Frontiers in pain research (Lausanne, Switzerland)最新文献

{"title":"Transcutaneous electrical nerve stimulation as an adjuvant treatment for thoracolumbar acute hyperesthesia in chondrodystrophic dogs: a prospective blinded controlled clinical study.","authors":"Débora Gouveia, Ana Cardoso, Carla Carvalho, Marina Moisés, André Coelho, Maria Manuel Balça, Rui Alvites, Ana Colette Maurício, António Ferreira, Ângela Martins","doi":"10.3389/fpain.2025.1496607","DOIUrl":"10.3389/fpain.2025.1496607","url":null,"abstract":"<p><strong>Introduction: </strong>Acute paraspinal hyperesthesia in dogs can result in a combination of nociceptive and neuropathic pain, often requiring pharmacological intervention. However, non-pharmacologic approaches, such as two-channel transcutaneous electrical nerve stimulation (TENS), may also be beneficial. Evidence from human medicine suggests that conventional TENS reduces pain scores and potentially decreases the need for analgesic medication. This study aimed to evaluate the efficacy of TENS as an adjunctive treatment for thoracolumbar paraspinal hyperesthesia in dogs.</p><p><strong>Methods: </strong>This prospective, blinded, controlled cohort study was conducted in a clinical setting. Dogs diagnosed with paraspinal hyperesthesia, classified as grade 4 or 5 on the modified Frankel scale (MFS) and with a dynamic interactive visual analog scale (DIVAS) score ≥14, were included. The subjects were randomized into two groups: the study group (SG), which received standard pharmacological protocol (PSP) plus TENS, and the control group (CG), which received PSP only. Observers blinded to treatment allocation scored video recordings of the dogs. Assessments were performed every 24 hours from T0 (admission) to T8, with evaluations in SG occurring 5 minutes before each TENS session.</p><p><strong>Results: </strong>A total of 818 dogs were enrolled, with 605 (74%) in the SG and 213 (26%) in the CG. In the first 48 hours, SG demonstrated a faster reduction in muscle tone compared to CG. While all dogs transitioned from a hyperesthetic to a non-painful state, SG showed a significantly faster recovery from T2 (48 h) to T4. A significant difference was observed between groups in DIVAS scores (<i>p</i> < 0.001). Additionally, SG had a shorter mean hospital stay (2.14 days) compared to CG, which required twice as long (<i>p</i> < 0.001).</p><p><strong>Discussion: </strong>These findings suggest that TENS may be an effective adjunctive therapy for managing acute thoracolumbar hyperesthesia in dogs, promoting early recovery by reducing pain, medication dependency, and hospitalization duration. However, the study's reliance on subjective assessments presents a limitation, potentially introducing bias. Further research with objective outcome measures is necessary to validate these findings and optimize the integration of TENS in veterinary pain management protocols.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1496607"},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797238","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":"The acceptability, feasibility, and usability of a virtual reality pain education and rehabilitation program for Veterans: a mixed-methods study.","authors":"Amelia K Mardon, Dianne Wilson, Hayley B Leake, Daniel Harvie, Andre Andrade, K Jane Chalmers, Aaron Bowes, G Lorimer Moseley","doi":"10.3389/fpain.2025.1535915","DOIUrl":"10.3389/fpain.2025.1535915","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent pain is a leading cause of medical discharges for Veterans. Pain science education (PSE) aims to better people's understanding about pain and is effective at reducing pain and depressive symptoms in Veterans. Preliminary evidence suggests virtual reality (VR)-delivered PSE has clinical benefits for people with persistent pain. This study investigated the acceptability, feasibility, and usability for VR-PSE for Veterans with persistent pain.</p><p><strong>Methods: </strong>Veterans (<i>n</i> = 7) and healthcare professionals (HCPs) experienced in treating Veterans (<i>n</i> = 5) participated in workshops that involved working through the VR-PSE program, online questionnaires, and a focus group. Quantitative data were analysed by descriptive statistics. Qualitative data were analysed using a framework analysis according to the Theoretical Framework of Acceptability (TFA). A mixed-methods analysis combined the quantitative and qualitative data via triangulation, with the findings presented according to the TFA domains.</p><p><strong>Results: </strong>The VR-PSE program was considered easy to use, engaging, and adaptable for different functional capabilities. Appropriate screening for contraindications prior to using the VR-PSE program was considered important by HCPs. Both Veterans and HCPs emphasized the need for a trusting client-clinician relationship to improve the acceptability of the VR-PSE program.