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

{"title":"Unmet health-related social needs are associated with pain outcomes among midlife and older adults.","authors":"Victoria H Davis, Elizabeth J Brines, Mary R Janevic","doi":"10.3389/fpain.2026.1885908","DOIUrl":"10.3389/fpain.2026.1885908","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain affects over one-third of U.S. older adults, and particularly socioeconomically constrained populations. Few studies examine how unmet social needs related to the social determinants of health, including food, housing, utilities, transportation, and social support, are linked to pain. This study assessed whether cumulative and individual unmet social needs are associated with pain outcomes in a predominantly Black/African American sample of adults aged 50 years and older with chronic pain recruited from an underserved urban setting.</p><p><strong>Methods: </strong>We pooled pre-intervention data from two randomized controlled trials of community health worker-led behavioral interventions. Multivariable linear regression examined associations of cumulative and individual unmet social needs with pain intensity, pain interference, and pain self-efficacy.</p><p><strong>Results: </strong>Among 438 participants, the mean age was 67.5 years, 87% (<i>n</i> = 380) were female, 77% (<i>n</i> = 338) identified as Black/African American, and 54% (<i>n</i> = 237) reported one or more unmet social needs. In adjusted regression models, participants with greater cumulative unmet social needs (three or more) experienced greater pain intensity (<i>B</i> = 0.75, <i>p</i> = .010), pain interference (<i>B</i> = 3.24, <i>p</i> = .002), and lower pain self-efficacy (<i>B</i> = -2.04, <i>p</i> = .006). Food access challenges were associated with all three outcomes; transportation difficulties were linked with greater pain interference and lower self-efficacy; and insufficient social support was associated with greater pain intensity and greater pain interference (<i>p</i> < .05). Housing and utility payment difficulties were not associated with pain outcomes.</p><p><strong>Conclusion: </strong>Cumulative and individual unmet social needs are associated with worse pain outcomes among midlife and older adults with chronic pain.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1885908"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978911","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":"Technologies to investigate the mechanisms of force-based manipulations: a narrative methods review.","authors":"Arin M Ellingson, Jennifer A Bent, Mary F Barbe, Karl J Lewis, Simon Y Tang, Gregory J Gerling, M Terry Loghmani, William R Reed, Greg N Kawchuk","doi":"10.3389/fpain.2026.1908955","DOIUrl":"10.3389/fpain.2026.1908955","url":null,"abstract":"<p><p>Force-based manipulations (FBM), as defined by the National Center for Complementary and Integrative Health (NCCIH), involve the passive application of mechanical force to the body with therapeutic intent. These approaches are commonly used in pain management, rehabilitation, wellness, and disease prevention, and include spinal and extremity manipulation, mobilization, soft tissue manipulation, massage, myofascial release, osteopathic manipulative treatment, and related manual or instrument-assisted therapies. FBM may involve light touch, pressure, mobilization, thrust, adjustment, needling, or other mechanically mediated inputs, and their effects may be influenced by contextual factors, including interpersonal relational dynamics, physical environment and patient psychophysics. Consistent with ongoing interprofessional efforts to standardize manual therapy nomenclature, this review emphasizes the careful descriptive terminologies and mechanical parameters rather than profession-specific labels. Although these therapeutic approaches are widely used to manage pain and improve function, the biological processes associated with FBM remain unknown and/or inadequately characterized. This narrative review synthesizes established technologies for investigating FBM across multiple domains, including biomechanical loading and motion analysis, tissue, cellular, and molecular imaging, biomarker, transcriptomic, and mechanobiological assessment, neurophysiological monitoring, vascular and microcirculatory assessment, computational modeling/data science, sensory, psychophysical, and contextual assessment, and mechanistic perturbation and neuromodulation methods. Rather than focusing on individual techniques in isolation, this review organizes these methods within a multi-scale framework that relates externally applied mechanical inputs to measurable internal mechanical, neural, vascular, cellular, molecular, regional, and whole-organism responses. Crucially, the physiological impact of these mechanical events is continuously modulated by the operationalized environment and therapeutic alliance, which must be treated as measurable covariates that interact with mechanical inputs. By providing a structured overview of validated and accessible methodologies, this work offers a roadmap for mechanistic FBM research and supports the future development of integrative, interdisciplinary studies. This framework is intended to help investigators characterize applied mechanical inputs using shared descriptive terminology, evaluate physiological responses across levels of structure and function, and examine relationships among mechanical input, contextual factors, biological mechanisms, and clinically meaningful outcomes.