Pain Management

Between 40%-60% of nursing home patients with dementia suffer from chronic and acute pain despite increasing their analgesic drug prescription.Determine the locations and intensity of pain and the association between quality of life (QoL) and four stratified pain-analgesic groups: (1) pain-analgesics treatment; (2) pain-no analgesics; (3) no pain-analgesics treatment; and (4) no pain-no analgesics.Multicenter, multicomponent cluster […]

This paper addresses the question of whether Europe is facing an opioid epidemic and utilises data from the European monitoring system on opioid use, harms and availability, to help assess the situation. Data sources covering the last decade on overdose deaths, drug treatment entrants and drug-related emergencies suggest that the health burden associated with opioid […]

The current COVID-19 pandemic is impacting individuals with pre-existing opioid use disorder (OUD), many of whom are receiving daily dosed buprenorphine treatment. There is a limited clinical experience with how to manage buprenorphine maintenance in infected individuals. Published guidance considers the possibility of dosage or formulation changes. This case series reports on 10 cases involving […]

To compare concomitant benzodiazepine (BZDs) use among chronic pain patients adherent to extended-release tapentadol (TapER) or oxycodone (OxnER) and estimate the number of lives potentially saved by switching pa-tients to the less BZD coprescribed treatment.Retrospective database study.Patients were identified using the IBM MarketScan® Commercial Database. The opioid overdose death esti-mates were obtained from the US […]

To describe current trends in filled opioid prescriptions for Medicaid-enrolled children, adolescents and young adults (AYAs) from 2012 to 2016, and to identify patient characteristics and clinical settings associated with a higher probability of filled opioid prescriptions.Retrospective cohort study of children and young adults enrolled in Medicaid from 2012 to 2016.10-12 states participating in the […]

Over 80 percent of surgery patients experience acute post-operative pain and less than half feel their pain is adequately controlled. Patients receiving chronic opioids, including methadone, are at the highest risk of inadequate pain control. Guidelines do not provide specific recommendations for analgesia management in this population. The purpose of this study was to evaluate […]

To determine the incidence and factors associated with long-term -opioid use in trauma patients who were previously opioid-naïve.A retrospective cohort study.Level I Trauma Center.Patients admitted to the study institution between January and October 2016 following traumatic injury. Trauma patients were linked with data from the state’s Controlled Substance Monitoring Program (CSMP) database regarding controlled substance […]

Patient beliefs about pain and opioids have been reported from qualitative data. To overcome limitations of unstructured assessments and small sample sizes, we determined if pain and pain medication beliefs varied by chronic pain status and opioid analgesic use (OAU) duration in primary care patients.Cross-sectional survey data obtained in 2017 and 2018 from 735 patients […]

To identify sociodemographic profiles of patients prescribed high-dose opioids.Cross-sectional cohort study.Veterans dually-enrolled in Veterans Health Administration and Medicare Part D, with ≥1 opioid pre-scription in 2012.We identified five patient-level demographic characteristics and 12 community variables re-flective of region, socioeconomic deprivation, safety, and internet connectivity. Our outcome was the proportion of vet-erans receiving >120 morphine milligram […]

Based on evidence of the immunosuppressive effects of chronic opioids, long-term users of prescription and illicit opioids comprise an unrecognized but growing population of Americans with compromised immune function and respiratory depression who may be at high risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)-related hospitalization, prolonged […]

Behavioral pain scales are recommended to assess postoperative pain for children who are too young to use self-report tools. Their main limitation is underestimation of pain in the days following an intervention. Although relevant, facial expression is not used in daily clinical practice. This prospective study aimed to assess the validity and reliability of the […]

It is widely agreed that carbamazepine and oxcarbazepine are highly effective in the long-term treatment of trigeminal neuralgia. However, the tolerability of these drugs across the different aetiologies of trigeminal neuralgia is still undetermined.In this retrospective, real-world study, we assessed the effectiveness and tolerability of carbamazepine and oxcarbazepine in a large cohort of patients with […]

The aim of this study was to confirm the effectiveness of open-label placebo (OLP) in Japanese patients with chronic low back pain (CLBP), similar to previous reports, and to investigate its short- and medium-term effects in this study population.Fifty-two patients with CLBP were randomized into a treatment as usual (TAU) group (n = 26) or an OLP + TAU […]

Beginning their post-licensure clinical practice can be a challenging time for new registered nurses. Pain management is considered an essential responsibility for nurses, requiring pain management that is prompt, safe and effective. Research is needed to examine the experiences of new registered nurses as they adjust to their new role using what they have already […]

