Poster Session 2 (Tuesday Afternoon)

Itch and pain are distinct sensations that arise from the central integration of peripheral nerve signals. Both itch- and pain-inducing chemicals activate the same population of peripheral neurons—mechanosensitive C-fibers (CM)—which also respond to noxious heat(1). How these fibers differentially encode itch versus pain remains unclear.
We proposed that CM fibers may distinguish between itch and pain through differences in temporal patterns of action potential discharge (2). In particular, non-histaminergic pruritogens evoke a slow bursting firing pattern in approx. 35% of human CM´s, a pattern that has not been observed with algogens.
This specific firing pattern has not yet been systematically investigated and characterized in detail. Here, we present analyses of chemically evoked temporal discharge patterns in human peripheral nerve fibers, providing further evidence for a role of patterned activity in the encoding of itch(2).

The main genes responsible for Charcot-Marie-Tooth type 2 (CMT2) polyneuropathies (axonal) are usually MFN2, GJB, MPZ, GDAP1, HSPB1, and HSPB8, and are a significant cause of neuropathic pain.

Pathogenic and probably pathogenic variants in the heterozygous state of the GDAP1 gene have been associated with CMT2 type 2K with autosomal dominant and recessive inheritance patterns.

In Latin America, we have limited data indicating the presence of mutations in this gene related to CMT2 type 2K.

Burn injury commonly leads to pain and persistent itch during wound healing, both of which markedly impair quality of life1-3. Despite their clinical significance, the underlying neural mechanisms of the neural processes that drive sensory dysfunction following burn injury remain poorly understood. This study seeks to develop a mouse model of post-burn pain and itch, and to investigate changes in primary sensory neuron activity using in vivo calcium imaging of trigeminal ganglion (TG) neurons.

TRPV1 receptors are predominantly expressed in primary sensory neurons whose cell bodies are located in the dorsal root ganglia (DRG), where they play a pivotal role in nociceptive signaling [1]. Nitric oxide (NO) is a diffusible signaling molecule that modulates pain processing, with context-dependent pro- or antinociceptive effects. However, the extent to which NO directly regulates TRPV1 receptor activity in primary nociceptors remains to be elucidated [2]. The present study aimed to investigate the effects of nitric oxide inhibition on TRPV1 activity in primary DRG cultures and to determine the impact of NO modulation on capsaicin-induced nociception in rats.

Interoception refers to sense of physiological condition of the body and plays a key role in emotion regulation, bodily awareness, and adaptive regulation of internal states [1] Altered interoceptive processing has been increasingly implicated in the development and maintenance of chronic pain [4]. While most interoception research focuses on cardiac signals, thermosensation remains relatively underexplored despite its relevance for bodily threat detection and pain processing [2,3]. The present study aims to develop and evaluate a novel thermoceptive biofeedback training paradigm designed to improve thermoceptive accuracy through short-term experimental training.

Noradrenaline is a key neuromodulator in pain processing and acts across the central nervous system, including the anterior cingulate cortex (ACC). The ACC is important in the affective component of pain. ACC noradrenaline levels increase in response to noxious stimuli (1)(2). In rodents, pain affect is reflected in pain-related coping behaviours following noxious stimulation, such as paw licking. Pain sensitivity fluctuates across the rodent oestrous cycle(3); however, how these behavioural changes relate to ACC noradrenergic signalling is poorly understood. Defining how ACC noradrenaline dynamics vary with pain behaviours and ovarian hormones may provide new insight into sex-specific mechanisms of pain.

Satellite glial cells (SGCs) in peripheral sensory ganglia are activated by signals transmitted from ganglion neurons. Activated SGCs are thought to induce abnormal excitation in ganglion neurons by transferring neurotransmitters and cytokines, resulting in hyperalgesia. However, it has not been demonstrated that neuronal excitability changes immediately following SGCs activation. In this study, we aimed to evaluate whether neuronal excitability changes after SGCs activation by ATP released from abnormally excited neurons in trigeminal ganglia (TG) and to clarify the mechanism involved. Furthermore, we aimed to clarify whether SGCs activation causes pain-related behavior/hyperalgesia in rats.

Nociception is critical for pain perception and survival and begins with the activation of nociceptors, specialized sensory neurons located in the dorsal root ganglia (DRGs)[1,2]. Sex plays a significant role in modulating pain perception, with important differences characterized in peripheral and central immune cells and glia[3]. However, little is known about the contribution of circadian (24-hour) rhythms to this process, governed by core clock genes within individual peripheral and central cells[4,5], We therefore sought to determine whether 1) nociception and pain are rhythmic in mice, 2) an endogenous circadian machinery exists in nociceptors, 3) these clocks might contribute to nociception and pain, and 4) there may be an interaction between circadian rhythms and sex differences. Understanding the contribution of circadian clocks at the cellular level presents a unique opportunity to decipher mechanisms regulating pain across both healthy and diseased states.

The face is a key location for sensory processing across the animal kingdom. Trigeminal ganglion neurons (TGNs) process facial somatosensory information, transmitting it to the nucleus caudalis and then to the brain. This processing can become abnormal, as is thought to occur in trigeminal neuralgia, a devastating pain condition with significant need for treatment. Understanding how TGN computation relates to perception and behavior, along with how this changes in chronic pain and analgesic states, necessitates recording TGN activity over time and in behaving animals. To address these gaps, here we longitudinally imaged TGN activity in anesthetized and awake animals.

There is a debate amongst investigators regarding whether fish feel conscious pain or not (Rose, 2016). The physiology of pain in fish, in general, has not yet been established due to the limited studies on the nociceptor pathways (Diggles et al., 2023). The processing of painful stimuli depends on specific structures within the central nervous system, the most important being the cortex in mammals and its counterpart, the dorsal pallium in bony fish and elasmobranchs (Rose et al., 2014). The target tissue for this project was the trigeminal nerve, the fifth cranial nerve (V), an essential component of the motor and sensory innervation of the jaw (Terrier et al., 2022). This project aims to determine whether there is a direct or indirect connection between the trigeminal nerve and the dorsal pallium to identify a relationship between structures that process painful stimuli in sharks.

Low-intensity pulsed ultrasound (LIPUS) is a non-invasive brain stimulation technique that utilizes the biophysical effects of ultrasound to treat brain disorders and injuries. This study investigated whether hippocampal-targeted LIPUS could improve perioperative neurocognitive disorder (PND) in aged mice and explored its potential mechanisms.

Chronic muscle pain is a prevalent and debilitating symptom across multiple diseases and impairs quality of life. However, currently available analgesics often provide limited efficacy, particularly for sng, which may persist or worsen despite partial pain relief. These limitations highlight an urgent need for effective therapeutics targeting sng/pain. In acid-induced fibromyalgia mouse model, substance P signaling from muscle afferent terminals suppresses sngceptor excitability and prevents mechanical hyperalgesia. These findings suggest that peripheral substance P signaling is a promising therapeutic target. Here, we aim to identify active components from Chinese medicines that modulate substance P–mediated antinociceptive signaling in fibromyalgia models.

Those with chronic pain differ in how they recall past experiences and imagine future scenarios. They show reduced specificity when recalling personal events (episodic memory; EM) and when imagining hypothetical future events (episodic future thinking; EFT) (Quenstedt et al., 2021). Chronic pain is also associated with greater pain catastrophising, a cognitive process involved in the avoidance of future scenarios perceived as potentially painful (Vlaeyen & Linton, 2000). In this study, we aimed to investigate whether pain catastrophising predicts the specificity and episodic detail produced during EM and EFT in chronic pain populations.

Up to 10% of people suffer from painful neuropathy (1), yet mechanisms remain unclear, limiting treatment development (2). Dysfunction of voltage-gated ion channels in peripheral C-fibers is one candidate mechanism (3,4). Inflammation, metabolic factors, and mutations can alter channel gating and ionic currents, thereby explaining increased excitability of C-fibers observed in painful neuropathy (5,6). Because voltage-gated ion channels shape the waveform of nerve action potentials (7,8), we hypothesize that channel alterations produce signatures in extracellular recordings of these potentials. Via microneurography, such recordings could be conducted in awake humans. However, identification of these signatures is experimentally difficult, as channel alterations in humans cannot be selectively manipulated or isolated from co-occurring changes in other channels, which potentially mask existing signatures.

Here, we aimed to develop a computational approach to identify extracellular signatures of defined channel alterations. If detectable in microneurographic recordings, such signatures could help identify ion-channel dysfunction in neuropathic pain.

The development of new analgesics has been slowed by limited translational value of preclinical pain models. Human donor–derived primary dorsal root ganglia (DRG) cultures provide a human-relevant system to interrogate neuronal excitability but are technically challenging to work with and constrained by availability. Differentiated human induced pluripotent stem cell sensory neurons (hiPSC-SNs) present a promising alternative to bridge the translational gap. We used moderate throughput multielectrode array (MEA) electrophysiology to assess how Merck’s selective Nav1.7, Nav1.8 and HCN channel inhibitors modulate hiPSC-SN excitability, offering a practical functional readout more amenable to analgesic drug discovery than traditional patch clamp techniques.

Orofacial pain (OFP) is a common and debilitating condition encountered by both medical and dental clinicians. Overlapping features between odontogenic and non-odontogenic causes create diagnostic uncertainty, resulting in inconsistent management and poorer patient outcomes. Misdiagnosis may lead to unnecessary investigations, inappropriate treatment, increased healthcare costs, and psychosocial burden. Although classification systems exist, their chairside application remains complex and limited. Variability in training and clinical experience further contributes to delayed or inappropriate referral. Therefore, this study compares the perspectives and clinical practices of Malaysian medical and dental clinicians regarding OFP and evaluates the need for a structured, chairside-friendly diagnostic framework development.

Understanding cross-species comparability in quantitative sensory testing (QST) is essential for bridging preclinical and clinical pain research. QST measurements are discussed as potential clinically relevant biomarkers [1], yet the translational gap between species remains a challenge. Although humans and rats share nociceptive pathways, the extent of variability in QST between species remains unclear. Rat studies involve genetically homogenous groups, controlled environments, and more direct signal detection [2], whereas humans exhibit substantial variability and rely on subjective pain ratings [3]. This discrepancy may contribute to high clinical trial failure rates. This study compared human and rat variability across seven QST measurements.