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1908955"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957412","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":"Organization of coping strategies and their proximal associations with pain intensity in spinal pain patients.","authors":"Alemu Sisay Nigru, Federico Maffezzoni, Sergio Benini, Serena Miglio, Matteo Bonetti, Michele Frigerio, Graziella Bragaglio, Chiara D'Adda, Riccardo Leonardi","doi":"10.3389/fpain.2026.1824864","DOIUrl":"10.3389/fpain.2026.1824864","url":null,"abstract":"<p><strong>Background: </strong>Although coping strategies are well-established psychological correlates of chronic pain, their relative importance and combined organization in relation to pain intensity remain unclear. Clarifying whether coping strategies act as independent correlates or as an organized system is essential for refining psychosocial assessment and intervention.</p><p><strong>Methods: </strong>In this cross-sectional study, 142 adults with spine-related pain in Brescia, Italy completed the Cope-NVI questionnaire, assessing five coping dimensions. A multi-method analytical framework was applied: multiple regression identified independent associations with pain intensity, bootstrap mediation analyses examined indirect associations among coping strategies, and k-means clustering identified person-centered coping profiles. Sensitivity analyses additionally adjusted for demographic and clinical characteristics.</p><p><strong>Results: </strong>Multiple regression identified Avoidance and Positive Attitude as the only coping dimensions independently associated with pain intensity. These associations remained significant after adjustment for age, sex, pain duration, and pain location. Bootstrap mediation analyses indicated that associations of Social Support and Problem Orientation with pain intensity were largely accounted for by indirect associations through Avoidance and Positive Attitude. Cluster analysis identified three clinically interpretable coping profiles: Adaptive Copers (low Avoidance, high Positive Attitude; lowest pain), Moderate Copers, and Maladaptive Copers (high Avoidance, low Positive Attitude; highest pain). Cluster differences were observed primarily in coping characteristics and pain intensity rather than demographic or clinical variables.</p><p><strong>Conclusions: </strong>Coping strategies in spine-related pain appear to be hierarchically organized in relation to pain intensity, with Avoidance and Positive Attitude showing the strongest independent associations. These findings provide a framework for understanding how coping dimensions co-occur within individuals and may help inform psychosocial assessment and person-centered intervention strategies. Given the cross-sectional design, the observed mediation patterns should be interpreted as statistical associations rather than causal mechanisms.</p><p><strong>Significance: </strong>This study clarifies how coping strategies jointly relate to pain intensity in individuals with spine-related pain. Using integrated regression, mediation, and cluster analyses, it identifies Avoidance and Positive Attitude as the coping dimensions most strongly associated with pain severity and demonstrates that coping strategies organize into clinically interpretable profiles. The findings support psychosocial assessment approaches that prioritize maladaptive avoidance and adaptive cognitive coping processes.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1824864"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931981","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":"Exploring the associations of cortical connectivity-modulation with clinical and psychological measures in acute low back pain.","authors":"Sabina Hotz-Boendermaker, Bart Boendermaker, Roman Buechler, Lars Michels","doi":"10.3389/fpain.2026.1884788","DOIUrl":"10.3389/fpain.2026.1884788","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) represents a significant global health burden. Transitioning from the traditional \"self-limiting\" perspective, emerging evidence suggests that neural plasticity and central maladaptation in the acute phase are pivotal in the progression to chronicity.</p><p><strong>Objectives: </strong>This study investigated whole-brain functional connectivity and sensorimotor processing during acute LBP.</p><p><strong>Methods: </strong>Thirteen participants with acute LBP (<4 weeks duration) underwent clinical, psychometric, and functional magnetic resonance imaging (fMRI) assessments. Brain activity and connectivity were mapped during lumbar mechanosensory stimulation, with a focused analysis on sensorimotor, salience, cerebellar, and limbic networks.