The rationale of spinal administration of endothelin-1(ET-1) mediated anti-nociceptive effect has not been elucidated. ET-1 is reported to promote nuclear effluxion of histone deacetylase 5 (HDAC5) in myocytes, and spinal HDAC5 is implicated in modulation of pain processing. In this study, we aimed to investigate whether central ET-1 plays an anti-nociceptive role by facilitating spinal […]

Complex regional pain syndrome (CRPS) is a neuropathic pain condition that is difficult to treat. For behavioral interventions, graded motor imagery (GMI) showed relevant effects, but underlying neural substrates in patient groups have not been investigated yet. A previous study investigating differences in the representation of a left/right hand judgment task demonstrated less recruitment of […]

Fibromyalgia syndrome (FMS) is a chronic widespread pain condition of unknown aetiology. The role of temperature in FMS pain has not been reviewed systematically. The goal of this study was to review the influences of temperature on pain in FMS, from meteorological and quantitative sensory testing (QST) studies. The review was registered with Prospero: ID-CRD42020167687, […]

The aim of the study was to evaluate musculoskeletal pain due to mechanical reasons and related risk factors in adolescents and to define posture profiles of adolescents.A cross-sectional study.The study was conducted with 2221 adolescents between February 2015 and May 2015. The questionnaire used to collect data consisted of three parts: (1) descriptive characteristics of […]

Nursing brings a unique lens to care of patients with pain and opioid misuse.This scoping review describes nursing’s contribution to the literature on the management of patients with pain and opioid misuse, generating evidence to guide clinical care.The scoping review was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping […]

Chronic pain is associated with significant physical and psychological impairments across the adult lifespan. However, there is a relative gap in knowledge on individual differences that predict pain-related functioning. The current study highlights one important source of individual variation: age.Using cross-sectional data from a large treatment-seeking cohort of 2,905 adults (M age = 46.6 [13.1]; […]

The adolescent years represent a key period for the development of musculoskeletal complaints (MSC) and the differences between boys and girls. We evaluated the prevalence and course of MSC and factors associated with MSC while growing up from age 11 to age 20.Questionnaire-based data at age 11 (n=2638), age 14 (n=2517), age 17 (n=2094) and […]

Our prior studies identified a high-risk phenotype (i.e. high pain sensitivity variant of the catechol-O-methyltransferase (COMT) gene (SNP rs6269) and pain catastrophizing scores) for shoulder pain. The current study identified sensory and psychological predictors of heightened pain responses following exercise-induced shoulder injury. Healthy participants (N=131) with the SNP rs6269 COMT gene and Pain Catastrophizing Scale […]

Cannabidiol (CBD) is widely advertised as helpful for chronic pain management but research is limited. Using a cross-sectional, anonymous survey, we examined patterns of naturalistic CBD use among individuals with fibromyalgia (FM) and other chronic pain conditions. Our objective was to better understand rates of CBD use, reasons for use and discontinuation, communication with healthcare […]

Biased interpretations of ambiguous bodily threat situations characterise youth with chronic pain, and have been associated with functional disability for this population. Despite predictions by the fear-avoidance model of chronic pain, that fear and avoidance of pain explain the association between threat perceptions and disability, this has not yet been explored in youth with chronic […]

Exercise therapy is recommended for low back pain (LBP) although the immediate effects on pain are highly variable. In 96 individuals with LBP this cross-sectional study explored 1) the magnitude of exercise-induced hypoalgesia (EIH), and 2) measures of pain sensitivity and clinical pain manifestations in individuals reporting a clinical relevant increase in back pain during […]

This study determines the prevalence and particularities of headache and pain with neuropathic characteristics (NC) in a large French group of patients with pituitary adenoma (PA).Analysis of validated self-administered questionnaires, radiological characteristics, and treatment strategies of PA was performed.Of the 221 sent questionnaires, 146 could be used for statistical analysis, 50% of which were completed […]

Rebound pain is a common, yet under-recognised acute increase in pain severity after a peripheral nerve block (PNB) has receded, typically manifesting within 24 h after the block was performed. This retrospective cohort study investigated the incidence and factors associated with rebound pain in patients who received a PNB for ambulatory surgery.Ambulatory surgery patients who received […]

The COVID-19 pandemic has led caregivers to modify patient healthcare, with a high impact on patients with chronic pain.To map recommendations for the management of chronic pain patients during the COVID-19 pandemic and propose a workflow for the management of these patients.This was a scoping review.The databases searched were PubMed, Embase, CINAHL, Scopus, Cochrane Library, […]

Massive screening campaigns for SARS-CoV-2 are currently carried out throughout the world, relying on reverse-transcriptase-polymerase chain reaction (RT-PCR) following nasopharyngeal swabbing performed by a healthcare professional. Yet, due to the apprehension of pain induced by nasopharyngeal probing, poor adhesion to those screening campaigns can be observed. To enhance voluntary participation and to avoid unnecessary exposition […]

