{"title":"Editorial Commentary: Bridging evidence and practice in sacroiliac joint complex pain management.","authors":"Elias Veizi, David M Dickerson, Ameet S Nagpal","doi":"10.1093/pm/pnaf134","DOIUrl":"10.1093/pm/pnaf134","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"815-816"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zachary L McCormick, Robert W Hurley, Steven P Cohen
{"title":"Sacroiliac joint complex pain consensus practice guidelines from a multispecialty, international working group: an infographic.","authors":"Zachary L McCormick, Robert W Hurley, Steven P Cohen","doi":"10.1093/pm/pnaf136","DOIUrl":"10.1093/pm/pnaf136","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"936-937"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter D Vu, Matthew Slitzky, Kobe Miller, Robert J Yong, Christopher L Robinson, Matthew Chung
Background: Magnetic resonance imaging (MRI) safety with implanted neuromodulation devices presents a critical challenge in modern medicine. While spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) devices are increasingly utilized for pain management, the scattered nature of manufacturer-specific MRI safety information creates substantial challenges for healthcare providers in making informed clinical decisions. Furthermore, despite the public availability of this information, a comprehensive review of the literature reveals no centralized repository of data regarding SCS and PNS.
Objective: To synthesize comprehensive MRI safety data from multiple manufacturers of SCS and PNS devices into a centralized resource for clinicians, thereby streamlining the decision-making process for MRI scanning in patients with implanted neuromodulation devices.
Methods: We collected MRI safety data for devices from 10 major neurostimulation companies (Abbott, Biotronik, Boston Scientific, Curonix, Mainstay, Medtronic, Nalu, Nevro, Saluda, and SPR Therapeutics) through December 2024. Data collection involved direct communication with manufacturers and analysis of technical documentation to extract specific MRI-related parameters.
Results: Full-body MRI safety at 1.5 T is standard across most SCS systems, with select devices permitting 3.0 T imaging. Specific limitations vary by manufacturer, including restrictions on spatial gradient magnetic fields (1000-4000 Gauss/cm), specific absorption rates, and active scan times (15-60 minutes). PNS systems show similar safety patterns.
Conclusions: This manuscript addresses the urgent need for centralized safety information. As device technology continues to evolve, this resource will require ongoing updates to maintain its utility in supporting informed clinical decision making and patient care.
{"title":"Provision of up-to-date magnetic resonance imaging conditionality for current peripheral nerve stimulation and spinal cord stimulation systems in pain management.","authors":"Peter D Vu, Matthew Slitzky, Kobe Miller, Robert J Yong, Christopher L Robinson, Matthew Chung","doi":"10.1093/pm/pnaf076","DOIUrl":"10.1093/pm/pnaf076","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) safety with implanted neuromodulation devices presents a critical challenge in modern medicine. While spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) devices are increasingly utilized for pain management, the scattered nature of manufacturer-specific MRI safety information creates substantial challenges for healthcare providers in making informed clinical decisions. Furthermore, despite the public availability of this information, a comprehensive review of the literature reveals no centralized repository of data regarding SCS and PNS.</p><p><strong>Objective: </strong>To synthesize comprehensive MRI safety data from multiple manufacturers of SCS and PNS devices into a centralized resource for clinicians, thereby streamlining the decision-making process for MRI scanning in patients with implanted neuromodulation devices.</p><p><strong>Methods: </strong>We collected MRI safety data for devices from 10 major neurostimulation companies (Abbott, Biotronik, Boston Scientific, Curonix, Mainstay, Medtronic, Nalu, Nevro, Saluda, and SPR Therapeutics) through December 2024. Data collection involved direct communication with manufacturers and analysis of technical documentation to extract specific MRI-related parameters.</p><p><strong>Results: </strong>Full-body MRI safety at 1.5 T is standard across most SCS systems, with select devices permitting 3.0 T imaging. Specific limitations vary by manufacturer, including restrictions on spatial gradient magnetic fields (1000-4000 Gauss/cm), specific absorption rates, and active scan times (15-60 minutes). PNS systems show similar safety patterns.</p><p><strong>Conclusions: </strong>This manuscript addresses the urgent need for centralized safety information. As device technology continues to evolve, this resource will require ongoing updates to maintain its utility in supporting informed clinical decision making and patient care.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"924-929"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacqueline Weisbein, Denis Patterson, Douglas Beall, Dan Nguyen, Jack Smith, Caroline Harstroem, Timothy Davis, Jeffrey Foster, Anne Christopher, Daniel Kloster, John Broadnax, Eric Anderson, John Hatheway, Andrew Trobridge, Charles Simmons, Thomas Stauss, Michael Harned, Christopher Mallard
Purpose: Sacroiliac joint (SIJ) pain, a frequent contributor to low back pain, is commonly treated with minimally invasive SIJ fusion. A large body of evidence supports the safety and effectiveness of lateral transiliac SIJ fusion. Traditionally performed by surgeons, this procedure is increasing in utilization by non-surgeon interventionalists. Herein, we present early safety results from a single-arm clinical trial of participants who underwent lateral SIJ fusion using threaded titanium implants placed by interventional pain management physicians.
