European Journal of Pain最新文献

{"title":"The Role of Catastrophizing in Enhancing Pain Interference and Depressive Symptoms in Endometriosis: A Longitudinal Examination","authors":"Marta Spinoni,&nbsp;Cristian Di Gesto,&nbsp;Maria Grazia Porpora,&nbsp;Caterina Grano","doi":"10.1002/ejp.70198","DOIUrl":"10.1002/ejp.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endometriosis is a prevalent condition characterised by chronic pelvic pain, significantly impacting women's quality of life and well-being. Pain catastrophizing is a cognitive tendency of exaggerated worrying, a sense of helplessness, and amplification of distressing thoughts in response to pain. According to the Fear-Avoidance Model, catastrophizing contributes to prolonged pain interference and mood disorders. This longitudinal study examines the relationship between pain catastrophizing, pain interference, and depressive symptoms in patients with endometriosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A sample of 128 cisgender women with endometriosis recruited from online patient associations completed self-report measures assessing pain catastrophizing, pain interference, and depressive symptoms at baseline (T1) and after 6 months (T2). A mediation model examining the indirect effect of pain catastrophizing on depressive symptoms through pain interference was tested. The pelvic pain level was considered as a covariate in the model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More than half of the sample reported depressive symptoms above the cut-off. Pain catastrophizing at T1 significantly predicted depressive symptoms at T2. Pain interference partially mediated this relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings indicate that heightened levels of catastrophizing correlate with increased pain interference, which, in turn, predicts elevated depressive symptoms over time. Findings suggest that by targeting catastrophizing tendencies, clinicians may help mitigate depressive symptomatology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This longitudinal study investigates for the first time the impact of pain catastrophizing on pain interference and depressive symptoms over time in cisgender women with endometriosis. Findings indicated both a direct influence of pain catastrophizing on depressive symptomatology and an indirect effect via increased pain interference, in line with the Fear-Avoidance Model. These findings underscore the importance of targeting pain catastrophizing tendencies in interventions aimed at improving the well-being of patients affected by endometriosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction Model for Factors Associated With Long-Term Opioid Use Following Total Knee Arthroplasty: A Retrospective Population-Based Study","authors":"Pin-Hung Yeh,&nbsp;Shun-Fa Yang,&nbsp;Jing-Yang Huang,&nbsp;Chao-Bin Yeh","doi":"10.1002/ejp.70195","DOIUrl":"10.1002/ejp.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Knee osteoarthritis (OA) affects approximately 10% of the general population. Of these, nearly 20% of patients undergo total knee arthroplasty (TKA). A proportion subsequently develops long-term opioid use, yet comprehensive evaluations of perioperative risk factors remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 15,051 patients with knee OA who underwent TKA between 2002 and 2018 were included. Our primary analysis used a Least Absolute Shrinkage and Selection Operator (LASSO)–Elastic Net logistic regression model with a 70/30 training–validation split to identify predictors of long-term opioid use and to estimate model performance using the area under the receiver operating characteristic curve (AUC) and calibration. As supplementary analyses, hierarchical logistic regression models progressively incorporated demographic, preoperative, in-hospital, and early post-discharge variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 1029 patients were identified as long-term opioid users. The LASSO–Elastic Net model achieved an AUC of 0.8213 (95% CI: 0.8080–0.8347). The AUCs of the hierarchical logistic models were 0.7523 (95% CI: 0.7364–0.7681) for demographic and preoperative factors (Model 1), 0.7682 (95% CI: 0.7534–0.7829) with added hospitalisation factors (Model 2), and 0.8251 (95% CI: 0.8119–0.8383) after further including post-discharge variables (Model 3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study systematically identifies risk factors for long-term opioid use across different phases of TKA care. A predictive model based on LASSO–Elastic analysis demonstrated an AUC of 0.8213, highlighting its potential for early identification of high-risk patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Using a population-based analysis, this study identifies risk factors for prolonged opioid use following TKA, aiding clinicians in early recognition and targeted preventive strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12740543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardising the Collection of Socio-Demographic Data in Pain Research","authors":"Emma L. Karran,&nbsp;Aidan G. Cashin,&nbsp;Alessandro Chiarotto,&nbsp;Saurab Sharma,&nbsp;Trevor Barker,&nbsp;Mark A. Boyd,&nbsp;Lara J. Maxwell,&nbsp;Vina Mohabir,&nbsp;Jennifer Petkovic,&nbsp;Peter Tugwell,&nbsp;G. Lorimer Moseley","doi":"10.1002/ejp.70194","DOIUrl":"10.1002/ejp.70194","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Unserved Majority: The Urgent Need to Address the Mild-Impact Chronic Pain Population","authors":"Flaminia Coluzzi","doi":"10.1002/ejp.70189","DOIUrl":"10.1002/ejp.70189","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatosensory Abnormalities, Dysesthesia