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

{"title":"Chronic pain in the aging adult with sickle cell disease.","authors":"Keesha Powell-Roach, Ugochi O Ogu","doi":"10.3389/fpain.2026.1907108","DOIUrl":"10.3389/fpain.2026.1907108","url":null,"abstract":"<p><p>Improved survival in sickle cell disease (SCD) has led to a growing population of older adults who experience a high burden of chronic pain. With aging, pain often shifts from episodic vaso-occlusive crises to persistent, multifactorial syndromes driven by cumulative tissue injury, central sensitization, and progressive organ damage. This evolution presents significant clinical challenges, particularly in the context of comorbidities, polypharmacy, and age-related physiological changes. This narrative review examines the epidemiology, pathophysiology, and management of chronic pain in aging adults with SCD. Key contributors to pain include musculoskeletal degeneration, neuropathic mechanisms, and chronic inflammation, compounded by renal, hepatic, and cardiovascular dysfunction. Pharmacological management requires careful consideration of analgesic safety, particularly with opioids, nonsteroidal anti-inflammatory drugs, and adjuvant agents. Nonpharmacological approaches, including rehabilitative and behavioral strategies, are essential components of care. Psychosocial factors and health disparities further influence pain experiences and treatment outcomes. A multidisciplinary, individualized approach integrating geriatric and SCD-specific principles is critical to improving quality of life in this vulnerable population.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1907108"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119321","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":"Cannabidiol/cannabigerol exposure and neuropathy-related outcomes after neurotoxic chemotherapy: a real-world cohort study.","authors":"Nicholas M Graziane, Ajay Macherla, Matthew Giampetro","doi":"10.3389/fpain.2026.1945720","DOIUrl":"10.3389/fpain.2026.1945720","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication of neurotoxic chemotherapy, yet effective pharmacologic options for both prevention and treatment of established painful CIPN remain limited. Non-delta-9-tetrahydrocannabinol (THC) cannabinoids and related minor cannabinoids show antinociceptive effects in preclinical CIPN models, but their real-world clinical relevance remains unclear.</p><p><strong>Methods: </strong>We performed a retrospective secondary analysis of de-identified electronic health record (EHR) data using the TriNetX Research Network to examine whether documented cannabidiol/cannabigerol (CBD/CBG) exposure was associated with subsequent neuropathy-related diagnoses among adults receiving neurotoxic chemotherapy. Patients with neuropathy-related diagnoses on or before chemotherapy were excluded. Two Cox proportional hazards analyses were performed. The post-chemotherapy exposure analysis compared post-chemotherapy CBD/CBG exposure with post-chemotherapy exposure to gabapentin, pregabalin, or duloxetine. The pre-chemotherapy exposure analysis compared patients with documented CBD/CBG exposure within one year before chemotherapy to patients who had no documented CBD/CBG exposure during that pre-chemotherapy window. The outcome was a composite neuropathy-related diagnosis 30-365 days after the index event.</p><p><strong>Results: </strong>In the adjusted post-chemotherapy exposure model, 83 CBD/CBG-exposed patients were compared with 118,001 active-comparator patients. Post-chemotherapy CBD/CBG exposure was associated with lower hazard of subsequent neuropathy-related diagnosis-code outcomes (Hazard ratio [HR] = 0.162, 95% confidence interval [CI] = 0.041-0.649, <i>p</i> = 0.010). In the adjusted pre-chemotherapy exposure model, 162 CBD/CBG-exposed patients were compared with 633,329 controls. Pre-chemotherapy CBD/CBG exposure was not significantly associated with neuropathy-related diagnosis-code outcomes (HR = 0.859, 95% CI = 0.476-1.551, <i>p</i> = 0.614).</p><p><strong>Conclusions: </strong>Post-chemotherapy CBD/CBG exposure was associated with lower observed hazard of neuropathy-related diagnosis-code outcomes, whereas pre-chemotherapy exposure was not significant. These exploratory findings require cautious interpretation because of sparse exposed-arm events, EHR exposure limitations, and potential competing-risk bias.