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

{"title":"Exploring the value of a well-established conditioned pain modulation paradigm in women: a Translational Research in Pelvic Pain (TRiPP) study.","authors":"Lysia Demetriou, Danielle Perro, Lydia Coxon, Michal Krassowski, Claire E Lunde, Joana Ferreira-Gomes, Ana Charrua, Pedro Abreu-Mendes, Lars Arendt-Nielsen, Qasim Aziz, Judy Birch, Kurtis Garbutt, Andrew Horne, Anja Hoffman, Lone Hummelshoj, Jane Meijlink, Maik Obendorf, Esther Pogatzki-Zahn, Naoko Sasamoto, Kathryn Terry, Rolf-Detlef Treede, Allison Vitonis, Jan Vollert, Nilufer Rahmioglu, Christian M Becker, Francisco Cruz, Stacey A Missmer, Krina Zondervan, Christine B Sieberg, Jens Nagel, Katy Vincent","doi":"10.3389/fpain.2025.1439563","DOIUrl":"10.3389/fpain.2025.1439563","url":null,"abstract":"<p><strong>Background: </strong>Conditioned pain modulation (CPM) is considered a human proxy for descending inhibitory pain pathways. However, there is wide variation in the CPM response described in the literature and ongoing debate about its utility.</p><p><strong>Methods: </strong>Here we explored CPM in women with (<i>n</i> = 59) and without (<i>n</i> = 26) chronic pelvic pain (CPP), aiming to determine the magnitude of effect and factors influencing variability in the CPM response.</p><p><strong>Results: </strong>Using a pressure pain threshold test stimulus and ischaemic pressure cuff conditioning stimulus (CS), we found no significant difference in the mean CPM effect between CPP and control participants. Using a robust statistical method (+/-2 standard error of measurement) to further investigate CPM, there was no significant difference in the proportion exhibiting inhibition between controls and CPP participants (<i>X²</i>  = 0.003, <i>p</i> = 0.96). Notably, only 23.1% of our healthy controls demonstrated a \"true\" CPM effect (<i>n</i> = 4 inhibitory, <i>n</i> = 2 facilitatory). Despite a rich data set, we were unable to identify any single questionnaire, clinical or psychophysical covariate correlating with the CPM effect.</p><p><strong>Conclusions: </strong>Despite using one of the recommended CPM paradigms we were only able to demonstrate \"true\" CPM in 23.1% of control participants. Thus, the absence of differences between women with and without chronic pelvic pain must be interpreted with caution. Future studies using different CPM paradigms or larger sample sizes may find different results. Although CPM in chronic pain populations is of major theoretical mechanistic interest, the lack of an established assessment standard led us to question its added value in current clinical research.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1439563"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722910","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":"TRPV4 activation in Schwann cells mediates mechanically induced pain of oral cancer.","authors":"Yatendra Mulpuri, Nguyen H Tu, Kenji Inoue, Grace Harden, Samuel J Nicholson, Anisa Seenauth, Yan Huang, Keylin G Escobar, Yalda Moayedi, Nigel W Bunnett, Donna G Albertson, Brian L Schmidt","doi":"10.3389/fpain.2025.1532885","DOIUrl":"10.3389/fpain.2025.1532885","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with oral cancer often experience intense functional pain due to mechanical stimulation at the cancer site. The role of mechanosensitive ion channels in oral cancer pain, such as TRPV4, is not fully understood.</p><p><strong>Objectives: </strong>Our objective was to investigate the role of Schwann cell TRPV4 in oral cancer pain.</p><p><strong>Methods: </strong>We examined the impact of TRPV4 inhibition on oral cancer pain in NU/J and C57BL/6J mice injected with human tongue cancer cell line (HSC-3) and mouse oral cancer cell line (MOC2) in the hind paw or tongue. Mechanical and heat sensitivity were assessed using the von Frey and Hargreaves tests, respectively. TRPV4 expression and functional activity in Schwann cells were analyzed using immunohistochemistry, qRT-PCR, Ca²⁺ imaging, and patch-clamp electrophysiology. The effect of TRPV4 activation on Schwann cell responses to mechanical stimulation was evaluated using a piezo stimulator. Conditioned media (CM) from TRPV4-activated Schwann cells were injected into the mouse paw to evaluate the contribution of TRPV4 in Schwann cells to mechanical hypersensitivity.</p><p><strong>Results: </strong>TRPV4 inhibition reduced paw cancer mechanical nociception in mice dose-dependently without affecting heat sensitivity. TRPV4 inhibition also decreased facial nociception in tongue cancer mice. TRPV4 was expressed mainly on the plasma membrane of mouse Schwann cells and activation of TRPV4 induced Ca²⁺ responses and whole-cell membrane currents in human Schwann cells. Mechanoactivated currents in human Schwann cells were inhibited by the TRPV4 antagonist HC-067047. Schwann cell CM induced mechanical hypersensitivity in mice, which was blocked by pre-treatment with HC-067047.</p><p><strong>Conclusion: </strong>TRPV4 activation plays a role in mediating mechanically induced pain of oral cancer.