Journal of Pain最新文献

{"title":"Neuromodulation to prevent the chronification of phantom limb pain: A theoretical neural circuit model.","authors":"Irit Weissman-Fogel, Roi Treister","doi":"10.1016/j.jpain.2026.106309","DOIUrl":"10.1016/j.jpain.2026.106309","url":null,"abstract":"<p><p>The central mechanisms of chronic phantom limb pain (PLP) are widely investigated, yet those underlying the transition from acute to chronic PLP (PLP chronification) are overlooked. Using insights from neuroscience of phantoms and pain phenomena, we propose a new, theoretical neural circuit model for PLP and its chronification. In this focus article, we suggest that maladaptive connectivity within and between specific neural circuits (multisensory integration, salience, and prefrontal modulatory) underlies PLP and its chronification. This conceptual theoretical model is supported by findings that a combination of neuromodulatory techniques (mirror therapy and transcranial direct current stimulation) prevented PLP chronification. Current literature suggests that mirror therapy modulates the multisensory integration circuit and that transcranial motor cortex stimulation may modulate the salience and prefrontal modulatory neural circuits. According to our proposed conceptual theoretical model, the combined therapy applied at the acute stage of PLP might prevent chronic PLP, suggesting the importance of these neural circuits in PLP chronification and its persistence. This framework aims to generate testable hypotheses, and its validity depends on future empirical studies. PERSPECTIVE: This paper offers a perspective on phantom limb pain (PLP), highlighting the often-overlooked shift from acute to chronic PLP. It introduces a theoretical neural circuit model connecting multisensory, salience, and prefrontal circuits, while emphasizing early combined neuromodulation as a promising approach to preventing PLP from becoming chronic.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106309"},"PeriodicalIF":4.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845815","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":"Reply to: \"On the relation between the CSI-7 and central sensitization\": Clarifying the purpose and interpretation of the Central Sensitization Inventory (CSI).","authors":"Randy Neblett, Juan V Luciano","doi":"10.1016/j.jpain.2026.106307","DOIUrl":"https://doi.org/10.1016/j.jpain.2026.106307","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106307"},"PeriodicalIF":4.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845785","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":"Elevating the voices of Black youth with painful Disorders of Gut Brain Interaction: A qualitative study of stigma and resilience.","authors":"Tolulope Adetayo, Corinne T Evans, Emily O Wakefield, Kaylee B Crockett, Reed A Dimmitt, Felicitas Huber, Demario S Overstreet, Burel R Goodin","doi":"10.1016/j.jpain.2026.106305","DOIUrl":"https://doi.org/10.1016/j.jpain.2026.106305","url":null,"abstract":"<p><p>Children with painful disorders of gut brain interaction (DGBIs) report stigmatization from medical providers, school personnel, family members, and peers. The consequences of pain-related stigma include concealment of symptoms, lower mood, and poorer functioning. Stigma from other identities (e.g., race, gender) can intersect with pain-related stigma. Unfortunately, intersectional stigma remains understudied in the pediatric pain literature. Furthermore, chronic pain research tends to focus on deficits, rather than strengths. Thus, the current study aimed to understand the experiences of stigma and means of resilience in a sample of Black youth with painful DGBIs. Twenty Black youth between 8 and 18 years old completed semi-structured qualitative interviews. Thematic analysis was conducted via a combined deductive (a priori codes based on theory) and inductive (codes emerging from the data) approach. Codes were grouped into 4 major themes including 1) Experiences of Stigma, 2) Responses from Social Spheres of Influence, 3) Coping Strategies, and 4) Patient-centered Approaches to Treatment, and 8 subthemes. Overall, participants reported stigma from providers, teachers and nurses, family, and peers, while also relying on these groups for support. They were most sensitive to support from caregivers. Others' lack of knowledge about DGBIs appeared to be the largest risk factor for stigma, indicating a potential role for providers in mitigating stigma. Some youth also described the ways that intersecting identities (i.e., race, age, and gender) influenced how others viewed and interacted with their pain. Considerations for reducing stigma and facilitating coping are discussed. PERSPECTIVE: This article presents qualitative data on the experiences of Black youth with painful disorders of gut brain interaction. This study contributes to efforts to diversify pain research. Findings may aid in developing patient-centered interventions for chronic pain.