The extracellular matrix (ECM) provides mechanical cues that shape how cells spread, migrate, and respond to injury. Microglia, key mediators of neuroinflammation and central sensitization, dynamically remodel the ECM and influence synaptic plasticity in pain pathways. Tissue stiffness changes in conditions such as neuropathic pain, tumors, and scarring, but the quantitative effects of matrix rigidity and inflammation on microglial morphology—as a proxy for state and function—are unclear. In this study, we developed and applied a scalable CellProfiler-based workflow to define how ECM stiffness and lipopolysaccharide (LPS) stimulation alter BV2 microglial morphology, providing an efficient and objective workflow for morphological analysis.

Low back pain is one of the most common clinical symptoms in orthopedics. It not only severely impairs patients' physical and mental health and reduces their quality of life but also imposes a substantial social burden and economic loss. Intervertebral disc degeneration is a major cause of chronic low back pain. Patients with chronic low back pain may present with structural or functional alterations in specific regions of the central nervous system; however, their clinical significance has yet to be fully elucidated.

Operant conditioning shows that behavior can be shaped by rewards and punishments. Such consequences may also shape treatment expectations and influence how individuals respond to a placebo [1,2]. Importantly, placebo effects can also be acquired through observational learning, where observers form expectations by watching how others respond to a placebo. In most observational learning paradigms, observers typically watch a demonstrator whose placebo responses have been established via classical conditioning. The present study tested whether placebo hypoalgesia can instead be acquired through vicarious operant conditioning, in which an observer watches a demonstrator whose reactions to placebo are reinforced or punished.

Recognizing pain in laboratory animals is crucial for valid interpretations of preclinical pain models. The Rat Grimace Scale (RGS), based on scoring facial expressions, presents itself as an objective and non-evoked method for measurement of pain. Although it is validated for use in acute pain models for up to 48 hours, it is often used outside this timeframe and in chronic and neuropathic models. Applying the RGS in unvalidated contexts may allow pain being undetected which could affect our results. We investigated whether the scale remains reliable beyond its established limits of time and pain types.

The spinal nerve ligation (SNL) model induces neuropathic pain through peripheral nerve injury, leading to central sensitization and neuroinflammation. Recent evidence suggests that activation of macrophage-inducible C-type lectin (Mincle) in the spinal cord may also trigger pain hypersensitivity without peripheral nerve injury. This study compared the effects of SNL and spinal Mincle activation on pain behavior and neuroglial activation.

General anesthesia (GA) induces reversible unconsciousness for surgery, yet mechanisms underlying changes of consciousness during GA remain largely unknown (1). Glutamatergic neurons in the medial septum (MS, a midline structure located in the basal forebrain) are identified to promote emergence from sevoflurane general anesthesia (GA), with the potential downstream neural circuit remaining to be explored (2). Glutamatergic MS neurons have been identified to promote wakefulness through glutamatergic neurons in the lateral hypothalamus (LH) (3). Here, we aimed to investigate the role of the glutamatergic MS-LH circuit in regulating states of consciousness during sevoflurane GA.

The spinal dorsal horn is a center for integration of somatosensory processing. Therein peripheral inputs of different modalities and intensities are processed before ascending to the brain. Wide Dynamic Range (WDR) neurons play a crucial role in encoding stimulus intensity from light touch to noxious stimuli [1, 2], and are strongly engaged in mechanism described as Gate Control Theory of Pain, acting as transmission cells [3]. Most knowledge about WDR neurons comes from single-unit recordings, limiting insight into population-level organization across spinal cord. Advances in high-density electrophysiological recordings provide an opportunity to study spinal sensory processing at population level.

Pain is a major yet under-recognised burden in Rett syndrome and related MECP2 disorders, but the underlying neurobiological mechanisms remain poorly defined. The endocannabinoid system (ECS) is a key nociceptive modulator potentially regulated by MeCP2 (1,2).

Kv7 potassium channels are widely expressed across nociceptive pathways and can regulate neuronal excitability by suppressing repetitive action potential firing. Dysregulation or reduced Kv7 activity has been associated with pathological pain states, highlighting a key role for Kv7 in pain signaling. Xenon is developing selective Kv7 opener, such as XEN1120, as a novel non-opioid approach to potentially treat acute and chronic pain.

Open-label placebos (OLPs) can reduce pain despite full transparency, yet little is known about whether learning mechanisms can enhance their effects. While classical conditioning has shown promise in strengthening placebo responses, operant conditioning remains unexplored in OLP paradigms. This study investigated (1) whether operant conditioning enhances OLP-induced hypoalgesia and (2) whether openly and deceptively induced operant placebo effects are comparable in magnitude.

The anterior cingulate cortex (ACC) is important for processing sensory and affective aspects of pain. Previous study reported that the ACC projects more strongly to the contralateral Claustrum (CLA) than the ipsilateral CLA, which is known as an important negative regulator of cortical activity for a range of functions by connecting with cortical areas including the ACC, but the functions of ACC projection to contralateral CLA have been largely unknown. In this study, we investigated the physiological roles of the ACC cross-hemispheric inputs to CLA using viral-tracing, in vivo and slice electrophysiology and pain behavioral tests.

Testing spatial acuity is a useful tool to understand how the nervous system integrates sensory information. Usually this is done by measures like the 2-point discrimination threshold (2PDT). Chronic pain is often associated with impaired spatial acuity. However, the method to test spatial acuity suffers from several drawbacks. Many of these drawbacks are related to the mechanical stimulations typically used for testing, these handheld stimulations offers little control of stimulation parameters, limiting repeatability and high variance. In this study a method based on electrical stimulation in the lower leg is tested to compare its ability to assess spatial acuity.

Diabetic peripheral neuropathic pain (DPNP) is a prevalent and debilitating complication of diabetes that diminishes patients' quality of life. While the gut microbiome's role in DPNP is increasingly recognized, the specific mechanisms, including those involving gut viruses, are not fully understood.

Ultrasound-guided hydrorelease (HR) is increasingly used for myofascial pain. While clinical efficacy is reported, the influence of HR on the gliding resistance force remains unverified. This study aimed to quantitatively measure the gliding resistance force between the aponeurotic fascia and epimysial fascia of the tibialis anterior and between two epimysial fasciae of the tibialis posterior and flexor digitorum longus using a biomechanical testing system. We hypothesized that HR physically reduces the gliding resistance force, thereby validating the treatment for pathological conditions involving these fascial layers.

Nociception is one of the characteristics of neurological disturbances. Some edibles seed like Picralima nitida have been used in traditional medicine for the management of metabolic and pain-associated disorders due to their bioactive phytochemicals. However, there is a paucity of data on Picralima nitida seed validation in nociceptive studies. Hence, the study investigates the antinociceptive potential of the ethanol seed extract of P. nitida (PNEE) and its mechanisms in mice.

The patch-clamp technique is a pivotal tool for the identification of promising analgesics, especially in the advent of high-throughput systems [1,3]. However, the analysis of patch-clamp data traditionally relies heavily on the manual guidance of the experimenter, which can introduce biases and may be infeasible for large datasets. Biases and changing analysis methods can hinder the reproducibility and assessment of pre-clinical findings [2]. Existing toolboxes fail to capture the decision-making process crucial to a successful analysis. We developed PyPatch as a toolbox that augments and automates the traditional analysis process and includes decisions as part of the data’s context.

Parkinson's disease (PD) is a neurodegenerative disorder of the central nervous system, characterized by progressive loss of dopaminergic neurons, particularly in the substantia nigra, leading to classic motor symptoms. In addition, PD patients also suffer from a wide range of non-motor symptoms, including pain, which markedly impact quality of life. Although TRPV4 has been implicated in nociceptive processing and neuroinflammatory mechanisms, the role of this channel in PD, especially in models of non-motor symptoms, remains unclear. Therefore, this study aimed to investigate the role of the TRPV4 receptor in regulating nociception in an experimental PD model assessing non-motor symptoms.

Tendon pain is a hallmark feature of tendinopathy, yet mechanisms driving pain remain poorly defined[1]. Pain persists despite resolution of inflammation or structural restoration, suggesting that non-steroidal anti-inflammatory drugs and surgical repair may not address the etiology of pain. Substance P (SP) and neurokinin-1 receptor (NK1R) signaling contribute to inflammation and remodeling in multiple tissues[2]. In tendon-derived cells (TDCs), exogenous SP administration alters proliferation and promotes matrix-degrading remodeling. However, regulation of endogenous SP signaling in inflammatory conditions remains unclear[3,4,5]. The objective of this study is to assess SP-NK1R in TDCs and whether inflammatory macrophage cues increase SP and TNF-α.

Intraperitoneal irritation paradigms are widely used as preclinical models of pain, yet they evoke heterogeneous behaviors including active stretching and prolonged movement suppression that are typically interpreted as a unitary nociceptive output. Emerging evidence suggests that tissue acidosis can engage sngceptive sensory programs distinct from pain, mediated by proton-sensitive ion channels expressed in both proprioceptors and nociceptors (1). How these peripheral pathways organize stretch, asthenia, and pain-like restricted movement remains unresolved. We hypothesized that acetic acid recruits parallel internal sensory states through ASIC- and tachykinin-dependent signaling that can be behaviorally and mechanistically dissociated rather than reflecting a single pain response.

Painful experience evokes coordinates behavioral, and autonomic responses, yet how these components are integrated at the cellular level remains poorly understood. The ventrolateral periaqueductal gray (vlPAG) is a central hub for response integration during defensive states, but whether distinct neuronal populations within the vlPAG differentially encode nociception and cardiac output is unclear. Previous work showed that activation of glutamatergic vlPAG neurons suppresses thermal nociception, increasing withdrawal latency in the tail immersion test (Tovote, 2016). Here, we further dissect the contribution of genetically defined vlPAG neurons to pain-related cardio-behavioral responses.

Prevalence of pain in low-income and middle-income countries is consistent with Global Burden of Disease data, with higher rates in the elderly general population and workers versus general adult population. Acute and chronic Pain needs local understanding of its prevalence and main determinants to identify and implement the most appropriate treatment, control and prevention pathways for the population of interest. Currently no data are available on the individual types of chronic pain among general or working population in the country. We aimed to determine prevalence of individual types of chronic pain diagnoses in adult working population in the capital city.