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1532885"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722911","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":"A home-based EEG neurofeedback treatment for chronic neuropathic pain-a pilot study.","authors":"Mohamed Sakel, Christine A Ozolins, Karen Saunders, Riya Biswas","doi":"10.3389/fpain.2025.1479914","DOIUrl":"10.3389/fpain.2025.1479914","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the effect of an 8-week home-based neurofeedback intervention in chronic neuropathic pain patients.</p><p><strong>Subjects/patients: </strong>A cohort of eleven individuals with chronic neuropathic pain receiving treatment within the NHS framework.</p><p><strong>Methods: </strong>Participants were trained to operate a home-based neurofeedback system. Each received a portable Axon system for one week of electroencephalogram (EEG) baselines, followed by an 8-week neurofeedback intervention, and subsequent 12 weeks of follow-up EEG baselines. Primary outcome measures included changes in the Brief Pain Inventory and Visual Analogue Pain Scale at post-intervention, and follow-ups compared with the baseline. Secondary outcomes included changes in depression, anxiety, stress, pain catastrophizing, central sensitization, sleep quality, and quality of life. EEG activities were monitored throughout the trial.</p><p><strong>Results: </strong>Significant improvements were noted in pain scores, with all participants experiencing overall pain reduction. Clinically significant pain improvement (≥30%) was reported by 5 participants (56%). Mood scores showed a significant decrease in depression (<i>p</i> < 0.05), and pain catastrophizing (<i>p</i> < 0.05) scores improved significantly at post-intervention, with continued improvement at the first-month follow-up.</p><p><strong>Conclusion: </strong>The findings indicate that an 8-week home-based neurofeedback intervention improved pain and psychological well-being in this sample of chronic neuropathic pain patients. A randomized controlled trial is required to replicate these results in a larger cohort. <b>Clinical Trial Registration:</b> https://clinicaltrials.gov/study/NCT05464199, identifier: (NCT05464199).</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1479914"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712319","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":"Amplitude of low-frequency fluctuations in classical trigeminal neuralgia patients with purely paroxysmal and concomitant continuous pain.","authors":"He Zhao, Shenghui Xie, Xueying Ma, Xue Bai, Yuanjun Song, Qiong Wu, Yang Gao","doi":"10.3389/fpain.2025.1523845","DOIUrl":"10.3389/fpain.2025.1523845","url":null,"abstract":"<p><strong>Background: </strong>Purely paroxysmal neuralgia (PP-CTN) and concomitant continuous pain (CCP-CTN) are different subtypes of classical trigeminal neuralgia (CTN). Our aim was to explore the common and unique spontaneous brain activity abnormalities between subtypes.</p><p><strong>Methods: </strong>A total of 101 PP-CTN patients, 52 CCP-CTN patients, and 122 age- and sex-matched healthy controls (HCs) were included. All the subjects underwent resting-state functional magnetic resonance imaging, and changes in spontaneous brain activity were observed via whole-brain static amplitude of low-frequency fluctuation (sALFF) and dynamic amplitude of low-frequency fluctuation (dALFF).</p><p><strong>Results: </strong>Compared with HCs, PP-CTN patients presented significantly lower sALFF values in the left calcarine fissure and surrounding cortex (CAL), left putamen, and left Rolandic operculum (ROL). Compared with HCs, CCP-CTN patients presented significantly increased sALFF values in the left superior frontal gyrus (SFG), right medial superior frontal gyrus (MSFG), left putamen, right insula, and brainstem. Compared with the PP-CTN group, the CCP-CTN group presented significantly greater sALFF values in the left CAL, left SFG, right MSFG, left putamen, right insula, left ROL and brainstem. The results of the dALFF analysis revealed that, compared with HCs, PP-CTN patients presented increased dALFF values in the anterior cingulate gyrus (ACG) and decreased dALFF values in the right cuneus. Compared with HCs, CCP-CTN patients presented increased dALFF values in the ACG, right insula, and brainstem and decreased dALFF values in the right cuneus. Compared with the PP-CTN group, the CCP-CTN group presented increased dALFF values in the right insula and brainstem.</p><p><strong>Conclusions: </strong>Our findings reveal different neural mechanisms between PP-CTN and CCP-CTN patients, providing important neuroimaging evidence to better understand the pathophysiology of different subtypes of CTN.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1523845"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702397","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":"Ice water immersion does not activate diffuse noxious inhibitory controls of spinal reflexes in sedated or anaesthetised dogs (<i>Canis familiaris</i>): a pilot study.","authors":"J R Hunt, D Knazovicky, J Harris, S Kelly, T G Knowles, J C Murrell, B D X Lascelles","doi":"10.3389/fpain.2025.1505064","DOIUrl":"10.3389/fpain.2025.1505064","url":null,"abstract":"<p><strong>Introduction: </strong>Diffuse noxious inhibitory controls (DNIC) may be impaired in human subjects with osteoarthritis (OA) pain. Spontaneously occurring OA in dogs is considered a valuable model of human OA; however, methodology for assessing DNIC in dogs has not been fully developed. The aim of this study was to develop a suitable DNIC protocol using ice water immersion, similar to protocols used in humans.