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106305"},"PeriodicalIF":4.0,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845844","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":"Maintaining physical activity after pain management programmes for people with persistent musculoskeletal pain: A qualitative exploration of barriers, facilitators and activity patterns","authors":"Gregory Booth ,&nbsp;Danielle D’Lima ,&nbsp;Lindsay Bearne ,&nbsp;Michael Ussher","doi":"10.1016/j.jpain.2026.106235","DOIUrl":"10.1016/j.jpain.2026.106235","url":null,"abstract":"<div><div>Many patients with persistent musculoskeletal pain have difficulty maintaining physical activity (PA) long-term following pain management programmes (PMPs). We conducted a qualitative study to explore the barriers and facilitators to maintaining PA long-term after PMPs. We also explored PA patterns that describe trajectories of activity since PMP completion. One researcher conducted semi-structured interviews with 24 people with persistent musculoskeletal pain that completed PMPs, seven partners/spouses of these patient participants, and eight healthcare professionals working on PMPs. The healthcare professionals included four physiotherapists, two occupational therapists and two psychologists. Data were analysed using reflexive thematic analysis and the findings were mapped to the Theoretical Domains Framework. Five themes were generated: (1) Internal drivers for PA maintenance, (2) Fitting PA into life, (3) Symptoms and symptom management, (4) Social networks and influences and (5) Environmental influences. The findings were mapped onto 13 of the 14 Theoretical Domains Framework domains. Four PA patterns were constructed from participants experiences of PA maintenance: (1) Consistently active, (2) Initially consistently active post-PMP but then inconsistently active, (3) Inconsistently active since PMP and (4) Same or a reduction in PA level since the PMP. The findings can inform the development of an intervention to support PA maintenance following PMPs; the intervention can address barriers and facilitators and be tailored to different PA patterns.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106235"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259979","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":"“Dancing in Pain is a Symbol of Determination” – Understanding dance related pain in relation to dancer identity using the biopsychosocial model of health","authors":"Helen Clegg ,&nbsp;Laura Blotor ,&nbsp;Margaret P. Tilley","doi":"10.1016/j.jpain.2026.106211","DOIUrl":"10.1016/j.jpain.2026.106211","url":null,"abstract":"<div><div>Dancers experience high levels of persistent pain but continue to dance despite risk of injury. A dancer’s identity is often rigid, restricted, and powerful suggesting that the integration of pain and identity will manifest differently for dancers compared to non-dancer chronic pain populations. Using the biopsychosocial model of health may help to elucidate the interplay between dancer identity and the pain dancers experience. Semi-structured interviews were conducted with twelve professional or vocational student dancers who were either currently performing or retired. Dancers engaged in a wide range of genres including ballet, contemporary, musical theatre, HipHop, and Latin. Using reflexive thematic analysis three themes were identified: “Maintaining Dancer Identity through the Pain” which highlighted the foreclosed dancer identity and how dancers normalise and reinterpret responses to pain to maintain their identity, “Just push through: Gatekeeping the pain narrative” that discusses how the dance world valorises dancing in pain and polices the pain narrative, and “An embodied pain identity” which considers how physical pain is psychologically reconstructed to protect dancer identity. Overall dancers had an ambiguous relationship with pain where pain both strengthened their foreclosed dancer identity, thus protecting them from identity crisis, and also threatened survival of their dancer identity. The analysis highlights the importance of integrating the biological, social and psychological aspects of pain to understand pain in dancers. Furthermore it highlights the importance of bespoke interventions for different pain populations. Future research should explore the relevance of the findings in other populations with restricted identities such as elite athletes.