Methods: STACI (NCT05870488) is a 2-year prospective study conducted at 15 US interventional pain management sites. The primary endpoint is change in SIJ pain from baseline to 6 months. Secondary endpoints include changes in function (Oswestry Disability Index), quality of life (PROMIS-29), device- or procedure-related adverse events, and evidence of fusion on CT scan at 2 years.
Results: A total of 110 patients were enrolled. Mean (SD) participant age is 64 (14) years and 68% are female. Mean (SD) operative time was 44 minutes (16) and estimated blood loss was 14 cc (15). No serious or device-related adverse events have occurred. Reported perioperative adverse events include one surgical site infection and one hematoma. At 1-month follow-up, ODI improved by 18 points (P < .0001) and SIJ pain (NRS) decreased by 4 points (P < .0001) from baseline.
Conclusion: Early results from this prospective multicenter study support the relative safety and early effectiveness of LTI SIJ fusion using a threaded implant when performed by interventional pain management physicians. The data are consistent with published literature with a low adverse event rate and early improvements in pain and function.
{"title":"Safety and initial effectiveness of minimally invasive sacroiliac joint fusion with metal implants using a lateral transiliac approach: a prospective trial.","authors":"Jacqueline Weisbein, Denis Patterson, Douglas Beall, Dan Nguyen, Jack Smith, Caroline Harstroem, Timothy Davis, Jeffrey Foster, Anne Christopher, Daniel Kloster, John Broadnax, Eric Anderson, John Hatheway, Andrew Trobridge, Charles Simmons, Thomas Stauss, Michael Harned, Christopher Mallard","doi":"10.1093/pm/pnaf082","DOIUrl":"10.1093/pm/pnaf082","url":null,"abstract":"<p><strong>Purpose: </strong>Sacroiliac joint (SIJ) pain, a frequent contributor to low back pain, is commonly treated with minimally invasive SIJ fusion. A large body of evidence supports the safety and effectiveness of lateral transiliac SIJ fusion. Traditionally performed by surgeons, this procedure is increasing in utilization by non-surgeon interventionalists. Herein, we present early safety results from a single-arm clinical trial of participants who underwent lateral SIJ fusion using threaded titanium implants placed by interventional pain management physicians.</p><p><strong>Methods: </strong>STACI (NCT05870488) is a 2-year prospective study conducted at 15 US interventional pain management sites. The primary endpoint is change in SIJ pain from baseline to 6 months. Secondary endpoints include changes in function (Oswestry Disability Index), quality of life (PROMIS-29), device- or procedure-related adverse events, and evidence of fusion on CT scan at 2 years.</p><p><strong>Results: </strong>A total of 110 patients were enrolled. Mean (SD) participant age is 64 (14) years and 68% are female. Mean (SD) operative time was 44 minutes (16) and estimated blood loss was 14 cc (15). No serious or device-related adverse events have occurred. Reported perioperative adverse events include one surgical site infection and one hematoma. At 1-month follow-up, ODI improved by 18 points (P < .0001) and SIJ pain (NRS) decreased by 4 points (P < .0001) from baseline.</p><p><strong>Conclusion: </strong>Early results from this prospective multicenter study support the relative safety and early effectiveness of LTI SIJ fusion using a threaded implant when performed by interventional pain management physicians. The data are consistent with published literature with a low adverse event rate and early improvements in pain and function.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"918-923"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zachary L McCormick, Robert W Hurley, Magdalena Anitescu, Arun Bhaskar, Anuj Bhatia, Ryan Carter Cassidy, Allen S Chen, Timothy C Dawson, Javier De Andrés Ares, José Luiz de Campos, Salim M Hayek, Berenice Carolina Hernández-Porras, Narayan R Kissoon, Lynn R Kohan, María Francisca Elgueta Le Beuffe, Jee Youn Moon, David A Provenzano, David E Reece, Nathaniel M Schuster, Clark C Smith, Alison Stout, Karolina Szadek, Donna-Ann Thomas, Nuj Tontisirin, Michael F Vagg, Jan Van Zundert, Anna Woodbury, Steven P Cohen