Chronic pain has been associated with altered cortical excitation/inhibition (E/I) balance[1]. However, scalable electrophysiological markers of these alterations, validated against independent neurobiological measures, are lacking. Aperiodic EEG features are frequently interpreted as reflecting E/I balance[2], yet evidence for this interpretation is sparse[3]. We leverage a large EEG dataset and PET-derived neurotransmitter receptor/transporter distributions(NT) from the neuromaps toolbox[4] to test whether spatial variation in EEG features, including aperiodic activity, aligns with neurochemical gradients. We quantify feature-wise EEG-NT associations and test joint glutamatergic and GABAergic contributions to aperiodic EEG variation, providing a foundation for non-invasive E/I assessment in chronic pain.

Nantes University Hospital promotes non-pharmacological interventions and complementary therapies (NPI/CT), provided they are delivered by trained healthcare professionals, according to a protocol, with a medical prescription and proper documentation in the patient’s medical record [1], [2], [3], [4].
The primary objective was to identify and analyze barriers and facilitators to the integration of NPI/CT into hospital practices. Secondary objectives were to identify professionals trained in NPI/CT and to describe their practices.

Voltage-gated sodium channels (VGSCs) are key regulators of cellular excitability and are typically characterized by their activation and inactivation dynamics. When Navs interact with endogenous blocking peptides like the C-terminal end of Navβ4, they can escape this familiar pattern and produce a second “resurgent” inward current. Resurgent currents help regulate excitability and are associated with various diseases such as neuropathic pain in the event of pathological changes. Here we aim to compare resurgent currents from various VGSCs at different temperatures.

Background
Physiotherapists’ pain-related attitudes and beliefs influence clinical reasoning, treatment decisions, patient education, and rehabilitation outcomes, particularly in musculoskeletal and chronic pain (Bishop et al., 2008; Darlow et al., 2012). The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) assesses biomedical and biopsychosocial orientations (Ostelo et al., 2003). Despite the growing emphasis on pain neuroscience education and biopsychosocial care, considerable variability persists, highlighting the need for standardized assessment to guide targeted education and professional development initiatives (Gatchel et al., 2007).

Aims
To assess pain-related attitudes and beliefs among practising physiotherapists using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT).

For decades, translational failures from preclinical models to patients have stalled analgesic drug discovery. Reasons for the poor translation are multitude, but one reason may be the disconnect between the clinical symptoms that are most bothersome to the patients, and commonly used pain-related outcome measures used in laboratory rodents, like experimenter-evoked responses. Previous studies have explored cage-lid hanging (Zhang 2021) and vertical climbing (Santos 2023) as novel, ethologically valid, and translationally relevant measures to assess the impact of pain on natural behavior in mice. In this project, we sought to investigate vertical climbing as a pain-related measure in various pain-models.

Chronic pain is highly prevalent among military veterans and is known to fluctuate daily, yet clinicians lack the ability to predict when pain will meaningfully worsen. Emerging research suggests data from wearable devices and daily self-report surveys may help predict pain increases. However, the nature of the predictive associations between these data sources and pain increases remains poorly understood. We used complementary predictive and interpretive methodological approaches to characterize links between both wearable device and daily self-report survey data and day-to-day pain increases among a sample of veterans with chronic pain.

Normally, as a posttraumatic reaction, spinal fields enlarge mostly ipsilateral to a distal injury and many of these enlarged fields return to normal size during healing. However, in some cases spinal changes spread to the contralateral side and field sizes enlarge more and cluster in the cord as early as in the posttraumatic phase. In these cases, fields shrink on the ipsilateral side long after trauma. In a compensatory attempt, the body might try to minimize the impact of pathologically altered neurons by minimizing their receptive fields.
Neuroinflammation intensifies with age, and microglial activation spreads contralaterally in tibia fractured mice.

Ziconotide (PRIALT) is a calcium channel blocker isolated from cone snail venom and approved for the treatment of severe and resistant chronic pain. It acts centrally by blocking presynaptic Cav2.2 channels in the dorsal horns of the spinal cord, reducing neurotransmitter release and spinal pain transmission. Because of its central mechanism of action and peptidic nature, it must be delivered intrathecally. However, this route of administration and the numerous central adverse effects it induces make ziconotide a last resort option. We found that peripheral ziconotide is analgesic and that its topical application relieves pain while avoiding central toxicity.

Cellular dynamics are shaped by the extracellular matrix (ECM), yet its role in sustaining chronic pain remains poorly understood. Microglia are "educated" by their environment to undergo lasting molecular adaptations; when dysregulated, they drive persistent inflammatory states. While these shifts are governed by epigenetic mechanisms, specifically histone post-translational modifications (PTMs), the biomechanical crosstalk between the ECM and glia remains a critical gap. We hypothesize that microglia cultured on varying substrate rigidities develop distinct epigenetic profiles. These states are predicted to directly regulate gene expression patterns involved in microglial inflammatory responses and synaptic remodeling in chronic pain.

Our previous studies found that activation of the anterior paraventricular thalamus (PVA) → bed nucleus of the stria terminalis (BNST) pathway can induce mechanical hypersensitivity. However, it remains unknown how genetically defined neurons in the oval BNST (ovBNST) mediate this effect and how persistent mechanical hypersensitivity is maintained.

Bone cancer and severe tendon injury can cause persistent pain. The underlying mechanisms for such painful conditions are elusive and the treatment approaches for pain relief remain limited. In this study, we investigated the peripheral neural mechanisms underlying chronic pain in tumor cell implantation (TCI) model, producing cancer pain, and the Achilles tendon partial transection injury (TTI) model, producing tendon injury pain, as well as exploring pain relief approaches.

The mechanisms underlying anesthetic-induced loss of consciousness are not yet fully understood. In this study, we compared the modulatory effects of the volatile anesthetic isoflurane on inhibitory synaptic transmission between inhibitory and excitatory neurons.

Immune checkpoint inhibitors (ICIs), particularly PD-1 blockade, have substantially improved clinical outcomes in cancer. However, accumulating clinical evidence indicates that concomitant opioid administration may compromise their antitumor efficacy. In contrast, the impact of immune checkpoint inhibition on opioid-mediated analgesia remains poorly defined. In this study, we tested the hypothesis that opioids and PD-1 blockade engage in bidirectional crosstalk mediated by peripheral μ-opioid receptor (MOR)–dependent neuroimmune signaling.

Intestinal inflammation often results in debilitating and poorly controlled abdominal pain. While sensory neurons are known to transmit these pain signals, the role of the surrounding enteric glial cells (EGCs) in modulating visceral nociception remains unclear. This study aims to investigate how p75 neurotrophin receptor (p75NTR) signaling in EGCs contributes to visceral hypersensitivity and to identify the underlying molecular mechanisms by which glia-neuron communication facilitates pain sensitization during inflammation.

Cancer-related pain remains a major clinical challenge, often necessitating escalating opioid doses with significant adverse effects. Magnesium, through N-methyl-D-aspartate (NMDA) receptor antagonism and modulation of central sensitization, has been proposed as an adjuvant analgesic capable of enhancing pain control and reducing opioid requirements. This systematic review aimed to evaluate the efficacy of magnesium supplementation, including magnesium sulfate and magnesium L-threonate, as an adjuvant analgesic in adult patients with cancer-related pain, focusing on opioid-sparing effects, pain intensity reduction, and opioid-related adverse outcomes.

We have previously demonstrated that individuals show considerable variability in the reported intensity of a series of identical noxious thermal stimuli; some report consistently stable pain ratings, whereas others show large fluctuations in perceived intensity. Furthermore, we have shown that this variability is associated with activity changes in the dorsolateral and sensorimotor cortices [1]. This current investigation extends this work in a longitudinal design to determine whether response patterns to repeatedly applied acute thermal stimuli are retained in the same individuals across time - that is - is noxious stimulus encoding consistency a trait-like phenomena.

Morphine is one of the most commonly used analgesics in clinical practice, and abrupt cessation or substantial dose reduction after prolonged use can precipitate withdrawal syndrome. Previous studies have shown that chronic morphine exposure activates the unfolded protein response (UPR); however, whether IRE1α/XBP1 signaling is involved in morphine withdrawal and how it is associated with NLRP3 inflammasome activation remain unclear. This study aimed to investigate the role of TLR4-IRE1α/XBP1 signaling in morphine withdrawal and to explore the potential involvement of the NLRP3 inflammasome in this process.

The scaffold protein, protein interacting with C kinase 1 (PICK1), is a promising target in chronic pain. Treatment with peripherally restricted PICK1-targeting peptide inhibitors provide relief of pain-like behaviour across rodent models of neuropathic and inflammatory pain. (Jensen 2024) However, the analgesic mechanism of action remains unknown. A mutation in the PICK1 PDZ-domain, A87L, weakens or ablates the binding of interaction partners and inhibitory peptides in vitro. (Christensen 2020) The aim of this project is to generate and characterize a PICK1 A87L knock-in (KI) mouse line to utilize as a tool for uncovering the analgesic mechanism of PICK1 inhibition.

Cancer pain is common yet often undertreated due to reliance on generalized, stepwise protocols such as the WHO analgesic ladder, which require trial-and-error titration and can delay optimal relief. This project aims to modernize cancer pain management using the PainRx AI platform, a two-phase precision medicine strategy that personalizes both analgesic dosing and drug selection. Phase 1 applies real-time, patient-specific dosing optimization; Phase 2 performs functional precision profiling using patient-derived sensory neurons to identify optimal drug combinations in advance. Together, these approaches aim to deliver faster, safer, and more effective pain control.

ATP‑sensitive potassium (KATP) channel opener levcromakalim is a robust inducer of vasodilation (1), headache, and migraine attacks in humans (2), and produces migraine‑relevant tactile hypersensitivity in mice (3). Although other migraine‑inducing agents — such as nitric oxide (NO) donors, CGRP, and PACAP — are thought to activate intracellular second‑messenger signaling that ultimately leads to KATP channel opening (4), the mechanistic link between KATP activation and migraine remains poorly understood. The aim of this study was to investigate the contribution of nitric oxide synthase (NOS) isoforms and downstream signaling pathways in a mouse model of levcromakalim‑induced tactile hypersensitivity.

Injury to the developing peripheral nervous system can lead to prolonged hypersensitivity after repeated injury later in life; a phenomenon called neonatal nociceptive priming. Macrophages have recently been found to be key drivers of this phenomenon. After early-life injury, peripheral macrophages retain epigenetic modifications and generate a more pro-inflammatory response to subsequent injury that contributes to prolonged pain-like responses. However, it is not known whether sensory neurons themselves establish similar “memories” of early life injury and therefore also contribute to neonatal nociceptive priming.

