Pain Reports最新文献

{"title":"A scoping review of music-based pain treatment mechanism research.","authors":"Joke Bradt, Adam Hirsh, Mark P Jensen, Elise Desbarats, Debra S Burns, Jeffery A Dusek, Eric L Garland, Raluca D Georgescu, Lynn Gumert, Kobe Hanson, Jannatul Khawsar, Tanya Smit, Mathieu Roy","doi":"10.1097/PR9.0000000000001467","DOIUrl":"10.1097/PR9.0000000000001467","url":null,"abstract":"<p><p>Research supports the efficacy of music-based interventions (MBIs) for pain management, but understanding of their underlying mechanisms is lagging. This scoping review aims to map existing mechanism-focused MBI research, identify knowledge gaps, and highlight the strengths and weaknesses of this body of research. Studies were eligible if they tested a mechanism, moderator, or predictor of the effects of MBIs on clinical or experimental pain and were published in English in a peer-reviewed journal. Following the Joanna Briggs Institute scoping review methodology, we searched MEDLINE, Embase, PsycINFO, PubMed, and Scopus from inception through February 2026. Two reviewers completed screening and data extraction, with discrepancies resolved by a third reviewer. From 663 records screened, 57 studies were included. Most studies employed experimental pain models with healthy volunteers. All but 4 studies examined the mechanisms of music audio recordings; the remaining studies examined active music-making. We identified convergent evidence for several candidate mechanisms, including positive emotional valence, cognitive agency, and sensorimotor synchronization. Evidence from neuroimaging studies point to the impact of music on early stages of pain processing as well as on higher-order cognitive and affective interpretation of pain. Finally, preliminary evidence suggests that music may restore default mode network connectivity involved in self-referential thoughts. Across studies, several methodological limitations constrained inferences. Future research should (1) employ rigorous designs that distinguish between competing mechanistic models and, when feasible, incorporate causal manipulations to test hypothesized mechanisms and (2) examine whether music influences pain processing differently in populations with vs without clinical pain.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1467"},"PeriodicalIF":4.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality paired with nitrous oxide for procedural pain in children: a randomized controlled trial.","authors":"Maykala J Williams, Breanne J Byiers, Nanette Aldahondo, Todd Dalberg, Frank J Symons, Chantel C Burkitt","doi":"10.1097/PR9.0000000000001462","DOIUrl":"10.1097/PR9.0000000000001462","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy and clinical implementation of virtual reality (VR) paired with nitrous oxide for procedural pain management during botulinum toxin (BoNT) injections in children with developmental disabilities.</p><p><strong>Methods: </strong>A randomized, crossover study was conducted with 31 children with developmental disabilities receiving BoNT injections with nitrous oxide (median age = 10 years, range = 5-17 years; 16 males). Child life specialists facilitated VR during one BoNT appointment and standard of care distraction (eg, music, tablet) at another. Primary outcomes included pain experience assessed using the Faces Pain Scale-Revised, anxiety, and nitrous oxide concentrations. Secondary outcomes assessed clinical implementation by side effects, preferences, and acceptability.</p><p><strong>Results: </strong>Children, parents, and child life specialists reported significantly lower pain scores, and nitrous oxide concentrations were reduced in the VR condition compared with standard of care. Virtual reality paired with nitrous oxide was used throughout the procedure for most children (n = 23; 74.2%). Eight children discontinued VR during the procedure (preference [n = 3], mild side effects [n = 5]). The procedure duration did not differ between conditions, and parents reported greater satisfaction with their experience when VR was used.</p><p><strong>Conclusion: </strong>On average, when VR was used, pain levels were lower while also using lower nitrous oxide concentrations. Implementation of VR into the clinical context, paired with nitrous oxide, appeared beneficial and clinically efficient. Virtual reality in combination with nitrous oxide may provide synergistic effects for procedural sedation resulting in improved patient experiences. Further research is warranted to explore potential effect modifiers for a personalized medicine approach.