</p><p><strong>Discussion: </strong>Overall, the VR-PSE program was found to be acceptable, feasible, and usable and may be a useful tool to incorporate into the clinical management of Veterans with persistent pain. Further research is needed to investigate the efficacy of VR-PSE programs on clinical outcomes for Veterans with persistent pain.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1535915"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782162","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":"Symptomatic joint hypermobility is not a barrier to attendance, graduation, or satisfaction for adults participating in a multidisciplinary pain rehabilitation program.","authors":"Lindsay G Flegge, Emma Estrella, Elizabeth K Harris, Adam T Hirsh, Michael A Bushey","doi":"10.3389/fpain.2025.1472160","DOIUrl":"10.3389/fpain.2025.1472160","url":null,"abstract":"<p><strong>Introduction: </strong>Symptomatic joint hypermobility, as found in conditions like hypermobile Ehlers-Danlos syndrome (hEDS), presents unique challenges in pain management due to associated symptoms such as chronic pain, joint instability, and dysautonomia. Despite the high prevalence of hypermobility and associated healthcare costs, there is a lack of research on effective treatments for these patients, particularly in the context of multidisciplinary pain rehabilitation programs.</p><p><strong>Objective: </strong>This study aims to compare the baseline characteristics, attendance, graduation rates, and patient satisfaction of hypermobile and non-hypermobile adult outpatients participating in a multidisciplinary pain rehabilitation program (PRP).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed clinical data from 335 patients at the Indiana University Health Pain Navigation Service between January 1, 2023, and December 31, 2023. Baseline characteristics were assessed using patient-reported outcome measures, and attendance and graduation rates were tracked. Hypermobile and non-hypermobile groups were compared with independent samples t-tests and chi-squared tests. A multiple linear regression model was used to assess the impact of hypermobility diagnosis on PRP attendance, with pertinent demographic and baseline clinical scores entered as covariates.</p><p><strong>Results: </strong>Hypermobile patients differed significantly from non-hypermobile patients in demographics, including age, gender, race, education, and employment status. Despite these differences, hypermobile patients did not differ from non-hypermobile patients in PRP attendance or graduation rates. Baseline pain, depression, and pain catastrophizing scores were lower in the hypermobile group. Exit surveys indicated similar levels of overall satisfaction with the program, though hypermobile patients were less likely to report that their needs were fully met than were non-hypermobile patients.</p><p><strong>Discussion: </strong>Despite the potential for joint hypermobility to pose a barrier to participation in multidisciplinary pain rehabilitation programs, we found no evidence that patients with a hypermobile diagnosis had less participation in an intensive outpatient pain rehabilitation program. After accounting for group differences in key demographic and clinical variables, there were no significant differences in PRP attendance between hypermobile and non-hypermobile patients. Our results are encouraging regarding the potential for multidisciplinary pain rehabilitation programs to serve the needs of these patients.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1472160"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782161","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":"Beyond <i>p</i>-values: a cross-sectional umbrella review of chemotherapy-induced peripheral neuropathy treatments.","authors":"Alice L Ye, Salahadin Abdi","doi":"10.3389/fpain.2025.1564662","DOIUrl":"10.3389/fpain.2025.1564662","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of neurotoxic chemotherapy agents, significantly impacting the daily lives of many cancer survivors. Despite thousands of articles published on CIPN, we remain no closer to a successful treatment regimen for the condition. In recent years, several new clinical trials and systematic reviews have been published, many exploring nonpharmaceutical interventions, prompting the need for a comprehensive synthesis of this emerging evidence.</p><p><strong>Methods: </strong>We conducted an umbrella review to identify and appraise the 19 systematic reviews (SRs) published in 2023 that examined randomized controlled trials (RCTs) for established CIPN treatment. We focused our analysis on the three most researched treatment options: oral drugs, exercise, and acupuncture. RCTs not previously synthesized together were reviewed, and effect size analyses were performed to allow readers to interpret the existing literature beyond binary <i>p</i>-values.