Journal of Pain Research最新文献

Purpose: Musculoskeletal (MSK) discomfort is a common concern among gamers globally, with prevalence estimates of 60-80%. Risk factors include prolonged sitting, awkward postures, repetitive hand use, and inadequate hardware setups. This study aimed to examine the prevalence and association of MSK pain with game genre, device type, and gaming duration among gamers in Saudi Arabia, with a focus on comparing professional and non-professional gamers.

Methods: A cross-sectional survey of 593 Saudi gamers aged 18 years and older was conducted from February to April 2024 using the Extended Nordic Musculoskeletal Questionnaire. Demographic and gaming-related variables were analyzed using chi-square tests and logistic regression to examine associations with MSK pain.

Results: MSK pain was reported by 78.2% (neck 49.4%, lower back 40.0%). Pain was associated with gender, age, and genre. Females had higher odds of neck (OR 2.08) and shoulder pain (OR 2.43); puzzle with shoulder pain (OR 2.46); VR with lower neck odds (OR 0.36). Longer duration increased discomfort. Non-professionals more often reported neck/shoulder/lower-back pain; professionals more wrist/hand pain.

Conclusion: MSK pain is highly prevalent among Saudi gamers and is associated with personal factors (eg, gender, age) as well as gaming genre. Competitive status may be associated with specific pain patterns, but ergonomic risk factors appear to be appear broadly relevant. Implementing targeted interventions that focus on posture, education, and proper gaming ergonomics may be warranted to help alleviate the MSK burden in this population.

Objective: The study was to explore the clinical effect of the Evidence-Based and Multidisciplinary pain management program for patients after hepatectomy. It examined the program's impacts on postoperative pain, active pain, quality of life, and satisfaction with pain control.

Methods: A quasi-experimental study was conducted at the Affiliated Hospital of Xuzhou Medical University from May 2024 to April 2025. Fifty-seven patients were enrolled to the experimental (n = 29) and control (n = 28) group. The experimental group was provided evidence-based pain management program by the Acute Pain Service Team. The primary outcome was pain level measured using The Numerical Rating Scale scores. Data were harvested at at the time points of transferring to the ward after surgery, 4 h, 12 h, 24 h, 48 h and 72 h after operation. Secondary outcomes were the Four Grade Functional Activity Score, the Houston Pain Outcome Instrument (HPOI) and quality of life at discharge.

Results: Lower NRS scores were observed in the experimental group compared to the control group at 4 h (t = -3.979, P < 0.001), 12 h (t = -2.426, P = 0.019), 24 h (t = -4.192, P < 0.001), 48 h (t = -2.924, P = 0.005) and 72 h (t = -2.797, P = 0.007) after operation. Significant between-group differences were found in the impact of pain on deep breathing at 12 h (z = -3.472, P = 0.001), 24 h (z = -2.217, P = 0.027), 48 h (z = -2.316, P = 0.021), and 72 h (z = -2.166, P = 0.030), coughing at 24 h (z = -2.446, P = 0.014), 48 h (z = -2.803, P = 0.005), and 72 h (z = -2.580, P = 0.010), turning over at 48 h (z = -2.639, P = 0.008) and 72 h (z = -2.493, P = 0.013), and getting out of bed for activities at 48 h (z = -2.205, P = 0.027) and 72 h (z = -3.151, P = 0.002) after operation. The experimental group showed significant differences from the control group in all dimensions of HPOI. There were no differences regarding psychological and social functions.

Conclusion: The Evidence-Based and Multidisciplinary pain management program improved postoperative pain, reduced impact of pain on functional activities, and enhanced satisfaction with pain control, but failed to improve psychological and social functions.

Purpose: Cervical radiculopathy (CR) poses a significant challenge due to its debilitating impact. Cervical rotation-traction manipulation (CRTM) is a representative manual therapy of traditional Chinese medicine (TCM) in China, which is beneficial to improve the pain, numbness, and dysfunction of CR patients. However, the optimal treatment frequency for CRTM remains systematically underexplored in randomized controlled trials (RCTs). This clinical study aims to assess the effectiveness and safety on three sessions per week of CRTM (TSWM) compared to one session per week of CRTM (OSWM) and cervical traction (CT) in patients with CR.