Children with medical complexity (MC) must rely on others to notice and address pain. Parents are aware of child pain behaviors and can serve as reliable proxy reporters. Thus, there is a critical need to understand parent perspectives to improve pain practices.Individual interviews were used as a data collection method in this qualitative study.Participants were […]

Pain prevalence in pediatric hospitals has been investigated in many developed countries, but little is known about this topic in China.This study sought to describe the frequency and pain intensity of procedures for medical care in hospitalized children in a Chinese children’s hospital.A cross-sectional study was designed to include interviews with children, their parents and the nurses.This […]

This study set out to investigate the effect of massage on the Toll-like receptor 4 (TLR4) signalling pathway in the dorsal root ganglia of rats that had undergone spinal nerve ligation (SNL), with the hypothesis that massage could be used as an analgesic. Forty female SD rats were randomly divided into 5 groups: the control […]

Temporal summation of pain, which is defined as the perception of greater pain evoked by repetitive painful stimuli, varies among individuals. This study aimed at determining the impact of the timing of rocuronium after induction with propofol on the temporal summation of pain.One hundred patients aged 19-60 years underwent gynecologic laparoscopic surgery. Patients were randomly […]

Hong-Hui-Xiang (HHX) is a sterilized aqueous solution extracted from Illicium lanceolatum A.C. Smith widely used for pain relief in China. Despite its history, it is not well understood. In the present study, we used a mouse model of arthritic knee pain to investigate the antinociceptive effects of HHX and its potential side effects on weight […]

Osteoporotic vertebral compression fracture (OVCF) is a common cause of pain and disability and is steadily increasing due to the growth of the elderly population. To date, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are almost universally accepted as appropriate vertebral augmentation procedures for OVCFs. There are many advantages of vertebral augmentation, such as short […]

Providing sustained and effective treatment via the peripheral nervous system for the management of chronic pain is challenging. Application of non-invasive high frequency stimulation at or near the painful area may benefit those with chronic pain. This open label pilot survey examined the impact of this stimulation on pain intensity, activities of daily living, functional […]

Dorsal root ganglion stimulation (DRG-S) is used as a treatment for chronic low back pain (CLBP), although its underlying mechanisms remain elusive. CLBP patients have been found to have reduced mechanoreceptive perception, reduced endogenous analgesia, as well as deep-tissue hyperalgesia when compared to healthy controls. Using quantitative sensory testing (QST), we studied if DRG-S in […]

The opioid overdose crisis underscores the need for health services among people who use drugs (PWUD) with concurrent pain.Investigating the effect of pain on barriers to accessing health services among PWUD.Prospective cohort study.A setting of universal access to no-cost medical care in Vancouver, Canada from June 2014 to May 2016.PWUD who completed at least one […]

Caesarean section is associated with moderate-to-severe postoperative pain, which can influence postoperative recovery and patient satisfaction as well as breastfeeding success and mother-child bonding. The aim of this systematic review was to update the available literature and develop recommendations for optimal pain management after elective caesarean section under neuraxial anaesthesia. A systematic review utilising procedure-specific […]

The high prevalence of inadequately managed chronic pain indicates the need for alternative and multimodal treatment options. Use of cannabinoids in medicine is becoming a growing area of interest, specifically in the context of chronic pain. The efficacy of cannabinoids for the treatment of chronic pain is not well established.The objectives of this rapid systematic […]

A literature review was conducted to assess nurse-led nonpharmacologic pain management interventions intended for total knee/hip replacement patients.This was a systematic review and meta-analysis.The PubMed, Embase, CINAHL, and Cochrane Library databases were searched to identify relevant studies.The systematic review was conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and all Preferred Reporting […]

Epiduroscopy, or spinal endoscopy, is the visualisation of the epidural space using a percutaneous and minimally invasive imaging fiberoptic device. Recently, as a result of some studies, it has been reported that laser therapy with epiduroscopic laser neural discectomy (ELND) was applied during multiple lesions.In this study, ELND performed between January 2012 and July 2016 […]

Several methods are currently used to manage pain related to temporomandibular disorder (TMD). Vibratory stimulation is applied as a pain treatment for several musculoskeletal disorders, but it has not yet been studied in-depth for TMD symptoms. The aim of this study is to analyse the effectiveness of at-home local vibration therapy (LVT) for the management […]

The incidence of osteoporosis and diabetes mellitus (DM) is known to increase with aging. DM is associated with osteoporotic fractures and decreased bone mineral metabolism. However, no studies have compared the effects of DM on the changes in bone mineral density (BMD) and osteoporotic fracture after epidural steroid injections (ESIs). The present study aimed to […]