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1945720"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119368","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":"Proposal to refine the mechanistic classification of chronic pain and corresponding clinical symptomatology.","authors":"Jean-Pascal Lefaucheur","doi":"10.3389/fpain.2026.1963056","DOIUrl":"https://doi.org/10.3389/fpain.2026.1963056","url":null,"abstract":"<p><p>The management and treatment of patients suffering from chronic pain must be based on a precise understanding of the pathophysiological mechanisms underlying the syndrome. However, it cannot be defined solely by the presence or absence of disease or injury affecting either non-neuronal tissues or the neuronal structures of the somatosensory system, as these elements do not always accurately or causally reflect the underlying mechanisms of the pain experienced by patients. The current taxonomy of chronic pain classically includes three main mechanisms: nociceptive, neuropathic, and nociplastic. However, certain ambiguities of this classification need clarification, such as: (1) the importance given to demonstrating a lesion of the somatosensory nervous system for the diagnosis of neuropathic pain; (2) the specificity of sensory descriptors for the diagnosis of neuropathic pain; (3) the imprecision of the concept of \"central sensitization\". In this article, a new taxonomy is proposed, identifying: (1) differential mechanisms of neuropathic pain related to \"large\" or \"small\" nerve fiber systems; (2) \"sensory\", \"cognitive\", and \"emotional\" components of nociplastic pain; (3) \"sensory nociplastic pain\", which can be distinguished from neuropathic pain by the presence of diffuse, variable, and multiform \"neuropathic-like\" symptoms; (4) a modulator linked to sensitization related to psychosocial vulnerability and stressors. A comprehensive understanding of the mechanisms of pain relies on a rigorous interpretation of patients' symptoms. It is particularly important to determine whether sensitization mechanisms are present from disease onset, suggesting primary nociplastic pain, or whether they emerge over time, reflecting secondary processes of nociceptive or neuropathic pain syndrome chronification.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1963056"},"PeriodicalIF":2.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119412","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":"Pain profiles in pancreatic cancer and chronic pancreatitis: a multicenter cross-sectional analysis.","authors":"Marie-Theres Kassik, Mahya Faghih, Conrad Bandhauer, Josefine Jäger, Sophie Rauschenberg, Søren S Olesen, Daniel A Laheru, Lei Zheng, Anna E Phillips, Dhiraj Yadav, Jonas Rosendahl, Vikesh K Singh, Asbjørn M Drewes, Marko Damm","doi":"10.3389/fpain.2026.1903789","DOIUrl":"https://doi.org/10.3389/fpain.2026.1903789","url":null,"abstract":"<p><strong>Introduction: </strong>Abnormal pain processing has been associated with impaired patient-reported outcomes (PROMs) in chronic pancreatitis (CP), but its clinical relevance in pancreatic ductal adenocarcinoma (PDAC) remains unclear. We investigated the association between P-QST-defined hyperalgesia and pain-related, psychological, and quality-of-life outcomes in patients with painful PDAC and compared these associations with CP.</p><p><strong>Methods: </strong>This multicenter cross-sectional analysis included patients with painful CP and PDAC at five tertiary referral hospitals in Denmark, Germany and the USA. Based on the results of pancreatic quantitative sensory testing (P-QST), patients were classified into three subgroups according to hyperalgesia status: no hyperalgesia, reflecting normal pain processing; segmental hyperalgesia at the pancreatic dermatome, suggesting abnormal spinal pain processing; widespread hyperalgesia, indicative of pathological pain processing across the entire neuraxis. PROMs included the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and EORTC QLQ-C30. Between-disease P-QST analyses were adjusted for age, sex, and regular opioid use. Exploratory disease-by-hyperalgesia interaction analyses assessed whether associations between hyperalgesia and selected PROMs differed between CP and PDAC.</p><p><strong>Results: </strong>A total of 275 patients (153 CP, 122 PDAC) were enrolled. Hyperalgesia was present in 53.6% of patients with CP and 43.8% of patients with PDAC, with no statistically significant difference after multivariable adjustment (aOR 0.75, 95% CI 0.43-1.33; <i>p</i> = 0.327). Patients with CP reported greater pain intensity (<i>p</i> = 0.027), pain interference (<i>p</i> = 0.049), and pain catastrophizing (<i>p</i> = 0.034) than patients with PDAC. Within the PDAC cohort, hyperalgesia was not associated with consistent differences in pain intensity, pain interference, catastrophizing, anxiety, or quality-of-life outcomes. However, formal interaction analysis demonstrated that the association between hyperalgesia and BPI pain interference differed between PDAC and CP (interaction <i>β</i>=1.61, 95% CI 0.27-2.95; <i>p</i> = 0.018).</p><p><strong>Conclusion: </strong>Although altered pain processing was frequent in painful PDAC, its association with patient-reported outcomes differed from that observed in CP. In particular, hyperalgesia showed a disease-specific relationship with pain-related functional impairment. These findings suggest that the clinical meaning of P-QST-defined hyperalgesia in PDAC cannot simply be inferred from CP and support further PDAC-specific studies linking pain phenotype to patient-reported burden and treatment response and pain management approaches might not be transferable across diseases.