Patients and methods: This multicenter, three-arm, prospective RCT is conducted at four hospitals in China. Participants will be randomly allocated in a 1:1:1 ratio to one of the TSWM group, OSWM group, or CT group through the central randomization system. All participants will receive 4-week treatment and 16-week follow-up (total 20 weeks). The primary outcome is pain intensity of neck and arm measured by the Visual Analog Scale (VAS) at week 4. The secondary outcomes include VAS for pain intensity, VAS for numbness intensity, Neck Disability Index (NDI), Short Form 12 (SF-12), the total cost, the recurrence rate, and Expectation of Treatment and Credibility Scale (ETCS). Adverse events (AEs) will be monitored and reported throughout the trial.

Conclusion: We expect this clinical study to evaluate the optimal frequency of CRTM for CR. It will also serve as a reference and exploration for investigating the dose-response relationship of manual therapy.

Trial registration: This clinical trial was registered at ClinicalTrials.gov (registration number: NCT06320249) on March 15, 2024.

Purpose: This trial compared the efficacy of intertransverse process block (ITPB) with erector spinae plane block (ESPB), each in combination with an interpectoral block (IPB), with systemic analgesia for breast cancer surgery.

Patients and methods: Ninety patients were randomized to ITPB/IPB, ESPB/IPB, or control under general anesthesia. The primary outcome was 24-hour morphine consumption. Secondary outcomes included intraoperative fentanyl use, numeric rating scale (NRS) pain scores, and recovery parameters. A 40% reduction in morphine consumption and a 2-point NRS decrease were prespecified as minimal clinically important differences (MCIDs). The IPB was applied equally in both intervention groups to reduce pectoral nerve-mediated pain.

Results: Median (IQR) 24-hour morphine use was 0 mg (0-6), 3 mg (0-4), and 6 mg (3-6) in the ITPB/IPB, ESPB/IPB, and control groups, respectively. Morphine consumption did not differ between the ITPB/IPB and ESPB/IPB (median difference 0 mg; 95% CI 0 to 1; p = 0.275) but was lower in both groups compared with the control group (-2.5 mg; 95% CI -4 to 0; p = 0.014 and -2.7 mg; 95% CI -3 to 0; p = 0.003), exceeding the MCID despite modest absolute differences. Mean NRS pain scores were lower in both block groups than in the control group by approximately 1-1.2 points across the postoperative period. Intraoperative fentanyl use and time to ambulation were significantly reduced in both groups compared with the control. ITPB required longer performance time (+3.4 minutes; 95% CI 1.9 to 5.0; p < 0.001).

Conclusion: Both ITPB/IPB and ESPB/IPB provided comparable and effective analgesia after breast cancer surgery. Given its shorter performance time, ESPB may be the more practical option. However, because the IPB constituted a shared analgesic component in both groups, the independent analgesic effects of ITPB and ESPB remain uncertain and warrant further investigation.

Objective: To systematically evaluate the efficacy of different acupuncture methods and sodium hyaluronate eye drops in the treatment of dry eye disease, and to rank the interventions through a network meta-analysis.

Methods: Chinese and English databases were searched to collect randomized controlled trials (RCTs) published from the establishment of the databases to October 14, 2025. The Cochrane Risk of Bias tool was used to assess the quality of the literature. Bayesian network Meta-analysis was performed using R software to calculate relative risk (RR), mean difference (MD), and SUCRA value to evaluate the efficacy of the interventions.

Results: A total of 30 RCTs were included, involving 2,514 patients and 10 acupuncture methods. Network meta-analysis showed that electroacupuncture was the best in terms of total effective rate (SUCRA = 0.98). With respect to Schirmer I test (SIT) and tear film break-up time (BUT), fascia release acupuncture combined with acupuncture had the best effect (SUCRA = 0.87 and 0.95, respectively). In general, fascia release acupuncture combined with acupuncture was the optimal intervention among the evaluated modalities.