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1462"},"PeriodicalIF":4.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Astrocyte store-operated calcium entry is required for centrally mediated neuropathic pain.","authors":"Mariya A Prokhorenko, Jeremy T Smyth","doi":"10.1097/PR9.0000000000001484","DOIUrl":"10.1097/PR9.0000000000001484","url":null,"abstract":"<p><strong>Introduction: </strong>Acute injuries transition to chronic neuropathic pain through central sensitization (CS), which involves plastic changes to nociceptive networks within the central nervous system. Astrocytes are essential mediators of CS, and many neuromodulatory functions of astrocytes are regulated by complex Ca²⁺ signaling mechanisms. The role of astrocyte Ca²⁺ signaling in CS and the specific astrocyte Ca²⁺ channels involved are poorly defined.</p><p><strong>Objectives: </strong>Our objective was to test the role of store-operated Ca²⁺ entry (SOCE), a highly conserved Ca²⁺ signaling mechanism that mediates Ca²⁺ influx in response to depletion of endoplasmic reticulum Ca²⁺ stores, in CS and neuropathic pain.</p><p><strong>Methods: </strong>We used a <i>Drosophila</i> model of CS based on the development of thermal allodynia 7 days after acute nerve injury, combined with a transcriptional reporter of intracellular Ca²⁺ mobilization. In vivo, astrocyte-specific RNAi was then used to test the role of Orai SOCE channels and Orai-activating Stim proteins in injury-induced astrocyte Ca²⁺ signaling and thermal allodynia.</p><p><strong>Results: </strong>Astrocytes exhibited Stim and Orai-dependent Ca²⁺ signaling 3 to 4 days postinjury. Astrocyte-specific suppression of Stim and Orai completely inhibited the development of thermal allodynia 7 days after injury and also inhibited the loss of GABAergic inhibitory neurons required for CS in flies as well as mammals. Finally, constitutive SOCE-mediated astrocyte Ca²⁺ signaling resulted in thermal allodynia even in the absence of injury.</p><p><strong>Conclusion: </strong>Astrocyte SOCE is necessary and sufficient for CS and thermal allodynia in <i>Drosophila</i>, adding key new understanding to the conserved astrocyte Ca²⁺ signaling mechanisms involved in development of neuropathic pain.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1484"},"PeriodicalIF":4.3,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do partner handholding effects linger? Order effects of handholding support on mechanical hypersensitivity in women.","authors":"Ketan Prafull Jaltare, Lisa Sanfrinnon, Diana M Torta","doi":"10.1097/PR9.0000000000001464","DOIUrl":"10.1097/PR9.0000000000001464","url":null,"abstract":"<p><strong>Introduction: </strong>Social support, such as handholding from a romantic partner, can reduce pain and physiological responses to noxious stimuli. We previously demonstrated that handholding during the induction of secondary mechanical hypersensitivity via electrical stimulation reduces the spatial spread of hypersensitivity. However, real-life social contexts are dynamic, and it remains unclear whether such support has lingering effects after its withdrawal or whether prior support buffers against subsequent absence.</p><p><strong>Objectives: </strong>In this preregistered study, we expanded our earlier sample (N = 37 couples) by adding 28 couples (total N = 65) to examine the effects of partner handholding and condition order on mechanical hypersensitivity.</p><p><strong>Methods: </strong>Healthy women underwent 2 sessions (support and alone), which involved romantic partner handholding during middle frequency stimulation (MFS) of the volar forearm. We measured the perceived intensity, unpleasantness, and spatial spread of hypersensitivity before and after MFS.</p><p><strong>Results: </strong>Handholding significantly reduced both vertical and horizontal spread of hypersensitivity, regardless of condition order. Subjective ratings of pain intensity and unpleasantness revealed a complex interaction with condition order. Elevated baseline mechanical sensitivity and MFS ratings were observed when handholding was provided first, while receiving handholding after having been alone yielded the lowest ratings, consistent with safety signaling or relief effects. The post-MFS increase in ratings was inversely related to baseline sensitivity, resulting in no significant differences.