Pain in osteoarthritis (OA) is not adequately treated clinically, with promising new analgesic treatments failing to translate. Possible reasons include that it is unclear how well animal models replicate human OA and which preclinical pain behaviour assays are the most useful indicators of pain in OA patients. Monoiodoacetate (MIA)-induced OA is the most used animal model to assay OA pain, however it is unclear how sensitive it is for testing drugs that act on peripheral nociceptors in OA. We aimed to identify pain behaviour assays suitable for measuring the activity of drugs that act on peripheral nociceptors in MIA-induced OA.

Bone union is the primary goal of fracture treatment, yet nonunion can occur despite appropriate therapy, often resulting in persistent pain and reduced activities of daily living. However, some nonunion are associated with only mild pain, and the mechanisms underlying this variability remain unclear. Clarifying the sources of pain in nonunion may enable the development of new therapeutic strategies and less invasive treatments. This study aims to investigate how mechanical stability influences pain in a rat femoral nonunion model by comparing bone union and nonunion under different fixation conditions and characterizing their pain-related features.

Acute postoperative pain differs widely among patients, even when similar anesthetic techniques are used. The reasons for this variation are not fully clear. Fluctuations in anesthetic depth during surgery may influence postoperative pain outcomes. However, limited data exist on how intraoperative anesthetic depth variability relates to different postoperative pain phenotypes. This study aimed to examine the association between anesthetic depth variability during surgery and acute postoperative pain patterns.

The recent advancements in understanding the neuroimmune landscape after injury have highlighted the role of various immune cells in the onset and resolution of pain. Notably, the interaction between macrophages and sensory neurons in post-surgical pain development has been recently reported [1]. Building on this, the aim of our current study is to investigate the role of neutrophils, the first immune cells to respond to injury, in a model of pediatric post-surgical pain. This study will also assess whether their involvement persists in later stages of life to modulate neonatal nociceptive priming.

Opiranserin (VVZ-149) is a novel analgesic combining glycine transporter 2 (GlyT2) inhibition and 5-hydroxytryptamine 2A (5-HT₂A) receptor antagonism, targeting central sensitization pathways underlying both nociception and pain hypersensitivity. These dual mechanisms are relevant to both intraoperative nociception and postoperative pain under general anesthesia. Clinical studies in humans have validated opiranserin's analgesic efficacy for postoperative pain management following laparoscopic abdominal surgery. However, its potential to suppress intraoperative nociception, and whether its analgesic effects extend across species, has not been evaluated. Castration in male dogs is a common procedure associated with significant intraoperative nociceptive responses and postoperative pain, providing a clinically relevant model for assessing both cross-species analgesic efficacy and intraoperative pain suppression. This study aimed to evaluate whether continuous rate infusion (CRI) of opiranserin reduces intraoperative rescue analgesia requirements and improves postoperative pain outcomes in male dogs undergoing castration under isoflurane anesthesia.

Postoperative pain remains a common yet frequently inadequately managed clinical challenge. The cannabinoid type-1 receptor (CB1R) is considered a promising target for the pain treatment. However, the specific role and mechanism of peripheral CB1Rs in postoperative pain remain elusive.

Neuropathic pain resulting from nervous system injury often leads to persistent and intractable condition. Current treatment strategy remains limited and showed unsatisfactory clinical outcomes. Glial derived neurotrophic factor (GDNF) originally isolated from rat glial cell and identified as neurotrophic factor enhances dopamine uptake of dopaminergic neuron in mecencephalone, sympathetic neurons, and notably motor neurons in peripheral nervous system. Consequently, GDNF and its receptors have targeted for development of novel analgesic therapies. Stem cells modulate the function and role of sensory and motor neuron, enhance neurogenesis, and stimulate axonal growth, myelination and analgesia effect by controlling the regulation of GDNF. Consequently, cell therapy emerges as an innovation in neural regeneration.
This study aims to explore the differences of GDNF levels on serum and peripheral nerves of rats with sciatic nerve injury.

Chemotherapy-induced peripheral neuropathy (CIPN) impairs quality of life and may require dose reduction or discontinuation of anticancer therapy. Although neuronal damage has been the primary focus, emerging evidence, including our findings, suggests fascial dysfunction contributes to nociceptive transmission in CIPN. Hyaluronan (HA), synthesized by hyaluronan synthase (HAS), is essential for fascial structure and may play a role in pain modulation. Cannabinoid receptor 2 (CB2) agonists exert anti-inflammatory and analgesic effects; however, their impact on fascial HA metabolism in CIPN remains unclear. We investigated whether CB2 agonist administration modulates fascial HAS expression in a rat CIPN model.

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common neurotoxic complications in patients undergoing chemotherapy, with significant implications for quality of life and the continuity of cancer treatment. The variability of clinical manifestations and the limitations of objective diagnostic approaches pose challenges in early detection and optimal management, particularly across different chemotherapy regimens with distinct neurotoxic mechanisms. This study aims to characterize the clinical manifestations and variability of CIPN across different chemotherapy regimens. It further seeks to evaluate treatment responses to commonly used pharmacological therapies. Additionally, the study underscores the importance of early diagnosis and timely intervention to minimize neurological morbidity and preserve treatment continuity.

In patients experiencing unendurable chemotherapy-induced peripheral neuropathy (CIPN), reduction the dose or discontinuation of therapeutic chemotherapy may complicate cancer treatment and prognosis. The aim of this study was to investigate the role of spinal P2Y6 receptor in CIPN models in rats.

Cancer-related pain may precede neurological deficits in malignant spinal cord compression (MSCC) and should be recognized as a critical diagnostic red flag. In young patients, intrathoracic masses often raise suspicion for primary mediastinal tumors, potentially leading to diagnostic bias and delayed identification of metastatic disease

Oxaliplatin-induced peripheral neuropathy (OIPN) is a common and severe adverse effect of chemotherapy, characterized by persistent mechanical and cold pain, for which effective treatments are lacking. We previously identified the Na,K-ATPase modulator Fxyd2, expressed in nociceptive sensory neurons, as a critical contributor to chronic neuropathic pain [1], a role also described in inflammatory pain [2]. Targeting FXYD2 using lipid-modified antisense oligonucleotides (FXYD2-LASO-Gapmer) has shown analgesic efficacy in preclinical models, correlated with altered excitability of nociceptors [3]. This study aimed to evaluate the preventive and therapeutic potential of FXYD2-LASO-Gapmer in a rat model of OIPN.

Post-herpetic trigeminal neuralgia remains the most common causes of facial neuropathic pain. According to its manifestation, neuropathic pain due to herpes zoster infection most likely effect trigeminal nerves, with 75% cases occurred on ophthalmic division of trigeminal nerve. Post-herpetic neuralgia, although seems mild, but the impact in patient’s quality of life can be debilitating. Conservative therapy guideline had been used widely with some benefits, but sometimes, with unwanted side effect of oral therapy. Interventional Pain Management has its role to manage post-herpetic neuralgia accurately and in longer periods of pain-remission.

Neuropathic pain, caused by a lesion or disease of the somatosensory system, is a debilitating condition with very limited therapeutic options. Macrophages are central to neuroinflammation driving the pathophysiology of neuropathic pain. IMT504, a non-CpG oligodeoxynucleotide, effectively reduces neuropathic pain-like behavior, through modulation of the immune microenvironment. However, if IMT504 directly modulates macrophages and through what types of signaling pathways, remains unknown. In this study, we employed bone marrow-derived macrophages (BMDMs) to evaluate potentially relevant events induced by the ODN. We also address the relevance of IL-10 in the mechanisms of action of IMT504 by use of knockout mice.

Proper neuronal function depends on tightly regulated interactions between neurons and surrounding other cells. Disruption of these interactions contribute to neurological disorders. In this study, we suggest the neuropeptide FAM19A5 as a critical modulator of interaction between cell to cell. Recently, it has been reported that FAM19A5 regulates synaptic adhesion between a leucine-rich repeat-containing molecule and a receptor protein tyrosine phosphatase, thereby leading to neurological disorders. We hypothesized that a similar FAM19A5-medicated mechanism also occurs between neurons-satellite glial cells (SGCs) within the dorsal root ganglion (DRG) and that this disruption may be associated with neuropathic pain.

Presenteeism—reduced productivity while working despite health problems—accounts for a substantial proportion of productivity loss in Japan (1,2). Pain, psychological distress, and impaired daily functioning are well-established correlates (3), yet much of the existing evidence has relied solely on self-report measures. We integrated questionnaire data with actigraphy-derived physical activity (vector magnitude counts per minute (VMCPM) and Step Counts) and sleep duration (actigraphy-derived) to clarify how subjective psychosocial factors and objective behavioral patterns jointly relate to work performance.

Cyclobenzaprine HCl sublingual tablets (CBP SL) are the first US FDA-approved therapy for adults with fibromyalgia in >15 years. In both of the pivotal phase 3 RELIEF (NCT04172831) and RESILIENT (NCT05273749) studies, CBP SL significantly reduced the weekly average of daily numeric rating scale pain scores versus placebo (primary endpoint) at Week 14.

Abdominal migraines and cyclic vomiting syndrome (CVS) can present with debilitating symptoms in the pediatric and young adult population. At the Children’s Hospital of Richmond, intravenous dihydroergotamine (DHE) is utilized as a treatment for refractory abdominal migraine and CVS. This IRB-approved, retrospective case series describes the response of 16 patients who received DHE treatment for abdominal migraine, CVS, or chronic migraines associated with nausea from 2023-2025.

Chronic back and abdominal pain are common presentations in pain clinics, but truncal variant restless legs syndrome (RLS) is frequently misdiagnosed as functional pain. Refractory cases unresponsive to both dopaminergic agents and first-generation α2δ ligands remain a major clinical challenge. Crisugabalin is a novel highly selective α2δ ligand with improved analgesic efficacy and safety profile.

Alexithymia is psychological trait characterized by difficulty noticing, naming, and understanding emotions [1] and is associated with chronic pain and psychosomatic conditions [2]. Emotion-Focused Therapy (EFT) improves emotional awareness and alexithymia [3,4], yet no digital EFT exists. We developed Unlexi, an EFT mobile application with structured reflective journaling and emotion detection features. We will first evaluate the feasibility of a safety-oriented and risk-mitigated digital framework prior to implementing EFT. The aim is to assess usability, emotional safety, and user acceptability, and whether individuals with alexithymia can engage with digital emotional awareness tasks.