</p><p><strong>Results: </strong>Pain intensity demonstrated a negative correlation with posterior supramarginal-precuneus connectivity and a positive correlation with cerebellar activity. Fear-avoidance behavior was positively associated with connectivity across a cerebellar-limbic axis (cerebellum, brainstem, and hippocampus). Furthermore, mechanical pain summation (wind-up ratio) and movement control impairments were significantly linked to connectivity shifts within the salience and sensorimotor-lateral networks.</p><p><strong>Conclusion: </strong>These findings demonstrate that acute LBP is characterized by immediate widespread neuronal reorganization. The modulation of these networks by pain intensity and motor dysfunction suggests an early interplay between sensory, motor, and affective processing. Identifying these neural signatures provides a mechanistic framework for targeted biopsychosocial interventions designed to intercept the transition from acute pain to chronic disability.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1884788"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931923","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":"Retraction: Effectiveness of medical ozone injections into the intervertebral disc on relieving lumbosacral pain-a systematic review and meta-analysis.","authors":"","doi":"10.3389/fpain.2026.1972267","DOIUrl":"https://doi.org/10.3389/fpain.2026.1972267","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.3389/fpain.2025.1668752.].</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1972267"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931992","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":"Potential applications of artificial intelligence in pain management: a scoping review.","authors":"Dmitriy Viderman, Sultan Kalikanov, Meiram Tungushpayev, Min-Ho Lee, Dong-Ok Won","doi":"10.3389/fpain.2026.1871943","DOIUrl":"10.3389/fpain.2026.1871943","url":null,"abstract":"<p><strong>Introduction: </strong>Pain management remains a critical challenge in clinical settings. This scoping review studied the applications of artificial intelligence (AI) in pain medicine, particularly pain detection, prediction, and classification.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Scopus, and Cochrane Library databases up to July 2025.</p><p><strong>Results: </strong>Forty-seven relevant studies were included. The findings demonstrated that AI may have the potential for objective pain assessment using facial expressions, electroencephalography, neuroimaging, and physiological signals. Detection models achieved high accuracy, frequently exceeding 85%-90%. Predictive models showed efficient forecasting in pain sensitivity, pain evaluation after operation, and pain treatment response. Classification approaches also reported high performance. The results are hindered by several limitations: risk of overfitting, shortage of real-world experiments, homogeneous or small data samples, and methodological heterogeneity. Critical barriers for clinical implementation are ethical concerns and external validity.</p><p><strong>Conclusion: </strong>AI showed significant potential as a pain assessment and decision-support tool in pain medicine and research, especially for populations unable to self-report. It is recommended to use large, diverse datasets and real-world clinical validation to ensure the effective transitioning of artificial intelligence into healthcare systems.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1871943"},"PeriodicalIF":2.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921999","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":"Correction: Advances in rehabilitation for bone and joint pain: a critical narrative review of evidence, gaps, and future directions.","authors":"Jie Zhuang, Jinyan Wang, Yinhu Hu, Juan Jin, Jing Shi, Lei Song, Zekai Hu","doi":"10.3389/fpain.2026.1953832","DOIUrl":"https://doi.org/10.3389/fpain.2026.1953832","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fpain.2026.1858635.].</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1953832"},"PeriodicalIF":2.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922051","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":"Effectiveness of epidural steroid injections in the treatment of lumbar radiculopathy: a systematic review and meta-analysis.","authors":"Sebastian E Moran, Samuel B Kankam, Andrew O Schindler, Sophia Dinh, Ryan Dinh, Neha Kulkarni, Sarah Voon, Audrey Demand, Paul J Holman, Meng Huang, Sean Barber","doi":"10.3389/fpain.2026.1904875","DOIUrl":"10.3389/fpain.2026.1904875","url":null,"abstract":"<p><strong>Introduction: </strong>Epidural steroid injection (ESI) techniques have demonstrated effectiveness in improving short- and intermediate-term pain and disability outcomes; however, their efficacy may vary depending on the specific approach used. This meta-analysis aims to compare disability and pain outcomes among different ESI techniques - transforaminal (TFESI), interlaminar (ILESI), caudal (CESI), and combined approaches - in patients with lumbar radiculopathy.