<p><strong>Background: </strong>The past two decades have witnessed tremendous growth in the appreciation and treatment of sacroiliac joint (SIJ) complex pain, including anatomical dissections that shed light on innervation, an appreciation for the contribution of extra-articular components to SIJ complex pain, the advent of radiofrequency ablation (RFA) and a host of minimally invasive surgical techniques. Yet, there is no standardization on diagnosis and treatment paradigms.</p><p><strong>Methods: </strong>In February 2023, the Boards of Directors for the American Academy of Pain Medicine (AAPM) and American Society of Regional Anesthesia & Pain Medicine (ASRA-PM) approved the development of multispecialty guidelines on SIJ complex pain. Thirty partner organizations with clinical and scientific interests in SIJ complex pain were identified, and formal letters of request-for-participation were sent to each, along with a request for nominees to serve on the committee. Twenty five organizations agreed to participate in addition to the Departments of Defense and Veterans Affairs. A steering committee developed 21 questions, which spanned criteria for diagnosis, non-interventional and interventional treatments including surgery, technical parameters on how to optimize results, and what constitutes positive outcomes. Questions were methodically assigned to specialized modules comprising 4-5 members with complementary expertise, who collaborated with the Subcommittee Lead and one of three Committee Chairs to develop preliminary drafts. Following thorough revisions, these drafts were subsequently submitted to the full committee for comprehensive review. A modified Delphi method was used in which the answers to questions were sent to the committee en bloc and comments were returned in a non-blinded fashion to the Chairs, who incorporated the comments and sent out revised versions until consensus was achieved. During a committee meeting before commencement, it was agreed that recommendations would be noted when there was >50% agreement among committee members, but that a formal recommendation would require ≥75% consensus.</p><p><strong>Results: </strong>Twenty-one organizations formally endorsed the guidelines. The American Society of Anesthesiologists, and American Academy of Physical Medicine & Rehabilitation, and the North American Spine Society affirmed the benefit of the guidelines but did not officially endorse them. The American Academy of Neurology declined to affirm the benefit of the guidelines citing "lack of relevance to their membership." Per policies, while the Departments of Defense and Veterans Affairs did not formally review the guidelines for endorsement, their representatives approved them. In addition to being endorsed or the benefit affirmed by all voting organizations, complete consensus from committee members was obtained on all 21 questions. On 2 recommendations, there were dissensions from 3 societies who thought that selecting p
{"title":"Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group.","authors":"Zachary L McCormick, Robert W Hurley, Magdalena Anitescu, Arun Bhaskar, Anuj Bhatia, Ryan Carter Cassidy, Allen S Chen, Timothy C Dawson, Javier De Andrés Ares, José Luiz de Campos, Salim M Hayek, Berenice Carolina Hernández-Porras, Narayan R Kissoon, Lynn R Kohan, María Francisca Elgueta Le Beuffe, Jee Youn Moon, David A Provenzano, David E Reece, Nathaniel M Schuster, Clark C Smith, Alison Stout, Karolina Szadek, Donna-Ann Thomas, Nuj Tontisirin, Michael F Vagg, Jan Van Zundert, Anna Woodbury, Steven P Cohen","doi":"10.1093/pm/pnaf129","DOIUrl":"10.1093/pm/pnaf129","url":null,"abstract":"<p><strong>Background: </strong>The past two decades have witnessed tremendous growth in the appreciation and treatment of sacroiliac joint (SIJ) complex pain, including anatomical dissections that shed light on innervation, an appreciation for the contribution of extra-articular components to SIJ complex pain, the advent of radiofrequency ablation (RFA) and a host of minimally invasive surgical techniques. Yet, there is no standardization on diagnosis and treatment paradigms.