Journal of Pain最新文献

{"title":"PROGRESS: A patient-centered engagement infrastructure and multi-level approach to enrich diversity, equity, and inclusion in a national randomized online behavioral pain treatment study","authors":"Jessica Clifton ,&nbsp;Emma Adair ,&nbsp;Matthias Cheung ,&nbsp;Calia Torres ,&nbsp;Wendy Andrews ,&nbsp;Brittany Dorsonne ,&nbsp;Arayam Y. Hailu ,&nbsp;Elizabeth Heggan ,&nbsp;Jackie Miefert ,&nbsp;Gabrielle Riazi ,&nbsp;Troy C. Dildine ,&nbsp;Shelly Spears ,&nbsp;Regina Greer-Smith ,&nbsp;Ting Pun ,&nbsp;Neely Williams ,&nbsp;Luzmercy Perez ,&nbsp;Heather P. King ,&nbsp;Maisa S. Ziadni ,&nbsp;Sean Mackey ,&nbsp;Beth D. Darnall","doi":"10.1016/j.jpain.2024.104718","DOIUrl":"10.1016/j.jpain.2024.104718","url":null,"abstract":"<div><div>Twenty percent of individuals experience chronic pain worldwide posing significant challenges to those living with it. Pain research is crucial for developing and characterizing effective strategies to reduce the burden of chronic pain. Traditional research approaches often yield homogeneous study samples that poorly generalize and have unknown applicability across diverse patient populations. The Pain Relief with Online Groups that Empower Skills-based Symptom Reduction (PROGRESS) study aims to address disparities in pain research engagement and patient outcomes through the intentional inclusion of people with varied backgrounds and experiences of pain, and through a multilevel design informed by diverse stakeholder recommendations. The composition of three advisory boards (Patient Engagement and Diversity Board, Local Patient Advisory Board, and the National Patient Advisory Panel) prioritized diversity in patient/expert advisor background, geographic location, race, and ethnicity. Our engagement approach aligns with the Foundational Expectations for Partnerships in Research by Patient-Centered Outcomes Research Institute (PCORI), which emphasizes diverse representation, early and ongoing engagement, dedicated funds for advisor compensation, collaborative decision making, meaningful participation, and continuous assessment. The first 24 months of study advisor engagement has yielded multiple recruitment strategies resulting in a study population enriched with a breadth of identities within PROGRESS (e.g., inclusive patient-facing materials). Lessons learned underscore the importance of investing time in building patient and stakeholder relationships, trust, and embracing diverse viewpoints amongst the study team. PROGRESS demonstrates the potential of diverse patient-centered engagement to support evidence-based outcomes and practices that are more inclusive, equitable, and representative of the broader population.</div></div><div><h3>Perspective</h3><div>The PROGRESS study demonstrates how diverse patient engagement and inclusive advisory boards enhance research outcomes. By aligning with PCORI standards and employing innovative recruitment strategies, it highlights the vital role of stakeholder relationships and diverse perspectives. Key lessons learned emphasize adaptive strategies and continuous feedback for advancing equitable pain research.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 104718"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512545","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":"Community leaders’ perceptions of pain and research engagement: Implications for participant diversity and inclusion in pain clinical trials","authors":"Shannon K. Jajko ,&nbsp;Elise V. Hoffman ,&nbsp;Kushang V. Patel ,&nbsp;Allison M. Cole ,&nbsp;Linda K. Ko","doi":"10.1016/j.jpain.2025.105389","DOIUrl":"10.1016/j.jpain.2025.105389","url":null,"abstract":"<div><div><span>Clinical trials lack diversity and representation of minoritized groups, reducing generalizability and potentially the effectiveness of interventions across these populations. The purpose of this study was to identify how community perceptions of pain and pain research shape participation in pain-related clinical trials among underrepresented groups from the perspective of community organization leaders. We conducted a qualitative study with in-depth, semi-structured interviews with representatives from community-based organizations (N=20). Interviews represented experiences of leaders serving minoritized populations, including Black/African American, Hispanic/Latino, and Asian communities in the Greater Seattle Area. Data were analyzed in Dedoose using thematic analysis. We identified five main themes: (1) Community perceptions of and communication around pain, (2) Pain research is an extension of Western medicine, (3) Community leaders’ experiences with researchers, (4) Returning the results to the community increases research meaning, (5) Understand the community experience with </span>social determinants of health<span>. Participants believed that their communities were largely uninterested in pain clinical trials because they perceived a misalignment between trial treatment options and their communities’ preferences and needs. Future research investigating integrative approaches to pain care, engaging the community in research design, and considering ways to address social determinants of health may help overcome this misalignment and improve the relevance of pain research to diverse communities.