</p><p><strong>Results: </strong>Our analysis of RCTs revealed the following key findings. For cancer survivors with CIPN after completing chemotherapy, serotonin-norepinephrine reuptake inhibitors (SNRIs) as well as acupuncture provided at least short-term relief for pain and sensory symptoms. For patients with CIPN who were actively undergoing chemotherapy, home-based balance and strength training exercises appeared to alleviate symptoms. Effect size analyses highlighted variability in treatment responses, underscoring the limitations of relying solely on <i>p</i>-values to assess intervention efficacy.</p><p><strong>Discussion: </strong>Through an umbrella review approach, we demonstrate that SRs are often less systematic than expected. None of the 19 SRs captured all relevant RCTs within their search timeframe. However, by cross-referencing SRs, we identified 41 RCTs across 42 publications, illustrating the feasibility of an umbrella review approach to uncover relevant trials. Furthermore, many SRs exhibited methodological concerns that limit the interpretability of their findings. Finally, we discuss multiple opportunities for refining methods and reporting in future CIPN treatment trials.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024508283, PROSPERO (42024508283).</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1564662"},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775156","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":"Preferential C-nociceptor stimulation facilitates peripheral axon reflex flare, but not secondary mechanical hyperalgesia.","authors":"Luana Daneffel, Roman Rukwied, Martin Schmelz, Wilhelm Ruppen, Tobias Schneider","doi":"10.3389/fpain.2025.1556429","DOIUrl":"10.3389/fpain.2025.1556429","url":null,"abstract":"<p><p>\"Silent\" C-nociceptors are crucial for inducing the axon reflex erythema in humans and may also contribute to spinal sensitization such as secondary hyperalgesia. Electrical slow depolarizing stimulation paradigms activate unmyelinated C-fibers [25 ms half-sine (HS) profile] whereas A-fibers are stimulated by 500 µs rectangular (R) pulses. We therefore expect to provoke larger areas of axon-reflex flare (silent nociceptor activation) and secondary hyperalgesia to HS stimuli. We compared axon-reflex erythema and secondary mechanical hyperalgesia areas induced by intracutaneous electrical HS and R stimuli using stimulation intensities that induced pain ratings of 3 and 6 on a numeric rating scale (NRS 0-10) in 24 healthy volunteers. Slowly depolarizing C-fiber stimulation was linked to lower current intensities required to induce pain (NRS 6: HS 3.6 vs. R 9.2 mA, <i>p</i> = 0.001) and resulted in larger axon reflex erythema for high stimulus intensities (AUC_Flare: NRS 6, 320.7 vs. 234.1 cm²⋅min, <i>p</i> = 0.015; NRS 3, 79.1 vs. 51.0 cm²⋅min; <i>p</i> = 0.114). Preferential C-fiber stimulation indicated a correlation of axon-reflex erythema with the areas of secondary mechanical hyperalgesia (NRS 6: <i>r</i> = 0.21, <i>p</i> = 0.036; NRS 3: <i>r</i> = 0.48, <i>p</i> = 0.0016). In contrast, the mean area of secondary mechanical hyperalgesia did not differ between HS and R [AUC_Hyper: NRS 6, 1,555 (HS) vs. 1,585 cm²⋅min (R), <i>p</i> = 0.893; NRS 3, 590 (HS) vs. 449 cm²⋅min (R), <i>p</i> = 0.212] albeit it developed faster during HS. Our data confirm that silent nociceptors provoke the axon reflex erythema, but their role in secondary hyperalgesia appears to be less crucial. <b>Clinical trial number:</b> NCT0544026.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1556429"},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775200","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":"Mobile phone dependence and musculoskeletal pain prevalence in adolescents: a cross-sectional study.","authors":"David Mauricio Parra-Fernandez, Margareth Lorena Alfonso-Mora, María Alejandra Sánchez-Vera, Paola Sarmiento-Gonzalez, Andrea Milena García Becerra, Miriam Guerra-Balic","doi":"10.3389/fpain.2025.1489293","DOIUrl":"10.3389/fpain.2025.1489293","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between adolescents' mobile phone dependence (MPD) and musculoskeletal pain.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 622 adolescents aged 10-18 in Tabio, Colombia. Participants completed an online survey that included the MPD and the Nordic Musculoskeletal Questionnaire, which assessed musculoskeletal pain symptoms.