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1903789"},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066488","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":"Patients' experiences and perceived outcomes of manual therapy: a qualitative systematic review with framework synthesis.","authors":"Ying Zhang, Shasha Liang, Hong Chen, Ya'nan Sun, Changhe Yu","doi":"10.3389/fpain.2026.1767395","DOIUrl":"10.3389/fpain.2026.1767395","url":null,"abstract":"<p><strong>Objective: </strong>To systematically synthesize qualitative evidence on patient-reported experiences of manual therapies (including massage therapy, osteopathic manipulation, and craniosacral therapy) across biological, psychological, and social dimensions. We aimed to identify patient-perceived outcomes, contextual factors influencing the therapeutic process, and hypothesized mechanisms underlying patient experiences, thereby constructing an integrated conceptual framework centered on patient narratives.</p><p><strong>Methods: </strong>A systematic search of Chinese and English databases was conducted from inception to March 2024 for qualitative studies exploring patient experiences of manual therapies. Methodological quality was assessed using the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist and the CASP (Critical Appraisal Skills Programme) Qualitative Checklist. Best-fit framework synthesis was employed to integrate patient-reported outcomes within the COMET (Core Outcome Measures in Effectiveness Trials) framework. Contextual factors influencing patient experiences were organized under the contextual factors framework proposed by Marco Testa for physical therapy. A diagnostic and therapeutic model of \"assessment-intervention-feedback\" was constructed based on the mechanisms of dynamic adaptation and multisensory integration.</p><p><strong>Results: </strong>Fifteen studies were included. Manual therapies were found to significantly improve clinical symptoms, physical function, affective function, and quality of life. Simultaneously, background factors-including therapist characteristics and patient characteristics-were revealed as multidimensional regulatory mechanisms of therapeutic efficacy. A diagnostic-treatment system was constructed using tactile input as the nexus, dynamic regulation as the foundation, and multisystem synergy as the distinctive feature. Its four technical dimensions synergistically functioned throughout the diagnostic-treatment cycle, achieving integrated regulation of physiological-psychological-social systems.</p><p><strong>Conclusion: </strong>Manual therapy achieves multidimensional synergistic therapeutic effects through a dynamic coupling mechanism mediated by touch, integrating mechanical, neurological, and social dimensions. Its diagnostic and therapeutic system provides an innovative paradigm for the management of chronic diseases and the promotion of psychosomatic health. Future research should focus on optimizing personalized interventions by integrating artificial intelligence and wearable technologies, thereby facilitating the transition from empirical medicine to a precision science paradigm.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1767395"},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066537","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":"Long-term outcomes of spinal cord stimulation for refractory phantom limb pain.","authors":"Long Ma, Yunjian Huang, Shiyun Xu, Guang Lu, Hongwei Zhu","doi":"10.3389/fpain.2026.1955515","DOIUrl":"10.3389/fpain.2026.1955515","url":null,"abstract":"<p><strong>Objectives: </strong>Phantom limb pain (PLP) is a disabling post-amputation neuropathic pain condition, and evidence regarding the long-term effectiveness of spinal cord stimulation (SCS) remains limited. This study evaluated trial stimulation outcomes, pain trajectories, device retention, explantation, and device-related complications in patients with refractory PLP.</p><p><strong>Methods: </strong>We retrospectively reviewed 28 patients with refractory PLP who underwent SCS trial stimulation at our center between June 2010 and September 2023. Baseline characteristics, procedural data, Numeric Rating Scale (NRS) scores, progression to permanent implantation, revision or replacement procedures, and device explantation were recorded. Changes in NRS scores from baseline were assessed, and exploratory regression analyses were performed.