</div></div><div><h3>Perspective</h3><div>This article highlights the interaction between dancer identity foreclosure and dance related pain cross the biopsychosocial model. The findings could enable clinicians to better care for and engage with dancers, and potentially elite athletes, by understanding the barriers that prevent dancers from seeking treatment for dance-related pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106211"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229538","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":"Item response theory modeling and confirmatory factor analysis of the Geriatric Pain Measure (GPM-24) with a North American sample","authors":"Kylie A. Arsenault ,&nbsp;Ying C. MacNab ,&nbsp;Thomas Hadjistavropoulos","doi":"10.1016/j.jpain.2026.106233","DOIUrl":"10.1016/j.jpain.2026.106233","url":null,"abstract":"<div><div>The Geriatric Pain Measure (GPM-24) is a commonly used self-report pain measurement tool among older adults. To date, the GPM-24 has undergone few psychometric evaluations, with limited application of robust statistical methods such as confirmatory factor analysis (CFA). Item response theory (IRT) analysis is also needed to examine its properties at the item level. The objective of this study was to conduct a psychometric evaluation of the GPM-24 at both the factor- and item-level. In January 2024, data were collected via Qualtrics Panels from 486 older adults who completed the GPM-24. Reliability was examined using McDonald’s omega coefficient, structural validity using CFA, and item properties using IRT modeling. The results showed that the overall GPM-24 and its subscales had acceptable-to-excellent reliability (ω =.77–.95). After removing two weak item cross-loadings, the five-factor model bordered on adequate fit: χ² = 4.28, CFI =.895, TLI =.881, RMSEA =.082 [CI .077–.087], SRMR =.057. Each GPM-24 item was shown to adequately discriminate between respondents with low and high levels of self-reported pain (<em>a</em> &gt;1), though items 13 and 24 were identified as having the lowest discriminatory and predictive efficacy and may warrant refinement. Item 10 was most effective at distinguishing between respondents with varying levels of self-reported pain (<em>a</em> = 4.74). This is the first study to demonstrate that the GPM-24 is an acceptably reliable and valid tool for evaluating self-reported pain among North American older adults. Future investigations should establish cross-validation with clinical and racially diverse samples.</div></div><div><h3>Perspective</h3><div>This article presents the psychometric properties and item performance of the Geriatric Pain Measure (GPM-24) when tested with a North American sample of older adults. Validation of this measure can help clinicians and researchers reliably assess the impact of pain on older adults’ physical functioning, affect, and quality of life.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106233"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259956","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":"Ultrasound-guided application of percutaneous electrolysis as an adjunct to exercise and manual therapy for tibialis posterior tendinopathy: A randomized clinical trial","authors":"Antonio Rejas-Fernández ,&nbsp;Ana I. de-la-Llave-Rincón ,&nbsp;Carlos Romero-Morales ,&nbsp;César Fernández-de-las-Peñas ,&nbsp;Joshua A. Cleland ,&nbsp;José L. Arias-Buría","doi":"10.1016/j.jpain.2026.106236","DOIUrl":"10.1016/j.jpain.2026.106236","url":null,"abstract":"<div><div>Percutaneous electrolysis has been advocated as a therapeutic strategy for tendinopathies; however, no previous trials have investigated the effects of percutaneous electrolysis on the treatment of tibialis posterior tendinopathy. The aim of this study was to investigate the effects on pain and disability of adding percutaneous electrolysis to a manual therapy and exercise program in individuals with tibialis posterior tendinopathy. A randomized clinical trial (clinical registry: NCT05370092) was conducted. Forty-six (n=46) patients with tibialis posterior tendinopathy were randomized into manual therapy/exercise (n=23) or manual therapy/exercise and percutaneous electrolysis (n=23) group. All participants received the same manual therapy/exercise protocol (one session/week, 4 weeks). Those allocated to electrolysis group also received this intervention US-guided at each treatment session. Pain intensity (Numerical Pain Rate Scale) as