</span></div></div><div><h3>Perspective</h3><div>This article presents perspectives on pain and participation in pain research among community organization leaders serving minoritized communities in the Greater Seattle Area. The expertise of community organization leaders may inform efforts to design pain research that best engages minoritized and underrepresented groups to improve equitable pain medicine and research.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 105389"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007552","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":"Emerging approaches to addressing longstanding inequities: Insights from the Journal of Pain special issue on pain disparities","authors":"Emily J. Bartley Ph.D. ,&nbsp;Mary R. Janevic Ph.D. ,&nbsp;Martha O. Kenney M.D.","doi":"10.1016/j.jpain.2025.105509","DOIUrl":"10.1016/j.jpain.2025.105509","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 105509"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762239","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":"Amputation for complex regional pain syndrome: A systematic review","authors":"Yannick L. Gilanyi ,&nbsp;Michael C. Ferraro ,&nbsp;Andreas Goebel ,&nbsp;Neil E. O’Connell ,&nbsp;Matthew D. Jones ,&nbsp;Saurab Sharma ,&nbsp;Debbie Bean ,&nbsp;Sylvia M. Gustin ,&nbsp;James H. McAuley","doi":"10.1016/j.jpain.2025.105571","DOIUrl":"10.1016/j.jpain.2025.105571","url":null,"abstract":"<div><div>Complex regional pain syndrome (CRPS) is a disabling pain condition, usually confined to a single limb. Amputation of the affected limb is sometimes performed to improve pain and function for treatment-resistant CRPS. This systematic review evaluated the benefits and harms of amputation for CRPS. Primary studies of adults with CRPS that reported the outcomes of amputation of a CRPS-affected limb were included. Primary outcomes were pain intensity and adverse events. The following databases were searched from inception to 23 September 2024: PubMed, EMBASE, Scopus, CENTRAL, CINAHL, and PsycINFO for published literature, and BASE, Web of Science, OpenMD and MedNar for grey literature. Study methodological quality was assessed using Joanna Briggs Institute critical appraisal tools. Data were synthesised using systematic review without meta-analysis guidance. The review included 67 studies, comprising one comparative study, 24 case series and 42 case studies. Studies included 249 patients who received 263 amputations. Amputation indications included pain relief, functional improvement, infection, fracture, and prosthetic complications. The heterogeneous designs of included studies precluded quantitative estimation of treatment effects. The only included comparative study reported that CRPS patients had lower mean pain intensity scores post-amputation than non-amputated, non-matched control patients. The four studies that assessed pain intensity scores before amputation and at least 6 months post-operatively reported reductions in average pain post-amputation. Adverse events in assessed patients included phantom pain (67%), residual limb pain (66%), and recurrence of CRPS (47%). The critically low quality of included evidence and incomplete reporting greatly reduced confidence in the results. This review found no clear evidence that amputation of a CRPS-affected limb offers greater pain relief than no amputation. High-quality, controlled prospective studies with embedded qualitative research are needed to determine the benefits and harms of amputation for CRPS, as well as the factors that drive patients to seek this permanent intervention that does not guarantee improvement.</div></div><div><h3>Perspective</h3><div>This article presents a systematic review of the benefits and harms of amputation for complex regional pain syndrome. The unclear benefits and likely harms can help inform individuals and clinicians considering amputation of the potential outcomes of this intervention.