Journal of Pain最新文献

{"title":"“My lived experience was valued”: Co-designing ‘OA Champions’ – A pain science-informed peer mentorship program for people with knee osteoarthritis","authors":"Monique V. Wilson ,&nbsp;Aaron Davis ,&nbsp;Felicity A. Braithwaite ,&nbsp;John B. Arnold ,&nbsp;Ian Gwilt ,&nbsp;Stuart Campbell ,&nbsp;John Porton ,&nbsp;Olivia Petropoulos ,&nbsp;Tasha R. Stanton","doi":"10.1016/j.jpain.2026.106193","DOIUrl":"10.1016/j.jpain.2026.106193","url":null,"abstract":"<div><div>Access to first-line care for knee osteoarthritis (OA) is limited. Peer-led strategies offer a promising alternative for delivering support and up-to-date information to help individuals manage knee OA. This study used a co-design approach to develop a pain science-informed peer mentorship program to support knee OA self-management. Peer mentorship involves one-to-one tailored support delivered by a trained mentor with the same condition. Co-design ensures meaningful involvement of end-users across all stages of program development, guaranteeing their needs and preferences are captured. Individuals with knee OA were engaged as equal partners across one rural and four metropolitan co-design workshops. Guided by the Double Diamond design process, workshops utilized a range of participatory strategies and involved both researcher-led and co-researcher-led analysis. Twenty-seven co-researchers (mean age 65.1 [SD 9.3] years; 59% female) participated across the workshops. Co-researchers identified unmet support needs throughout the knee OA journey and informed the type of support that could be offered by peer mentors in these situations, drawing from lived experience. Key components of the program were also informed, including preference for a blended mentor training model, considerations for mentor-mentee matching, the development of mentorship session cards, and the importance of session monitoring. The co-designed peer mentorship program, now ready for pilot feasibility testing, offers a flexible intervention that can be tailored to individual support needs, promoting self-management and disseminating contemporary pain science education. Strong evidence of meaningful end-user involvement also positions this study as an exemplar for engaging people with lived experience in developing complex interventions.</div></div><div><h3>Perspective</h3><div>This article presents a multi-stage co-design process that meaningfully involved people with lived experience of knee osteoarthritis to develop a pain-science informed peer mentorship program supporting self-management. Aligning with end-user needs and preferences, the flexible program can be tailored to individual support needs.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"40 ","pages":"Article 106193"},"PeriodicalIF":4.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953766","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":"Potential mediators of the effects of clinical hypnosis, mindfulness meditation, and pain education on chronic pain in Veterans","authors":"Mark P. Jensen ,&nbsp;Marcia A. Ciol ,&nbsp;Kevin J. Gertz ,&nbsp;Dawn M. Ehde ,&nbsp;Shahin Hakimian ,&nbsp;Melissa A. Day ,&nbsp;Mark W. Pettet ,&nbsp;Aaron P. Turner ,&nbsp;Colin G. Sarabosing ,&nbsp;Rhonda M. Williams","doi":"10.1016/j.jpain.2025.106176","DOIUrl":"10.1016/j.jpain.2025.106176","url":null,"abstract":"<div><div>Psychological interventions have reliable but modest effects on chronic pain outcomes, but our understanding of the mechanisms that underlie these effects remains limited. This paper presents the findings from a series of secondary analyses using data from a randomized clinical trial (clinicalTrials.gov, NCT02653664). Three hundred and twenty-eight Veterans of the US Armed Forces with chronic pain were randomized to receive clinical hypnosis, mindfulness meditation training, or pain education via 8 in-person group sessions. Of 17 candidate mediator variables assessed before and after treatment, 10 changed with treatment. Three of these were associated significantly with reductions in pain intensity and interference across all three treatment conditions: greater willingness to tolerate pain, greater engagement in valued activities despite pain, and reduced catastrophizing. A fourth candidate mediator assessed during treatment (working alliance) was significantly associated with reductions in pain intensity for those receiving clinical hypnosis. When comparing effects between treatments, catastrophizing appeared to play a larger role for the effects of mindfulness training on pain intensity and interference, and pain willingness appeared to play a larger role in the effect of therapeutic hypnosis on pain interference. Further research is needed to validate the reliability of the mediators identified in this study. If the findings from the current study replicate in other samples, they would support the importance of focusing treatment on thoughts about pain, pain avoidance, engagement in valued activities, and working alliance.