Journal of Pain最新文献

{"title":"What we read matters: Exploring emotional and cognitive responses of pain science education and biomedical education in older adults with knee osteoarthritis","authors":"Vahideh Jafarzadeh ,&nbsp;Felicity A. Braithwaite ,&nbsp;Tasha R. Stanton ,&nbsp;Eden Daniel ,&nbsp;Luciana Macedo ,&nbsp;Neil Pearson ,&nbsp;Milena Head ,&nbsp;Lisa C. Carlesso","doi":"10.1016/j.jpain.2026.106229","DOIUrl":"10.1016/j.jpain.2026.106229","url":null,"abstract":"<div><div>Educational content can influence how individuals with knee osteoarthritis (KOA) understand and manage their condition. Standard biomedical education often emphasizes joint damage and degeneration, while pain science education (PSE) uses a constructivist approach highlighting the modifiability of pain and promoting self-management. Participants immediate emotional and cognitive responses to these two educational approaches were explored via custom-made websites. This qualitative study was embedded within a pilot randomized trial that recruited 35 adults aged 55 years or older with diagnosed or symptomatic KOA Participants were randomized to receive either standard biomedical education or PSE content provided on custom-made websites. After viewing the content, participants completed a think-aloud task and a semi-structured interview. Using a qualitative descriptive approach, audio-recorded data were transcribed verbatim and analyzed using inductive thematic analysis until thematic saturation. Eighteen transcripts were analyzed with nine per group. Four key themes were constructed: (1) Motivated to move, (2) Knowledge and support, (3) Sentiments and self-recognition, and (4) Perspectives on knee surgery. PSE participants expressed hope, willingness to self-manage, and belief in pain modifiability. Standard biomedical education participants commonly described frustration, emotional distress, and a sense of inevitability regarding disease progression and future surgery. The educational content appeared to shape how people with KOA perceive their condition, emotions, and behavioural intentions. PSE encouraged a positive interpretation of osteoarthritis that enhanced individual empowerment. These findings emphasize the importance of adopting a less biomedical focus in patient education to promote self-management and reduce fear-related beliefs in individuals with KOA.</div></div><div><h3>Perspectives</h3><div>Pain Science Education presenting osteoarthritis as a modifiable condition appeared to immediately influence patients’ perceptions, emotions, and motivation for self-management. Compared with standard biomedical information, pain science education fostered more positive views on physical activity and surgery, highlighting the need for empowering educational resources to support patient engagement.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106229"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229586","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":"Carrying a double burden: The impact of pain and gender-related stigma in women with chronic pelvic pain","authors":"Jenna M. Wilson ,&nbsp;Savannah Kazemipour ,&nbsp;Diya Dharmendran ,&nbsp;Samantha M. McKetchnie ,&nbsp;Michaela Sawada ,&nbsp;Emily J. Bartley ,&nbsp;Samantha M. Meints","doi":"10.1016/j.jpain.2026.106251","DOIUrl":"10.1016/j.jpain.2026.106251","url":null,"abstract":"<div><div>Women with chronic pelvic pain (CPP) often experience stigma related to both their gender identity and chronic pain status, as symptoms are frequently dismissed, disbelieved, or attributed to psychological causes, negatively affecting care. This study examined how chronic pain and gender-related stigma intersect in cisgender women with CPP and their associations with pain and psychosocial factors. Participants completed an online survey with validated questionnaires assessing stigma, pain severity and interference, physical functioning, and psychosocial factors. Pain stigma was correlated with greater pain severity and interference, poorer physical functioning, higher depression and perceived injustice, and lower pain self-efficacy, self-esteem, and social support, even after controlling for gender-related stigma. In contrast, gender-related stigma was correlated with lower social support, but also with lower pain and better physical functioning when controlling for pain stigma. A composite variable representing intersectional stigma categorized participants into four groups: high pain/high gender stigma, low pain/high gender stigma, high pain/low gender stigma, and low pain/low gender stigma. Analyses of covariance examined intersectional group differences in pain and psychosocial factors. Women high in both pain and gender-related stigma reported the most adverse profile across pain and psychological factors, highlighting the compounded challenges of confronting both forms of stigma. Women high in gender-related stigma, regardless of pain stigma, reported the lowest social support, suggesting that gender-related stigma may be especially linked to social factors. These findings underscore the need for stigma-reduction initiatives for chronic pain, with attention to the unique challenges faced by women experiencing both pain and gender-related stigma.