</p><p><strong>Results: </strong>Eighteen patients (64%) met the criteria for trial success and proceeded to permanent SCS implantation. In an exploratory analysis, a higher baseline NRS score was associated with trial success. Among the 18 patients with permanent implants, the median follow-up was 78 months. Five SCS systems (28%) were explanted: three because of inadequate pain relief and two after battery depletion without replacement. In a <i>post hoc</i> analysis of the 13 patients who retained their devices at the last available follow-up, the mean NRS score decreased from 8.9 ± 0.8 at baseline to 2.8 ± 0.7 after trial stimulation and was 4.8 ± 0.6 at 1 year, 5.6 ± 1.0 at 2 years, and 6.2 ± 1.1 at the last available follow-up. Three patients underwent planned IPG replacement because of battery depletion, and two underwent unplanned device-related revision procedures.</p><p><strong>Conclusions: </strong>SCS provided substantial short-term pain relief in selected patients with refractory PLP. However, the magnitude of pain relief diminished over time, and device explantation occurred in a substantial minority of patients, underscoring the need for careful patient selection, long-term follow-up, and device management.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1955515"},"PeriodicalIF":2.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018939","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":"Neuropeptide Y signaling in osteoarthritis pain: neuroimmune mechanisms, joint remodeling, and translational opportunities.","authors":"Heng Qiu, Li Wang, Danni Luo, Yong Huang","doi":"10.3389/fpain.2026.1884062","DOIUrl":"10.3389/fpain.2026.1884062","url":null,"abstract":"<p><p>Osteoarthritis is a leading cause of chronic musculoskeletal pain, but pain severity is not fully explained by cartilage loss or radiographic damage. Neuropeptide Y is a multifunctional neuropeptide with receptor- and compartment-dependent effects on nociceptive signaling, sympathetic activity, immune regulation, and skeletal remodeling. Direct osteoarthritis-specific evidence links synovial-fluid neuropeptide Y to pain in some human knee osteoarthritis cohorts, NPY2R signaling to chondrocyte hypertrophy and matrix catabolism, and osteocyte-derived neuropeptide Y to experimental osteoarthritis remodeling. By contrast, proposed effects on synovial fibroblast phenotypes, macrophage polarization, central sensitization, and gut-joint communication are supported mainly by mechanistically adjacent non-osteoarthritis models and remain hypothesis-generating. This review synthesizes current evidence with a pain-centered and translational focus, emphasizing receptor specificity, evidence source, and disease context. Neuropeptide Y is best viewed as one candidate node within broader nociceptive, inflammatory, vascular, metabolic, and biomechanical networks rather than as a primary or exclusive driver of osteoarthritis. Translation will require receptor-selective and tissue-selective strategies, local delivery systems, validated multi-marker panels, and phenotype-stratified studies that distinguish pain-related from structure-related effects.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1884062"},"PeriodicalIF":2.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009520","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":"Tailoring an auricular point acupressure self-management program for chronic pain: lessons learned from rural partners.","authors":"Jungkyung Min, Jennifer Kawi, Rupsikha Bora, Sarah Pace, Tonychris Nnaka, Hulin Wu, Jane Bolin","doi":"10.3389/fpain.2026.1851109","DOIUrl":"10.3389/fpain.2026.1851109","url":null,"abstract":"<p><strong>Introduction: </strong>Rural residents experience a disproportionate burden of chronic musculoskeletal pain and face persistent barriers to nonpharmacologic care. To address these gaps, we developed an evidence-based, app-delivered auricular point acupressure self-management (APA-SM) program and adapted it through sustained engagement with rural partners. This paper synthesizes lessons learned from rural partner engagement and describes how these insights informed APA-SM's design and refinement for rural settings.</p><p><strong>Methods: </strong>This paper summarizes lessons learned from three complementary approaches used to tailor the APA-SM program for rural settings: (1) four community advisory board meetings with 13 members across Texas and South Carolina; (2) focus group interviews with rural partners (<i>N</i> = 24; patients, providers, and administrators); and (3) a pilot feasibility study with rural adults (<i>N</i> = 11), using remote intervention training, app-based instructions, and post-participation interviews.</p><p><strong>Results: </strong>Partner engagement shifted APA-SM from a researcher-led program adaptation to a community co-design approach. Adaptations emphasized trust and workflow fit through community health workers and clinic-liaison roles, alignment with clinic priorities, and integration to reduce clinic burden. Community accessibility was enhanced through demonstrations and skills training that cultivated local champions. Participant engagement and retention were supported by plain-language, bilingual materials, low-tech laminated guides, and milestone-based incentives. These refinements improved the program's cultural relevance, feasibility, and acceptability in rural settings.