Current Pain and Headache Reports最新文献

Purpose of review: Cancer is a devastating disease that affects many people across the world. Cancer has a variety of different locations and body systems it can affect, making it a complex disease to manage at times, especially when dealing with cancer of the head and neck.

Recent findings: Patients suffering from this disease can experience significant levels of pain, and it is made worse by the treatments for the disease, causing additional pain. Sphenopalatine ganglion blocks are a form of pain management observed in head and neck cancer treatment. This technique aims to disrupt the signaling pathways of the sphenopalatine ganglion and serve as an efficient, minimally invasive form of acute pain management. In this review, we will discuss the pathophysiology of head and neck cancer-related pain, the details of the sphenopalatine ganglion block, and its efficacy in clinical use, particularly with head and neck cancer patients.

Purpose of review: Periosteal osteosarcomas are rare bone tumors that comprise less than 2% of all bone malignancies. The tumor was previously thought to affect the diaphysis of long bones solely, but Recent case reports have demonstrated its existence in the clavicle, mandible, and scapula.

Recent findings: Several factors, including stage, grade, and medullary invasion primarily drive survival and recurrence of periosteal osteosarcomas. Related to its rarity, little data currently exists regarding optimum treatment strategies, including limb amputation, surgical resection, and chemotherapy in the neoadjuvant/adjuvant setting. In this regard, bone pain is the most common manifestation. Pain treatment can include medications such as oral or transdermal opioids. Adjuvant drugs can reduce inflammation and neuropathic pain, including corticosteroids, gabapentinoid agents such as gabapentin or pregabalin, lidocaine patches, tricyclic antidepressants such as amitriptyline, nortriptyline, and desipramine, or selective serotonin-norepinephrine reuptake inhibitors such as duloxetine and venlafaxine. More advanced pain treatment interventions can be provided by interventional pain medicine physicians, such as radiofrequency ablation, peripheral nerve stimulation, spinal cord stimulation, or intrathecal drug delivery systems, when conventional opioids and adjuvants do not adequately provide relief. Molecular workups of case reports have shown common mutations, such as the p53 gene, which may provide utility for future molecular targets. The present investigation aims to synthesize currently available data on periosteal osteosarcomas, including common clinical, histologic, and radiographic presentations. In addition, this review aims to further examine the potential for biomarkers and provide recommendations for treatment and future research direction.

Purpose of review: Postoperative pain management is an important aspect of shoulder surgery as it directly influences patient recovery, satisfaction, and the overall success of surgical interventions. While the interscalene nerve block (ISB) has been the standard approach for managing pain in these procedures, it is accompanied by a range of adverse effects, including phrenic nerve paralysis and respiratory complications. These drawbacks can complicate recovery and limit rehabilitation efforts.

Recent findings: In recent years, the suprascapular nerve block (SSNB) has gained use as a promising alternative for postoperative analgesia in shoulder surgeries, particularly in arthroscopic procedures. This review focuses on a comprehensive analysis of the SSNB, exploring its mechanism of action and comparing its efficacy, safety, and clinical benefits to the ISB. Evidence suggests that SSNB effectively targets the suprascapular nerve, which innervates key structures of the shoulder, providing adequate analgesia with a decreased risk of complications typically associated with ISB. The SSNB is also advantageous in the context of ongoing efforts within healthcare to identify safer, effective opioid-sparing pain management strategies. As the demand for effective pain relief continues to grow, the SSNB stands out as a viable option that could transform the approach to postoperative pain management in shoulder surgery.

Background and aim: Chronic pain affects about 20% of adults worldwide, severely impacting quality of life and functioning. Many chronic pain syndromes share symptoms such as fatigue, poor sleep, anxiety, and depression, suggesting a common mechanism. Central sensitization, an abnormal amplification of pain by the nervous system, is considered a key underlying factor. Assessment tools like the Central Sensitization Inventory (CSI) and laser-evoked potentials (LEPs) may improve diagnosis and guide targeted treatment strategies. This review evaluates the validity of the CSI for assessing central sensitization in chronic musculoskeletal pain. It also explores integrating objective measures like LEPs to enhance diagnosis and treatment strategies.