</p><p><strong>Results: </strong>56.3% (<i>n</i> = 350) participants reported experiencing musculoskeletal pain, with the upper back being the most affected area (30.4%, <i>n</i> = 193). Adolescents reporting pain had significantly higher MPD scores compared to those without pain (mean 29 vs. 24, <i>p</i> < 0.001). Additionally, females exhibited higher MPD scores than males (mean 29 vs. 25, <i>p</i> < 0.001) and had a higher prevalence of pain (32% vs. 24%). Furthermore, older adolescents in the 11th grade had higher MPD scores than younger adolescents in the 5th grade (mean 31 vs. 21, <i>p</i> < 0.019). Logistic regression analysis indicated that specific MPD dimensions, namely \"abuse\" and \"difficulty regulating use,\" were significantly associated with general pain and neck pain, but no association was observed with upper back pain. Furthermore, female sex was linked to both neck and upper back pain.</p><p><strong>Conclusion: </strong>This study found that the MPD dimensions of \"abuse\" and \"difficulty regulating use\" were significantly associated with neck pain, regardless of the adolescents' sex.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1489293"},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775197","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":"Editorial: Women in science: pediatric pain.","authors":"Anna M Hood, Karen E Weiss, Maria Forsner","doi":"10.3389/fpain.2025.1539856","DOIUrl":"https://doi.org/10.3389/fpain.2025.1539856","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1539856"},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775162","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":"Preliminary safety and effectiveness of psilocybin-assisted therapy in adults with fibromyalgia: an open-label pilot clinical trial.","authors":"Jacob S Aday, Jenna McAfee, Deirdre A Conroy, Avinash Hosanagar, Vijay Tarnal, Cody Weston, Katherine Scott, Dana Horowitz, Jamarie Geller, Steven E Harte, Niloufar Pouyan, Nicolas G Glynos, Anne K Baker, Jeffrey Guss, Alan K Davis, Helen J Burgess, George A Mashour, Daniel J Clauw, Kevin F Boehnke","doi":"10.3389/fpain.2025.1527783","DOIUrl":"10.3389/fpain.2025.1527783","url":null,"abstract":"<p><strong>Introduction: </strong>Fibromyalgia (FM) is the prototypical nociplastic pain condition, characterized by widespread pain and issues with cognition, mood, and sleep. Currently, there are limited treatment options available that effectively treat FM symptoms. Psilocybin-assisted therapy (PAT) is an emerging combined drug-therapy intervention, but no studies to-date have investigated PAT for FM.</p><p><strong>Methods: </strong>Here, we report findings from an open-label, pilot clinical trial of PAT for FM (<i>N</i> = 5). In conjunction with psychotherapy (two preparatory, four integration sessions), participants received two doses of oral psilocybin (15 mg and 25 mg) delivered two weeks apart.</p><p><strong>Results: </strong>Regarding safety (primary outcome), there were transient elevations of blood pressure or heart rate during dosing which normalized by the end of treatment, with no serious adverse events. Four of five participants reported transient headaches following dosing. Compared to baseline, participants reported clinically meaningful improvements in the following secondary outcomes one month following their second psilocybin dose (reported as Cohen's <i>d</i>): pain severity [<i>d</i> = -2.1, 95% CI(-3.7 to -0.49)], pain interference [<i>d</i> = -1.8, 95% CI (-3.27 to -0.24)], and sleep disturbance [<i>d</i> = -2.5, 95% CI (-4.21 to -0.75)]. Using the Patient Global Impression of Change, one participant reported their symptoms \"very much improved,\" two reported \"much improved,\" and two reported \"minimally improved.\" We stopped recruitment early because of concerns about generalizability and changes in FDA guidance for psychedelic clinical trials that occurred data collection.</p><p><strong>Discussion: </strong>This small open-label trial preliminarily supports that PAT is well-tolerated by people with FM, establishing a basis for larger randomized controlled trials.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier, (NCT05128162).</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1527783"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765819","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":"The effcet of annulus fibrosus suture combined with percutaneous transforaminal endoscopic discectomy on obese patients with lumbar disc herniation.","authors":"Leyu Zhao, Qi Yan, Lijie Yuan, Tianyi Wu, Yun Teng, Junjie Niu, Dawei Song, Jinning Wang, Xiao Sun, Rui Chen, Xianggu Zhong, Jiarong Li, Xiaolan Gu, Jun Zou","doi":"10.3389/fpain.2025.1568227","DOIUrl":"10.3389/fpain.2025.1568227","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation (LDH) is a prevalent degenerative disc disorder frequently resulting in lumbar and leg pain. Obese patients with LDH often encounter the scenario where the disc herniation is not completely resolved in the short term following percutaneous transforaminal endoscopic discectomy (PTED), necessitating subsequent surgical intervention, or where long-term reherniation occurs post-procedure. Currently, the literature provides little information regarding the application of annulus fibrosus suture (AFS) as a supplementary measure to PTED for diminishing the recurrence of disc herniation. Our aim was to evaluate the short-term and long-term therapeutic outcomes of combining PTED with AFS, with a particular focus on the impact of AFS on the recurrence rate of disc herniation following PTED.