</div></div><div><h3>Perspective</h3><div>Using an intersectional framework, this study examined associations of pain- and gender-related stigma with pain and psychosocial factors in cisgender women with chronic pelvic pain. Women reporting high levels of both stigmas exhibited the most adverse pain and psychological profiles, highlighting the compounded challenges of confronting multiple, intersecting stigmas.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106251"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322629","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":"Catastrophizing contributes to the association between posttraumatic stress symptoms and pain outcomes in individuals with chronic low back pain: Differential effects as a function of sex","authors":"Jolin B. Yamin ,&nbsp;Jenna M. Wilson ,&nbsp;Samantha M. Meints ,&nbsp;Robert N. Jamison ,&nbsp;Linda S. Aglio ,&nbsp;Aleksandra E. Zgierska ,&nbsp;Bruce Barrett ,&nbsp;Eric L. Garland ,&nbsp;Cindy A. Burzinski ,&nbsp;Ellen Goldstein ,&nbsp;Robert R. Edwards","doi":"10.1016/j.jpain.2026.106250","DOIUrl":"10.1016/j.jpain.2026.106250","url":null,"abstract":"<div><div>Posttraumatic stress symptoms (PTSS) are prevalent among individuals with chronic low back pain (CLBP) and are associated with worse pain-related outcomes. Pain catastrophizing is a cognitive factor associated with both trauma symptoms and pain, though it remains unclear whether these associations differ by sex, particularly given evidence that males and females may differ in trauma-related cognitive and emotional responses to pain. This study examined the extent to which pain catastrophizing contributes to the association between PTSS and pain outcomes in patients with CLBP, and whether these associations vary by sex. Participants were 742 adults with opioid-treated CLBP enrolled in a multisite randomized trial. Self-report measures assessed presence of PTSS (i.e., positive screen), pain catastrophizing, severity, and interference, and CLBP-related disability. Moderated mediation analyses were conducted using PROCESS Macro, controlling for psychological well-being, age, opioid dose, and study site. Results indicated that a positive PTSS screen was associated with higher catastrophizing, which in turn was associated with worse pain outcomes (severity, interference, and disability). Sex moderated the association between PTSS and catastrophizing, with a stronger relationship in males than females. Consequently, the indirect associations of PTSS with all pain outcomes via catastrophizing were significantly stronger among males. Findings support catastrophizing as a cognitive factor influencing the association between PTSS and pain-related outcomes in CLBP, and this association appears more salient in males. These findings highlight the importance of screening for PTSS and pain-related cognitive processes. Trauma-responsive interventions, informed by sex-related differences in coping and socialization, may enhance precision care in CLBP.</div></div><div><h3>Perspective</h3><div>This article identifies pain catastrophizing as a cognitive factor contributing to the relationship between posttraumatic stress symptoms and pain outcomes in patients with chronic low back pain, with stronger indirect associations observed in males. Findings underscore the importance of trauma- and sex-informed approaches to optimize treatment of low back pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106250"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318933","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":"Threat-related mental imagery reduces endogenous pain modulation in healthy individuals","authors":"Julie L. Ji ,&nbsp;Meghan Whitehouse ,&nbsp;Sam Mugglestone ,&nbsp;Sam W. Hughes","doi":"10.1016/j.jpain.2026.106254","DOIUrl":"10.1016/j.jpain.2026.106254","url":null,"abstract":"<div><div>Mental imagery-based simulations of threat can evoke “as-if-real” emotional and motivational responses, which may alter top-down pain processing. This study investigated the impact of mental imagery simulations of threat on endogenous pain modulation in n = 71 healthy participants using a cuff-pressure algometry protocol. In block one, participants were assessed on their baseline pain detection threshold (PDT), pressure pain tolerance (PTT), and their conditioned pain modulation (CPM) responses. In the second block, participants underwent the same procedures again but were randomly allocated to imagine the dominant leg cuff as being made of bubble-wrap (benign imagery condition; <em>n</em> = 36) or metal wire (threat imagery condition; <em>n</em> = 35). In between blocks, participants went to a separate room to interact with a piece of real bubble wrap or metal wire around their legs, facilitating mental imagery generation in Block 2. Partially consistent with our hypothesis, mental imagery impacted CPM effects for pain detection threshold (PDT), which was significantly reduced in the Wire relative to the Bubble-wrap condition. Mental imagery did not influence pressure pain tolerance (PPT). These results indicate that mental simulations of threat may reduce threshold-based conditioned pain modulation (CPM) responses in healthy individuals. Present findings suggest that mental simulation of threat may influence endogenous pain modulation processes.</div></div><div><h3>Perspective</h3><div>This study examined whether imagining physical pressure sensations as more or less threatening influenced pain perception and regulation in healthy adults<strong>.