primary outcome and disability as secondary outcome (Foot and Ankle Ability Measure, FAAM) were assessed at baseline, post-treatment and at 3- and 6- months. Patients receiving percutaneous electrolysis had significantly greater improvements in pain (post: Δ-3.4, 95%CI −4.8 to −2.0; 3months: Δ-3.4, −5.0 to −1.8; 6months: Δ-2.6, −4.2 to −1.0) and disability (post: FAAM/Sports Δ49.6, 95%CI 34.6–64.6 - FAAM/ADL Δ26.9, 14.6–39.2; 3months: FAAM/Sports Δ31.6, 14.8–48.4 - FAAM/ADL Δ4.9, 2.0–7.8; 6months: FAAM/Sports Δ17.4, 2.0–32.8 – FAAM/ADL Δ2.4, 1.0–3.8) than those receiving just manual therapy/exercise alone. This clinical trial found that adding US-guided percutaneous electrolysis to a manual therapy/exercise program was more effective for improving pain and disability than the application of just manual therapy/exercise in people with tibialis posterior tendinopathy at short-term and mid-term follow-ups.</div></div><div><h3>Level of evidence</h3><div>Therapy, Level 1b</div></div><div><h3>Perspective</h3><div>This clinical trial found that adding US-guided percutaneous electrolysis to a manual therapy/exercise program was more effective for improving pain intensity and disability than the application of manual therapy/exercise alone in subjects with tibialis posterior tendinopathy at short-term and mid-term follow-ups.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106236"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272579","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":"Association of pain sensitization with prefrontal cortex activation and movement patterns during single- and dual-task walking in people with knee osteoarthritis","authors":"Soyoung Lee ,&nbsp;Ehyun Kim ,&nbsp;Tuhina Neogi ,&nbsp;Baekdong Cha ,&nbsp;Claudio L. Ferre ,&nbsp;Meryem Yücel ,&nbsp;Deepak Kumar","doi":"10.1016/j.jpain.2026.106231","DOIUrl":"10.1016/j.jpain.2026.106231","url":null,"abstract":"<div><div>Pain sensitization may contribute to heightened prefrontal cortex (PFC) activity during walking in people with knee osteoarthritis (OA), especially under cognitively demanding conditions. We examined associations of central and peripheral pain sensitization with PFC activation and walking performance during single- and dual-task walking. Forty-eight individuals with symptomatic knee OA completed single-task walking (STW) and dual-task walking (DTW) with a serial-7 subtraction. Central and peripheral sensitization were indexed by pressure pain threshold (PPT) at the wrist and knee, respectively. Oxygenated hemoglobin (HbO₂) in bilateral PFC was recorded using functional near-infrared spectroscopy. Gait speed, step duration variability, stride length variability, and serial-7 accuracy were assessed. Linear mixed-effects models tested group (lowest vs highest PPT tertile) by task (STW vs DTW) interactions on HbO₂ and performance, adjusting for age, sex, and BMI. When stratified by wrist PPT, participants (72.9% female, mean age 64.8 ± 7.2 years) showed significant group-by-task interactions for HbO₂ in left dorsolateral PFC (p=0.03, η²p=0.10) and stride length variability (p=0.01, η²p=0.16). When stratified by knee PPT, gait speed showed a significant interaction (p=0.02, η²p=0.11). No other comparisons reached statistical significance. Across walking tasks, the most centrally sensitized group exhibited moderately higher PFC activation (Cohen’s d≈0.6–0.7) than the least sensitized group. Central pain sensitization in knee OA is associated with greater recruitment of PFC resources and more variable gait under walking and dual-task conditions. Central sensitization may represent a therapeutic target to reduce executive control demands and improve gait in people with knee OA.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106231"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259935","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":"Neurophysiological potentials mediating the influence of social support on pain","authors":"Marina Horvat ,&nbsp;Jana Verdnik ,&nbsp;Saša Zorjan ,&nbsp;Satja Mulej Bratec","doi":"10.1016/j.jpain.2026.106247","DOIUrl":"10.1016/j.jpain.2026.106247","url":null,"abstract":"<div><div>The supportive presence of a significant other can act as an efficient analgesic. However, neurophysiological mechanisms of this effect have not been adequately explored. The current EEG study, using electrical pain stimulation, explored neurophysiological mechanisms mediating the influence of romantic partner’s presence on acute pain perceptions. Female participants (N = 41, mean age = 27.44, <em>SD</em> = 7.93) were exposed to painful stimuli in two alternating conditions: a) while receiving support from a male romantic partner via a live camera interaction and b) in the absence of partner support. It was hypothesised that social support would influence subjective reports and pain-related potentials, and that early and late pain-related ERPs would mediate the effect of social support on pain perception. Multilevel mediation analysis showed that partner support predicted lower pain unpleasantness and pain intensity. Additionally, the relationship between social support and both outcomes (unpleasantness and intensity) was mediated by neurophysiological components, the N130 potential at the C4 electrode, and the P300 potential at the central-parietal and parietal clusters. Exploratory whole-brain mediation confirmed and extended the relevance of the P300 component at central and parietal locations as an important brain mediator of social support and pain. The current study identified early and late pain-related potentials as mediators between social support and pain, highlighting potential clinical use of this social non-pharmacological pain analgesic and providing an important foundation for further explorations of social pain regulation.</div></div><div><h3>Perspective</h3><div>This investigation uncovered early and late pain-related potentials as neurophysiological mediators between social support and pain intensity as well as pain unpleasantness. The findings could potentially help with the development or introduction of non-pharmacological methods to (additionally) reduce pain during painful procedures.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106247"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318984","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":"Predicting the course of high-impact chronic pain using machine learning algorithms","authors":"Matthew C. Morris ,&nbsp;Hamidreza Moradi ,&nbsp;Maryam Aslani ,&nbsp;Stephen Bruehl ,&nbsp;Mustafa al’ Absi ,&nbsp;Sicong Sun ,&nbsp;Gloria T. Han ,&nbsp;Daniel B. Larach ,&nbsp;Carrie E. Brintz ,&nbsp;Amanda Stone ,&nbsp;Keith Cole ,&nbsp;Cynthia Karlson ,&nbsp;Rogelio A. Coronado ,&nbsp;Kerry Kinney ,&nbsp;Emily J. Bartley ,&nbsp;Kristin R. Archer ,&nbsp;Burel R. Goodin","doi":"10.1016/j.jpain.2026.106252","DOIUrl":"10.1016/j.jpain.2026.106252","url":null,"abstract":"<div><div>High-impact chronic pain (HICP) affects over 17 million U.S. adults and follows highly variable courses. To date, the relative importance of biopsychosocial predictors of HICP incidence, persistence, and recovery, remains poorly understood. The National Health Interview Survey Longitudinal Cohort, which comprises 10,415 adults who completed baseline surveys in 2019 and follow-back surveys in 2020, is ideally suited for addressing this critical knowledge gap. Machine learning algorithms were evaluated for their discriminatory power and classification accuracy in predicting HICP group membership for eligible sample adults who reported pain at one or both time points (n=10,260): incident HICP (new onset in 2020; n=506), persistent HICP (present in both years; n=480), HICP recovery (present in 2019 only; n=471), or no HICP (neither year; n=8803). Shapley Additive Explanation values were generated for input features to assess their relative importance for model prediction. Gradient Boosting Decision Trees, which exhibited the highest discriminatory power (macro-AUC=0.80), revealed that family income was a strong predictor of both incident HICP and HICP recovery, while physical health (e.g., self-rated health, arthritis, prescription opioid use) was a key predictor of persistent HICP. Depression severity was the most important mental health predictor across all outcomes. This study highlights the relative prognostic importance of physical health, mental health, and socioeconomic factors for HICP over a one-year follow-up. These findings can help to advance predictive frameworks for HICP, refine clinical risk screening tools, and set the stage for future research evaluating modifiable risk and resilience factors to prevent or alleviate HICP.</div></div><div><h3>Perspective</h3><div>This study used a machine learning approach to reveal differential prognostic importance of biopsychosocial factors for high-impact chronic pain incidence, persistence, and recovery over a one-year follow-up. These findings could help improve clinical risk screening tools and inform future targeted interventions to prevent or alleviate high-impact chronic pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106252"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322648","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}