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

{"title":"The analgesic effect of green light on neuropathic pain: a mini-review of the literature and a proposal for future work.","authors":"Wenjing Dai, Ying Zhang, Rui Gu, Xiaoyan Zhu, Yujie Leng, Lijie Ma, Ming Zhang","doi":"10.3389/fpain.2025.1653186","DOIUrl":"10.3389/fpain.2025.1653186","url":null,"abstract":"<p><p>Medically refractory, severe, and unrelenting neuropathic pain remains a public health challenge worldwide. Green light has been found to have an analgesic effect on neuropathic pain. Interestingly, this analgesic effect is prolonged even after green light exposure. Peripheral and central mechanisms include the inhibition of the inflammatory response and the activation of the endogenous cannabinoid system and nerve circuits between the lateral geniculate nucleus and other brain regions, such as the dorsal raphe nucleus and the rostral ventromedial medulla, which may mediate the analgesic effect of green light. An increasing number of clinical studies highlight the side effects of traditional analgesics. The antinociceptive effect of green light has been proven in fibromyalgia and migraine patients. However, the effect of green light on neuropathic pain has not been reported in clinical settings. Here, we review the cellular and molecular mechanisms of the antinociceptive effect of green light. Furthermore, the green light parameters (intensity, duration, and wavelength) used in clinical trials are also summarized.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1653186"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088338","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":"Commentary: The treatment of chemotherapy-induced peripheral neuropathy: a review of current management options and a potential role for scrambler therapy.","authors":"Giuseppe Marineo","doi":"10.3389/fpain.2025.1677861","DOIUrl":"10.3389/fpain.2025.1677861","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1677861"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082605","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":"Patient satisfaction and pain relief following radiofrequency rhizotomy for trigeminal neuralgia: a prospective cohort study.","authors":"Eyad Faizo, Maher Kurdi, Badr Hafiz, Wareef Alzahrani, Norah Alajmi, Bashayer Althaqafi, Raed Gasemaltayeb, Afaf Albalawi, Ahmad A Fallata, Iman Mirza, Ahmed Najjar, Mohammed Alyousef, Alaa Alkhotani, Saleh Baeesa","doi":"10.3389/fpain.2025.1639140","DOIUrl":"10.3389/fpain.2025.1639140","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) causes severe facial pain and affects quality of life. Radiofrequency rhizotomy (RFR) is often used when medications fail. This multicenter study assesses pain relief and patient satisfaction following this minimally invasive procedure in affected individuals treated across multiple institutions in Saudi Arabia and Pakistan.</p><p><strong>Methods: </strong>In this prospective cohort study, 50 patients aged 40-60 with medically refractory TN (V2/V3) underwent percutaneous RFR at 75°C for 60 s under fluoroscopy, followed by dexamethasone injection. Pain (VAS) and patient satisfaction (PGIC) were evaluated at 1 and 6 months post-procedure. Inter-statistical analysis of patients' clinical outcomes using repeated measures ANOVA and Chi-square tests was performed.</p><p><strong>Results: </strong>The average age of the participants was 50.58 ± 5.67 years. 72% were female. The right side was more commonly affected (62%) than the left (38%). The maxillary branch (V2) was the most frequently involved (76%), followed by the mandibular branch (V3) in 24%. Pain scores significantly decreased from a baseline mean of 8.04 ± 0.78-3.20 ±  1.05 at 1 month and 2.58 ± 1.18 at 6 months (p  <  0.001). Patient satisfaction scores also improved significantly, from 5.60 ± 1.20 at baseline to 2.52 ± 1.11 at 1 month and 1.92 ± 0.80 at 6 months (p < 0.001). The most common complication was facial numbness (32%), followed by masticator weakness (14%), dysesthesia (6%), hematoma (2%) and pain recurrence occurred in 6% of cases, defined by either an increase in VAS ≥ 4 or the need for a second intervention during the follow-up window.</p><p><strong>Conclusion: </strong>Radiofrequency rhizotomy offers effective, well-tolerated pain relief for trigeminal neuralgia with high patient satisfaction. It improves symptom control and outcomes, though further long-term studies are needed to assess sustained benefits and quality-of-life impacts beyond six months.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1639140"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076758","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":"Fear-learning is altered in a mouse neuropathic pain model.","authors":"Neda Assareh, Eddy E Sokolaj, Saima Sadia, Kristen E Anderson, Caitlin Frith, Olivia B Walls, Vanessa A Mitchell, Christopher W Vaughan, Bryony L Winters","doi":"10.3389/fpain.2025.1648374","DOIUrl":"10.3389/fpain.2025.1648374","url":null,"abstract":"<p><strong>Background: </strong>While chronic neuropathic pain is characterised by abnormal pain signs, such as allodynia, highly disabling co-morbidities, such as anxiety and depression, have a major impact. It is thought that these co-morbidities arise from learning maladaptations related to inappropriate associations between pain and stimulus/environmental cues. However, the impact of animal neuropathic pain models on the interactions between fear-learning, pain and anxiety are poorly understood, particularly during early stages prior to establishment of anxiety.