Journal of Pain最新文献

{"title":"Associations between pain experiences and gray matter volume in youth in the adolescent brain cognitive development (ABCD) study","authors":"Carmen I. Bango ,&nbsp;Scott A. Jones ,&nbsp;Sara Shao ,&nbsp;Dani Y. Del Rubin ,&nbsp;Arturo Lopez Flores ,&nbsp;Bonnie J. Nagel ,&nbsp;Amy L. Holley ,&nbsp;Anna C. Wilson","doi":"10.1016/j.jpain.2025.105527","DOIUrl":"10.1016/j.jpain.2025.105527","url":null,"abstract":"<div><div>Pain in youth is a growing public health concern. While research suggests pervasive differences in brain morphology with pain in adulthood, this relationship is less studied in adolescence. To address this gap, the present study explored pain-related associations with gray matter volume across 82 brain regions in a community sample of 7712 youth (mean age = 11.96) by comparing structural brain measures between those with (n = 2668; 34.6%) and without (n = 5044; 65.4%) past-month pain and examining associations with a continuous latent pain factor composed of average pain ratings, worst pain ratings, and pain limitations. Results showed no significant morphological differences between groups with and without past-month pain. Among participants reporting pain, average pain limitations were generally low, despite varied pain intensity, duration, and number of pain locations. Within this group, higher latent pain scores were associated with lower gray matter volume in six cortical regions (bilateral precentral, right postcentral, right inferior parietal, left supramarginal and left lateral occipital gyri; all p_fdr &lt; 0.05). However, in secondary analyses adjusting for total intracranial volume (ICV), only the result in the right inferior parietal gyrus remained significant, suggesting this region may represent a more robust and regionally specific correlate of pain, independent of global brain effects. Together, these findings suggest that heightened pain experiences are related to lower gray matter volume in predominantly sensorimotor and parietal regions. Future work exploring the temporal dynamics of these morphological differences is needed to clarify their clinical implications.</div></div><div><h3>Perspective</h3><div>This article describes an association between lower gray matter volume in primarily sensorimotor and parietal areas and higher pain scores among youth reporting past-month pain (n = 2668) in a nonclinical community sample (n = 7712). The findings contribute to the understanding of neurobiological correlates of adolescent pain and pain-related neurodevelopmental patterns.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"36 ","pages":"Article 105527"},"PeriodicalIF":4.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856987","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":"Crossing a chasm: Patient partnership and preclinical pain research.","authors":"Rob Murphy, Richelle Mychasiuk","doi":"10.1016/j.jpain.2025.105529","DOIUrl":"https://doi.org/10.1016/j.jpain.2025.105529","url":null,"abstract":"<p><p>Despite the increasing recognition of the value that patient involvement in clinical research adds, patient partners or lived experience consultants remain underutilized in preclinical pain research. This commentary, co-authored with a lived experience consultant, highlights the mutual benefits of integrating patient partners into discovery-based research, including enhanced innovation, improved trust, increased transparency, empowered advocacy, and more effective knowledge translation. Lived experience consultants offer unique insights into symptom burden, treatment outcomes, and model relevance, contributing to more meaningful and translatable research. However, barriers persist, including limited access to patient networks, power imbalances, lack of training for researchers, and insufficient funding for lived experience consultant engagement. Addressing these challenges requires structural support, education, and mandates from funding and regulatory bodies. By fostering collaborative, bi-directional partnerships, preclinical researchers can ensure their work aligns more closely with patient needs and priorities, ultimately improving outcomes and accelerating impact. This commentary proposes actionable strategies for building effective, ethical, and sustainable researcher-patient collaborations for not only chronic pain research, but all discovery-based science. PERSPECTIVE: Involving patient partners in preclinical pain research improves health outcomes by aligning studies with real patient needs. Their insights enhance study design, relevance, and impact, leading to more meaningful outcomes. This collaboration improves quality of life, trust in science, and results in more effective translation of discoveries into real-world solutions.