Trends in Mixed Pain Research Over Three Decades (1993-2024): A Bibliometric Analysis.

Background: The term "mixed pain" is frequently used in clinical practice to describe the coexistence of nociceptive, neuropathic, and nociplastic pain mechanisms. However, its inconsistent use and lack of a formal definition warrant further investigation. This bibliometric analysis aims to explore publication trends, research networks, and key themes in mixed pain literature.

Methods: A bibliometric analysis was conducted using the Web of Science Core Collection. The search was performed in February 2024, with journal rankings obtained from Journal Citation Reports™ 2022 (Clarivate Analytics). Extracted data included publication trends, citation analysis, co-authorship networks, and keyword mapping.

Results: A total of 229 publications were identified, demonstrating an increasing trend in both publication volume and citations. Most studies were published in high-ranking Q1 journals as research (77%) and review articles (19%). The USA (21%), Italy (15%), and Germany (12%) were the leading contributors, yet global collaboration was weak, with limited co-authorship connections except within the USA. The keyword analysis revealed five major research clusters, with "neuropathic pain," "management," and "quality of life" emerging as central themes.

Conclusions: Despite the progressive increase in mixed pain articles in highly ranked journals, this bibliometric analysis highlighted the absence of a well-structured collaborative network among authors and a lack of clear connections between keywords. Given the critical clinical implications of mixed pain, further high-quality studies on this topic and enhanced international collaborations are recommended.