</p><p><strong>Methods: </strong>We examined the impact of fear-conditioning on fear, anxiety-like behaviours and cold/mechanical allodynia in the mouse sciatic nerve chronic constriction injury (CCI) model of neuropathic pain, at an early post-injury time point.</p><p><strong>Results: </strong>At 2 weeks post-surgery, CCI and sham operated mice displayed similar acquisition of fear-like freezing responses to a paired audio-tone/footshock fear-conditioning paradigm. On the following day, CCI mice displayed greater freezing than sham mice in response to the same context and subsequent tone presentations. While CCI and sham mice display similar anxiety-like behaviour in the light-dark box and open field, these were increased by fear-conditioning in CCI but not mice. Finally, CCI but not sham surgery produced cold and mechanical allodynia, however, these were unaffected by fear-conditioning.</p><p><strong>Conclusions: </strong>These findings indicate that a neuropathic pain model enhances learned context/cue evoked fear behaviours at an early stage following nerve-injury. Furthermore, fear-conditioning enhances anxiety-like behaviour, before such behaviour is normally developed. Thus, fear-conditioning induces exaggerated fear-learning which triggers enhanced fear and anxiety, even during early stages of chronic neuropathic pain.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1648374"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066464","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":"Ultrasound-guided block of the superior cervical ganglion for migraine attacks: a propensity score-matched retrospective study.","authors":"Wenxing Zhao, Hong Yue, Liqiang Yang, Liangliang He","doi":"10.3389/fpain.2025.1556654","DOIUrl":"10.3389/fpain.2025.1556654","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine the efficacy and safety of ultrasound (US)-guided superior cervical ganglion (SCG) block in conjunction with standard triptan in the management of migraine attacks.</p><p><strong>Methods: </strong>In total, 243 subjects who received an adjunctive US-guided SCG block alongside triptan for a migraine attack were enrolled as the SCG cohort. A 1:1 propensity score based on baseline covariates was used to match 243 cases who received triptan alone as the control. The primary endpoints were pain relief and freedom from pain within 24 h after the procedure. Secondary outcomes included headache relief and freedom from pain within 2 h, monthly migraine days (MMDs), Migraine Disability Assessment (MIDAS) scores, Migraine-Specific Quality of Life questionnaire (MSQ) scores, and adverse events.</p><p><strong>Results: </strong>The rates of pain relief and freedom from pain at 24 h after the block were increased in the SCG cases compared to the controls {73.3% vs. 49.4%, with mean difference [MD] of 23.9% [95% confidence interval (CI): 15.5%-29.0%] and 64.2% vs. 37.4%, with MD = 26.7% [95% CI: 18.2%-31.3%], respectively}. Superiority was met, as the 95% CI fell within the superiority margin of 15%. Higher rates of pain relief and freedom from pain at 2 h following the procedure were reported in the SCG cohort (both <i>p</i> < 0.001). At the 1-month follow-up, the SCG cohort had a greater improvement in MMDs (<i>p</i> < 0.01), MIDAS scores (<i>p</i> = 0.040), and MSQ scores (<i>p</i> = 0.036). There were no severe adverse events in the SCG group.</p><p><strong>Conclusions: </strong>US-guided SCG block with triptan was superior to triptan alone in achieving headache remission during a migraine attack for up to 24 h, resulting in reduced migraine days and improved functional ability and life quality at the 1-month follow-up.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1556654"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066382","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 intrinsic reason why LANSS, DN4, and PainDETECT questionnaires cannot distinguish neuropathic pain from nociplastic pain.","authors":"Jean-Pascal Lefaucheur","doi":"10.3389/fpain.2025.1658126","DOIUrl":"10.3389/fpain.2025.1658126","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1658126"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016713","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":"Advancing outcome measure development and analytical approaches: Pain in Animals Workshop 2023.","authors":"B D X Lascelles, D Barratt, P S Basran, D C Brown, J F Coetzee, M Gill, M R Hutchinson, C Johnson, S P L Luna, D P Mohapatra, M L Oshinsky, S Robertson, C F Ruberman, E R Smith, Q Zhang","doi":"10.3389/fpain.2025.1615862","DOIUrl":"10.3389/fpain.2025.1615862","url":null,"abstract":"<p><p>Annually, millions of humans and animals suffer from chronic and acute pain, creating welfare and quality of life concerns for both humans and animals who suffer this pain. In developing new therapeutic approaches, the challenge is to accurately measure this pain to ascertain the efficacy of novel therapeutics. Additionally, there