</p><p><strong>Conclusion: </strong>Our findings suggest that although the modulation of hypersensitivity spread by handholding is robust and order-independent, processes related to expectation and habituation shape subjective reports of hypersensitivity and their modulation by handholding.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1464"},"PeriodicalIF":4.3,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of cytochrome phenotyping in patients with chronic noncancer pain with inadequate response to tramadol.","authors":"Deborah Montmeat, Xavier Declèves, Alicja Puszkiel, Serge Perrot, Anne-Priscille Trouvin","doi":"10.1097/PR9.0000000000001474","DOIUrl":"10.1097/PR9.0000000000001474","url":null,"abstract":"<p><strong>Introduction: </strong>The opioid crisis is one of the most serious public health emergencies in the United States today. Opioid prescribing requires vigilance and reducing inappropriate opioid prescriptions is a key to decreasing opioid misuse. For that reason, we often focus solely on therapeutic indications or dosage while overlooking the polymorphisms of metabolism. Cytochromes P450 (CYP) are highly susceptible to interindividual and intraindividual variations and the analgesic activity of tramadol is dependent on the activity of CYP2D6.</p><p><strong>Objectives: </strong>To evaluate whether CYP phenotyping could identify metabolic abnormalities in patients with chronic non-cancer pain (CNCP) who experienced an inadequate response to tramadol and to assess the impact of phenotype-guided therapeutic adaptation on patient care.</p><p><strong>Methods: </strong>This exploratory study assessed CYP's activity using a phenotyping drug cocktail protocol adapted from the Geneva cocktail in patients suffering from CNCP who experienced an inadequate response to tramadol, either ineffectiveness or side effects leading to discontinuation of tramadol. Patients' drug therapy was subsequently tailored according to their cytochromes' activity, and its impact was evaluated one year later using patient-reported outcomes.</p><p><strong>Results: </strong>72.7% of patients who had side effects resulting in treatment discontinuation had slow metabolism for CYP2D6; 87.5% of patients who had experienced ineffectiveness with tramadol had slow metabolism for CYP2D6. The patients believed that this test led to a great improvement in their therapeutic management on average.</p><p><strong>Conclusion: </strong>An inadequate response to tramadol in a patient with CNCP could trigger consideration of metabolic phenotype exploration to facilitate personalised pain management and reduce unwarranted opioid prescription.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1474"},"PeriodicalIF":4.3,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of N-acetylcysteine in enhancing paracetamol's analgesic effect and inhibiting hepatotoxicity: a preclinical mouse model.","authors":"Basile Chrétien, Romain Goy, Mickaël Guillaume, Guillaume Bazin, Mathilde Collet, Jean-Jacques Dutheil, Catherine Baugé, Denis Vivien, Véronique Agin, Charles Dolladille","doi":"10.1097/PR9.0000000000001461","DOIUrl":"10.1097/PR9.0000000000001461","url":null,"abstract":"<p><strong>Introduction: </strong>Paracetamol (PCM) is extensively administered in clinical settings to alleviate mild to moderate pain and/or decrease fever. However, noncompliance with prescribed dosages can lead to severe and irreversible liver damage from PCM overdose. Although N-acetylcysteine (NAC) serves as the standard antidote for PCM toxicity, no commercially available combination of PCM and NAC has been marketed to mitigate its toxic effects. <b>Objectives:</b> This study aims to evaluate both the antinociceptive and hepatoprotective effects of the PCM and NAC combination in a murine model.</p><p><strong>Methods: </strong>Male and female C57Bl6/J mice were assigned to 4 groups. Group A received oral PCM exclusively, administered every 6 hours (4 doses within 24 hours), whereas groups B-D were administered PCM alone, a combination of PCM/L-NAC (N-acetyl-l-cysteine), or PCM/D-NAC (N-acetyl-d-cysteine) every 4 hours (6 doses within 24 hours).</p><p><strong>Results: </strong>Both PCM/L-NAC and PCM/D-NAC combinations yielded superior analgesia compared with the standard regimen. Furthermore, L-NAC administration mitigated the increase of glutamate pyruvate transaminase, a key hepatic marker associated with PCM hepatotoxicity. In addition, a protective effect from D-NAC in conjunction with PCM on glutathione levels was suggested. Our findings suggest that NAC enhances the analgesic properties of PCM while concurrently reducing its hepatotoxic potential in mice. Moreover, data indicate that L-NAC may represent a more effective candidate than D-NAC for this purpose, particularly regarding hepatoprotection.