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"105529"},"PeriodicalIF":4.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849567","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":"I do not feel your pain: Exploring the impact of state empathy on placebo and nocebo effects evoked by observational learning","authors":"Stefanie H. Meeuwis ,&nbsp;Joanna Kłosowska ,&nbsp;Aleksandra Budzisz ,&nbsp;Amelia Jankowska ,&nbsp;Daryna Rubanets ,&nbsp;Julia Badzińska ,&nbsp;Elżbieta A. Bajcar ,&nbsp;Przemysław Bąbel","doi":"10.1016/j.jpain.2025.105526","DOIUrl":"10.1016/j.jpain.2025.105526","url":null,"abstract":"<div><div>Observational learning (OBL) can elicit placebo hypoalgesia or nocebo hyperalgesia if pain relief or exacerbation is observed after placebo administration. While dispositional empathy has occasionally been associated with increased placebo and nocebo responding, the contribution of situational empathy remains elusive. This study addresses this gap using a validated experimental paradigm. Healthy individuals (n=180, 60% females) were randomized to four experimental (placebo-OBL, high-empathy placebo-OBL, nocebo-OBL, high-empathy nocebo-OBL) or two control groups (random-ratings OBL, no-observation). Medium pain was evoked at baseline and post-OBL with heat stimuli to both arms. Before OBL, a placebo ointment was applied to one arm. In the experimental groups, participants observed a model expressing hypoalgesia or hyperalgesia in reaction to the ointment. In the empathy groups, participants were instructed to empathize with the model. OBL did not alter pain intensity (F(3,176)=1.02, <em>p</em>=.39, η_p²=.02), although pain expectations changed in the expected direction (F(5.76,337.84)=5.81, <em>p</em>&lt;.001, η_p²=.09). There were no between-group differences in situational empathy (indicating a failed empathy manipulation), and the magnitude of placebo hypoalgesia, or nocebo hyperalgesia (all <em>p</em>’s≥.19). The current study is one of only a few highlighting the limits of OBL-induced placebo and nocebo effects. It suggests that changing expectations alone may not always be sufficient to produce changes in pain perception. Potential factors explaining these findings, including attention and cognitive load, are discussed. Increasing our understanding of OBL-induced pain changes can support the development of interventions for (chronic) pain. Studying the contribution of empathic processes may be particularly relevant given their vital role in human interactions.</div></div><div><h3>Perspective</h3><div>This article presents the results of an experimental mixed-model study on state empathy and placebo hypoalgesia and nocebo hyperalgesia, induced by observational learning (OBL). Although expectations changed, empathy and OBL did not elicit any changes in the experience of pain. The findings highlight the limits of OBL for altering pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105526"},"PeriodicalIF":4.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829910","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":"Economic evaluation of the FIBROWALK multicomponent intervention in online and outdoor formats for fibromyalgia (The On&Out Study).","authors":"William Auer, Mayte Serrat, Juan P Sanabria-Mazo, Estíbaliz Royuela-Colomer, Adrián Pérez-Aranda, Sonia Ferrés, Brenda Robles, Francesco D'Amico, Miriam Almirall, Eugenia Cardeñosa, Xavier Borràs, Juan V Luciano, Albert Feliu-Soler","doi":"10.1016/j.jpain.2025.105515","DOIUrl":"https://doi.org/10.1016/j.jpain.2025.105515","url":null,"abstract":"<p><p>Fibromyalgia (FM) is a chronic condition with substantial healthcare and societal costs. Although multicomponent interventions are widely available, evidence of their economic impact remains scarce. This study evaluated the cost-utility and cost-effectiveness of the FIBROWALK intervention in online (FIBRO-On) and outdoor (FIBRO-Out) formats, compared to treatment as usual (TAU), for individuals with FM. An economic evaluation (n = 225) was conducted over six months from government (total costs) and healthcare (direct costs) perspectives. The follow-up assessment was conducted six months after baseline, which corresponds to three months after the end of the 12-week intervention. Direct and indirect costs were collected through the Client Service Receipt Inventory. Cost-utility was assessed with Quality Adjusted Life Years (QALYs) and cost-effectiveness with the Revised Fibromyalgia Impact Questionnaire (FIQR). FIBRO-On was superior to TAU in reducing specialized healthcare costs (Cohen's d = 0.71), improving perceived health (d = 0.50), and reducing FM severity (d = 0.56). Compared to FIBRO-Out, FIBRO-On also