Methods: A systematic review was conducted following PRISMA guidelines. Searches in PubMed, Web of Science, Cochrane Library, Embase, and Scopus included studies published before September 2025. After removing duplicates and non-English articles, titles and abstracts were screened, and full texts assessed for eligibility. Study quality was evaluated using the JBI checklists.

Results: From 557 retrieved studies, 8 met the inclusion criteria. All used the CSI, showing it as a valid and practical tool correlating with pain, disability, and impaired quality of life. However, limitations due to its subjective nature were noted.

Conclusions: While CSI is valuable for initial screening, combining it with LEPs can provide a more precise and comprehensive assessment, improving diagnosis, management, and treatment personalization.

Purpose of review: Chronic pain is a prevalent and debilitating late effect of pediatric cancer. It is also multifaceted and requires comprehensive assessment to guide optimal treatment. While pharmacological interventions for chronic pain in this population are well summarized elsewhere, a current review of less invasive non-pharmacological interventions and assessments to guide them is needed.

Recent findings: Recent research has found the utility of biopsychosocial assessment of pain in pediatric cancer survivors using both validated measures such as the PROMIS and brief screeners. For intervention, preliminary studies found positive outcomes for physical activity interventions and biofeedback for pain in survivors. Advances in management of chronic pain in survivors are promising, though future research should refine identification and treatment. More research is needed on comprehensive biopsychosocial pain assessments and tailoring treatment. Further, promising interventions in broad chronic pain literature such as hypnosis should be explored for pediatric cancer survivors.

Purpose of topical review: In this topical review, we aim to (1) overview relevant theoretical models on the impact of digital media use on adolescent health and well-being, (2) propose a new conceptual framework for considering digital media use in adolescent migraine, and (3) highlight future directions for research and clinical care in this area.

Recent findings: Theoretical models on the impact of digital media on adolescent health and well-being have shifted away from screen time duration in favor of ecological approaches viewing youth digital media use through a developmental systems lens. Although adolescents with migraine are known high users of digital media, little is known about their context and motivations of use to inform clinical practice. We propose an integrative framework of digital media use in pediatric migraine that considers reciprocal interactions of individual, parent/family, and structural digital media use factors in relation to migraine symptoms and associated disability, as well as potential moderators such as age, sex, sleep, and mental health. Research on problematic and adaptive digital media use in adolescents with migraine is needed to determine whether and how to tailor clinical recommendations for digital media use in the general adolescent population to address the unique treatment needs of adolescents with migraine.

Purpose of review: Shoulder arthroplasty is associated with significant postoperative pain. Pain management following shoulder arthroplasty has been traditionally treated using interscalene block (ISB) and systemic opioids. However, these techniques are limited by short analgesic duration, respiratory complications, and a high risk of opioid dependence. Surgeons have considered the benefits of a multimodal approach via the suprascapular nerve block (SSNB) combined with an axillary nerve block (ANB) for managing postoperative pain following shoulder arthroplasty.The present investigation aims to evaluate the efficacy, safety, and clinical utility of a combined suprascapular nerve block (SSNB) and axillary nerve block (ANB) as an alternative to ISB for postoperative analgesia in shoulder arthroplasty. A comprehensive literature search was conducted and particular attention was given to outcomes such as pain control, opioid consumption, adverse events, and patient-specific considerations.

Recent findings: Multiple studies demonstrate that SSNB + ANB provides comparable pain control to ISB while significantly reducing the risk of phrenic nerve paralysis, rebound hyperalgesia, and opioid-related complications. SSNB alone offers diaphragmatic-sparing benefits but may have limited analgesic coverage. When paired with ANB, the dual-block technique achieves broader sensory blockade and improved patient satisfaction. Recent advances in ultrasound-guided delivery and long-acting adjuvants, such as liposomal bupivacaine, dexmedetomidine, and dexamethasone, further enhance block duration and safety. The combined SSNB and ANB represents a safe, effective, patient-centered alternative to ISB for postoperative analgesia in shoulder arthroplasty. Its favorable safety profile and comparable efficacy make it especially valuable in high-risk populations and in settings aiming to reduce opioid reliance.