</p><p><strong>Conclusion: </strong>This study presents novel insights into the synergistic effects of the PCM/NAC combination on pain relief and hepatic safeguarding, warranting consideration for the development of novel therapeutic strategies targeting pain and fever management in patients.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1461"},"PeriodicalIF":4.3,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dopamine transporter gene (<i>SLC6A3</i>) polymorphism rs2963257 and chronic pain susceptibility in a Japanese population.","authors":"Keiko Yamada, Daisuke Nishizawa, Hideko Arita, Kazuo Hanaoka, Choku Yajima, Jitsu Kato, Setsuro Ogawa, Ayako Hiranuma, Junko Hasegawa, Yuko Ebata, Kyoko Nakayama, Masako Iseki, Kazutaka Ikeda","doi":"10.1097/PR9.0000000000001478","DOIUrl":"10.1097/PR9.0000000000001478","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain exhibits significant interindividual variability, partly because of genetic factors. The dopaminergic system is implicated in pain modulation.</p><p><strong>Objectives: </strong>This study investigated the association between single-nucleotide polymorphisms (SNPs) in dopamine pathway genes and chronic pain susceptibility in a Japanese population.</p><p><strong>Methods: </strong>A case-control study compared 191 patients with chronic pain with 282 healthy controls in Japan. Genotype data from previous whole-genome studies were analyzed for SNPs within or flanking 8 candidate genes (tyrosine hydroxylase, solute carrier family 6 member 3 [<i>SLC6A3</i>], dopamine D1-D5 receptor genes, and catechol-O-methyltransferase), including the gene body and ±30 kb flanking regions. Association analyses used Pearson chi-squared tests and modified Poisson regression with Bonferroni correction.</p><p><strong>Results: </strong>After quality control, 184 SNPs were analyzed. A significant association was identified between the rs2963257 SNP flanking the <i>SLC6A3</i> gene and chronic pain (genotypic <i>P</i> = 0.00026). This remained significant after Bonferroni correction. Analysis using a dominant model for the A allele (GA + AA vs GG) also showed a significant association (prevalence ratio = 2.11, 95% confidence interval = 1.23-3.61, <i>P</i> = 0.0017), indicating individuals carrying at least one A allele had a significantly higher prevalence of chronic pain vs those with the GG genotype. No other SNPs showed a significant association after multiple comparison correction.</p><p><strong>Conclusions: </strong>The <i>SLC6A3</i> rs2963257 polymorphism is associated with chronic pain susceptibility in the Japanese population. Specifically, the A allele appears to increase susceptibility under a dominant model, suggesting the GG genotype may have a protective effect against chronic pain.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1478"},"PeriodicalIF":4.3,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zoledronic acid produces analgesia by inhibiting the transient receptor potential vanilloid 1 (TRPV1) channel.","authors":"Karina Carvajal-Zamorano, César A Amaya-Rodríguez, Ana Gómez Del Campo, Angelina Palacios-Muñoz, Nicolas M Ardiles, Carlos Ancatén-González, Rodrigo C Meza, Wladimir Plaza-Briceño, Ignacio Segura, Rosa Scala, Domenico Tricarico, Pablo R Moya, Rodolfo Madrid, Andrés E Chávez, Ramón Latorre, Karen Castillo","doi":"10.1097/PR9.0000000000001477","DOIUrl":"10.1097/PR9.0000000000001477","url":null,"abstract":"<p><strong>Introduction: </strong>The TRPV1 channel is activated by noxious heat and capsaicin and is expressed in primary nociceptive fibers, where it plays a key role in pain perception and inflammation. Although vanilloid compounds can induce topical analgesia, their systemic use is limited by thermoregulatory side effects. Zoledronic acid (ZOL), a bisphosphonate widely used to treat bone disorders and cancer-associated bone loss, has reported analgesic properties, although its effects on TRPV1 remain incompletely understood.</p><p><strong>Objective: </strong>To determine whether ZOL modulates TRPV1 channel function and to elucidate the mechanism underlying its analgesic effects.