reduced healthcare costs and improved both QALYs and FIQR scores. In contrast, FIBRO-Out led to significantly higher costs than TAU and showed no significant benefit in QALYs or FIQR scores. Across intention-to-treat, complete case, and per-protocol analyses, FIBRO-On was also the more favorable intervention, particularly in comparison to FIBRO-Out. These findings suggest that FIBRO-On may be a cost-effective intervention for managing FM compared to TAU or FIBRO-Out. Furthermore, they underscore the potential benefits of exploring digital interventions such as FIBRO-On to improve accessibility and promote efficient use of healthcare resources to manage FM. TRIAL NUMBER: NCT05377567 PERSPECTIVE: Economic evaluations of interventions for fibromyalgia are crucial to guide healthcare decisions and optimize resource allocation. This study shows that the multicomponent FIBROWALK intervention in its online format (FIBRO-On) offers good value for money compared to TAU or the outdoor format (FIBRO-Out), based on cost-utility and cost-effectiveness analyses performed from a government and healthcare perspective.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"105515"},"PeriodicalIF":4.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994293","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":"Effectiveness of the FIBROWALK multicomponent therapy in online and outdoor formats for fibromyalgia: A randomized controlled trial (The On&Out study).","authors":"Mayte Serrat, Estíbaliz Royuela-Colomer, William Auer, Sonia Ferrés, Míriam Almirall, Randy Neblett, Jo Nijs, Juan P Sanabria-Mazo, Xavier Borràs, Juan V Luciano, Albert Feliu-Soler","doi":"10.1016/j.jpain.2025.105514","DOIUrl":"https://doi.org/10.1016/j.jpain.2025.105514","url":null,"abstract":"<p><p>This study evaluated the effectiveness of FIBROWALK multicomponent intervention, delivered online (FIBRO-On) or outdoors (FIBRO-Out), compared to treatment as usual (TAU) in reducing fibromyalgia (FM) severity measured by FIQR, which assesses functional impairment, symptom intensity, and overall impact. A total of 225 individuals with FM were randomly assigned to 12 weeks of FIBRO-On (plus TAU), FIBRO-Out (plus TAU), or TAU alone. Assessments were conducted at baseline, mid-intervention (6 weeks), post-intervention (12 weeks), and 6-months (3 months post-intervention). Results from linear mixed-effects models indicated that FIBRO-On (ꞵ = -10.68, 95% CI = -15.13, -6.23) and FIBRO-Out (ꞵ = -9.91, 95% CI = -14.4, -5.42) were more effective than TAU in reducing FM severity at post-intervention. FIBRO-On (ꞵ = -6.02, 95% CI = -10.78, -1.27) was more effective than TAU in reducing FM severity at 6 months, whereas FIBRO-Out showed no such advantage. No significant differences were observed between FIBRO-On and FIBRO-Out for any clinical measure at any time point. Clinically meaningful improvement was observed in 36.3% of FIBRO-On and 37.2% of FIBRO-Out post-intervention and ∼20% at follow-up. Reductions in psychological inflexibility and kinesiophobia after the intervention mediated the effects of FIBROWALK on FM severity at 6-month follow-up, supporting the inclusion of acceptance and commitment therapy components in future versions. Low dropout rates, minimal adverse effects, and significant improvements across clinical outcomes highlight the feasibility and effectiveness of both formats. These findings support FIBROWALK, particularly FIBRO-On, as a scalable FM intervention. Future research should optimize long-term outcomes and explore personalized treatment delivery. TRIAL NUMBER: NCT05377567. PERSPECTIVE: This study supports the short-term effectiveness of FIBROWALK in both formats, and mid-term reduction of fibromyalgia severity and pain in the online version. Mediation analyses suggest that reductions in psychological inflexibility and kinesiophobia underlie treatment effects. Its feasibility and scalability support potential for broader clinical implementation in fibromyalgia care.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"105514"},"PeriodicalIF":4.