</p><p><strong>Methods: </strong>In February 2023, the Boards of Directors for the American Academy of Pain Medicine (AAPM) and American Society of Regional Anesthesia & Pain Medicine (ASRA-PM) approved the development of multispecialty guidelines on SIJ complex pain. Thirty partner organizations with clinical and scientific interests in SIJ complex pain were identified, and formal letters of request-for-participation were sent to each, along with a request for nominees to serve on the committee. Twenty five organizations agreed to participate in addition to the Departments of Defense and Veterans Affairs. A steering committee developed 21 questions, which spanned criteria for diagnosis, non-interventional and interventional treatments including surgery, technical parameters on how to optimize results, and what constitutes positive outcomes. Questions were methodically assigned to specialized modules comprising 4-5 members with complementary expertise, who collaborated with the Subcommittee Lead and one of three Committee Chairs to develop preliminary drafts. Following thorough revisions, these drafts were subsequently submitted to the full committee for comprehensive review. A modified Delphi method was used in which the answers to questions were sent to the committee en bloc and comments were returned in a non-blinded fashion to the Chairs, who incorporated the comments and sent out revised versions until consensus was achieved. During a committee meeting before commencement, it was agreed that recommendations would be noted when there was >50% agreement among committee members, but that a formal recommendation would require ≥75% consensus.</p><p><strong>Results: </strong>Twenty-one organizations formally endorsed the guidelines. The American Society of Anesthesiologists, and American Academy of Physical Medicine & Rehabilitation, and the North American Spine Society affirmed the benefit of the guidelines but did not officially endorse them. The American Academy of Neurology declined to affirm the benefit of the guidelines citing \"lack of relevance to their membership.\" Per policies, while the Departments of Defense and Veterans Affairs did not formally review the guidelines for endorsement, their representatives approved them. In addition to being endorsed or the benefit affirmed by all voting organizations, complete consensus from committee members was obtained on all 21 questions. On 2 recommendations, there were dissensions from 3 societies who thought that selecting p","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"817-917"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eyal D Maoz Halevy, Allison Verhaak, Yin Wu, Dale S Bond, Lucas J Carr, Brian Grosberg, Olivia Begasse de Dhaem
{"title":"Evaluating Physical Activity Levels in Patients with Migraine: Insights from a Tertiary Headache Center Using the Exercise Vital Sign (EVS) Tool.","authors":"Eyal D Maoz Halevy, Allison Verhaak, Yin Wu, Dale S Bond, Lucas J Carr, Brian Grosberg, Olivia Begasse de Dhaem","doi":"10.1093/pm/pnaf166","DOIUrl":"https://doi.org/10.1093/pm/pnaf166","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145605389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda S Bruce, Tara M D Mullen, Megan Behrman, Jade Robichaud, Ruobin Wei, Nivedita Chaudhary, Anna M Georgiopoulos, Lael M Yonker, Jianghua He, Andrea L Chadwick, Jonathan Greenberg, Deborah Friedman
Background: Despite treatment advances, the majority of adults with cystic fibrosis (CF) experience chronic pain, negatively impacting quality of life. CF Foundation guidelines call for a multi-modal approach to pain management. While non-pharmacologic behavioral interventions are an effective and safe component of such an approach, there are no existing behavioral interventions that have been designed specifically for adults with CF who experience chronic pain.
Objective: We created a novel cognitive-behavioral and mind-body intervention tailored to the needs, preferences, and experiences of adults with CF and chronic pain.
Methods: Individual qualitative interviews were conducted with 14 adults with CF and chronic pain. A hybrid inductive-deductive thematic analysis was conducted to identify themes regarding needs and preferences to inform intervention development.
Results: We identified the following themes: 1) the importance of addressing mental health, 2) need for an individualized/tailored program, 3) preference for CF care team delivery, 4) CF-specific modifications of proposed content, 5) barriers and facilitators of patient engagement with a mind-body pain management intervention in CF.