</p><p><strong>Methods: </strong>We recruited 23 obese patients with single-level LDH diagnosed between December 2021 and December 2023. All patients successfully underwent PTED in conjunction with AFS and the postoperative follow-up. We collected and analyzed data related to baseline parameters, disc degeneration grading, clinical effectiveness, surgery-related factors, lumbar spine function, pain severity, quality of life, and adverse prognosis events.</p><p><strong>Results: </strong>Compared with preoperative assessments, all patients exhibited significant improvements in Visual Analog Scale for leg pain (VAS-LP), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores (<i>P</i> < 0.05). During the short-term follow-up period, no patient required a secondary conventional microdiscectomy due to severe complications. At the one-year follow-up, no patient experienced significant recurrent radicular leg pain that would raise suspicion of LDH recurrence. However, when PTED was combined with AFS, the improvement in Visual Analog Scale for back pain (VAS-BP) was relatively less pronounced.</p><p><strong>Conclusions: </strong>The synergy of PTED and AFS seems to be a comparatively safe and efficacious approach for treating LDH in obese patients. AFS reduces the incidence of long-term recurrent leg pain, which may in turn reduce the probability of LDH recurrence after PTED. Consequently, AFS should be regarded as an efficacious supplementary procedure to PTED, adept at efficiently reducing the recurrence rate in obese individuals with LDH.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1568227"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756390","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":"The impact of a heat therapy intervention on pain and fibromyalgia symptoms in patients with fibromyalgia: a pilot study.","authors":"Andrea L Chadwick, Chloe Shi, Miranda McMillan, Josh Miller, Jinxiang Hu, Paige C Geiger","doi":"10.3389/fpain.2025.1526491","DOIUrl":"10.3389/fpain.2025.1526491","url":null,"abstract":"<p><strong>Introduction: </strong>FM is characterized by widespread musculoskeletal pain and associated somatic symptoms including fatigue, cognitive difficulties, and problems with sleeping. Multidisciplinary treatment of fibromyalgia including pharmacologic and non-pharmacologic interventions are recommended to improve symptoms and physical functioning. The goal of the present pilot investigation was to evaluate the effects of heat therapy via hot water immersion on clinical and objective pain measures in addition to blood measurements of heat shock proteins (HSPs) and inflammatory markers in patients with FM.</p><p><strong>Methods: </strong>After screening, informed consent, and enrollment into the study, all subjects underwent a baseline pre-intervention evaluation which included a battery of pain phenotyping questionnaires, quantitative sensory testing, and collection of blood for measurements of HSPs and inflammatory markers. Subjects received heat therapy three times a week for four weeks, where they were immersed in hot water for 45 min. After four weeks, participants completed the same battery of testing done at baseline.</p><p><strong>Results: </strong>We found that four weeks of heat therapy via hot water immersion in patients with FM showed statistically significant reductions in average and worst pain NRS severity scores when compared to baseline. There was also statistically significant improvement in overall impact of fibromyalgia symptoms, physical function, and sleep-related impairment. Regarding heat shock proteins, there was a statistically significant reduction in HSP90 and induction of HSP40 and HSC70. The number of extracellular vesicles were also statistically significantly increased. There were no statistically significant changes found in depression, anxiety, quantitative sensory testing measures, or pro- or anti-inflammatory markers.</p><p><strong>Conclusions: </strong>As a whole, these findings suggest that heat therapy via hot water immersion may be an effective non-pharmaceutical intervention for patients with FM and that its analgesic benefits may be related to decreases in HSP 90 and increases in HSP 40 and 72. Further large-scale, well-powered studies are needed to confirm our preliminary clinical and translational results.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1526491"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782163","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}