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994336","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":"Choosing well: A narrative review on chronic pain and decision-making","authors":"Marilyn Horta PhD ,&nbsp;Kylie Wright ,&nbsp;Nichole R. Lighthall PhD ,&nbsp;Roger B. Fillingim PhD","doi":"10.1016/j.jpain.2025.105525","DOIUrl":"10.1016/j.jpain.2025.105525","url":null,"abstract":"<div><div>Chronic pain is one of the most prevalent and costly health conditions in the United States. Previous work has demonstrated that chronic pain impacts cognition and behavior. However, the impact of chronic pain on daily decisions is less well-known. This narrative review identified and synthesized findings from a literature search that yielded 18 peer-reviewed, experimental, cross-sectional studies on the effects of chronic pain on different decision-making outcomes. According to the literature, the effects of chronic pain on decision-making are evidenced by 1) reduced decision performance, 2) increased risk-taking and delay discounting, 3) altered sensitivity to outcomes, and 4) reduced cognitive flexibility and learning. Chronic pain effects on decision-making also vary by individual factors such as sex/gender, age, and affective and social factors. Guided by these findings, current limitations and future directions in the field are discussed.</div></div><div><h3>Perspective</h3><div>This narrative review highlights current evidence and identifies critical knowledge gaps, emphasizing a need to better understand the relationship between chronic pain and decision-making. Findings can guide future theory and shape interventions aimed at improving decision-making in chronic pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105525"},"PeriodicalIF":4.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818091","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":"Harmful words: A qualitative survey of pain clinicians’ perspectives on unhelpful messages in chronic pain","authors":"Abbie Jordan ,&nbsp;Phoebe Brook-Rowland ,&nbsp;Melanie Noel ,&nbsp;Jeremy Gauntlett-Gilbert","doi":"10.1016/j.jpain.2025.105524","DOIUrl":"10.1016/j.jpain.2025.105524","url":null,"abstract":"<div><div>Individuals living with chronic pain report experiences of stigma and invalidation, including from health professionals. Anecdotally, specialist pain clinicians must work hard to engage and treat patients who have past experiences of professionals discounting their pain, or of confusing or unsettling messaging about the cause of their symptoms. However, no study has yet explored pain clinicians’ perspectives on unhelpful clinical messaging in this area. We conducted an online qualitative survey of 165 international pain clinicians, asking about the unhelpful messages heard, and repeated, by their patients. Participants reported unhelpful messaging as prevalent and clinically impactful. Qualitative survey data was analysed using inductive reflexive thematic analysis. Five themes were generated: (1) all in your head, (2) you’re physically vulnerable, (3) an elusive fix, (4) the end of the line, (5) inadequate pain explanations. The results underscore the importance of taking a validating stance towards patients’ pain report and avoiding messages that discourage movement and exercise. Pain clinicians were reluctant to endorse multiple investigations to find an imagined ‘cause’ for pain but also disliked clinical messages that implied hopelessness about the chronic pain situation. These results can guide clinical conversations in many settings where people with chronic pain receive care.</div></div><div><h3>Perspective</h3><div>Messages provided by clinicians to individuals living with chronic pain can be deleterious and unhelpful. Such clinical messages may invalidate pain, discourage movement, increase diagnostic uncertainty and/or provide a fatalistic long term outlook. Improvements in pain education for clinicians are required.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105524"},"PeriodicalIF":4.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812656","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":"Scale development of the Osteoarthritis Conceptualisation Questionnaire: Phase 3 convergent validity and test-retest reliability","authors":"Brian W. Pulling PhD ,&nbsp;Tasha R. Stanton PhD ,&nbsp;Felicity A. Braithwaite PhD ,&nbsp;David S. Butler EdD ,&nbsp;Anna R. Vogelzang BClinExPhys ,&nbsp;G. Lorimer Moseley PhD ,&nbsp;Erin MacIntyre MPT ,&nbsp;Mark J. Catley PhD","doi":"10.1016/j.jpain.2025.105433","DOIUrl":"10.1016/j.jpain.2025.105433","url":null,"abstract":"<div><div>The Osteoarthritis Conceptualisation Questionnaire (OACQ) aims to evaluate people’s understanding of osteoarthritis. This study aimed to evaluate construct validity and reliability among those with painful knee osteoarthritis. Using previously collected data (n = 454, n = 336 female; 64 ± 9yrs) and a second confirmatory sample (n = 64, n = 47 female; 67 ± 8yrs), the scale properties of the four-dimensional (i.e., subscale) OACQ were evaluated. Both samples were compared to a Rasch model indicative of measurement to evaluate the targeting, category ordering, unidimensionality, local dependence, person fit, internal consistency, and differential item functioning (DIF). Convergent validity was evaluated in both samples, evaluating associations between the OACQ and related