Pain modulation in people with knee osteoarthritis (KOA) is complex and insufficiently understood. Conditioned pain modulation (CPM) is a widely used measure for assessing the efficiency of descending pain modulation. Greater adiposity, metabolic syndrome and its components, have been reported to weaken pain modulation in healthy adults. However their impact on pain modulation in people with KOA is unknown. Therefore, this study aimed to assess the association of levels of adiposity, metabolic syndrome and its components, with CPM in people with KOA.

Postoperative opioid use may contribute to long-term exposure and opioid-related harm, yet population-level trajectories following surgical procedures remain insufficiently characterized. This study describes postoperative opioid use patterns across the ten most frequent non-cancer surgical procedures in Denmark and examines the association between preoperative opioid use and long-term postoperative opioid use.

Juvenile Idiopathic Arthritis (JIA) affects daily functioning and quality of life. Beyond inflammation, psycho-emotional factors may influence how children and parents perceive disease status and patient-reported outcomes (PROs).This study aimed To evaluate the contribution of children’s and parents’ psychological variables to perceived disease impact and well-being in JIA, comparing child- and parent-reported outcomes.

Postherpetic neuralgia (PHN) is intractable with inaccurate traditional treatments, affecting over 30% of middle-aged and elderly people and often causing emotional disorders. Western medicines like pregabalin have side effects, while Zhuang Medicine acupuncture lacks visualization, leading to low efficacy. This study verifies the efficacy, safety and positioning optimization of AI ultrasound-guided Zhuang Medicine meridian-tendon acupuncture for PHN, clarifies the synergistic mechanism of the combined technology, and establishes a standardized protocol to meet clinical needs for precise therapy and promote ethnic medicine modernization.

Effective management of Whiplash-Associated Disorders (WAD) requires adherence to evidence-based guidelines. Although educational strategies and e-resources have improved guideline knowledge among healthcare professionals, their integration within physiotherapy education remains underexplored. We aimed to evaluate the impact of a multifaceted implementation strategy, including an integrated e-resource, on physiotherapy students’ knowledge of WAD assessment and management. Secondary aims were to assess implementation reach and students’ acceptance of the e-resource.

Phantom limb pain (PLP) is linked to disturbances of the embodied self, particularly the sense of agency and ownership. Although agency-based approaches such as mirror therapy and virtual reality can reduce PLP, their effects are often limited. Evidence suggests that stronger prosthesis ownership is associated with lower PLP severity. We hypothesized that synchronized tactile feedback delivered to referred sensation areas would enhance prosthesis embodiment and alleviate PLP. We further aimed to identify underlying neural network mechanisms using EEG-based hidden Markov modeling of dynamic brain states.

High‑quality healthcare is a fundamental right, yet persistent disparities in pain assessment and treatment continue to disadvantage racialized groups. Evidence shows that Black patients’ pain is more frequently underestimated and less adequately treated than that of White patients, suggesting that empathy‑related processes may contribute to these inequities. This work‑in‑progress project aims to examine mechanisms underlying racialized differences in empathic responding during pediatric pain assessment. Specifically, we investigate whether clinical psychologists in training exhibit different emotional and communicative responses to pain expressions from White versus Black children, and whether an empathy‑enhancing intervention can reduce such disparities.

Many people experience musculoskeletal (MSK) pain that impedes movement, although exercise is a cornerstone of MSK pain management (1). Movement-evoked pain can limit participation, reduce adherence, and hinder active rehabilitation (2). Transcutaneous electrical nerve stimulation (TENS) is an easy-to-use, safe, non-invasive technique that provides analgesia and may reduce movement-evoked pain, making exercise easier when applied concurrently (3). This quadruple-blind pilot randomized controlled trial aims to assess the feasibility and acceptability of a 3-week exercise program delivered with active versus sham TENS, and to explore preliminary effects on IMMPACT-recommended pain domains (4) and complementary outcomes (e.g., kinesiophobia, compensatory movement strategies).

Cannabis has been increasingly used for symptom management among patients with chronic pain [1]. Despite the potential benefits of cannabis, high-frequency cannabis use and THC intake can lead to health-related problems. To date, the bulk of cannabis research has focused on non-medical cannabis use and little is known on the factors that contribute to cannabis craving and THC intake among patients with chronic pain [2]. Aims: To examine the influence of pain intensity, negative affect (i.e., nervousness, depressed mood), and sleep on day-to-day exacerbations in cannabis craving. We also examined the contribution of cannabis craving to daily THC intake.

Insomnia and chronic pain frequently co‑occur and represent growing treatment priorities in an ageing population [1]. Disrupted sleep may amplify central sensitisation and weaken descending inhibitory control to worsen mood [2] and pain‑related impairment in daily functioning, known as pain interference [3]. Cognitive Behavioural Therapy for Insomnia (CBT‑I) is the primary online and face-to-face insomnia treatment, increasingly applied to pain management contexts [4-6]; however, its relationship to pain phenotypes remains unclear. We aimed to estimate the pooled effect of CBT‑I on pain interference in adults with chronic pain and potential influences of pain phenotype and delivery mode.

Digital solutions are increasingly common in primary care physiotherapy, but it is unclear whether digital assessments of patients with non-specific pain or mental health disorders are efficient. Digital consultations offer potential to improve efficiency and patient experiences, but new methods must be evaluated to understand their impact and ensure care quality. Some assessment components are difficult in video-based consultations, and physiotherapists may only take the patient history and schedule a second face-to-face visit. This study investigates how an initial digital or face-to-face assessment affects the total number of physiotherapist consultations and the format of a possible second visit.

For the one in five youth living with chronic pain, quality of life is negatively impacted by debilitating and unpredictable pain flares. Pain flares describe the intra- and inter-daily fluctuations in pain level and symptomology across other health domains (eg., sleep, mood, physical activity). These pain flares are not well characterized, making them difficult to predict, treat, and prevent. The purpose of this study was to (1) characterize pain flares in a large sample of youth with chronic musculoskeletal (MSK) pain, (2) compare pain flares as described through both retrospective self-reports and real-time pain flare monitoring.

Chronic pain is a complex condition, requiring multidisciplinary care that not only targets the physical component but also the emotional, psychological and social aspects. This often leads to better management and improved quality of life among chronic pain patients. Hospital Canselor Tuanku Muhriz (HCTM), UKM is one of the few public hospitals providing specialized chronic pain management under the Department of Anaesthesiology & Intensive Care, involving a team of professionals who co-manage patients with chronic pain.

Opioid use disorder (OUD) affects more than two million people in the United States, yet only one‑third receive pharmacologic treatment such as buprenorphine. Even with optimal dosing, many continue to experience withdrawal, craving, and pain, which undermine treatment retention. Because pain and addiction share overlapping neurobiological pathways, including impaired descending inhibition, non‑pharmacologic strategies that modulate these circuits are needed. Transcutaneous Electrical Nerve Stimulation (TENS) activates descending inhibitory pathways and may reduce both pain and addiction‑related symptoms. This pilot study evaluated the feasibility and preliminary effect of a 6‑week TENS intervention on pain, withdrawal, and craving among individuals receiving buprenorphine.

Chronic pain is a disorder characterized by aberrant temporal dynamics of large-scale brain networks. However, traditional analysis methods often overlook the rapid temporal evolution of these networks. EEG microstate analysis offers a solution by capturing sub-second brain dynamics that reflect large-scale brain network organization. This study aimed to characterize microstate dynamics across pain intensity levels and evaluate their predictive utility for intensity classification.

Functional disability in pain populations is a complex outcome influenced by more than just subjective pain intensity [1,2]. In Malaysia, pain medicine has emerged as a specialised clinical service focused on multidisciplinary strategies to improve quality of life [3]. However, there remains a lack of empirical data within Malaysian pain healthcare regarding how emotional distress and pain-specific cognitive-behavioural factors uniquely contribute to functional impairment [4,5]. This study aimed to evaluate the incremental validity of emotional distress (depression, anxiety, stress) and pain-specific cognitive-behavioural variables (self-efficacy, self-statements, self-management) in predicting disability beyond the variance explained by pain intensity.

Chronic pain affects 38% of older adults in the United States (US)[1] and is associated with significant disability, poorer aging outcomes, and accelerated cognitive decline[2-4]. The prevalence of chronic pain in older adults is expected to rise, given that the population of older adults and rates of multimorbidity are increasing[5,6]. Despite this growing public health burden, relatively little is known about the onset of chronic pain and its downstream consequences in later life. Therefore, the aims of this study were to examine consequences of the onset of chronic pain among US older adults.

Patients at the end of life frequently experience distressing symptoms such as pain, agitation, anxiety, dyspnea, and delirium that may persist despite standard palliative therapies, including opioids and benzodiazepines. These conventional agents are also associated with adverse effects such as excessive sedation, respiratory depression, and paradoxical agitation. Dexmedetomidine, a selective alpha-2 adrenergic agonist with sedative, anxiolytic, and analgesic properties, provides arousable sedation with minimal respiratory suppression, making it a potential option for refractory symptoms in end-of-life care. However, evidence supporting its use in this setting remains limited and largely observational.

Psychotherapeutic interventions can be effective treatments for chronic pain (CP). Yet, few studies have investigated the brain mechanisms underlying their effects using structural or functional magnetic resonance imaging (MRI) techniques. Characterizing how psychotherapy influences conceptual brain systems implicated in CP is critical for advancing a basic science of treatment effectiveness and warrants focused review. The aims of this systematic review were to (1) identify brain mechanisms of psychotherapy for CP; (2) establish which brain regions and measures are potential mediators of change; and (3) determine whether parameters of published studies converge in ways that allow replication and comparison of findings.

Patients presenting with fatigue-dominant, hypoperfusion-associated clinical phenotypes—such as postoperative recovery states or menstrual blood-loss–related weakness—frequently report musculoskeletal pain and reduced functional resilience. Autonomic imbalance, impaired microcirculation, and metabolic stress may contribute to symptom persistence and responsiveness to pain-directed interventions. Emerging evidence links microvascular dysfunction to chronic pain (Coderre, 2023), while nutritional factors appear to modulate inflammatory tone and central sensitization (Elma et al., 2022; Nijs et al.). However, systematic evaluation of metabolic–microcirculatory optimization strategies in pain-relevant clinical populations remains limited.

