Pain Research & Management最新文献

Background: Complex regional pain syndrome (CRPS) is a disabling condition requiring long-term treatment. This study evaluated long-term outcomes in CRPS patients compared to posttraumatic neuralgia (PN) and nociceptive limb pain (NLP) 1-5 years after diagnosis and treatment initiation in a tertiary clinic.

Methods: Patients with CRPS lasting more than 1 year (n = 116), PN (n = 68), or NLP (n = 75) participated in a standardized telephone interview assessing pain intensity, functional impairment, neglect-like symptoms, and disability in daily life and work.

Results: PN patients had higher pain intensity compared to CRPS (NRS 5.7 ± 2.1 vs. 4.5 ± 2.6; main effect: p = 0.005; post hoc test: p = 0.003). Functional outcomes varied significantly between groups (p < 0.001). CRPS patients showed the highest rate of severe impairment (71%), especially in those with ≥ 3 clinical signs, while outcome was better in NLP (p ≤ 0.027), especially in part-time workers. The global impression of disability varied between groups (p = 0.044): PN patients reported a high level of severe disability (70%), while CRPS had the most subjects with "none/slight" disability (23%). Pain and function were tightly linked to perceived disability in all groups. Neither the neglect-like total score (CRPS: 2.4 (2.2-2.6); neuralgia: 2.5 (2.3-2.7); NLP: 2.2 (1.9-2.5); p = 0.055) nor the working ability differed between groups (p = 0.397); however, only in CRPS, neglect-like symptoms were associated with higher pain intensity and global disability, as well as lower functional outcome. CRPS patients treated with corticosteroids (n = 55) had more positive clinical signs at baseline and poorer outcomes than patients without corticosteroids (n = 61).

Conclusions: Long-term impairment, work-related, and global disability in CRPS were similar to those of neuralgia and NLP patients treated in a tertiary pain clinic. Despite shorter disease duration, CRPS patients more often report severe disability, while pain is comparable to other chronic limb pain courses. More pronounced positive signs in CRPS at baseline are associated with poor outcomes. These findings emphasize the heterogeneous course of CRPS and the importance of individualized multidimensional approaches.

Background: Persistent pain is a leading cause of disability worldwide. Long waiting times can adversely affect outcomes and impede effective management; thus, waiting list-targeted interventions may be beneficial.

Objective: To explore the perceptions of people with persistent pain receiving pain science education (PSE) online, en masse, whilst on an NHS waiting list.

Methods: A mixed-methods observational study of people with persistent pain on NHS waiting lists was undertaken. PSE-informed webinars were delivered by Flippin' Pain, a U.K.-based public health campaign. A questionnaire was circulated postwebinar exploring participants' experience of the webinars collectively and future behavioural intentions. Quantitative data were analysed using descriptive statistics. Reflexive thematic analysis was used to analyse qualitative data.

Results: Participants' (n = 114) pain originated primarily from musculoskeletal sources. Postwebinar, participants felt more hopeful about their future (64%), intended to increase activity levels (71%), intended to reduce their opioid use (51%) and felt that they may be more confident to talk to others about their pain (42%). Overall the webinars were well received; they were considered interesting, and participants reported that they provided feelings of hope and empowerment. 80% of participants would recommend the webinars to others, although a small minority of participants were strongly negative about the webinars and found them unhelpful.

Conclusion: Participants on NHS waiting lists with persistent pain predominantly found PSE webinars helpful. It shifted their understanding of pain, and they intended to undertake self-management activities in line with evidence-based care. Appropriately powered RCTs are warranted to robustly investigate the effectiveness of en masse PSE for patients awaiting care.

Peripheral neuropathic pain (PNP), a chronic condition resulting from nerve damage and characterized by altered sensory signaling and central sensitization, poses significant therapeutic challenges. Botulinum toxin (BTX), known for neuromuscular blockades, also exhibits analgesic properties, prompting its investigation for PNP management. However, existing evidence regarding its efficacy and safety is fragmented. This systematic review aimed to synthesize current data on BTX injections for PNP. Guided by PRISMA and the neuromatrix theory, major databases (PubMed, Web of Science, Cochrane, Embase, Scopus, EBSCOhost) were searched up to March 2025. Included studies evaluated BTX (primarily type A) in adults with PNP using validated pain outcomes and reported safety, covering designs from randomized controlled trials (RCTs) to observational research. Independent reviewers performed data extraction and quality assessment using risk of bias tools. This review has been registered on Prospero with the following number: CRD420251022222. The patient groups studied (1343 participants: 547 males and 632 females) showed substantial variability in age, diagnosis, and treatment setting. Results indicated BTX use across diverse PNP etiologies (e.g., trigeminal neuralgia, painful diabetic neuropathy (DN), postherpetic neuralgia, and phantom limb pain) and across multiple countries. RCTs often reported statistically significant reductions in pain intensity and improvements in related outcomes compared with placebo, although effect sizes were heterogeneous and sample sizes were generally modest. Nonrandomized studies suggested similar trends but frequently presented moderate to serious risk of bias. Adverse events were usually mild and transient, most often localized injection-site reactions or temporary facial asymmetry in cranial applications, while serious complications were rare but could not be excluded with confidence because of incomplete safety reporting. Overall, BTX may offer clinically meaningful benefit for selected PNP subtypes, particularly trigeminal neuralgia and painful DN, yet the certainty of evidence remains low to moderate due to study limitations and methodological diversity. Routine use in PNP therefore requires cautious, individualized consideration rather than broad generalization.