Discussion: Adults with CF provided vital feedback on the structure and substance of a cognitive-behavioral and mind-body intervention for chronic pain, which was utilized to create the Pain Acknowledgement, Coping, and Empowerment (PACE CF), a program to be delivered as part of routine care in CF centers.
{"title":"Patient-centered development of a cognitive behavioral pain intervention for cystic fibrosis: The pace CF program.","authors":"Amanda S Bruce, Tara M D Mullen, Megan Behrman, Jade Robichaud, Ruobin Wei, Nivedita Chaudhary, Anna M Georgiopoulos, Lael M Yonker, Jianghua He, Andrea L Chadwick, Jonathan Greenberg, Deborah Friedman","doi":"10.1093/pm/pnaf167","DOIUrl":"https://doi.org/10.1093/pm/pnaf167","url":null,"abstract":"<p><strong>Background: </strong>Despite treatment advances, the majority of adults with cystic fibrosis (CF) experience chronic pain, negatively impacting quality of life. CF Foundation guidelines call for a multi-modal approach to pain management. While non-pharmacologic behavioral interventions are an effective and safe component of such an approach, there are no existing behavioral interventions that have been designed specifically for adults with CF who experience chronic pain.</p><p><strong>Objective: </strong>We created a novel cognitive-behavioral and mind-body intervention tailored to the needs, preferences, and experiences of adults with CF and chronic pain.</p><p><strong>Methods: </strong>Individual qualitative interviews were conducted with 14 adults with CF and chronic pain. A hybrid inductive-deductive thematic analysis was conducted to identify themes regarding needs and preferences to inform intervention development.</p><p><strong>Results: </strong>We identified the following themes: 1) the importance of addressing mental health, 2) need for an individualized/tailored program, 3) preference for CF care team delivery, 4) CF-specific modifications of proposed content, 5) barriers and facilitators of patient engagement with a mind-body pain management intervention in CF.</p><p><strong>Discussion: </strong>Adults with CF provided vital feedback on the structure and substance of a cognitive-behavioral and mind-body intervention for chronic pain, which was utilized to create the Pain Acknowledgement, Coping, and Empowerment (PACE CF), a program to be delivered as part of routine care in CF centers.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rena Elizabeth Courtney, Jody Caretti, Jessica Dunham, Laura Curry, Stephanie Smith, Camden O Novikova
{"title":"Anti-Inflammatory Kitchen: Feasibility and Acceptability of a Cooking Demonstration Class for Veterans with Chronic Pain.","authors":"Rena Elizabeth Courtney, Jody Caretti, Jessica Dunham, Laura Curry, Stephanie Smith, Camden O Novikova","doi":"10.1093/pm/pnaf164","DOIUrl":"https://doi.org/10.1093/pm/pnaf164","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yun-Yun K Chen, Jenna M Wilson, Sheila R Gokul, Patrick W Collins, Martin Kiik, Emily Rosado, Kamen V Vlassakov, Kristin L Schreiber
{"title":"When Clinical Intuition Fails: Exploration of Clinicians' Underrecognition of Preoperative Pain Catastrophizing Despite Direct Observation.","authors":"Yun-Yun K Chen, Jenna M Wilson, Sheila R Gokul, Patrick W Collins, Martin Kiik, Emily Rosado, Kamen V Vlassakov, Kristin L Schreiber","doi":"10.1093/pm/pnaf158","DOIUrl":"https://doi.org/10.1093/pm/pnaf158","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John A Sturgeon, Noel Vest, Meredith Barad, Beth Darnall, Sean Mackey
Objective: Chronic migraine is a condition marked by highly frequent, intense, and disabling headaches. However, less commonly examined symptoms, such as persistent fatigue, widespread non-cephalic pain, and post-traumatic stress disorder, may also play a key role in migraine-relevant clinical outcomes.
Methods: The current study utilized retrospective clinical registry data from 704 treatment-seeking patients with chronic migraine to examine longitudinal trajectories of pain intensity and pain-related life interference using linear growth modeling.