</p><p><strong>Methods: </strong>We combined behavioral assays of thermal nociception in mice and <i>Drosophila melanogaster</i>, Ca²⁺ imaging in primary dorsal root ganglion neurons, electrophysiological recordings from TRPV1 expressed in <i>Xenopus laevis</i> oocytes, and acute hippocampal slice recordings to assess TRPV1-dependent synaptic plasticity.</p><p><strong>Results: </strong>Systemic ZOL administration significantly reduced thermal nociceptive behaviors in both models without affecting locomotion or core temperature. In vitro, ZOL decreased capsaicin-evoked Ca²⁺ responses in dorsal root ganglion neurons and markedly reduced TRPV1-mediated currents in excised membrane patches from oocytes. In hippocampal slices, ZOL prevented TRPV1-dependent synaptic depression without altering basal transmission. Loss of inhibition under asymmetric ionic strength conditions suggests a pore-blocking mechanism.</p><p><strong>Conclusions: </strong>Our findings identify a previously unrecognized pore-blocking mechanism by which zoledronic acid inhibits TRPV1 channel activity, providing a mechanistic explanation for its analgesic effects. These results support a potential role for bisphosphonates as scaffolds for the development of novel analgesics and as tools to probe TRPV1-mediated pain pathways.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1477"},"PeriodicalIF":4.3,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effort and control of pain: a dilemma for patients and providers.","authors":"John A Sturgeon, Matthew B Jennings, Zina Trost","doi":"10.1097/PR9.0000000000001468","DOIUrl":"10.1097/PR9.0000000000001468","url":null,"abstract":"<p><p><b>Commentary on:</b> Habermann MB, Christian MB. Uncontrollability of experimental pain decreases pain intensity and relief pleasantness ratings in a between- group design. PAIN Rep 2026;11:e1448.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1468"},"PeriodicalIF":4.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13362845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and competing risk of psychiatric comorbidities in chronic low back pain by age group.","authors":"Ryan J Pontiff, Abigail Helm, Sadaf Arefi Milani, Melissa Morrow, Carole A Tucker","doi":"10.1097/PR9.0000000000001480","DOIUrl":"10.1097/PR9.0000000000001480","url":null,"abstract":"<p><strong>Introduction: </strong>Nonspecific chronic low back pain (cLBP) frequently accompanies psychiatric comorbidities, including anxiety, depression, insomnia, and substance use disorders (SUDs), which worsen patient outcomes. However, research characterizing the prevalence and temporal risk of these comorbidities using large-scale, age-stratified data remains limited. <b>Objectives:</b> This study evaluated the prevalence of anxiety, depression, insomnia, and SUDs after cLBP diagnosis and the population's vulnerability to these conditions.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the TriNetX network, analyzing deidentified electronic health records from over 150 million patients. Individuals with cLBP from 2014 to 2023 were categorized into age groups (0-25, 26-49, and 50+ years) based on neurodevelopmental milestones and cLBP epidemiology. Annual point prevalence of anxiety, depression, insomnia, and SUDs was calculated for each group. Competing risk analysis determined the 10-year cumulative incidence of each outcome after cLBP diagnosis.</p><p><strong>Results: </strong>Among 1,045,921 individuals with cLBP, all psychiatric comorbidities rose in prevalence across age groups from 2014 to 2023. By 2023, anxiety prevalence reached 30.8% (0-25), 39.0% (26-49), and 33.0% (50+); depression prevalence was 20.9%, 28.7%, and 27.1%, respectively. Insomnia prevalence increased from 6.9% (0-25) to 13.6% (26-49) and 20.1% (50+). SUD substantially increased from 0 to 25 (7.73%) to 26 to 49 (27.7%) and 50+ (23.2%) groups. For all groups, females showed higher anxiety, depression, and insomnia rates, whereas SUDs were more common in males. Ten-year competing risk cumulative incidence showed that anxiety had the highest risk across all groups: 30.5% (0-25), 27.3% (26-49), 20.5% (50+).</p><p><strong>Conclusion: </strong>Individuals with cLBP face a rising and substantial burden of psychiatric comorbidities, with age- and sex-specific increasing patterns. Screening and interventions should be tailored by age to improve outcomes for this high-risk population.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 4","pages":"e1480"},"PeriodicalIF":4.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13363195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}