</div></div><div><h3>Perspective</h3><div>Three psychological variables were identified as being possible mediators of the beneficial effects of mindfulness, clinical hypnosis, and pain education on pain. Additional research is needed to definitively test these variables as potential mediators of psychological pain treatments.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"41 ","pages":"Article 106176"},"PeriodicalIF":4.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936005","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":"Beyond Linear Assumptions: Advancing Lipidomic Analysis in Localized provoked Vulvodynia.","authors":"Souichi Oka, Kiyo Yoshida, Yoshiyasu Takefuji","doi":"10.1016/j.jpain.2025.106179","DOIUrl":"https://doi.org/10.1016/j.jpain.2025.106179","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106179"},"PeriodicalIF":4.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936030","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":"Re: Letter to the Editor Re: Effects of centrally acting analgesics on resting-state electroencephalography biomarker candidates of chronic pain.","authors":"Paul Theo Zebhauser, Markus Ploner","doi":"10.1016/j.jpain.2026.106183","DOIUrl":"10.1016/j.jpain.2026.106183","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106183"},"PeriodicalIF":4.0,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913876","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 effect of positive, neutral, and negative expectations about spinal manipulative therapy on pain intensity in chronic low back pain: A randomized controlled trial","authors":"Bianca Emanuelli Saes Campanha ,&nbsp;Thamiris Costa de Lima ,&nbsp;Helen Cristina Nogueira Carrer ,&nbsp;Steven Z. George ,&nbsp;Felipe J.J. Reis ,&nbsp;Thaís Cristina Chaves","doi":"10.1016/j.jpain.2025.106177","DOIUrl":"10.1016/j.jpain.2025.106177","url":null,"abstract":"<div><div>Spinal manipulative therapy (SMT) has favorable, but small effects on pain intensity to treat chronic low back pain (CLBP). However, there is the potential for these effects to be enhanced by manipulating treatment expectations. Our objective was to investigate the effect of verbally delivered treatment expectations in association with SMT on pain intensity for individuals with CLBP. Our sample consisted of sixty participants who were randomly allocated to three groups in which verbally delivered expectations (positive [PEG], neutral [NEUG], and negative [NEG]) were administered by video before one session of SMT. Pain intensity (primary outcome), global perceived effect (GPE) of improvement, disability, participants’ expectations, and empathy as secondary outcomes were assessed immediately post-treatment and pain intensity, GPE, and disability at the 3-month follow-up. Participants were interviewed about their perceptions regarding the videos. Pain intensity significantly decreased in the PEG and NEUG immediately after the SMT session (mean difference=MD), PEG - MD=-1.9 [95% CI −3.4 - −0.3] and NEUG - MD=-1.6 [95% CI −3.2 - −0.05], both when compared to the NEG. However, these findings weren’t maintained at the 3-month follow-up. No significant changes in GPE and disability were observed between groups. Our findings suggest that positive and neutral verbally delivered treatment expectations resulted in short-term SMT hypoalgesia compared to negative expectations; however, these effects did not persist at 3-month follow-up. Such results suggest that both positive and neutral SMT-related expectations should be adopted when communicating the expected treatment effects to patients.</div></div><div><h3>Clinical trials registration number</h3><div>NCT05996991, protocol registration: August 2023, study start date 1st October, 2023</div></div><div><h3>Perspective</h3><div>Our findings showed that using positive or neutral verbally delivered expectations has the potential to enhance short-term hypoalgesia associated with SMT in CLBP.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"40 ","pages":"Article 106177"},"PeriodicalIF":4.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893460","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":"Quality matters: Interpreting amputation outcomes in CRPS - Authors reply.","authors":"Yannick L Gilanyi, Michael C Ferraro, Andreas Goebel, Neil E O'Connell, Matthew D Jones, Saurab Sharma, Debbie Bean, Sylvia M Gustin, James H McAuley","doi":"10.1016/j.jpain.2025.106178","DOIUrl":"10.1016/j.jpain.2025.106178","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"106178"},"PeriodicalIF":4.