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 105571"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234053","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 relationship between neighborhood disadvantage and markers of chronic pain risk: Findings from the Oklahoma Study of Native American Pain Risk (OK-SNAP)","authors":"Parker A. Kell ,&nbsp;Felicitas A. Huber ,&nbsp;Travis S. Lowe ,&nbsp;Joanna O. Shadlow ,&nbsp;Jamie L. Rhudy","doi":"10.1016/j.jpain.2024.104659","DOIUrl":"10.1016/j.jpain.2024.104659","url":null,"abstract":"<div><div>Socioeconomic disadvantage contributes to health inequities, including chronic pain. Yet, research examining socioeconomic disadvantage and pain risk in Native Americans (NAs) is scant. This exploratory analysis assessed relationships between socioeconomic position (SEP), ethnicity, and neighborhood disadvantage on pronociceptive processes in 272 healthy, chronic pain-free NAs (n = 139) and non-Hispanic Whites (NHWs, n = 133) from the Oklahoma Study of Native American Pain Risk (OK-SNAP). Neighborhood disadvantage was quantified using the Area Deprivation Index (ADI). Regression models tested whether ADI predicted pain-promoting outcomes (ie, peripheral fiber functionality, pain sensitivity, pain and nociceptive amplification, and endogenous pain inhibition) above-and-beyond SEP and ethnicity. The Ethnicity × ADI interaction was also tested. Of the 11 outcomes tested, 9 were not statistically significant. Of the significant findings, neighborhood disadvantage predicted impaired inhibition of the nociceptive flexion reflex above-and-beyond SEP and ethnicity. Additionally, ethnicity moderated the relationship between ADI and warm detection threshold; disadvantage was associated with higher thresholds for NAs, but not for NHWs. Together, the results suggest neighborhood disadvantage is associated with reduced C-fiber function and impaired spinal inhibition, thus pointing to a role of neighborhood disadvantage in the relationship between the environment and pain inequities.</div></div><div><h3>Perspective</h3><div>This study assessed neighborhood socioeconomic disadvantage and pronociceptive processes in chronic pain-free Native Americans (NAs) and non-Hispanic Whites (NHWs). Irrespective of ethnicity, greater neighborhood disadvantage predicted less descending inhibition of spinal nociception. Neighborhood disadvantage was associated with a marker of C-fiber impairment (higher warm detection threshold) in NAs only.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 104659"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057254","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 disparities attributed to linguistic minoritization in health care settings","authors":"Paulina S. Lim ,&nbsp;Michelle A. Fortier ,&nbsp;Zeev N. Kain","doi":"10.1016/j.jpain.2024.104688","DOIUrl":"10.1016/j.jpain.2024.104688","url":null,"abstract":"<div><div>There is a paucity of understanding about how language influences pain communication and outcomes for families who speak languages other than English in the United States. This is of great importance because 21.6% (68 million) of the population speak a language other than English, with 8% (25 million) of the population speaking English “less than very well<em>.</em><span><span>” Thus, the aim of this paper is to present a narrative review that describes how spoken language influences pediatric pain assessment and outcomes for children who speak languages other than English and discuss hypothesized factors that contribute to pain disparities in hospital settings. Results from the narrative review reveal that children and families who speak languages other than English have disparate pain outcomes compared with children from English-speaking families. It is hypothesized that individual (eg, clinician bias), interpersonal (eg, miscommunication of pain concepts), cultural (eg, misunderstanding of cultural concepts of pain), and systemic (eg, lack of access to interpretation services) factors influence disparate pain outcomes for linguistically minoritized children. Empirical research, including </span>randomized control trials, regarding hypothesized factors that contribute to pediatric pain disparities for language other than English-speaking children, is severely lacking. Thus, improved understanding of pain concepts and pain communication processes that center individual, interpersonal, cultural, and systemic factors will enable future research to design interventions that enhance culturally relevant pain assessment and management for families who speak languages other than English.</span></div></div><div><h3>Perspective</h3><div>This article summarizes factors that contribute to pain disparities for children who speak languages other than English. Hypothesized factors that contribute to pain disparities for language other than English-speaking children and families include clinician bias, misunderstanding of pain concepts, and lack of access to interpretation services.