</strong> Findings suggest that threat-related mental simulation may reduce endogenous pain regulation. Results highlight mental imagery and threat appraisal as potential targets for cognitive mental imagery-based pain interventions.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106254"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345859","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":"Safety assessment of a soft metal-free silicone peripheral nerve cuff implanted in rat models of neuropathic and inflammatory pain","authors":"Yiru Guo ,&nbsp;Gila Moalem-Taylor ,&nbsp;Mohit N. Shivdasani ,&nbsp;Gene Y. Fridman ,&nbsp;Felix P. Aplin","doi":"10.1016/j.jpain.2026.106232","DOIUrl":"10.1016/j.jpain.2026.106232","url":null,"abstract":"<div><div>Peripheral nerve stimulation offers a promising alternative to pharmacological treatments for chronic pain, and recent advances in direct current stimulation enable selective inhibition of nociceptive activity. However, the safety of direct current delivery systems, particularly soft, metal-free nerve cuffs, remains poorly characterized under pathological conditions. This study evaluated the safety and biocompatibility of a silicone tripolar cuff for ionic direct current delivery in naïve rats and rodent models of neuropathic (spared nerve injury) and inflammatory (complete Freund’s adjuvant) pain. The cuff was implanted around the sciatic nerve and evaluated through behavioral testing (von Frey and Hargreaves), magnetic resonance imaging, and immunohistochemistry of the sciatic nerve, dorsal root ganglia, and spinal cord. In naïve cohorts, both short- and long-term implantation did not alter behavior outcomes, and neither disease model showed worsening of pain sensitivity. Across implanted groups, markers associated with immune activation and fibrotic encapsulation were upregulated. Notably, only the implanted spared nerve injury cohort exhibited additional pathological changes, including T cell infiltration in the sciatic nerve and dorsal root ganglia, elevated satellite glial and astrocytic responses, and significant interaction between injury and implantation. Demyelination and C-fiber loss were observed in spared nerve injury cohort irrespective of cuff placement, consistent with baseline injury-driven pathology. These findings indicate that the soft, metal-free cuff is well tolerated in healthy and inflammatory pain conditions but may exacerbate local inflammation and tissue changes when implanted near nerve injury. This supports its potential use in chronic pain management when implantation is distal to local injury site.</div></div><div><h3>Perspective</h3><div>This study provides the first comprehensive safety assessment of a soft, metal-free nerve cuff for iDC delivery in healthy and pathological pain models. This work advances iDC as a potential treatment for chronic pain, and helps identify pathological conditions in which invasive cuff implantation could exacerbate existing nerve injury.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106232"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319015","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":"Sex-related differences in response to noxious stimulation at the beginning of life explored through a secondary analysis","authors":"Stefano Bembich ,&nbsp;Elena Castelpietra ,&nbsp;Gilda Paternuosto ,&nbsp;Laura Travan ,&nbsp;Davide Zanon ,&nbsp;Alessandra Maestro","doi":"10.1016/j.jpain.2026.106255","DOIUrl":"10.1016/j.jpain.2026.106255","url":null,"abstract":"<div><div>This study explored sex-related differences in neonatal nociception, an area that remains relatively understudied despite well-documented disparities in adult pain experience. The research aimed to highlight sex-related patterns in neonatal responses to noxious stimulation using both behavioural and neurophysiological data, obtained through the Neonatal Infant Pain Scale and cerebral near‐infrared spectroscopy. Specifically, a secondary analysis was conducted on previously published data from our research group, collected from 100 healthy full-term newborns (48 males, 52 females) undergoing a routine heel-prick for metabolic screening. Participants in the original studies were randomly allocated to one of the following non-pharmacological analgesic methods: oral glucose solution, expressed breast milk, maternal holding with glucose administration, breastfeeding or maternal holding alone. Results showed that female newborns exhibit a significantly more pronounced behavioural response to noxious stimulation compared to male newborns (P = 0.031), with this difference being particularly evident during breastfeeding as an analgesic intervention (P = 0.010). Female newborns also showed an increased activation of the left somatosensory cortex in response to contralateral heel-prick (P = 0.005). During breastfeeding analgesia, this difference involved the right somatosensory cortex too (P = 0.010). These findings underscore the importance of incorporating sex-specific considerations in neonatal pain assessment and management protocols. The study suggests that developing tailored, sex-specific approaches may be crucial for ensuring optimal pain care in newborns, potentially leading to more effective and personalised neonatal care strategies. Ultimately, this research contributes to the growing body of evidence supporting the need for sex-specific considerations in pain management from early-life.