is a need to develop new and effective analgesic options that may offer alternatives to using opioids that contribute to the opioid epidemic. The Pain in Animals Workshop (PAW) meetings are held every other year in partnership with the National Institutes of Health (NIH), bringing key stakeholders together to understand pain in humans and animals better. The 2023 workshop focused on presenting and discussing updates on validated approaches to measuring pain, highlighting opportunity areas for additional outcome measure development. It also discussed study design and analytic approaches to the use of outcome measures in clinical trials, including the important concepts of success-failure approaches and the application of multiple endpoints in evaluating analgesic therapies. The workshop also introduced the concept of the biopsychosocial model of pain, broadening the conversation around the impact of pain and thus opportunities to modulate the pain experience. The application of artificial intelligence to the measurement of pain was introduced. The workshop brought together academia, government, and industry experts in human and animal pain assessment and analgesic intervention development. Given the topic's importance and the meeting's uniqueness, capturing the thoughts and ideas presented and discussed is critical. This narrative is one product from that meeting, summarizing several presentations from the workshop.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1615862"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016762","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":"Wound infection and pain one month after trauma: an underestimated threat.","authors":"Kateryna Ksenchyna, Oleh Ksenchyn, Dmytro Dmytriiev, Oleksandr Nazarchuk","doi":"10.3389/fpain.2025.1647785","DOIUrl":"10.3389/fpain.2025.1647785","url":null,"abstract":"<p><strong>Background: </strong>Pain is a common complication after combat injuries to the extremities. The role of nerve damage in the development of post-traumatic pain is recognized and described in the literature, superinfection as a potential factor has not been studied sufficiently.</p><p><strong>Objective: </strong>To establish the relationship between the characteristics of the wound microbiota, the intake of different groups of antibiotics and the development of chronic pain in patients with traumatic injuries of the extremities.</p><p><strong>Methods: </strong>We conducted a prospective study that included 56 patients. All participants were male, aged 25 years and older. In addition, a mandatory inclusion criterion in the study was the presence of prolonged wound healing, longer than 1 month. We performed a microbiological study of wound contents and assessed the frequency of use of different antibiotics to combat infection. At the same time, pain intensity was assessed using a numerical pain rating scale. Patients were divided into two groups: uncomplicated infection and superinfection. Statistical analysis was performed using <i>t</i>-tests, Fisher's exact test, and multiple linear regression.</p><p><strong>Results: </strong>Superinfection was found in 50% of patients and was significantly associated with higher pain intensity (<i>p</i> < 0.01). Based on the results of the regression analysis, superinfection was found to be an independent predictor of pain severity (<i>β</i> = 1.31; <i>p</i> = 0.001). The use of aminoglycosides and carbapenems showed a trend towards increased pain scores, although statistical significance was not achieved.</p><p><strong>Conclusions: </strong>Wound superinfection is a distinct predictor of the development of chronic pain after traumatic injury. Early microbiological monitoring and cautious use of neurotoxic antibiotics may reduce long-term pain in affected patients. For a deeper understanding of the processes and factors that contribute to and potentiate the development of pain syndrome, further studies are needed on microbial-neuroimmune interactions, taking into account the duration of antibiotic use and their combinations.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1647785"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016781","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":"Facial/sinus pain or pressure and migraine: exploratory findings from the HEADS registry.","authors":"Deena E Kuruvilla, Gretchen E Tietjen, Gregory A Panza, Victoria L Hodgkinson, Frederick A Godley","doi":"10.3389/fpain.2025.1625442","DOIUrl":"10.3389/fpain.2025.1625442","url":null,"abstract":"<p><strong>Background: </strong>Rhinosinusitis (RS) is a leading reason for antibiotic prescriptions but treatment satisfaction is low. Misdiagnosis may contribute to poor outcomes, as migraine-often underrecognized-can mimic RS symptoms, with studies showing overlap between RS and migraine diagnoses. Our aims were to explore the demographics and clinical features of facial pain or pressure (FPP), its relationship with migraine and RS, and distinguish symptoms between these overlapping conditions.