Procedural anxiety during peripheral nerve blocks can amplify pain perception, sympathetic activation, and patient distress. Non-pharmacological neuro modulatory strategies may improve peri-procedural experience without sedative-related risks. Binaural music therapy, which entrains cortical oscillations through frequency differentials, has shown anxiolytic effects in surgical settings(1,2). This study evaluates its impact during ultrasound-guided peripheral nerve blocks for upper limb surgery.

Depression and chronic pain often co-occur in young people, with co-occurrence associated with reduced efficacy of common treatments [1]. Recent qualitative evidence found young people explained their co-occurring depression and chronic pain as a never ending cycle that impacted physical functioning [2]. Both depression [3] and chronic pain [4] have fluctuating symptoms that can change moment-to-moment. Yet there is limited evidence on the moment-to-moment associations between depressive affect, pain intensity, and physical function. We aimed to estimate between- and within-participant associations between depressive affect, pain intensity, and physical function in young people help-seeking for depression with chronic pain.

Background –
Up to 20% of pain procedures require sedation and additional analgesia. Midazolam is the most commonly used agent to achieve this by providing deeper sedation and slower recovery.
Methoxyflurane is an inhaled anaesthetic agent that is a potential alternative.
Methoxyflurane is already used in prehospital scenarios, and emergency department- to provide safe and self administered procedural sedation.

Aim –
To evaluate the effectiveness and safety of Methoxyflurane versus Midazolam during pain procedures using patient and operator reported outcomes.

Chronic pain is a leading cause of disability worldwide, and many patients self-medicate with cannabis obtained from unregulated black market sources. While this may provide symptomatic relief, black market cannabis (BMC) use carries avoidable risks, including unknown potency, contamination, reliance on combustion, and lack of clinical guidance. Prescribed medicinal cannabis (MC) offers a regulated alternative, enabling safer dosing, quality assurance, and structured clinical support. Patients accessing MC often transition from BMC; however, there is limited Australasian data examining outcomes during this process. This audit aimed to evaluate the impact of clinic-based MC prescribing on patient-reported outcomes, cannabis use patterns, harm reduction behaviours, and changes in concomitant pharmaceutical medication use in patients previously reliant on BMC. Understanding these transitions may help inform best-practice models of care and support harm minimisation strategies in chronic pain management.

The non-therapeutic use of anabolic androgenic steroids (AAS) has increased among recreational athletes. However, their effects on nociceptive processing remain unclear. While supraphysiological testosterone exposure has been associated with antinociceptive properties, potential phase-dependent alterations in pain modulation during AAS cycles have not been sufficiently examined. This preliminary within-subject analysis from an ongoing longitudinal study investigated the influence of AAS on pain modulation.

Chronic musculoskeletal pain affects 17 to 35% of children and young people (1). Pain communication enables healthcare professionals to capture information about patients’ pain experiences, provide opportunities to form therapeutic alliances and validate the individual’s experience, improving pain management and health outcomes (2). Despite this, research indicates that many healthcare professionals report feeling unconfident discussing pain with children and young people and receive little training on pain communication (3). Pain communication can be improved through behaviour change interventions, and this review aims to systematically identify and characterise the evidence of existing interventions to improve pain communication in paediatric contexts.

Repetitive transcranial magnetic stimulation (rTMS) can induce analgesic effects when applied to several cortical targets, including the primary motor cortex (M1), dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and posterosuperior insula (PSI) [1]. However, no established method exists to identify the optimal stimulation site at the individual level. This mechanistic, three-arm, randomized, double-blind clinical trial (NCT06395649) investigated whether a global phase-based connectivity index derived from transcranial magnetic stimulation and electroencephalography (TMS–EEG) could guide rTMS target selection in chronic pain. We hypothesized that stimulating cortical targets with lower pre-treatment global connectivity would result in a greater analgesic response [2].

Temporomandibular disorders (TMD) affect the temporomandibular joint (TMJ), masticatory muscles, and related structures. TMJ arthralgia has a prevalence of about 7% and is often treated with medication, which may be limited by adverse effects in refractory cases. Minimally invasive approaches such as ozone therapy have been proposed but remain underresearched. This double-blind randomized clinical trial aimed to compare intra-articular ozone gas infiltration versus saline solution in adults with bilateral TMJ arthralgia diagnosed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).

Pain is a leading cause of healthcare consultations and disability worldwide, with chronic pain often involving psychological and social burden and limited access to effective care [1]. Digital health solutions have been proposed to improve access and delivery of cost-effective interventions [2]. Conversational agents (CAs), powered by artificial intelligence, are emerging tools for supporting patients through emotional support, information gathering, reminders, and behaviour change. While evidence suggests benefits of CAs in mental health, their effectiveness in pain management remain underexplored [3,4]. This scoping review aims to evaluate the applications and effectiveness of CAs to support pain management in adults.

Chronic Pain affects around 17% of women postpartum impacting their wellbeing and capacity to take care of their new born. Eventhough Pain Catastrophization has been shown to be a psychological factor that influences the perception of pain, it’s relation with Pain Intensity and the development of Chronic Pain is not yet clear. This study aims to understand the changes in time of Pain Catastrophization in women postpartum, it’s relation to prepartum Pain Catastrophization and the Pain Intensity in every follow-up, and to identify differences in the trajectories of the women that do or don’t develop Chronic Pain 12 months postpartum.

Cancer pain in advanced disease affects not only patients but also family caregivers who provide prolonged physical, emotional, and practical support. Caregivers of bedridden patients often experience substantial psychological distress, fatigue, financial strain, and social disruption. In many low- and middle-income countries, including Sri Lanka, family members provide most home-based cancer care because formal palliative services remain limited. Despite this, caregiver burden remains under-recognized in pain management systems. Previous research has mainly focused on patient symptoms rather than family impact. Understanding the relationship between caregiver burden, support systems, and caregiving demands is essential for developing family-centered pain services. This study aimed to assess the level of caregiver burden among informal caregivers of bedridden cancer patients in Sri Lanka and identify socio-demographic, caregiving-related, and support-related factors associated with higher burden.

Pain is a multifaceted experience shaped by sensory, cognitive, and emotional dimensions. While standard treatments include exercise and cognitive-behavioral therapy, we focus specifically on the emotional dimension. We previously developed a novel approach using emotion-arousing images, allowing individuals to actively "erase" perceived painful scenes through manual manipulation. Our prior work demonstrated improved pain intensity and thresholds in healthy individuals. To further expand upon these findings, the present study aimed to investigate the therapeutic effects and associated clinical changes of this intervention in five patients with specific and nonspecific chronic low back pain using a single-case study design.

Chronic pain is common, yet there is currently no reliable way to identify people with chronic pain in the general population, for example through electronic health records (EHRs). This limits population surveillance and service planning [1, 2]. Analgesic prescribing is often used as a surrogate marker but is likely to underestimate prevalence of chronic pain [3]. Existing approaches either show limited sensitivity/specificity or have not been validated [2, 4]. This study evaluated an algorithm (designed using a combination of diagnostic and prescribing codes) for use in primary care. We aimed to identify people with clinically meaningful, high-impact chronic pain.

Advances in pain neuroimaging have improved understanding of central pain mechanisms, yet translation of these insights into routine clinical pain care remains limited. This gap is particularly evident in complex clinical populations, where pain presentations are heterogeneous and influenced by cognitive, emotional, and functional factors. Clinically grounded perspectives are essential to ensure that neuroimaging research addresses meaningful patient outcomes. The aim of this poster is to examine key translational challenges between clinical pain care and neuroimaging research, highlighting the potential role of nurse-led contributions in improving alignment between research design and real-world pain management.

Cannabis products are increasingly used to manage chronic pain and other symptoms; As it became increasingly commercialized, inhalation via joints, bongs, pipes, and vapes have emerged as a major mode of use for both medical and recreational purposes [1]. However, the literature on harms associated with this route of use is limited. We conducted a systematic review and meta-analysis of observational studies to explore the harms associated with inhaled cannabis.

Children with chronic abdominal pain often undergo evaluation for symptoms induced by carbohydrates, including those triggered by fructose ingestion. Although fructose sensitivity is widely recognised, the temporal pattern of pain and associated symptoms remains poorly characterised. A deeper understanding of symptom trajectories could provide valuable insights into the underlying nociceptive mechanisms and enhance diagnostic accuracy. Our aim was to characterise the timing and progression of visceral pain and non-painful gastrointestinal symptoms in paediatric patients identified as fructose-sensitive following fructose ingestion.

Treatment response in chronic musculoskeletal pain (CMSP) is highly heterogeneous, yet clinical decision-making remains largely guided by group-level effects rather than patient-specific benefit. Predictive models in pain research have primarily focused on outcome prediction, while estimation of counterfactual treatment responses—essential for personalized allocation—has rarely been embedded within randomized trial settings. We therefore evaluated the feasibility of causal, deep-learning–based models to estimate individual treatment effects (ITEs) and associated uncertainty across multiple psychological interventions.

The International Association for the Study of Pain (IASP) defines three pain descriptors - nociceptive, neuropathic and nociplastic pain - but no gold-standard method exists to discriminate between them, and current grading systems do not permit identification of a predominant mechanism or the contribution of mixed mechanisms. Recent work derived mechanistically discriminative features using systematic review and expert consensus; however, disagreement remains regarding how these features should be operationalised into assessment tools. This study aimed to develop a multimodal tool to discriminate between pain descriptors by operationalising consensus-derived features into candidate measures and criteria using expert consensus.

Adolescents with chronic pain often experience substantial interference in physical, psychological, social, and school functioning. Although psychosocial interventions are recommended, access to specialized care remains limited, particularly outside large urban centers. Digital health interventions may help reduce this gap, but their relevance depends on whether they respond to the real needs, expectations, and contexts of intended users. DigiDOL-Ad is a digital psychosocial intervention currently being developed for adolescents with chronic pain, complemented by websites for parents and teachers. This study aimed to identify stakeholder perspectives on the needs, barriers, and preferences that should guide the development of DigiDOL-Ad and its accompanying resources.

Evidence suggests that pain interference is linked to depression and anxiety in youth with chronic pain, but the specific contribution of the social environment to these associations remains unclear. Guided by the Stress-Buffering Model of Social Support, this study tested theory-driven mediation and moderation models to examine whether peer relationships and bullying contribute to or modify concurrent and short-term longitudinal associations between pain interference and psychological function.