Conclusion: Acupuncture is superior to sodium hyaluronate eye drops in the treatment of dry eye disease. Fascia release acupuncture combined with acupuncture performs best in improving tear secretion and tear film stability, while electroacupuncture is most likely to be optimal in improving the overall effective rate.

Purpose: Chronic orofacial pain (COP) is associated with substantial pain interference and emotional distress. Psychosocial treatments for COP are scarce, rely on talking, which is often painful for this population, and require intensive resources. There is a clear need for a novel, scalable, accessible, "talk free" intervention to reduce pain interference and emotional distress among individuals with COP. This study explored people with COP's perceptions of a novel mind-body web-based intervention targeting pain interference and emotional distress (Face-Forward-Web) to inform its development and optimization.

Patients and methods: We conducted semi-structured focus groups (N=4 groups, 22 participants; 77% female; mean age 47 (SD = 15.9)) and used Rapid Data Analysis (RDA) to gauge perceptions of the intervention's content structure, format, and barriers and facilitators to participation.

Results: Perception of the intervention was largely positive, and participants perceived its value for increasing engagement in life activities. They emphasized the importance of tailoring the intervention to the unique characteristics of COP. They expressed that the self-paced web-based format was ideal given unpredictable pain flares and variable needs. Concurrently, they desired social connection. They perceived the content and skills as helpful and relaxing. They identified barriers and facilitators to participation, including technical considerations, reminders and incentives, and providers setting up realistic expectations for outcomes.

Conclusion: This study elucidates insights that can inform psychosocial and mind-body interventions for people with COP. Findings give voice to the needs and perceptions of people with COP, guiding the development of tailored, patient-informed treatment approaches such as Face-Forward-Web.

Background and objectives: Faculty members are considered highly exposed to work-related injuries such as work-related stress (WRS) and work-related musculoskeletal disorders. This study aimed to investigate the prevalence of musculoskeletal pain (MSP) among faculty members and explore its association with work performance, occupational factors and WRS.

Methods: A cross-sectional study conducted between September 2023 and August 2024 and enrolled 369 faculty members from various universities who completed a self-administered online questionnaire. Musculoskeletal pain was evaluated with the Nordic Musculoskeletal Questionnaire (NMQ), psychological stress with the Workplace Stress Scale (WSS), and work performance-covering absenteeism, presenteeism, and functional capacity-with the WHO Health and Work Performance Questionnaire (WHO-HPQ). Binary logistic regression and multiple linear regression were used to identify predictors of pain and work performance outcomes.

Results: A total of 92.6% of participants reported experiencing pain in at least one body region annually, and 74% reported pain weekly, with 64.4% experiencing pain in three or more regions. The most commonly affected areas were the shoulders at 69.1%, the neck at 66.9%, and the lower back at 59.3%. Psychological stress levels were highest among those with lower limb pain and among participants with multisite involvement. MSP was associated with reduced work functioning and presenteeism, but not absenteeism. Higher stress, uncomfortable posture, female gender, obesity, and repetitive movements were significant predictors of MSP. Stress and lower limb pain predicted impaired work functioning.

Conclusion: Musculoskeletal pain and psychological stress were highly prevalent among academic faculty and were associated with reduced work functioning and productivity. These findings highlight the need for targeted ergonomic interventions and stress management strategies to promote health and maintain performance in academic work settings.

Background: Pain and mental disorders frequently co-occur, yet the direction and specificity of their relationship remain uncertain due to limitations of observational studies. Mendelian randomization (MR) provides an opportunity to clarify causal links between distinct pain phenotypes and psychiatric outcomes.

Methods: We performed a comprehensive bidirectional MR analysis to investigate causal relationships between multiple pain conditions and mental and personality disorders. Multivariable MR was applied to assess the independence of these associations while accounting for common comorbidities. Robustness was evaluated using complementary sensitivity analyses.