Background: Tension-type headache (TTH), a prevalent form of primary headache, has been linked to alterations in spinal biomechanics.

Objective: This study aimed to compare spinal posture, mobility, and muscle endurance between women with and without TTH.

Methods: This case-control study included 68 women aged 18-55 years with (n = 34, age = 20.51 ± 1.73 years, BMI = 22.03 ± 2.90 kg/m²) and without (n = 34, age = 19.91 ± 0.99 years, BMI = 21.38 ± 2.99 kg/ m²) TTH. Posture (craniovertebral angle) and mobility (range of motion) of the cervical region were evaluated with a goniometer and posture and mobility of the thoracic and lumbar and sacral regions in the sagittal plane were evaluated with the Spinal Mouse device (IDIAG M360, Fehraltorf, Switzerland), cervical region muscle endurance was evaluated with cervical flexion and extension endurance tests and the craniocervical flexion test, and trunk muscle endurance was evaluated with McGill's trunk muscle endurance tests and the Sahrmann test.

Results: Cervical flexion (95% CI: -1.38 to -0.40, d = 0.90, p ≤ 0.001) and extension (95% CI: -2.02 to -0.97, d = 1.50, p ≤ 0.001) mobility and cervical flexor (95% CI: -1.49 to -0.49, d = 0.99, p ≤ 0.001) and deep neck flexor muscle endurance (95% CI: -1.64 to -0.61, d = 1.13, p ≤ 0.001) scores were lower in women with TTH compared to the healthy controls. It was also observed that the thoracic angle (95% CI: 0.11 to 1.08, d = 0.60, p = 0.015) was higher in the sagittal plane and trunk flexor (95% CI: -1.33 to -0.35, d = 0.84, p = 0.001) and trunk right/left lateral flexor muscle endurance (95% CI: -1.75 to -0.73, d = 1.24, p ≤ 0.001)/(95% CI: -1.76 to -0.73, d = 1.25, p ≤ 0.001) and trunk core stability (p = 0.003) scores were lower.

Conclusion: Cervical mobility was less and cervical muscle endurance was lower in women with TTH, but their cervical postures were similar. It was also observed that thoracic angle was higher in sagittal plane and trunk muscle endurance was lower.

Advanced cancer continues to pose a substantial global challenge, with complex symptom burdens and limited therapeutic options. Traditional Chinese Medicine (TCM), grounded in holistic theory and the principles of syndrome differentiation, employs interventions such as herbal medicine, acupuncture, moxibustion, and acupoint-based therapies to address both the malignancy and the patient's overall functional status. Emerging evidence indicates that TCM may alleviate symptom clusters associated with advanced cancer, enhance quality of life, and potentially contribute to improved survival outcomes. This review synthesizes findings from the past decade on the role of TCM in advanced cancer care, with a focus on herbal decoctions, Chinese herbal injections, acupuncture-either alone or in combination with herbal therapy-moxibustion with adjuvant medication, and other external TCM modalities. Evidence is examined regarding their effects on cancer-related pain, fatigue, gastrointestinal dysfunction, chemotherapy- and radiotherapy-induced toxicities, and immune modulation. By consolidating current clinical and mechanistic insights, this review aims to inform future research and support the integration of evidence-based TCM approaches into contemporary oncology practice.

Objective: Trigeminal neuralgia (TN) is a debilitating disorder characterized by severe facial pain. While percutaneous balloon compression (PBC) is an effective surgical treatment for TN, recurrence remains a significant concern, with varying reported rates. The identification of factors that contribute to recurrence after PBC is critical for improving treatment outcomes. However, existing predictive models for recurrence have limitations in accuracy and generalizability. This study aims to explore the influencing factors of TN recurrence after PBC and to construct a TN recurrence risk prediction model.