</div></div><div><h3>Perspective</h3><div>This secondary analysis further demonstrates that female newborns show a significantly more pronounced behavioural response and a more intense cortical response to noxious stimulation than male newborns. Therefore, developing tailored, sex-specific approaches to pain management may lead to more effective and personalised neonatal care strategies.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106255"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345836","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":"Pain and precision. An analysis of the effectiveness of calibration procedures in experimental pain studies using electrical stimuli","authors":"Julia Badzińska ,&nbsp;Magdalena Żegleń ,&nbsp;Przemysław Bąbel","doi":"10.1016/j.jpain.2026.106237","DOIUrl":"10.1016/j.jpain.2026.106237","url":null,"abstract":"<div><div>Effective pain calibration is critical in experimental pain research, particularly in studies utilizing individually adjusted electrocutaneous stimuli. However, methods used to match subjective pain intensity with objective stimulation parameters vary across studies and their effectiveness remains unclear. The present secondary analysis compared calibration outcomes from three independently conducted experiments (N = 401) that applied distinct pain calibration procedures. Each method aimed to identify individually adjusted stimulus intensities. To evaluate calibration accuracy, baseline trials were analyzed during which participants received predetermined stimuli and rated perceived pain intensity. Calibration effectiveness was operationalized as the correspondence between actual pain ratings and target values. The results revealed significant differences in calibration effectiveness between procedures. Calibration, which employed an ascending technique with an additional pseudo-random series, resulted in significantly smaller differences between the anticipated and perceived pain levels, suggesting that the method of calibration can substantially influence the precision of pain induction. Additionally, differences were observed between participants’ pain expectations and the target pain values. Further analysis confirmed that higher pain expectations were positively correlated with higher pain ratings, supporting the predictive role of expectancy in pain perception. These findings underscore the critical importance of calibration procedures in experimental pain research and emphasize the need for further studies to develop more precise and reliable calibration methods.</div></div><div><h3>Perspective</h3><div>This study demonstrates that the effectiveness of pain calibration varies significantly across procedures. The findings highlight the methodological relevance of calibration in experimental pain research and point to the need for further investigation into how different calibration strategies shape pain measurement accuracy.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106237"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The power to adapt: How resilience and changing expectations contribute to placebo effects","authors":"Sharon Thomas ,&nbsp;Barbara Resnick ,&nbsp;N. Jennifer Klinedinst ,&nbsp;Shijun Zhu ,&nbsp;Luana Colloca","doi":"10.1016/j.jpain.2026.106234","DOIUrl":"10.1016/j.jpain.2026.106234","url":null,"abstract":"<div><div>Expectations about medical treatment are important prognostic indicators of treatment success and play a key role in shaping individual pain experiences. Placebo interventions can modify these expectations and promote pain relief. Resilience, a psychological trait implicated in pain recovery, has also been positively associated with placebo responsiveness. In this study, we tested the hypotheses that (1) pain resilience is negatively associated with pain interference, and (2) pain resilience is positively associated with placebo effects via reinforced expectations of analgesia. A total of 152 participants with chronic orofacial pain underwent a placebo intervention involving classical conditioning and verbal suggestion. Expectations of pain reduction were assessed both before and after the conditioning phase. Participants completed self-report measures, including the Pain Resilience Scale, Life Orientation Test-Revised, Pain Catastrophizing Scale, and Beck Depression Inventory-II. Analyses controlled for optimism, catastrophizing, depression, sex, race, and education. Pain resilience was negatively associated with pain interference (b = −0.930, t = −2.107, p =.037) and positively associated with reinforced expectations of analgesia (b = 1.176, t = 2.949, p =.004), controlling for psychological and demographic factors. Importantly, reinforced—but not baseline—expectations mediated the relationship between resilience and placebo effects (a*b = 0.03, bootstrapped 95% CI = 0.0003–0.0758). These findings suggest that the ability to revise expectations following a positive treatment experience, is a key mechanism linking resilience to placebo effects. Interventions that target both resilience-building and expectation updating may enhance treatment responsiveness in chronic pain.