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 104688"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367242","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":"Advancing equity in pain care through education, strategic partnerships, and advocacy","authors":"Amber K. Brooks ,&nbsp;Janki Patel","doi":"10.1016/j.jpain.2025.105505","DOIUrl":"10.1016/j.jpain.2025.105505","url":null,"abstract":"<div><div>This article highlights three key pathways to advancing equitable pain care: education, strategic partnerships, and advocacy. Education remains foundational, emphasizing both provider training in cultural competency and bidirectional patient education to improve pain management outcomes. Strategic partnerships between the private sector, academia, and the community are needed to advance pain care and research in an increasingly challenging sociopolitical climate. Moreover, community-based participatory research (CBPR) and patient advisory boards ensure that research remains patient-centered and impactful. Finally, advocacy is crucial in mitigating legislative and policy shifts that threaten equitable pain care. While institutional constraints may limit public advocacy efforts, individual researchers and clinicians can engage policymakers, promote equitable funding structures, and advocate for high-quality pain care. By integrating action research principles with community-driven solutions, the pain research community can move beyond identifying disparities to actively implementing strategies that improve outcomes for marginalized populations, ensuring that pain care remains inclusive, responsive, and effective amidst ongoing challenges.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 105505"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668982","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":"Response to Nufi. letter to the editor, “From fragmented services to whole-person care: Rethinking young people’s pain-mental health management”","authors":"Nardia-Rose Klem,&nbsp;Andrew M. Briggs,&nbsp;Helen Slater","doi":"10.1016/j.jpain.2025.105574","DOIUrl":"10.1016/j.jpain.2025.105574","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"37 ","pages":"Article 105574"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259935","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":"Heterogeneity matters: Interpretating amputation outcomes in CRPS.","authors":"Daniël P C van der Spek, Jan van den Brink, Frank J P M Huygen, Maaike Dirckx","doi":"10.1016/j.jpain.2025.105627","DOIUrl":"https://doi.org/10.1016/j.jpain.2025.105627","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"105627"},"PeriodicalIF":4.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649999","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":"Post-traumatic osteoarthritis in aged rodents is associated with brain changes that correlate with joint remodeling","authors":"Jacob L. Griffith ,&nbsp;Pedro A. Valdes-Hernandez ,&nbsp;Taylor D. Yeater ,&nbsp;Shane H. Priester ,&nbsp;Marcelo Febo ,&nbsp;Yenisel Cruz-Almeida ,&nbsp;Kyle D. Allen","doi":"10.1016/j.jpain.2025.105594","DOIUrl":"10.1016/j.jpain.2025.105594","url":null,"abstract":"<div><div>Preclinical models of osteoarthritis (OA) can provide insights into joint-level remodeling and pain-related behaviors, but effects beyond the joint are poorly understood. The current study investigates joint remodeling and brain remodeling using aged rats in a surgical rodent model of post-traumatic OA. Male and female Fischer 344 rats (68 weeks old) received either a skin incision (n=6 male and n=10 female) or medial collateral ligament transection plus medial meniscus transection (MCLT+MMT) surgery (n=5 male and n=11 female). Tactile sensitivity was assessed pre-surgery and 4-, 8-, 12-, and 16-weeks post-surgery. Neuroimaging was performed pre-surgery and 6- and 14-weeks post-surgery, with analyses focused on gray matter volume, blood oxygen level dependent (BOLD) signal, and functional connectivity. Following euthanasia, histological analysis was performed to assess joint changes. Histology confirmed advanced cartilage loss and bone damage in animals with MCLT+MMT animals relative to skin-incision sham; however, tactile sensitivity decreased over time for both surgery groups. From the neuroimaging data, differences between the MCLT+MMT and skin-incision groups were present for both males and females at week 6 and week 14. Differences include gray matter volume, BOLD signal, and functional connectivity in regions responsible for pain transmission and modulation (thalamus, somatosensory cortex, and periaqueductal gray), along with the emotional and affective aspects of pain (striatum, hippocampus, prefrontal cortex, and amygdala). Despite a lack of differences in tactile sensitivity between groups, these findings in the central circuits involved in sensory and nociceptive processing indicate an association with knee OA development and brain remodeling.</div></div><div><h3>Perspective</h3><div>This work is the first to examine brain remodeling in the acute and chronic stages of osteoarthritis pain using the medial meniscus transection model in aged animals. Results demonstrate evidence of brain remodeling in a preclinical model of osteoarthritis and help elucidate osteoarthritis effects beyond the joint.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"39 ","pages":"Article 105594"},"PeriodicalIF":4.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598060","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}