"<p><p>Part of the June 2026 issue supplement, to be published in its entirety on May 12, 2026.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445563","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":"A Systematic Review and Meta-Analysis of the Effectiveness of Process Interventions for Reducing Distress during Vaccine Injections.","authors":"Anna Taddio, Vibhuti Shah, C Meghan McMurtry, Eddy Lang, Noni E MacDonald, Kaytlin Constantin, Elizabeth Uleryk, Elissa M Abrams, Shaindy Alexander, Lucie M Bucci, Jeannette Comeau, Jocelyn Marcelo Cortes, Julene Cranch, Lauralee Gallinger, Stéphane Girouard, Betty Golightly, Marion Guenther, Scott A Halperin, Lyndsay Howitt, Christina Jensen, Sabrina Kolker, Erin Kryschuk, Ripudaman Minhas, Melanie Noel, Rebecca Pillai Riddell, Janet Probst, Michael J Rieder, Kathleen Ross, Sarah Siamaki","doi":"10.1097/AJP.0000000000001372","DOIUrl":"10.1097/AJP.0000000000001372","url":null,"abstract":"<p><p>Part of the June 2026 issue supplement, to be published in its entirety on May 12, 2026.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445649","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":"A Systematic Review and Meta-Analysis of Psychological Interventions for Reducing Distress During Vaccine Injections.","authors":"C Meghan McMurtry, Anna Taddio, Vibhuti Shah, Eddy Lang, Noni E MacDonald, Kaytlin Constantin, Charlotte Logeman, Elizabeth Uleryk","doi":"10.1097/AJP.0000000000001376","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001376","url":null,"abstract":"<p><p>Part of the June 2026 issue supplement, to be published in its entirety on May 12, 2026.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516391","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":"A Systematic Review and Meta-Analysis of the Effectiveness of Procedural Interventions for Reducing Distress during Vaccine Injections.","authors":"Anna Taddio, Vibhuti Shah, C Meghan McMurtry, Eddy Lang, Noni E MacDonald, Kaytlin Constantin, Elizabeth Uleryk","doi":"10.1097/AJP.0000000000001373","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001373","url":null,"abstract":"<p><p>Part of the June 2026 issue supplement, to be published in its entirety on May 12, 2026.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516426","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}