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893393","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 efficacy and safety of repetitive transcranial magnetic stimulation for comorbid chronic low back pain and insomnia: A randomized, double-blind, sham-controlled pilot trial","authors":"Jeremy R. Chang ,&nbsp;Eliza R. Sun ,&nbsp;Minxia Jin ,&nbsp;Leo GH Lin ,&nbsp;Shirley X. Li ,&nbsp;Jannet LC Lee ,&nbsp;Frank F. Huang ,&nbsp;Rachel LC Kwan ,&nbsp;Daniel KY Zheng ,&nbsp;Dino Samartzis ,&nbsp;Siu-Ngor Fu ,&nbsp;Arnold YL Wong","doi":"10.1016/j.jpain.2025.106180","DOIUrl":"10.1016/j.jpain.2025.106180","url":null,"abstract":"<div><div>Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy in treating chronic pain or insomnia independently. Given the high prevalence of insomnia in individuals with chronic low back pain (CLBP), this pilot randomized controlled trial assessed the feasibility, acceptability, and preliminary efficacy of rTMS targeting either the left primary motor cortex (M1) or right dorsolateral prefrontal cortex (DLPFC) in individuals with comorbid CLBP and insomnia. Thirty-six participants were randomized to receive sham-rTMS, active M1-rTMS (10 Hz, 1500 pulses), or active DLPFC-rTMS (1 Hz, 1500 pulses) over 10 sessions for two weeks (five sessions per week), with a one-month follow-up. Primary outcomes were feasibility and acceptability. Secondary outcomes included pain intensity, insomnia severity, disability, psychological measures, subjective and objective sleep parameters, pain threshold, temporal summation of pain, and conditioned pain modulation. rTMS was highly feasible and acceptable, as evidenced by excellent session attendance and no participant attrition. No serious adverse events were reported. Both active M1- and DLPFC-rTMS significantly reduced pain intensity and enhanced the descending pain inhibitory pathways compared with sham stimulation. Importantly, DLPFC-rTMS was superior to sham in reducing insomnia severity, objective wake after sleep onset, and temporal summation of pain. These findings suggest that rTMS is a feasible, well-tolerated, and promising intervention for individuals with comorbid CLBP and insomnia. While both stimulation protocols yielded analgesic benefits, DLPFC-rTMS may confer additional advantages for addressing sleep disturbance. Further full-scale randomized clinical trials are warranted to validate these preliminary findings and optimize rTMS protocols for this complex clinical population.</div></div><div><h3>Perspective</h3><div>rTMS was feasible for comorbid chronic low back pain and insomnia, with DLPFC stimulation yielding superior effects on sleep disturbance and pain processing. Further large-scale RCTs using neuroimaging are warranted to validate and expand upon these preliminary results and elucidate the neurophysiological basis of treatment efficacy.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"40 ","pages":"Article 106180"},"PeriodicalIF":4.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893472","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":"How do people with fibromyalgia interpret ambiguous cues in empathy-related healthcare scenarios?","authors":"Maria Planes Alias ,&nbsp;David J Moore ,&nbsp;Nicholas Fallon ,&nbsp;Katie Herron ,&nbsp;Charlotte Krahé","doi":"10.1016/j.jpain.2025.106181","DOIUrl":"10.1016/j.jpain.2025.106181","url":null,"abstract":"<div><div>Empathic communication is essential for high-quality healthcare, yet patients must often interpret subtle and ambiguous interpersonal cues during healthcare encounters. In such contexts, prior experiences and cognitive-affective processes may shape interpretations in biased ways. In Fibromyalgia Syndrome (FMS), a frequently stigmatised and ‘invisible’ condition, such biases may influence how patients perceive unclear messages from healthcare professionals. While interpretation bias for pain-related information has been explored, bias in interpreting social-emotional information has not. This study investigated interpretations of ambiguous social-emotional cues from healthcare professionals in individuals with FMS (<em>n</em> = 65), compared with those with other chronic pain conditions (<em>n</em> = 51) and pain-free controls (<em>n</em> = 77). Participants completed a novel scenario-based task assessing the perceived likelihood of positive, neutral, and negative interpretations of ambiguous clinical situations. Validated self-report measures of psychological distress and perceived clinical empathy were also administered. Results showed that individuals with FMS were significantly more likely to endorse negative interpretations and less likely to endorse positive ones relative to both comparison groups, even after controlling for depression, anxiety, and stress. The FMS group also reported greater psychological distress and lower perceived empathy. Moreover, negative interpretation bias was associated with greater distress and lower perceived clinical empathy, while positive bias showed the opposite pattern. These findings suggest that individuals with FMS interpret ambiguous healthcare communication through a distinct cognitive-affective lens. This highlights that patient–provider interactions are not experienced uniformly across chronic pain populations, and that interpretative biases should be considered to improve healthcare communication.</div></div><div><h3>Perspective</h3><div>We explored how individuals with fibromyalgia (compared to other chronic pain and pain-free groups) interpret empathy-related ambiguous cues from healthcare professionals. Controlling for psychological distress, the fibromyalgia group showed a stronger negative interpretation bias than both comparison groups. Understanding these socio-cognitive patterns may help improve communication and empathy in fibromyalgia care.