</p><p><strong>Methods: </strong>The HEADS Registry, a web-based survey, targets adults with head and/or neck symptoms. Participants who answered \"yes\" (FPP+) or \"no\" (FPP-) to experiencing recurrent facial or sinus pain/pressure were included in this analysis. The ID Migraine screening tool was used to classify participants as ID Migraine+ or ID Migraine-. Demographics, symptoms, disability, history of allergies, sinusitis, and antibiotic use were compared between 1) FPP+ and FPP- groups, 2) FPP+/ ID Migraine+ and FPP+/ID Migraine-, and 3) FPP+/ID Migraine- and FPP-/ID Migraine+ subgroups. Continuous variables were compared using independent samples t-test or Mann-Whitney U, and categorical variables were compared using chi-square or Fisher's exact test.</p><p><strong>Results: </strong>The FPP+ group (<i>n</i> = 598) was younger, more often female, and reported higher rates of nasal, vestibular, and otologic symptoms compared to the FPP- group (<i>n</i> = 146). They also had more severe headaches, migraine-associated symptoms, and higher ID Migraine screening rates. The FPP+ group reported greater daily symptom interference, and more allergies, sinus infections, and antibiotic use. Those who screened positive for migraine (FPP+/ID Migraine+, <i>n</i> = 438) had more severe symptoms, greater disability, and more frequent forehead/eye pain. FPP+/ID Migraine- (<i>n</i> = 48) participants were more likely to report nasal symptoms, allergies, and sinus infections, while FPP-/ID Migraine+ (<i>n</i> = 85) participants reported more disabling headaches.</p><p><strong>Conclusion: </strong>In this exploratory analysis, FPP was strongly associated with headache, including migraine, as well as allergies, rhinosinusitis, and antibiotic use. The low reported effectiveness of antibiotics suggests potential misdiagnosis. Findings that migraine, plus autonomic, vestibular, otologic symptoms are associated with FPP, highlight the need to expand the differential diagnosis beyond infectious causes. These insights, along with ongoing registry improvements, will support efforts to refine diagnostic accuracy and optimize treatment strategies for neurologic, otologic, and rhinologic conditions.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1625442"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016727","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":"Novel multimodal mechanical stimulation is superior to TENS to treat and prevent chronic low back pain: a randomized controlled trial.","authors":"Amy Lynn Baxter, Jena L Etnoyer-Slaski, Owen Tucker, Jessica Allia Rice Williams, Kevin Swartout, Lindsey L Cohen, M Louise Lawson","doi":"10.3389/fpain.2025.1625420","DOIUrl":"10.3389/fpain.2025.1625420","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is the leading cause of disability worldwide. Up to half of moderate-to-severe acute LBP (aLBP) progress to chronic (cLBP), with neuromotor, fascial, and muscle pathology contributing to inoperable mechanical disability. A novel thermomechanical stimulation (M-Stim) device delivering stochastic and targeted vibration frequencies relieved LBP in a pilot. Efficacy versus an active control, for cLBP prevention, or reversing disability was undetermined.</p><p><strong>Methods: </strong>As part of a National Institutes of Health (NIH) double-blind, randomized controlled trial, 159 chiropractic patients with non-radiating moderate-to-severe LBP [Numeric Rating Scale (NRS) ≥4] were randomized to add either the multimodal M-Stim device or 4-lead transcutaneous electrical nerve stimulation (TENS) for 30 minutes daily to other therapies. Between June 2022 and July 2024, pain scores, analgesic use, and device adherence were recorded for 28 days, with weekly follow-up up to 6 months. Primary outcomes included PROMIS Pain Interference scores, NRS pain scores, and transition from aLBP to cLBP (Pain Interference ≥55 at 3 months). Exploratory analyses examined higher-severity subgroups, including those meeting NIH Research Task Force (RTF) criteria, obesity, longer pain duration, and an integrated analysis with common criteria for intractable inoperable mechanical cLBP.</p><p><strong>Results: </strong>For 44 aLBP and 115 cLBP participants [mean age 42.6, 54% female, BMI 30.9 (SD 6.19), NRS 5.51 (SD 2.15)], M-Stim was noninferior to TENS for initial and 10-day relief. Over time, Linear Mixed Models (intention-to-treat) showed M-Stim significantly improved pain and disability for both aLBP and cLBP, (<i>p</i> < .001 to <i>p</i> = .024). With higher severity, 23.9% (11/46) M-Stim users reached \"no disability\" (PROMIS = 40.7) vs. 7.1% (2/28) TENS users [RR 0.81 (95% CI 0.66-0.99), <i>p</i> = 0.04]. M-Stim yielded significantly greater improvement than TENS in those with pain ≥5 years, BMI ≥30, or mechanical cLBP (all <i>p</i> < .05). Significantly fewer aLBP M-Stim users transitioned to cLBP at 3 months [31.8% vs. 72.7%, RR 0.44 (95% CI 0.23-0.85), NNT = 2.4, <i>p</i> = 0.015].</p><p><strong>Conclusions: </strong>A multimodal M-Stim device reduced progression to cLBP significantly more than TENS. Both devices reduced pain initially, but M-Stim reduced pain and disability significantly more over time, particularly in cLBP subsets with higher severity, duration, or BMI.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT04494698, identifier NCT04494698.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1625420"},"PeriodicalIF":2.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994700","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}