</p><p><strong>Methods: </strong>The authors searched PubMed/MEDLINE, Scopus, and Cochrane from inception to December 16, 2025, in accordance with PRISMA guidelines. Studies comparing disability and pain outcomes between different ESIs were assessed. Random-effects meta-analyses were performed to estimate the pooled mean difference between treatment groups at different follow-up timepoints. Sensitivity analyses and publication bias assessments were conducted.</p><p><strong>Results: </strong>In total, 31 studies comprising 2,452 patients were included. Compared with ILESI, TFESI demonstrated significantly greater pain reduction at 2 weeks and 1 month of follow-up, as well as superior improvements in both disability and pain at 3 and 6 months. Compared with CESI, TFESI showed superior disability improvements at 2 weeks and 1 month, with pain outcomes remaining superior at 1 and 3 months; however, both disability and pain outcomes plateaued by 6 months. At 12-month follow-up, TFESI demonstrated improved disability scores compared with CESI, with no significant difference in pain outcomes. Across all follow-up timepoints, the combined TFESI + CESI approach was associated with significantly greater improvements in both disability and pain relief compared with TFESI alone.</p><p><strong>Conclusions: </strong>TFESI demonstrated superior short- and intermediate-term improvements in disability and pain compared with ILESI, but its advantages over CESI remained inconsistent. Limited evidence suggests that the combined TFESI + CESI approach may offer additional benefits over TFESI alone. Further prospective randomized trials are warranted to better define the efficacy and long-term outcomes of the combined approach.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261320804.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1904875"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898532","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 the term \"central sensitization\" should be refined, by introducing the terms \"spinal sensitization\", \"pain-related brain network sensitization\", and \"psychosocial-related sensitization\".","authors":"Jean-Pascal Lefaucheur","doi":"10.3389/fpain.2026.1825371","DOIUrl":"10.3389/fpain.2026.1825371","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1825371"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898460","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":"Opioid receptor agonist-antagonists in pain management: receptor specific mechanisms, dose response relationships, and clinical combination strategies.","authors":"Sining Zhao, Zhiqiang Xue, Shu Wang","doi":"10.3389/fpain.2026.1903184","DOIUrl":"10.3389/fpain.2026.1903184","url":null,"abstract":"<p><p>Opioid receptor agonist-antagonists occupy a distinctive position between high-efficacy agonists and pure antagonists and have been widely used in clinical pain management. Nevertheless, their pharmacological complexity and dose-dependent receptor interactions have led to persistent controversy regarding their analgesic efficacy, ceiling effects, and clinical performance when combined with full <i>μ</i>-opioid receptor agonists. Most existing reviews focus on individual agents or isolated mechanisms and do not adequately address the dynamic relationship between receptor selectivity, intrinsic efficacy, and dose-effect behavior that underlies their clinical outcomes. This narrative review integrates recent preclinical and clinical evidence to examine the pharmacological properties and clinical application strategies of opioid receptor agonist-antagonists, with particular emphasis on <i>κ</i>-opioid receptor agonism, μ-opioid receptor partial agonism or antagonism, and their interactions across different dose ranges. We discuss the mechanistic basis of the analgesic ceiling effect observed with μ-partial agonists, highlighting that this phenomenon reflects limited intrinsic efficacy rather than a dose-dependent transition to pure antagonism. Furthermore, the review analyzes how agonist-antagonists may exert synergistic or functional antagonistic effects when co-administered with full μ-opioid agonists, depending on dose, receptor affinity, and binding kinetics. At low to moderate doses, complementary <i>κ</i>-μ receptor modulation may enhance analgesia while attenuating opioid-related adverse effects such as respiratory depression, pruritus, and nausea, whereas excessive dosing may compromise analgesic efficacy or increase sedation. By synthesizing receptor-specific mechanisms with clinical dosing considerations, this review proposes a receptor-selective, dose-dependent framework to support safer and more effective use of opioid receptor agonist-antagonists in contemporary multimodal pain management.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"7 ","pages":"1903184"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898537","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}