</div></div><div><h3>Perspective</h3><div>Pain resilience predicts lower pain interference and greater placebo analgesia by enhancing the ability to update expectations after positive treatment experiences. Reinforced but not baseline, expectations mediate resilience-related placebo effects, highlighting expectation updating as a key mechanism and potential target to improve treatment responsiveness in chronic pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"42 ","pages":"Article 106234"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312216","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":"Research recommendations for the HEAL Initiative: A path forward for pain research.","authors":"Robert W Gereau, Stephani P Sutherland, Tamara Baker, Claudia M Campbell, Yenisel Cruz-Almeida, Lynn L DeBar, Michael Falcon, John T Farrar, Steven Z George, Jennifer Haythornthwaite, Susmita Kashikar-Zuck, Janelle E Letzen, John Markman, Jessica S Merlin, Linda L Porter, Theodore J Price, Joanna Starrels, Cheryl L Stucky, Vivianne L Tawfik, Jacqueline M Ward, Kathleen A Sluka","doi":"10.1016/j.jpain.2026.106301","DOIUrl":"10.1016/j.jpain.2026.106301","url":null,"abstract":"<p><p>Chronic pain conditions affect 24% of the US population and account for the greatest cause of disability, leading to tremendous suffering and lost productivity. The enormity of the problem is magnified by the dearth of safe, effective medications. We need more research that advances our understanding of pain to aid in the development of new therapies. Existing non-drug treatments are greatly underutilized for pain management despite evidence of their effectiveness, demonstrating the need for research on how best to implement these therapies. The NIH Helping End Addiction Long-term® Initiative (the NIH HEAL Initiative®) was launched in response to the opioid overdose crisis and set out to increase research and improve treatments for addiction disorders and chronic pain conditions. The HEAL Initiative® has made tremendous strides toward these goals since its initial launch in 2018. In 2024, the NIH convened a working group of external experts to assess its progress and strategize for the next five years of HEAL funding specifically for pain research. That process culminated in the production of an accepted Report containing these ten Research Priorities and five Core Principles to guide NIH leadership in planning and funding pain research within the HEAL initiative over the next five years. Here, we present these recommendations for consideration by the wider pain research community and invite further active discussion. PERSPECTIVE: Chronic pain remains a major public health crisis in the U.S. that has been insufficiently addressed. The research priorities outlined here were created to build the HEAL Initiative's pain research portfolio over the next five years. The primary aims are to develop and advance treatments for chronic pain.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106301"},"PeriodicalIF":4.0,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788324","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":"Limited perceived value of pain science education among people with persistent pain reporting no improvement: A mixed-methods secondary analysis.","authors":"Hayley B Leake, Sarah B Wallwork, G Lorimer Moseley","doi":"10.1016/j.jpain.2026.106304","DOIUrl":"https://doi.org/10.1016/j.jpain.2026.106304","url":null,"abstract":"<p><p>Pain science education (PSE) aims to shift unhelpful beliefs about pain and improve clinical outcomes. However, some people report little improvement after receiving PSE-informed care. Understanding their perspectives may help refine educational delivery. We conducted a convergent mixed-methods analysis of survey data from adults with persistent pain who self-identified as 'not improved' following individual PSE-informed care (n=19). Quantitative data captured perceived importance of 11 predefined pain concepts using a 6-point Likert scale (from \"very important\" to \"I don't know what this means\"). Qualitative free-text responses described participants' most important pain concepts. Thematic analysis and descriptive statistics were integrated in a joint display to identify convergence and divergence across data strands. Most participants were female (58%), aged 35-55 years (69%) and living with pain for more than five years (79%). Except for \"all pain is real,\" which 68% rated as very important, most target concepts were rated as unimportant or unclear. Qualitative themes described seeking a clear diagnosis, accepting pain as unchangeable, finding trusted clinicians, and pursuing biologically-based and individually tailored treatments, while rejecting notions that their beliefs or learning about pain could change their pain. Limited valuing of PSE concepts among non-improvers may reflect disrupted trust and validation within clinician-patient relationships, as well as messages that felt implausible or dismissive of lived experience. Strengthening relational foundations and co-designing clearer, affirming educational messages may enhance engagement with PSE among people with persistent pain. PERSPECTIVE: This article presents a mixed-methods analysis that found that people whose persistent pain did not improve after pain science education placed limited value on many target concepts. Findings can help improve delivery of this intervention.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106304"},"PeriodicalIF":4.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787950","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}