</p><p><strong>Objective: </strong>This study objective was to create an experimental protocol for inducing DNIC in sedated or anesthetized dogs, ensuring it has face validity for future assessments of DNIC in studies involving the spontaneous canine OA model. We hypothesized that inducing DNIC in healthy dogs would result in a reduced electromyographic (EMG) response to a specific nociceptive stimulus.</p><p><strong>Methods: </strong>Electromyographic (EMG) responses of the cranial tibial muscle to test electrical stimuli and interdigital skin temperature were recorded in seven healthy dogs before and during a 20-min duration conditioning ice water immersion of the distal forelimb. The protocol was repeated for each dog using three different states: sedation with acepromazine or alfaxalone or anaesthesia with alfaxalone.</p><p><strong>Results: </strong>Ice water immersion caused a decrease of interdigital skin temperature in dogs in all three groups with the nadir (4.9-13.6°C) at 10 min following immersion. Skin temperatures remained significantly higher (<i>p</i> = 0.018) in alfaxalone sedated compared to acepromazine sedated dogs and returned to baseline more quickly than in acepromazine sedated dogs. Magnitudes of EMG responses were significantly larger in acepromazine sedated dogs compared to alfaxalone treated dogs (<i>p</i> < 0.001). DNIC was not induced, as the EMG magnitude did not significantly change over time for either the early (<i>p</i> = 0.07) or late responses (<i>p</i> = 0.27), and no significant interactions were observed between time and anaesthetic state in relation to EMG magnitude.</p><p><strong>Conclusion: </strong>Our data suggest that a cold conditioning stimulus failed to elicit DNIC. It is possible that the magnitude of the conditioning stimulus was not sufficient to recruit DNIC in dogs.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1505064"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702404","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":"Self-reported questionnaires assessing body perception disturbances in adults with chronic non-cancer pain: a scoping review.","authors":"Marion Dagenais, Charlotte Proulx, Tania Augière, Jean-Sébastien Roy, Catherine Mercier","doi":"10.3389/fpain.2025.1497328","DOIUrl":"10.3389/fpain.2025.1497328","url":null,"abstract":"<p><strong>Introduction: </strong>Body perception disturbances (BPD) are well documented in certain chronic pain populations [e.g., complex regional pain syndrome (CRPS)], while being far less studied in chronic pain as a general condition. The aims of this scoping review are to identify the self-reported questionnaires used to assess BPD in individuals with chronic non-cancer pain and to refine the definition of the BPD construct as used in these questionnaires.</p><p><strong>Methods: </strong>A search strategy focusing on the concepts of \"chronic pain\", \"body perception\" and \"questionnaire\" was used across four databases. Each record was screened for eligibility by two independent reviewers, and data extraction was performed by one reviewer and validated by a second reviewer.</p><p><strong>Results: </strong>Eighty-seven studies were included, comprising 18 different questionnaires-either directly related to BPD or containing relevant items. The three most commonly used questionnaires were the Bath Body Perception Disturbance Scale, the Fremantle Back Awareness Questionnaire, and the Neurobehavioral Questionnaire. Appraisal of the construct derived from the questionnaire items identified five main facets: size, shape, cognitive neglect-like symptoms, proprioceptive awareness, and agency, along with 11 other less frequently addressed facets. The most represented clinical populations were CRPS (40 studies) and chronic low-back pain (20 studies).</p><p><strong>Discussion: </strong>A variety of self-reported questionnaires are available to assess BPD, but most are diagnosis- or body-region specific. To better assess BPD in individuals with chronic non-cancer pain, a consensus on the general definition and the key facets of the construct is needed.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1497328"},"PeriodicalIF":2.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671777","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: Pain and relationships.","authors":"Bernie Carter, Line Caes, Joanna McParland","doi":"10.3389/fpain.2025.1563825","DOIUrl":"10.3389/fpain.2025.1563825","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1563825"},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659979","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 virtual wound on pain sensitivity: insights into the affective dimension of pain.","authors":"Ingrid Koopmans, Robert-Jan Doll, Maurice Hagemeijer, Robert van Barneveld, Marieke de Kam, Geert Jan Groeneveld","doi":"10.3389/fpain.2025.1502616","DOIUrl":"10.3389/fpain.2025.1502616","url":null,"abstract":"<p><strong>Background: </strong>The perception of pain is difficult to assess due to the complex combination of various components related to nociception, experience, and cognition. There are currently no biomarkers to assess the affective component of pain in healthy volunteers. Using Virtual Reality (VR), it may be possible to assess changes in pain perception when adding an affective component to painful stimulation.