and Central Neuropathic Pain in Youth With Cerebral Palsy","authors":"Michael Nørregaard Vinkel,&nbsp;Gija Rackauskaite,&nbsp;Mette Thorup,&nbsp;Andrea Truini,&nbsp;John Rosendahl Østergaard,&nbsp;Hatice Tankisi,&nbsp;Nanna Brix Finnerup","doi":"10.1002/ejp.70188","DOIUrl":"10.1002/ejp.70188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pain is common in people with cerebral palsy. Despite the presence of central nervous system injury, it is unknown whether central neuropathic pain occurs in cerebral palsy and whether unpleasant, abnormal sensations such as dysesthesia are present. The study aims to examine the presence of sensory abnormalities and neuropathic pain in youth with cerebral palsy and relate these findings to specific brain injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional observational study examines 27 ambulant youth with cerebral palsy and 48 healthy controls aged 15–22 using structured interviews, detailed bedside examinations, laser evoked potentials, quantitative sensory testing and MRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of self-reported sensory abnormalities in the cerebral palsy group was lower than found using bedside sensory mapping (41% vs. 74%, <i>p</i> = 0.003) and quantitative sensory testing (41% vs. 70%, <i>p</i> = 0.021). Furthermore, three had evoked dysesthesia. Ongoing or recurrent pain occurred in 70% of youth with cerebral palsy, without evidence of central neuropathic pain. The relative risk of having sensory loss was 3.2 (95% CI 1.47–7.00) when an injury to the spinothalamic tract, thalamus, insula, or somatosensory cortex was present, while the relative risk of sensory gain was 5.3 (95% CI 0.78–35.85) with the presence of white matter injury from periventricular leucomalacia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We recommend addressing sensory function and dysesthesia in future studies and cerebral palsy follow-up programs. Brain injury patterns may predict sensory loss or gain and distinct somatosensory topographies could clarify these mechanisms. These insights may enable earlier identification of sensory abnormalities in cerebral palsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>1) This study highlights the high prevalence yet underrecognition of sensory abnormalities and pain in individuals with cerebral palsy. 2) It explores the subjective experience and perception of sensory abnormalities and is the first to identify and characterize dysesthesia in this population. 3) The findings demonstrate that pain is common among young, ambulant individuals with cerebral palsy; however, central neuropathic pain appears to be absent despite underlying central nervous system injury.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Phenotyping Chronic Pain and Neuropathic Pain in Population Studies”","authors":"Fiona M. Blyth,&nbsp;Saman Khalatbari-Soltani","doi":"10.1002/ejp.70193","DOIUrl":"10.1002/ejp.70193","url":null,"abstract":"&lt;p&gt;The journal recently published a position paper by Liang et al. (&lt;span&gt;2025&lt;/span&gt;) titled “Phenotyping chronic pain and neuropathic pain in population studies.” There can be little argument about the central proposition of the paper—that we need to have consistent approaches to defining commonly occurring categories of chronic pain and to identifying meaningful phenotypes. The current lack of clarity and consistency undermines both our understanding of the overall population burden of chronic pain and progress on the potential of precision medicine to improve how treatment effectiveness is assessed in clinical populations.&lt;/p&gt;&lt;p&gt;The pyramid model for phenotyping based on chronic neuropathic pain that is proposed in the paper succinctly captures the different goals of epidemiological research spanning general population-level studies through to richly characterised clinical cohort studies, with indicative approaches to phenotyping matched to those goals. Also implicit in the pyramid model is the trade-off between generalisability and precision (breadth versus depth) required at different levels of the model, according to the primary goal at each level of the pyramid. While the paper outlines the substantial progress for neuropathic pain conditions, a significant challenge remains to replicate this for other common forms of chronic pain.&lt;/p&gt;&lt;p&gt;Efforts to standardise or harmonise data collection and phenotyping are essential, and will likely reduce variation in prevalence due to methodological differences between studies. When consistent definitions are used, other drivers of differences in prevalence can be identified, notably geographical and equity-related factors (Zimmer et al. &lt;span&gt;2022&lt;/span&gt;). These include groups exposed to multiple, often intersecting forms of marginalisation across ethnicity, gender, disability, and socioeconomic position. Yet, perhaps paradoxically, the large-scale studies and biobanks that exist are overwhelmingly from high-income countries and settings, and even within these settings consistently under-recruit from and therefore under-represent the priority populations most at risk of high pain burden. In the rapidly developing field of clinical risk prediction modelling, there are related concerns about model fairness if models are developed from large datasets where minority populations are under-represented, and the accuracy of risk prediction in these populations is more uncertain (Riley et al. &lt;span&gt;2025&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;The authors point out that progress towards developing tailored interventions needs more clarity and consistency in identifying biopsychosocial contributors of pain, and this in turn depends on consistency in case definitions and phenotyping. Collectively, this should be underpinned by conceptually coherent models of how risk factors work together over time that can be empirically tested and refined. Cohort studies are particularly valuable in this context, as they collect longitudinal data that","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing the Prediction and Understanding of Placebo Responses in Chronic Back Pain Using Large Language Models","authors":"Diogo A. P. Nunes,&nbsp;Dan Furrer,&nbsp;Sara Berger,&nbsp;Guillermo Cecchi,&nbsp;Joana Ferreira-Gomes,&nbsp;Fani Neto,&nbsp;David Martins de Matos,&nbsp;A. Vania Apkarian,&nbsp;Paulo Branco","doi":"10.1002/ejp.70184","DOIUrl":"10.1002/ejp.