assessments. Test-retest reliability was evaluated in the second sample over a one-week period. Results showed that targeting was generally adequate, although all OACQ subscales showed unidimensionality. Two subscales demonstrated person misfit; however, sensitivity analyses revealed the misfit had minimal impact on scale functioning. Internal consistency was good for all subscales, and DIF was consistent with expectations. Rasch findings were supported in the confirmatory sample. The OACQ had correlations with related measures supportive of convergent validity and demonstrated good to excellent reliability (ICC = 0.89, 95% CI [0.80 to 0.94]). This study provides evidence supportive of validity and reliability of the OACQ as an assessment of how people understand knee osteoarthritis. It has utility as a tool for clinicians and researchers to understand how their patients/participants conceptualise knee osteoarthritis, its causes and consequences, contributors to pain, and optimal management approaches.</div></div><div><h3>Perspective</h3><div>The OACQ is a 36 item, four-domain questionnaire with evidence for construct, structural, and convergent validity, as well as reliability for people with knee osteoarthritis. The OACQ can be used to comprehensively evaluate the conceptual framework of painful knee osteoarthritis.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"33 ","pages":"Article 105433"},"PeriodicalIF":4.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087021","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":"Corrigendum to “Pathways to growth in chronic pain: Understanding mechanisms of posttraumatic growth in racial minorities” [J Pain 30C (2025)105381]","authors":"Shinye Kim PhD ,&nbsp;Yuki Shigemoto PhD ,&nbsp;Patrina Wong BA ,&nbsp;Jyotsna Dhar MA","doi":"10.1016/j.jpain.2025.105448","DOIUrl":"10.1016/j.jpain.2025.105448","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"33 ","pages":"Article 105448"},"PeriodicalIF":4.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188507","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":"Conditioned pain modulation and temporal summation in patients with knee osteoarthritis: A systematic review and meta-analysis","authors":"Leonardo Rodríguez-Lagos ,&nbsp;Josué Fernández-Carnero ,&nbsp;Sofía Laguarta-Val ,&nbsp;Beatriz Serrano-García ,&nbsp;Daniel Martín-Vera ,&nbsp;Nils Runge ,&nbsp;Alberto Arribas-Romano","doi":"10.1016/j.jpain.2025.105464","DOIUrl":"10.1016/j.jpain.2025.105464","url":null,"abstract":"<div><div>This review aims to determine the current evidence on conditioned pain modulation (CPM) and temporal summation of pain (TSP) in patients with knee osteoarthritis (KOA) compared to healthy pain-free controls. A comprehensive search was conducted across. seven electronic databases (MEDLINE/PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, and Scopus) were searched. Studies measuring CPM/TSP in patients with KOA compared to a group of healthy pain-free controls were included. Two reviewers independently determined study eligibility, rated risk of bias and extracted data. Where possible, data were combined into meta-analyses and pooled estimates with 95% confidence intervals (CI) for standardized mean differences (SMD) were calculated. From a total of 1943 papers identified in the initial search, 19 studies were included after screening. Most studies were of moderate to high risk of bias. Very low-certainty evidence suggests lower local CPM efficiency with a moderate effect size (556 patients and 379 controls; SMD = −0.55 [−0.86 to −0.24]; p = 0.00) and higher TSP with a small effect size when assessed both locally (910 patients and 463 controls; SMD = 0.40 [0.21 to 0.58]; p = 0.00) and remotely (468 patients and 231 controls; SMD = 0.27 [0.04 to 0.51]; p = 0.03) in KOA patients compared to pain-free controls. These findings suggest impaired CPM and facilitated TSP in patients with KOA. Clinicians should implement treatment strategies not only directed at nociceptive sources but also aimed at addressing alterations in central pain processing and symptoms related to nociplastic pain.</div></div><div><h3>Protocol registration</h3><div>(CRD42022370869).</div></div><div><h3>Perspective</h3><div>This study highlights the impaired conditioned pain modulation and facilitated temporal summation in knee osteoarthritis patients, suggesting central sensitization. These findings emphasize the need for targeted treatments to address both nociceptive sources and central pain processing alterations.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"33 ","pages":"Article 105464"},"PeriodicalIF":4.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303498","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}