Results: Forward analyses showed that several pain phenotypes - including back pain, headaches, neck or shoulder pain, stomach or abdominal pain, migraine, and trigeminal neuralgia-were associated with increased risk of specific mental disorders. Reverse analyses indicated that mental disorders also predispose individuals to certain pain conditions. Most associations remained robust after multivariable adjustment, although some were attenuated by obesity or substance use.

Conclusion: These findings demonstrate structured, pain - type - specific bidirectional relationships between pain and mental disorders. Clinically, they support phenotype-informed screening and management strategies, including targeted assessment of depression and anxiety in patients with high-risk pain conditions and proactive evaluation of pain symptoms in patients with mental disorders, to facilitate earlier risk stratification and integrated care.

Purpose: Transversus abdominis plane (TAP) block is a widely accepted technique for postoperative pain management in kidney transplant (KT) patients, typically with 0.25-0.5% bupivacaine. Lower concentrations, such as 0.125%, may reduce systemic toxicity while remaining effective. This study aimed to compare the efficacy and safety of 0.125% versus 0.25% bupivacaine for TAP block in KT patients.

Patients and methods: In this prospective, double-blind, randomized trial, KT patients received either 0.125% or 0.25% bupivacaine for ultrasound-guided TAP block prior to surgery, followed by intravenous fentanyl patient-controlled analgesia postoperatively. The primary outcome was 24-hour fentanyl consumption. Secondary outcomes included intraoperative fentanyl use, time to first analgesic request, pain scores, TAP block complications, opioid-related side effects, and patient satisfaction.

Results: Seventy-six patients were enrolled, with 74 completing the study (37 per group). Baseline characteristics were comparable between groups. Intraoperative fentanyl use was significantly lower in the 0.25% bupivacaine group (140.5 ± 39.7 mcg) compared to the 0.125% group (166.8 ± 44.7 mcg; P = 0.009). However, 24-hour postoperative fentanyl consumption did not differ significantly, with the 0.125% group using 201.5 ± 110.4 mcg and the 0.25% group using 177.3 ± 104.1 mcg (mean difference: -24.2; 95% CI: -73.9 to 25.5; P = 0.335). The 0.25% group had a longer median time to first analgesic request (15 vs 10 minutes; P = 0.020). Postoperative pain scores, TAP block complications, and patient satisfaction were similar between groups.

Conclusion: TAP block with 0.125% bupivacaine provided comparable postoperative opioid consumption and pain scores to 0.25%, without associated complications.

Background: Endometriosis is a chronic gynecological disorder characterized by pain and impaired quality of life (QoL). While pharmacological and surgical options exist, their limitations necessitate complementary strategies. The comparative effectiveness of non-pharmacological interventions remains uncertain.

Objective: This network meta-analysis (NMA) aimed to evaluate and rank the efficacy of non-pharmacological therapies for pain and QoL in women with endometriosis.

Methods: We systematically searched PubMed, Embase, CENTRAL, Web of Science, and CNKI from inception to August 31, 2025. Eligible randomized controlled trials (RCTs) compared structured non-pharmacological interventions-acupuncture (ACU), exercise (EXE), nutritional supplementation (NUT), physical therapy (PHY), or psychological interventions (PSY)-against conventional care (CON). Primary outcomes were pain (overall, pelvic, dysmenorrhea) and QoL; the secondary outcome was anxiety.

Results: Thirty-three RCTs involving 2323 women were included. For overall pain, PHY (SMD = -1.44), ACU (SMD = -1.27), and PSY (SMD = -1.22) were significantly superior to CON, with PHY ranking highest (SUCRA = 74.4%). ACU was most effective for pelvic pain (SMD = -4.53; SUCRA = 99.1%), while PHY was optimal for dysmenorrhea (SMD = -1.30; SUCRA = 82.3%). Both ACU (SMD = 4.09) and PHY (SMD = 4.18) significantly improved QoL compared to CON. No statistically significant differences were observed among interventions for anxiety.

Conclusion: Non-pharmacological interventions, particularly PHY and ACU, provide significant benefits for pain and QoL in endometriosis, with subtype-specific advantages. These findings support their integration into multimodal management pathways.