Purpose of review: Medical documentation is a significant pillar of healthcare, enabling quality care, legal protection, billing and reimbursement, and collaboration between physicians. However, it is time-consuming and resource-intensive, posing a significant burden on chronic pain physicians, leading to outcomes such as increased work stress, diminished patient-physician quality time, and burnout. A range of ambient artificial intelligence (AI)-powered scribes have been developed to document based on listening to the patient-doctor interactions. These scribes utilize voice recognition and data processing capabilities to summarize and interpret patient-physician conversations, freeing physicians' time and resources and refocusing their efforts on core aspects of patient care.

Recent findings: Studies indicate that ambient AI scribes can score significantly higher than traditional notetaking on critical metrics such as completeness, conciseness, and accuracy. Additionally, they have demonstrated the potential to reduce time spent on documentation and cognitive workload while enhancing the quality of the consultation experience. Common challenges include errors, patient autonomy and privacy risks, and broader ethical implications.

Conclusion: While still in its early stages, AI-assisted documentation presents a possible solution to persistent issues in healthcare, such as administrative overload, physician burnout, and documentation-related errors. However, realizing its full potential requires addressing concerns with accuracy, privacy, and trust. The successful implementation of AI in clinical documentation will depend on striking a balance between innovation and safeguards, ensuring that such systems support patient care without compromising ethical standards or clinical safety within pain management, including the broader field of medicine.

Purpose of review: The erector spinae plane block (ESPB) has emerged as a novel regional anesthesia technique for managing pain during labor, providing an effective alternative to traditional methods. The present investigation evaluates efficacy and safety as well as maternal satisfaction in labor pain management.

Recent findings: A comprehensive analysis of patients receiving ESPB was conducted, comparing outcomes to those receiving standard analgesia, such as epidural anesthesia. Results show that the ESPB provided significant pain relief during labor, with comparable or superior efficacy to traditional methods. Patients reported high levels of satisfaction due to the minimally invasive nature of the procedure and its favorable side effect profile, including reduced motor blockade and improved mobility during labor. The ESPB was also associated with a lower risk of complications, such as hypotension, commonly observed with epidural techniques. Furthermore, the technique's simplicity and versatility make it an attractive option for obstetric anesthesia providers, particularly in settings where epidural placement may be contraindicated or those with limited resources. This study explores the importance of exploring alternative pain management strategies that prioritize maternal comfort, safety, and overall labor experience. By reducing pain effectively while maintaining maternal mobility and minimizing adverse effects, the ESPB offers a patient-centered approach to labor analgesia. Future research should focus on optimizing regimens and long-term outcomes for both mothers and neonates. The findings support ESPB as a valuable addition to the arsenal of pain management options during labor.

Purpose of review: Chronic pain and opioid use disorder (OUD) are highly prevalent and frequently co-occurring conditions that pose complex treatment challenges. While opioids are effective for pain management, prolonged use significantly enhances risk of developing substance dependence. Conversely, addiction-focused therapies often fail to relieve persistent somatic pain.

Recent findings: Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a novel adjunctive treatment with potential to address chronic pain and substance use disorders concurrently. The present investigation examines the role of intravenous ketamine infusions in cases with coexisting chronic pain and OUD. It explores pharmacological mechanisms, therapeutic applications, clinical efficacy, and safety considerations of ketamine. Ketamine primarily acts by blocking NMDA receptors, which are central to glutamatergic signaling. This inhibition reduces neural excitability and promotes neuroplastic changes, including upregulation of brain-derived neurotrophic factor (BDNF), a protein associated with synaptic remodeling and recovery within pain and addiction pathways. These mechanisms are likely to contribute to ketamine mediated dual efficacy in managing nociceptive symptoms and reducing opioid dependence. Clinical studies suggest that ketamine may reduce pain severity, decrease opioid consumption, and alleviate withdrawal symptoms in select populations. While early evidence supports ketamine's use, its side effect profile, including dissociative symptoms, sympathomimetic activity, and potential for misuse, necessitates careful patient selection, monitoring, and oversight. Evidence remains limited by inadequate sample sizes, non-standardized protocols, and short follow-up periods. Despite these limitations, ketamine remains a promising adjunct in multimodal care, especially when conventional therapies are ineffective. Ongoing research is essential to refine protocols and to explore integration with behavioral and pharmacologic addiction interventions.