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"40 ","pages":"Article 106181"},"PeriodicalIF":4.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890527","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":"Pain and functional disability in older adults with cardiovascular disease: A cross-national comparison of India, China, and Mexico","authors":"Hongtao Cheng ,&nbsp;Huijun Wu ,&nbsp;Lu Shao,&nbsp;Jie Jiang,&nbsp;Tingting Xie,&nbsp;June Zhang","doi":"10.1016/j.jpain.2025.106182","DOIUrl":"10.1016/j.jpain.2025.106182","url":null,"abstract":"<div><div>Pain is highly prevalent among older adults with cardiovascular disease (CVD) and may compromise functional independence. However, the nature of this relationship in different cultural and healthcare contexts is not well understood. We examined the association between pain and functional limitations among adults aged 60 years and older with self-reported cardiovascular disease (CVD) using nationally representative data from the Longitudinal Aging Study in India (LASI, n = 11,247), the China Health and Retirement Longitudinal Study (CHARLS, n = 3733) and the Mexican Health and Aging Study (MHAS, n = 5108). Pain was assessed through self-report, and functional status was evaluated across activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility. Cross-sectional associations were estimated using multivariable logistic regression, and longitudinal analyses examined the effect of baseline pain on incident disability at 3-year follow-up in the Chinese and Mexican cohorts. Pain was reported by 43.7%, 36.2%, and 43.6% of participants in India, China, and Mexico, respectively. After adjustment for covariates, pain was significantly associated with ADL disability in all three countries (India OR=1.86, China OR=2.22, Mexico OR=2.32), with similar associations observed for IADL and mobility limitations. Strong dose–response relationships were identified between pain frequency or severity and functional limitations. Longitudinal analyses further showed that baseline pain predicted new-onset ADL and IADL disability at follow-up. These findings demonstrate that pain is consistently associated with functional decline among older adults with CVD, underscoring the importance of pain assessment and management in geriatric cardiovascular care globally.</div></div><div><h3>Perspective</h3><div>This study reveals consistent cross-national associations between pain and functional disability among older adults with cardiovascular disease. Pain independently predicts future functional decline, underscoring its value as a clinical marker for early intervention and as a modifiable target in integrated cardiovascular and geriatric care programs.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"40 ","pages":"Article 106182"},"PeriodicalIF":4.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890551","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":"Are gray matter changes following pain reprocessing therapy associated with clinical improvement? A voxel-based morphometry mediation analysis","authors":"Carlos Murillo ,&nbsp;Tor D. Wager ,&nbsp;Yoni K. Ashar","doi":"10.1016/j.jpain.2025.105644","DOIUrl":"10.1016/j.jpain.2025.105644","url":null,"abstract":"<div><div>Chronic back pain (CBP) has been associated with reorganization of gray matter (GM), and treatment may reverse these GM adaptations. Prior trials testing treatment effects on GM did not included a randomized control group, found no treatment vs. control differences, or did not attempt to link treatment-induced GM changes to improvements in clinical outcomes. We addressed this gap by performing a voxel-based morphometry mediation analysis testing for effects of a psychological treatment (pain reprocessing therapy, PRT, n=44) vs. two randomized control groups (treatment as usual, n=47, and open-label placebo, n=44) on GM, and testing whether treatment-specific GM changes were associated with reductions in disability (ODI) and pain intensity (BPI). Relative to both control groups, PRT increased GM in the anterior cingulate and orbitofrontal cortex. These treatment-induced GM increases, however, did not mediate PRT effects on clinical outcomes. Instead, improvements in disability and pain were associated with GM increases in the lateral prefrontal cortex and GM decreases in the thalamus and amygdala. These findings indicate that PRT vs. control increases GM in key pain-modulatory regions, and, that clinical improvement is related to different prefrontal and subcortical GM changes in regions processing nociceptive input and regulating pain. The lack of mediation may indicate either that GM changes are not a treatment mechanism, or a lack of power to detect smaller effects. Future research is needed to better understand how treatments act on neurobiology to drive clinical improvement.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"40 ","pages":"Article 105644"},"PeriodicalIF":4.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835250","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}