</p><p><strong>Discussion: </strong>Early, reciprocal engagement with rural partners transformed APA-SM into a culturally grounded and operationally feasible program positioned for sustainable use in rural settings. The co-design principles developed here offer a transferable framework for pragmatic implementation of nonpharmacologic interventions in underserved communities.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1851109"},"PeriodicalIF":2.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009509","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":"Serial MRI documentation of sequestrated lumbar disc resorption during conservative management: a case report.","authors":"Zhou Zhang, Zhiliang Yang, Yongqi Zhao, Yuchen Guo, Guangwen Wu","doi":"10.3389/fpain.2026.1853632","DOIUrl":"10.3389/fpain.2026.1853632","url":null,"abstract":"<p><strong>Background: </strong>Although spontaneous resorption in lumbar disc herniation (LDH) is a recognized phenomenon, systematic visual evidence of its temporal progression remains limited. This report utilizes short-interval serial magnetic resonance imaging (MRI) to document the longitudinal clinico-radiological evolution of a sequestrated LDH managed within an integrative conservative framework, providing a continuous imaging-clinical timeline linking structural resolution to symptomatic recovery.</p><p><strong>Case presentation: </strong>A 33-year-old man presented with acute-onset low back pain and right lower limb radicular pain. MRI demonstrated a right posterolateral L4/5 disc extrusion with sequestration, featuring peripheral contrast enhancement (the \"bull's-eye\" sign). After declining non-steroidal anti-inflammatory drugs (NSAIDs), the patient opted for a 16-week integrative regimen comprising acupuncture and modified Duhuo Jisheng decoction. Serial MRI across five time points enabled high-resolution longitudinal tracking of morphological changes. Imaging documented the complete resorption of the free sequestrated fragment, achieving a 79.3% reduction in the herniation ratio alongside a 77.7% reduction in the cross-sectional area at 4 months. These morphological adjustments coincided with substantial clinical recovery, with the Visual Analogue Scale (VAS) score decreasing from 8 to 0 and the Japanese Orthopaedic Association (JOA) score improving from 5 to 28. A 5-month post-treatment follow-up confirmed sustained resolution without recurrence, showing only residual L4/5 disc bulging.</p><p><strong>Conclusions: </strong>Serial MRI dynamically captured the progressive resorption of a sequestrated L4/5 disc and its concordant clinical recovery during integrative conservative management. While this approach was temporally associated with favorable outcomes, the observational design precludes definitive causal attribution. This report suggests that such management may provide a supportive clinical window allowing spontaneous resorption to proceed; however, higher-level controlled studies are required to differentiate potential therapeutic modulation from the natural history of disc regression.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1853632"},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992877","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":"Understanding risk and protective factors for pain and healthy aging: an intersectional and resilience-based perspective.","authors":"Joanna M Hobson, Indonesia A Jordan, Shinye Kim, Taylor L Taylor","doi":"10.3389/fpain.2026.1885948","DOIUrl":"https://doi.org/10.3389/fpain.2026.1885948","url":null,"abstract":"<p><p>Chronic pain (CP) is a major public health concern in the United States, with healthcare costs exceeding $700 billion. Beyond its' economic burden, CP imposes significant physical, emotional, and functional strain, particularly among populations that are disproportionately affected by pain (i.e., older adults, people with HIV, racial and gender minorities). Despite growing trends in pain research, there remains no consensus on optimal pain management or the mechanisms underlying pain exacerbation. Therefore, this review highlights key risk (e.g., sociodemographic determinants of health, clinical co-morbidities) and protective (e.g., resilience, spirituality, complementary approaches, lifestyle) factors that shape pain experiences and influence trajectories of healthy aging. This manuscript will integrate both risk and resilience promoting factors to inform intervention development, clinical practice, and policy. We discuss intersectionality, defined as the interaction of multiple social identities, as well as its influence on pain and aging trajectories over time. Lastly, we propose a framework that integrates intersectionality and resilience to improve pain outcomes among aging adults.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1885948"},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992932","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}