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Placebo analgesia is a widely studied clinical phenomenon, yet placebo responses vary widely across individuals. Prior research has identified biopsychosocial factors that determine the likelihood of an individual to respond to placebo, yet generalizability and ecological validity in those studies have been limited due to the inability to account for dynamic personal and treatment effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed fine-tuned large language models (LLMs) for the prediction of placebo responses in chronic low-back pain using contextual features extracted from patient interviews, as they speak about their lifestyle, pain, and treatment history. Interviews were conducted as part of two RCTs designed to study the placebo effect. These interviews were collected after treatment in the first trial (discovery cohort) and prior to treatment in the second trial (validation cohort).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Semantic features extracted with LLMs can predict which individuals respond to a placebo, with an accuracy of 74% in unseen data, and validating with 70% accuracy in an independent cohort. Furthermore, in contrast to previous work, LLMs eliminated the need for pre-selecting search terms, enabling a fully data-driven approach, and provided interpretable insights into psychosocial factors underlying placebo responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings expand on prior research by integrating state-of-art NLP techniques to address limitations in interpretability and context sensitivity of the traditional methods in related work. This method highlights the role of language models to link language and psychological states, paving the way for a deeper quantitative exploration of biopsychosocial phenomena, and to understand how they relate to treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study paves the way for a deeper yet quantitative exploration of biopsychosocial phenomena through language, and to understand how they relate to treatment outcomes, namely placebo. In this case it highlights nuanced linguistic patterns linked to responder status, which tap into semantic dimensions such as “anxiety,” “resignation,” and “hope”.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Structured Exercise Program Versus Aerobic Exercise in Tension-Type Headache: A Randomised Clinical Trial","authors":"Kübra Ataş,&nbsp;Ebru Kaya Mutlu","doi":"10.1002/ejp.70186","DOIUrl":"10.1002/ejp.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the widespread use of exercise in managing tension-type headache, there remains a lack of research on the effectiveness of combined structured exercise programs. The aim of this study was to investigate the effects of a structured exercise program versus aerobic exercise of equal duration on tension-type headache (TTH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-four female participants aged between 18 and 55 years were randomised to receive a 12-week exercise program, conducted twice a week for 45 min per session. The Structured Exercise Group (SEG) participated in a combination of aerobic, strengthening, and stretching exercises, whereas the Aerobic Exercise Group (AEG) performed only aerobic exercises. The primary outcome measure was the Headache Impact Test (HIT-6), a quality-of-life questionnaire. Secondary outcome measures included headache intensity, disability level, pressure pain threshold, proprioception, muscle strength, cervical posture, exercise capacity, anxiety, and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both groups showed statistically significant improvements in quality of life, pain intensity, disability, anxiety, depression, exercise capacity, pressure pain threshold, and proprioception (<i>p</i> &lt; 0.05). Between-group comparisons revealed that the SEG demonstrated significantly greater improvements in quality of life, pressure pain threshold, proprioception, muscle strength, and posture (<i>p</i> &lt; 0.05), whereas the AEG showed superior gains in exercise capacity (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both exercise programs appear similarly effective for self-reported outcomes. Based on clinical measurement results, we recommend incorporating strengthening and stretching exercises into the aerobic exercise program and extending the duration to 12 weeks for additional benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study highlights the clinical value of supervised, physiotherapist-led exercise and the integration of personalised, multi-component strategies in managing tension-type headache. While both structured and aerobic programs improved pain, activity, and participation, the structured approach provided additional benefits in pressure pain threshold, proprioception, muscle strength, and posture. Tailoring interventions to individual clinical needs and extending the duration beyond 8 weeks may further enhance outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Total Pain in Ukraine Study: How Does War Affect Civilians With a History of Chronic Pain? An Observational Study","authors":"Iana Burmistr,&nbsp;Ruth Zaslansky,&nbsp;Dmytro Dmytriiev,&nbsp;Andreas Kopf","doi":"10.1002/ejp.70185","DOIUrl":"10.1002/ejp.