Background: A survey of European Pain Federation 2019 attendees was conducted to identify unmet needs in chronic pain patients. Materials & methods: Four questions were asked focusing on functional impairment in chronic pain, including who are at increased risk and ways to better identify and manage these patients. Results: In total 143 respondents indicated that key issues […]

Aim: We sought to determine if opioid exposure may have a detrimental effect on the course of Clostridioides difficile infection (CDI). Materials & methods: We compared opioid exposure in patients with well-defined severe CDI and non-severe CDI. Results: Following exclusions, 403 records were reviewed. Of this group, 128/403 (31.7%) were determined to have severe CDI […]

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients’ use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary […]

Aim: Low back pain is a leading cause of patient disability in the USA. Our goal was to determine association between patient characteristics and their response to lumbar medial branch block, radiofrequency ablation of medial nerves or lumbar facet joint injections. Materials & methods: Medical records for the first 100 patients who underwent lumbar medial […]

The aim of this study is to describe the effects of percutaneous cervical cordotomy (PCC) on pain, opioid consumption, adverse events, and satisfaction in palliative care patients with cancer pain after PCC until end of life.This is a prospective observational case series of 58 PCCs in 52 consecutive patients. Indication for PCC was unilateral cancer […]

To ensure an adequate pain therapy with high patient adherence, it is necessary to know and consider patient preferences. A discrete choice experiment (DCE) was used to obtain patients’ preferences regarding treatment with systemic or topical pain medication. Patients with peripheral neuropathic pain (pNP) were recruited in two pain-focused practices in Germany. To identify relevant […]

The Central Sensitization Inventory (CSI) is often used in clinical settings to screen for the presence of central sensitization. However, various cutoff scores have been reported for this tool, and scores have not been consistently associated with widespread pain sensitivity as measured with quantitative sensory testing (QST). The purpose of this study was to compare […]

Stress activates several neural pathways that inhibit pain sensation. Nucleus accumbens (NAc) as an important component of the mesolimbic dopaminergic system, has a major role in pain modulation and is differentially affected by stress. Based on the nature of stressors, the direction of this effect is controversial. We previously showed that forced swim stress-induced analgesia […]

Persistent pain during pregnancy is a significant health issue, which could be correlated with psychological distress resulting from inadequate social support. This study aims to investigate whether the relationship between poor social support and antenatal pain is mediated by psychological distress. We also aimed to examine whether social cohesion moderates the influence of psychological distress […]

In the context of neuropathic pain, the contribution of regeneration to the development of positive symptoms is not completely understood. Several efforts have been done to described changes in axotomized neurons, however, there is scarce data on changes occurring in intact neurons, despite experimental evidence of functional changes. To address this issue, we analyzed by […]

The purpose of this study was to investigate the effectiveness and safety between electroacupuncture (EA) combined with usual care (UC) and UC alone for pain reduction and functional improvement in patients with non-acute low back pain (LBP) after back surgery.In this multicentre, randomised, assessor-blinded active-controlled trial, 108 participants were equally randomised to either the EA […]

Pain is underrecognized and undertreated in patients with dementia. It has been suggested that nurses’ attitudinal barriers may contribute to the challenges surrounding pain assessment and management in dementia.This integrative literature review aims to identify and explore nurses’ knowledge and attitudes towards pain assessment in older people with dementia and how it may affect pain […]

Pain is underrecognized and undertreated in patients with dementia. It has been suggested that nurses’ attitudinal barriers may contribute to the challenges surrounding pain assessment and management in dementia.This integrative literature review aims to identify and explore nurses’ knowledge and attitudes towards pain assessment in older people with dementia and how it may affect pain […]

The goal of this study was to comprehensively evaluate the analgesic and antiemetic effects of adjuvant dexmedetomidine (DEX) for breast cancer surgery using a meta-analysis.Electronic databases were searched to collect the studies that performed randomized controlled trials. The effect size was estimated by odd ratio (OR) or standardized mean difference (SMD). Statistical analysis was performed […]

Pain is one of the most disturbing and distressing symptoms experienced by cancer patients, and it is the most stressful factor affecting all aspects of patients and their families’ lives. Understanding the barriers to effective cancer pain management in home setting is essential for designing programs to improve the quality of the patients and their […]

Pain is one of the most disturbing and distressing symptoms experienced by cancer patients, and it is the most stressful factor affecting all aspects of patients and their families’ lives. Understanding the barriers to effective cancer pain management in home setting is essential for designing programs to improve the quality of the patients and their […]