The Central Sensitization Inventory (CSI) is a 25-items instrument designed to measure symptoms related to central sensitization. It was developed from a comprehensive literature review of symptom dimensions and related factors common to central sensititivity-related conditions (e.g., widespread pain, cognitive slowing, sleep disturbance, etc.). The CSI has been adapted and tested in multiple languages. The aim of this study was to develop a brief version of the CSI-25 with the fewest possible items, while still capturing the most widely accepted central sensitivity symptoms. Rasch analysis of CSI-25 data from a large multicultural sample was used to develop the new short form.

Opioid-based anesthesia-analgesia remains the standard for total knee arthroplasty under general anesthesia but is associated with adverse effects that may impair postoperative recovery. Opioid-free anesthesia (OFA) has been proposed to reduce these complications, yet its impact on patient-centered recovery quality, as measured by the QoR-15 score, has not been established. We hypothesized that an OFA-analgesia regimen would be non-inferior to a conventional opioid-based regimen in terms of the QoR-15 score 24 hours after total knee arthroplasty.

High-frequency electrocutaneous stimulation (HFS) of peripheral nerve fibers is a method used to induce secondary hyperalgesia and allodynia in the human skin, which has been proposed as a surrogate model for studying central sensitization. We aimed to evaluate an HFS-model and evaluate the analgesic effects of oxycodone and nefopam on HFS-induced allodynic changes. Additionally, we explored whether HFS could induce an increase in pain facilitation (∆NRS>2) characteristic of chronic pain states through multimodal temporal summation (TS) testing.

Humanitarian crises devastatingly impact on health and increase burden of care in the affected population. Acupuncture is widely used for chronic pain, functional disorders and mental health conditions. Cumulative evidence supports such use with varying certainty, although they have been mainly generated in non-conflict settings. To address this gap, we aimed to identify the types of evidence available in acupuncture for care of people under humanitarian crises.

Interdisciplinary care is recommended for chronic pain but is commonly delivered in tertiary settings with substantial barriers to access[1]. Consequently, most people are managed in primary care where resources (e.g., time, expertise) required for coordinating and sustaining multidisciplinary collaboration, particularly for culturally and linguistically diverse (CALD) communities, are limited[2]. Existing primary care pain programs are seldom informed by consumers or incorporate cultural responsiveness and are inconsistently delivered and evaluated[3]. This qualitative study aimed to inform the design of a chronic pain model of care in multicultural Australian primary care by engaging patients, carers, primary healthcare professionals and tertiary pain services.

Sleep deprivation among healthcare workers is associated with impaired cognitive performance, reduced vigilance, and an increased risk of medical errors. Anaesthesia personnel are particularly vulnerable due to frequent night shifts, prolonged working hours, and the need for sustained attention in high-acuity clinical settings. Fatigue-related impairment may adversely affect perioperative safety, including the delivery of effective and timely pain management.

Despite growing recognition of clinician wellbeing, data on sleep quality among anaesthesia personnel in Malaysian public hospitals remain limited. Understanding sleep health in this high-risk workforce is essential to inform strategies aimed at improving clinical performance and patient outcomes.

This study aimed to assess sleep quality among anaesthesia personnel using the Pittsburgh Sleep Quality Index and to explore its association with demographic and work-related factors, with implications for perioperative and pain care.

Neuromodulation is increasingly used in chronic pain management across regions, yet the global distribution of evidence and the outcomes prioritised in research remain unclear. Evidence and gap maps (EGMs) provide a structured approach to identify evidence concentration and critical gaps. We aimed to develop an EGM evaluating neuromodulation for adults with chronic pain.

Converging evidence from the general population suggests that pain can motivate the use of nonopioid substances such as nicotine, alcohol, and cannabis. This use may be driven in part by maladaptive cognitive-affective responses to pain (e.g., pain catastrophizing[1]). However, less is known about substance use for pain-coping among older adults specifically. This research gap is surprising given the high prevalence of chronic pain in later life and the heightened risk of adverse substance-related effects[2-4]. Therefore, these analyses examined use of nonopioid substances for pain coping and their associations with pain catastrophizing among adults aged ≥65 with chronic pain.

Chronic pain is a debilitating condition shaped by biological, psychological, and social factors. Stress has been linked to pain; however, its role in the interplay between pain and suffering remains underexplored. The aim of this study was to explore how pain and stress shape the lived experience of suffering among individuals living with chronic pain.

Peribulbar block (PBB) ensures anesthetic conditions with akinesia and promotes intraoperative and postoperative analgesia without the use of non-steroidal anti-inflammatory drugs and opioids; however, it may be associated with ocular or systemic complications, such as hematoma, nerve injury, or systemic toxicity, especially in elderly patients with comorbidities. The primary age group undergoing this surgery is over 65 years old, which implies an adjustment of the anesthetic technique, both due to age-related physiological changes. The study aims to compare the anesthetic technique for CT and to evaluate potential outcomes.

Pain is a common and burdensome symptom among cancer survivors, often limiting daily functioning and quality of life. In young adult (YA) survivors, pain is influenced by complex biopsychosocial factors, including sociodemographic characteristics, disease and treatment related factors, psychological distress, and comorbidities such as chronic illness, fatigue, depression, and anxiety. However, the influence of social and behavioral determinants such as neighborhood deprivation, food insecurity, and health behaviors on pain interference in YA survivors remains insufficiently understood. Addressing this gap is essential for developing targeted prevention and intervention strategies that reduce pain burden and improve survivorship outcomes in this population.

Chronic pain is common in individuals with opioid use disorder. Because the opioid antagonist naltrexone blocks opioid receptors, fear of inadequate pain management can cause reluctance among patients to enter treatment for opioid use disorder with this medication. A considerable number of patients with co-occurring chronic pain nevertheless begin naltrexone treatment for their opioid use disorder[1]. Here, we explored observational data from a work package in the Norwegian NaltRec study (NCT03647774)[2] to identify potential differences in the pain experiences of extended-release naltrexone- (XR-NTX) and opioid agonist-treated (OAT) patients with co-occurring opioid use disorder and chronic pain.

Clinical Practice Guidelines (CPGs) provide systematically developed, evidence-based, and consensus-driven recommendations to support clinical decision-making. Although many CPGs address pain management, few specifically focus on pain assessment in geriatric populations, despite frequent cognitive impairment and communication barriers that complicate pain recognition. Within the development of the German guideline “Pain Management in Geriatric Patients,” [1] we conducted a guideline synopsis to compare and synthesize international recommendations on this topic. This contribution focuses on the clinical question: “How can information about pain be obtained in geriatric patients?”, emphasizing international differences and gaps in recommendations for clinical practice and future guideline development.

Delivering early psychosocial interventions for those at risk of delayed recovery with acute injury-related pain is challenging. Two approaches have been described: (1) Stratified care is provided according to assessed group level of risk but, despite initial promise, subsequent studies have been disappointing1. (2) Matched care tries to match the intervention to the psychosocial risk factors at the individual level2. Promising results were reported in an Australian study3, but it needs replication. Using injured workers assessed as being at high-risk of delayed recovery, this study evaluated the same matched protocol2 but in a different industry and with different treatment providers

Musculoskeletal pain is a leading cause of work disability and early labour market exit. Evidence supports work retention as net-beneficial[3], yet primary care practitioners tend to address this passively, awaiting patient initiation[5]. Physiotherapists have comparatively longer consultation windows than other healthcare professionals and are well-placed to adopt a proactive role[7]. This study aimed to identify competency-relevant physiotherapist profiles and explore conditions supporting proactive work retention practice.

The COVID-19 pandemic had a profound impact on the wellbeing of youth, especially those with chronic pain. Chronic pain is known to co-occur with symptoms of mental health, including anxiety and depressive disorders (1). Considering the negative impacts of the COVID-19 pandemic on chronic pain and mental health (2,3), understanding the clinical overlap in these experiences is critical to ensure appropriate clinical support is offered to youth, especially given the chronicity of pain and mental health disorders. Experiences of pain and mental health are heterogenous (4); however, specific patterns of mental health symptoms occurring concurrently with chronic pain have yet to be identified. Creating such profiles can improve how youths’ pain and mental health symptoms are assessed and treated. This work aimed to explore patterns in experiences of pain and mental health symptoms among youth during the COVID-19 pandemic, with a view toward offering clinical considerations for supporting these youth.

Chronic pain affects 11–20% of adolescents and is linked to disability, school absence and mental health challenges. Neurodivergent youth, including those with autism or ADHD, experience chronic pain at nearly twice the rate of neurotypical peers (8.2% vs 15.6-19.9% in US data). Unique pain expression and communication differences create additional barriers to diagnosis and treatment, suggesting actual prevalence may even be higher. However, Australian-specific data remains limited. Understanding the prevalence of chronic pain in neurodiverse youth is essential for inclusive healthcare.

Near-infrared spectroscopy (NIRS) is widely used as a surrogate marker for cerebral perfusion, particularly during cardiac and non-cardiac surgeries, where decreases in cerebral oxygen saturation (rSO₂) have been linked to poor outcomes, including postoperative cognitive dysfunction (POCD). POCD, affecting up to 40% of non-cardiac surgery patients, is a significant concern, especially among elderly patients undergoing laparoscopic gastrointestinal surgeries. The cognitive risks associated with opioids have spurred interest in opioid-free anesthesia (OFA), which utilizes non-opioid adjuncts to reduce opioid consumption, potentially improving postoperative outcomes.

Pain trajectory research has focused on negative trajectories despite evidence of trajectories with positive prognoses and associated protective factors.

The Raine Study (www.rainestudy.org.au) involves participants born between 1989 and 1992 in Western Australia (Gen2). While positive pain trajectories exist in the Raine Study Gen 2, these have not been a research focus. Multidimensional protective variables (e.g. marital status, adiposity, sleep) have been collected from Raine Study Gen2 participants at multiple timepoints to 28 years old.

This study aimed to derive positive musculoskeletal pain trajectories and determine associated protective factors in the Raine Study Gen2.

Psychological interventions are strongly endorsed for chronic pain management by the National Institutes of Health, the Centers for Disease Control and Prevention, and the International Association for the Study of Pain. These recommendations are grounded in randomized controlled trials (RCTs) in which treatment efficacy is determined by selected outcome measures. Yet, it remains unclear which outcomes are prioritized in the trials informing these recommendations and whether they reflect domains most relevant to individuals living with chronic pain. We therefore systematically map outcome selection in guideline-supported trials and examine alignment with daily functioning, participation, and overall life impact.