Results: High levels of co-occurring non-cephalic pain (71.9% of patients) were noted in this sample. Patients endorsing more widespread pain reported higher average levels of pain intensity over time (β = 0.189 [0.103, 0.275], p < 0.001) and less improvement in pain interference over time (β = 0.328 [0.131, 0.525], p = 0.001). Additional findings included greater reductions in pain interference among patients with higher baseline levels of pain intensity (β = -0.185 [-0.351, -0.020], p = 0.028) and fatigue (β = -0.280 [-0.493, -0.067], p = 0.010) and non-significant associations between post-traumatic stress symptoms and pain intensity and pain interference in all models.
Conclusions: The current findings suggest that clinical factors sometimes overlooked in headache research, such as co-occurring non-cephalic pain and fatigue, may contribute to trajectories of treatment response and psychosocial function in chronic migraine. Future research may benefit from examining these factors in headache-specific treatment settings and in the context of examining the effects of multidisciplinary care on patients with complex symptom presentations.
目的：慢性偏头痛是一种以频繁、剧烈和致残头痛为特征的疾病。然而，不常被检查的症状，如持续疲劳、广泛的非头部疼痛和创伤后应激障碍，也可能在偏头痛相关的临床结果中起关键作用。方法：本研究利用704例寻求治疗的慢性偏头痛患者的回顾性临床登记数据，使用线性增长模型检查疼痛强度和疼痛相关生活干扰的纵向轨迹。结果：在该样本中注意到高水平的同时发生的非头侧疼痛（71.9%的患者）。随着时间的推移，更广泛疼痛的患者报告了更高的平均疼痛强度水平（β = 0.189 [0.103, 0.275], p < 0.001），疼痛干扰的改善较少（β = 0.328 [0.131, 0.525], p = 0.001）。其他研究结果包括基线疼痛强度较高（β = -0.185 [-0.351, -0.020], p = 0.028）和疲劳（β = -0.280 [-0.493, -0.067], p = 0.010）的患者疼痛干扰减少更大，所有模型中创伤后应激症状与疼痛强度和疼痛干扰之间无显著关联。结论：目前的研究结果表明，在头痛研究中有时被忽视的临床因素，如同时发生的非头侧疼痛和疲劳，可能有助于慢性偏头痛的治疗反应和社会心理功能的轨迹。未来的研究可能会受益于在头痛特定治疗环境中检查这些因素，以及在检查多学科护理对复杂症状表现患者的影响的背景下。
{"title":"Beyond Headache: Non-cephalic Pain, Fatigue, and Post-Traumatic Stress Symptoms as Longitudinal Predictors of Chronic Migraine Outcomes.","authors":"John A Sturgeon, Noel Vest, Meredith Barad, Beth Darnall, Sean Mackey","doi":"10.1093/pm/pnaf162","DOIUrl":"10.1093/pm/pnaf162","url":null,"abstract":"<p><strong>Objective: </strong>Chronic migraine is a condition marked by highly frequent, intense, and disabling headaches. However, less commonly examined symptoms, such as persistent fatigue, widespread non-cephalic pain, and post-traumatic stress disorder, may also play a key role in migraine-relevant clinical outcomes.</p><p><strong>Methods: </strong>The current study utilized retrospective clinical registry data from 704 treatment-seeking patients with chronic migraine to examine longitudinal trajectories of pain intensity and pain-related life interference using linear growth modeling.</p><p><strong>Results: </strong>High levels of co-occurring non-cephalic pain (71.9% of patients) were noted in this sample. Patients endorsing more widespread pain reported higher average levels of pain intensity over time (β = 0.189 [0.103, 0.275], p < 0.001) and less improvement in pain interference over time (β = 0.328 [0.131, 0.525], p = 0.001). Additional findings included greater reductions in pain interference among patients with higher baseline levels of pain intensity (β = -0.185 [-0.351, -0.020], p = 0.028) and fatigue (β = -0.280 [-0.493, -0.067], p = 0.010) and non-significant associations between post-traumatic stress symptoms and pain intensity and pain interference in all models.</p><p><strong>Conclusions: </strong>The current findings suggest that clinical factors sometimes overlooked in headache research, such as co-occurring non-cephalic pain and fatigue, may contribute to trajectories of treatment response and psychosocial function in chronic migraine. Future research may benefit from examining these factors in headache-specific treatment settings and in the context of examining the effects of multidisciplinary care on patients with complex symptom presentations.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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