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic pain is common and can burden individuals, families and society. This exploratory study conducted in response to the full-scale war in Ukraine from February 2022 aimed to assess the impact of war-related distress on civilians living with chronic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were asked to fill in an online questionnaire evaluating pain diagnoses, pain characteristics, analgesic use, screening for anxiety and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort comprised individuals receiving care in five chronic pain centres in Ukraine before February 2022. Between December 2022 and March 2023, 952 participants accessed the survey, with data from 833 qualifying for analysis. Men represented 64% (<i>n</i> = 533) of the cohort; 55% of the cohort (<i>n</i> = 455) were aged 21–40 years; 61% reported indirect exposure to the war. The majority (80%) had received some form of psychological support before February 2022. For most (72%), economic status worsened since the onset of the war. Alcohol consumption increased in 44% of the cohort. At the time of the survey, 40% reported pain intensity scores of 0–3/10, 26% scored intensities of 4–6/10 and 34% scored intensities of ≥ 7/10; 41% described their pain as ‘distressing’ or ‘horrible’. Most participants met criteria for clinically relevant anxiety (71%) and depression (82%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this cohort, pain severity before the war is unknown; however, 70% reported moderate to severe pain at evaluation. Combined with high rates of anxiety and depression, these findings highlight significant distress among Ukrainians with chronic pain and the need for sustained, individualised pain and psychological support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>We assessed the impact of war on civilians with chronic pain in Ukraine. An online survey completed by 833 patients from five clinics explored bio-psycho-social pain aspects. Most were men aged 21–40 with indirect war exposure. Economic hardship was common, and half reported increased alcohol use. Moderate to severe pain affected 59%; 41% found it distressing or horrible. Anxiety and depression were prevalent. Findings highlight major gaps in care, stressing the need for personalised pain management and integrated psychological support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Relationship Between Physical Activity and Pressure Pain Tolerance in the General Population. The Tromsø Study 2015–2016","authors":"Anders Pedersen Årnes,&nbsp;Mats Kirkeby Fjeld,&nbsp;Bente Morseth,&nbsp;Laila Arnesdatter Hopstock,&nbsp;Alexander Horsch,&nbsp;Tom Wilsgaard,&nbsp;Thomas Graven-Nielsen,&nbsp;Audun Stubhaug,&nbsp;Christopher Sivert Nielsen,&nbsp;Ólöf Anna Steingrímsdóttir","doi":"10.1002/ejp.70187","DOIUrl":"10.1002/ejp.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Physical activity (PA) is commonly recommended for the treatment and prevention of pain. Several small-sample studies have indicated a relationship between PA and pressure pain sensitivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study used data from the seventh Tromsø Study (2015–2016) cohort to assess how questionnaire-based leisure time PA (LTPA), occupational PA (OPA), and exercise-expended metabolic equivalent of task (MET) hours per week (<i>n</i> = 21,083), as well as accelerometer-measured total counts and moderate-to-vigorous PA (MVPA; <i>n</i> = 6778) relate to pressure pain tolerance (PTol). Flexible parametric survival analysis was used to estimate hazard ratios (HR) with 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher LTPA and MET-hours per week were associated with higher levels of PTol (<i>p</i> &lt; 0.001). With sedentary LTPA as a reference group, results indicated a HR of 0.87 (95% CI: 0.83, 0.92) for light, 0.75 (0.71, 0.80) for moderate, and 0.63 (0.53, 0.73) for vigorous PA. Compared to &lt; 7.5 MET-hours per week, HRs were 0.92 (0.88, 0.96) for 7.5–14.9 MET-hours per week, 0.84 (0.78, 0.89) for 15–22.5 MET-hours per week, and 0.86 (0.82, 0.91) for &gt; 22.5 MET-hours per week. A similar pattern was observed for accelerometer-measured PA, with a HR of 0.91 (0.88, 0.95) for MVPA and 0.93 (0.90, 0.96) for total activity counts. No clear pattern was observed for OPA. Interaction analysis indicated generally stronger effects for men, but no differences across age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings suggest that higher PA in leisure-time contexts is associated with higher pain tolerance levels in the general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Higher physical activity levels are linked to increased pressure pain tolerance, highlighting its role in modulating pain. Notably, only leisure-time activity shows a beneficial effect, while occupational activity does not. These findings suggest that the type and combination of activity may uniquely influence pain perception, challenging the idea that all physical activity benefits pain equally. Since physical activity is widely used in clinical pain management, this distinction has key implications for tailoring exercise-based interventions to optimize outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"30 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}