Methods: The clinical data of 448 TN patients treated for PBC were retrospectively analyzed and divided into a modeling group (n = 317) and a validation group (n = 131) in a ratio of 7:3. Patients were divided into two groups based on whether they experienced recurrence or not. Risk prediction models were constructed using three machine learning methods: logistic regression, random forest, and XGBoost. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity were used to evaluate the model performance.

Results: Multivariate analysis showed that the duration of disease, pain type, balloon shape, compression time, and delayed disappearance of pain were influencing factors for TN recurrence after PBC, while facial numbness was a protective factor. All three predictive models exhibit high accuracy. In the modeling group, the AUC values for the logistic regression, random forest, and XGBoost models are 0.810, 0.824, and 0.816, respectively. Furthermore, the random forest model outperforms the other two models in terms of accuracy, sensitivity, and specificity. Additionally, external validation also demonstrates that the random forest model has good predictive value for TN after PBC (AUC = 0.835).

Conclusion: The random forest model showed excellent performance in predicting TN recurrence after PBC, providing a powerful reference for clinical prevention.

[This corrects the article DOI: 10.1155/prm/7873155.].

Disorders of the musculoskeletal system cover a broad spectrum of conditions that impact the muscles, skeletal structure, joints, tendons, and ligaments, leading to discomfort, swelling, and limited movement. Bee venom acupuncture (BVA), a practice commonly used in Asian countries, has been employed for a considerable time in traditional medicine systems to treat these disorders by utilizing bee venom and its main constituent, melittin. The purpose of this extensive evaluation on is to offer a detailed examination of the healing capabilities, modes of operation medical uses, and safety records of melittin and BVA in the treatment of different musculoskeletal disorders.

Purpose: This study aims to detect influential works and authors, collaboration patterns, the developmental trajectory, current hotspots, and research gaps by multiple-perspective bibliometric analyses on publications related to temporomandibular disorders in children and adolescents from 2000 to 2024.

Methods: All documents were obtained from the Web of Science Core Collection (WoSCC). Excel, VOSviewer, Pajek, SCImago Graphica, and CiteSpace software were utilized for visualized analyses of research trends, co-authorship (including authors, institutions, and countries), journals, keywords, and cited references.

Results: A total of 2208 articles and reviews were retrieved and extracted. Both annual publications and citations exhibited the trend of significant increases. Pedersen TK was the most productive author, while List T was the most cited. The co-author networks represented by Yang C exhibited independent activities and emerging trends. Aarhus University was the most productive institution. Malmo University was influential with the most citations. The United States of America was leading and majorly collaborative in this field. Most Asian countries demonstrated a lack of cooperation but growingly engaged. Journal of Oral Rehabilitation was the core journal. The keywords "diagnostic criteria" and "cone-beam computed tomography" were high in burst strength recently. The largest cluster of cited references was "juvenile idiopathic arthritis" (JIA).

Conclusions: Burst keywords and references showed that prevalences, the diagnostic criteria for temporomandibular disorders, temporomandibular joint involvement in JIA, contrast-enhanced magnetic resonance imaging, and psychosocial factors were hotspots in recent years. It is hoped that this study will favor both clinicians and researchers by recommending valuable works, guiding their future work priorities, and inspiring their potential collaborations.

Background: The aim of this review was to evaluate studies concerned with substances which can be used as biochemical biomarkers of migraine (MH). Current MH diagnosis is based on the clinical criteria provided by International Headache Society (IHS) in the third edition of International Classification of Headache Disorders from 2018. Biochemical biomarkers could be useful in more precise and differential diagnosis which is important for proper choice of treatment.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PRISMA) were applied. MEDLINE (via PubMed), Web of Science, and Embase databases were searched in the recent 5 years. Studies exclusively focused on MH and biochemical biomarkers in adults and children, which can be applied as diagnostic tools, were conducted.

Results: Finally, 31 researchers were assessed and discussed. Most of the presented studies were focused on calcitonin gene-related peptide (CGRP), pituitary adenylate cyclase-activating peptide (PACAP), pentraxin 3 (PTX3), cytokines, and markers related to mitochondrial metabolism, making CGRP and PACAP possible diagnostic biomarkers. However, other agents have promising value.

Conclusion: Based on the available studies, there are no specific substances which could be proposed as potential, practical, and useful biomarkers in HD. However, a few agents could be promising. The standardization of methodology would help in further investigations. Panels of biomarkers, easily obtained from blood but also from saliva and urine, could be interesting purposes for research in future.