</p><p><strong>Methods: </strong>In this two-visit feasibility study, we assess the effect of a simulated wound in VR on the electrical pain detection (PDT) and tolerance (PTT) threshold in 24 healthy male study participants. The VR simulation presented a copy of the research room from first person view. Prior to each VR assessment, study participants were primed by interacting with the VR environment. Two conditions were assessed: (1) VR-Wound: a burn-wound, smoke, and electrical sparks become visible and audible with increasing stimulus intensity, and (2) VR-neutral: no additional aspects. The PDT and PTT to electrical stimuli were recorded during both VR conditions and outside of VR. VAS-Questionnaires were used to assess unpleasantness and fear.</p><p><strong>Results: </strong>The PDT decreased when a virtual wound is presented compared to a neutral condition. Study participants experienced the electrical stimulation as more painful and more intense during the wound simulation than during the neutral condition. The effect was more pronounced during the second visit.</p><p><strong>Conclusion: </strong>VR enhanced the perception of pain, thereby providing new insights into the affective component of pain. Further testing of this methodology is warranted by performing a clinical study that evaluates drug effects on the affective component of pain.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1502616"},"PeriodicalIF":2.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617899","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: Phantom pain: mechanisms and updates in management.","authors":"Weibin Shi, Balakrishnan Prabhakaran, Thiru Annaswamy","doi":"10.3389/fpain.2025.1567956","DOIUrl":"10.3389/fpain.2025.1567956","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1567956"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598376","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":"Unpacking excessive polypharmacy patterns among individuals living with chronic pain in Quebec: a longitudinal study.","authors":"Gwenaelle De Clifford-Faugère, Hermine Lore Nguena Nguefack, Nancy Ménard, Sylvie Beaudoin, M Gabrielle Pagé, Line Guénette, Catherine Hudon, Oumar Mallé Samb, Anaïs Lacasse","doi":"10.3389/fpain.2025.1512878","DOIUrl":"10.3389/fpain.2025.1512878","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive polypharmacy, which can be defined as the concurrent use of ≥10 medications, is prevalent among individuals with chronic pain. However, it remains unclear how it may vary between individuals or over time.</p><p><strong>Objectives: </strong>This study aimed to describe and identify factors associated with trajectories of excessive polypharmacy.</p><p><strong>Methods: </strong>A retrospective longitudinal study was conducted using the TorSaDE Cohort, which links Canadian Community Health Surveys (2007-2016) and Quebec health administrative databases. Among 9,156 adults living with chronic pain and covered by public prescribed drug insurance, the presence of excessive polypharmacy (yes/no) was assessed monthly for one-year post-survey completion (12 time points). Group-based trajectory modelling was applied to identify groups with similar patterns over time (trajectories). Multivariable multinomial regression was used to identify factors associated with trajectory membership.</p><p><strong>Results: </strong>Four trajectories were obtained: (1) \"No excessive polypharmacy\" (74.8%); (2) \"Sometimes in excessive polypharmacy\" (8.6%); (3) \"Often in excessive polypharmacy\" (6.1%); 4) \"Always in excessive polypharmacy\" (10.5%). Factors associated with the \"always in excessive polypharmacy\" trajectory membership were: being older, being born in Canada, having a lower income, having a higher comorbidity index score, more severe pain intensity, and more daily activities prevented by pain, reporting arthritis or back pain and poorer perceived general health, and having a family physician. Using opioids or benzodiazepines, having a lower alcohol consumption, doing less physical activity, a higher number of prescribers and visits to a family physician also predicted being always in excessive polypharmacy.</p><p><strong>Discussion: </strong>This study identifies distinct trajectories of excessive polypharmacy in adults with chronic pain, emphasizing key sociodemographic and clinical factors and the need for tailored interventions for effective medication management.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1512878"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588495","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}