Persistent pain is a major public health problem with substantial functional, social, and economic impact and is a leading contributor to years lived with disability. In Mexico, limited evidence describes pain management from a physiotherapy perspective within primary care. This study aimed to describe the prevalence, characteristics, and coping strategies related to persistent pain in an adult population from Nuevo León, Mexico, and to examine differences according to age, sex, and functional limitation.

Wait times at Canadian multidisciplinary pain clinics often exceed benchmarks, leaving patients struggling to access timely specialist advice for chronic pain and causing delays in treatment. Asynchronous teleconsultation enables primary care providers (PCPs) appropriate, timely and equitable access to specialists' advice in shared models of care, reducing the need for people to receive treatment in hospital settings. However, little is known about the implementation and impact of asynchronous teleconsultation tailored to chronic pain. In this study, we examine the implementation and scale-up of asynchronous teleconsultation for chronic pain and evaluate its impact in urban and rural areas of Quebec.

Evolving evidence on the risks and long-term benefits of opioid therapy, along with the opioid epidemic, has prompted widespread implementation of opioid deprescribing guidelines aiming to reduce opioid-related harms. However, emerging evidence suggests that opioid tapering or discontinuation may be associated with higher risk of suicide-related outcomes. We sought to synthesize the evidence evaluating the association between opioid deprescribing and composite suicide-related outcomes including suicidal ideation, suicide attempts, and suicide death among adults prescribed long-term opioid therapy.

Pain in children with communication or neurocognitive impairment remains a complex and frequently under-recognized clinical challenge. Accurate assessment is essential for effective management but is often hindered by non-verbal presentation, developmental variability, and the influence of sedation or illness. This review aims to explore commonly used observational pain assessment tools and highlight their clinical strengths, limitations, and applicability in non-verbal pediatric populations.

Post-COVID pain is a global healthcare emergency affecting up to 60% of survivors, severely impacting quality of life. Distinguishing de novo post-COVID pain from pre-existing pain conditions is essential for clinical management. Recent research highlights that miRNA regulate host-virus interactions and can predict infection severity by modulating the overexpressed inflammatory response. As stable, circulating epigenetic regulators, miRNAs also influence inflammatory and nociceptive pathways. This study aims to evaluate plasma miRNA profiles in subjects reporting de novo post-COVID pain after SARS-CoV-2 infection, and the biological pathways they are regulating.

Median sternotomy produces significant nociceptive stimulation during cardiac surgery and may lead to marked intraoperative hemodynamic responses requiring additional opioid administration. The pecto-intercostal fascial plane (PIFP) block is a novel ultrasound-guided regional technique that provides analgesia to the anterior chest wall. This study aimed to evaluate the effect of bilateral PIFP block on intraoperative opioid consumption and hemodynamic responses to sternotomy in adult cardiac surgical patients.

Peripheral neuropathy is one of the most common neurological complications associated with the use of chemotherapy drugs, significantly affecting patients functional capacity in their daily activities. In this context, nurses play a key role in the early detection and management of symptoms. It is essential to train these professionals to effectively identify, assess, and intervene in the risks related to chemotherapy-induced peripheral neuropathy (CIPN). Objective: To investigate the prevalence of peripheral neuropathy symptoms and neuropathic pain in patients undergoing chemotherapy in the context of antineoplastic treatment.

Prescription opioids play a central role in the global overdose crisis, creating a need to rethink chronic pain (CP) management(1). Therapeutic cannabis has emerged as a potential opioid-sparing strategy, offering analgesia with lower risks of respiratory depression and dependence(2). While clinical trials directed at validating this therapeutic utility measure pain scores and opioid reductions, they fail to capture the emotional, social, & existential dimensions of tapering(3). Phenomenological vignette methodology provides a rigorous approach to examining those embodied realities(4). This study employed phenomenological vignettes to illuminate how CP patients interpret medically supervised opioid tapering when cannabis is introduced within routine clinical care(5).

Psychological inflexibility (PI) and flexibility (PF) are core processes influencing how individuals respond to challenges in life, including pain. Pain catastrophizing (PC) is consistently elevated in chronic pain, yet interventions targeting PC have had limited success. Enhancing PF may provide a more effective route to adaptive regulation of PC, but relations between these constructs remain underexplored. Network analysis can identify patterns of conditional dependence among survey items, thus this approach may be useful for examining interconnections among the psychological constructs of PI, PF and PC in individuals with and without chronic pain.

Patients with β-thalassemia undergo lifelong, repeated intravenous cannulations, often resulting in procedural pain, anticipatory anxiety, and cumulative psychological distress (1,2). Virtual reality (VR) has emerged as a non-pharmacological intervention capable of modulating attentional and emotional pain pathways (3). This study aimed to evaluate the effectiveness, feasibility, and tolerability of therapeutic VR as an adjunct to standard care in reducing pain- and anxiety-related outcomes during routine cannulation in patients with β-thalassemia in the United Arab Emirates.

Pain during exercise has been reported across exercise type and age group, negatively impacting exercise behaviors [1,2]. Creative activity interventions are needed to reduce exercise barriers, namely pain with movement. The primary objective of this study was to translate offset analgesia to an exercise task to reduce pain and improve feelings towards exercise (affective valence) across the lifespan. To enhance the real-world applicability of these findings, data collection included two local retirement communities in addition to the academic lab setting.

Patients undergoing maintenance hemodialysis experience a high burden of physical and psychological symptoms. Chronic pain is highly prevalent in this population, affecting approximately 60% of patients, with moderate to severe pain reported in more than 40% of cases. Anxiety and psychological distress are also common among hemodialysis patients and are associated with poorer quality of life and treatment tolerance. These findings highlight the need for effective non-pharmacological interventions to address pain and anxiety during dialysis sessions.
The objective of this study was to demonstrate the effects of Music Care© on pain and anxiety in patients undergoing chronic hemodialysis.

While multisite pain is common among older adults, limited evidence exists regarding how these individuals differ from those with no pain or pain in only one location. This study aimed to compare community-dwelling older adults with multisite pain to those with no or single-site pain in terms of physical function, cognitive performance, and gut microbiota composition.

The World Health Organization has defined since 2002 palliative care as care provided to people with a disease with reserved prognosis. Their goal is to achieve the best possible quality of life, including pain relief [1]. Digital technologies are increasingly being used to strengthen national health systems [2,3]. Recent publications have described the effects of musical interventions on pain and anxiety [4,5]. However, few studies have focused on their impact on the African continent and particularly in Mali. The objective of this study was to demonstrate the effects of Music Care© on pain and anxiety in end-of-life patients.

For adolescents with chronic pain and significant pain-related disability, family-focussed paediatric intensive interdisciplinary pain management programmes (PIIPMP) can: improve emotional, physical and family function; support shifts to self-management of pain; enhance progress toward developmentally appropriate goals; and reduce healthcare costs. However, the strength of evidence varies across studies.(1-4)
Aims:
- describe development of a PIIPMP integrated into Chronic Pain Clinic pathways at Great Ormond Street Hospital (GOSH);
- report data covering recommended mandatory, important and research outcome domains for paediatric chronic pain trials (5) at baseline, completion of PIIPMP and follow-up;
- discuss progress and feasibility of randomised trial with longterm follow-up.

The consistent quality of quantitative sensory testing (QST) data of healthy participants according to the German Research Network on Neuropathic Pain (DFNS) protocol within European centers was a crucial prerequisite for comparing QST data between centers and performing multicenter QST-based studies [1]. To comply the QST Thai reference data with the German reference data, it was essential to evaluate the quality of QST performance. The study aims were to find the reliability of a Thai investigator in performing QST investigations and the effects of living in different climates on the QST parameters of healthy Caucasian participants (HCPs) compared to the German normative values.

Social, economic, and institutional environments are increasingly recognized as important contributors to chronic pain vulnerability. Trust towards physicians, peers, and workplaces, along with financial stress, has been shown to play a role in the development of chronic pain (1-7). However, validated tools that measure how individuals internalize these socioecological factors remain limited. This study presents the development and validation of the Internalized Resource Availability (IRA) questionnaire, designed to quantify individuals' perceived access to resources relevant to pain management.

Geriatric patients, characterized by advanced age, multimorbidity and increased overall vulnerability, experience an increased prevalence of pain. Cognitive impairment and communication barriers are also common and contribute to the underreporting of pain and challenges in pain recognition. Age-associated changes in metabolism and risk of adverse events limit the use of common analgesics, especially in long-term therapy and applicability of common non-pharmacological interventions is also compromised. To address these challenges, an evidence-based guideline was developed in Germany, providing interprofessional recommendations for pain management in geriatric patients across the primar healthcare, hospital and long-term care settings.

Air pollution is strongly linked to respiratory and cardiovascular diseases, but its role in pain is comparatively unexplored. Chronic pain conditions are a leading cause of disability worldwide, shaped by biological, psychological, and social factors. Evidence suggests that air pollution may increase inflammatory processes and psychological distress, both of which can contribute to pain sensitivity and persistence. Although research has examined associations between air pollution and chronic pain conditions, no review has mapped the evidence for the air pollution-chronic pain relationship. This review aims to investigate the scope, consistency, and gaps in this literature.

Acute and chronic pain are common conditions affecting individuals world wide from childhood to old age. Acute pain is a warning signal about tissue damage and a necessary sign for survival, while chronic pain is pain that persists after normal healing of damaged tissue i.e. lasting more than three months. Approximately 20% of the adult population in Western countries have chronic pain. Previous studies suggest that cold environment is associated with a high prevalence of for example musculoskeletal pains among indigenous people living in Arctic areas. The prevalence of both acute and chronic pain in Greenland is unknown. The aim of this study was to estimate and compare the age and gender specific prevalence of pain in Greenland and Denmark using the prescription of analgesics as a proxy for the presence of pain.

Gout is the most common inflammatory arthritis worldwide, with increasing prevalence in older adults. While acute gout flares are dominated by intense inflammation, advanced tophaceous gout progresses to persistent chronic pain driven by urate crystal-induced inflammation, cumulative joint damage, and probable central sensitization mechanisms. In elderly patients, frailty and depression amplify pain perception and functional decline. Pain becomes multidimensional, exceeding purely nociceptive mechanisms. This case aims to illustrate the complex impact of severe gout in a frail geriatric patient and to emphasize the importance of comprehensive geriatric assessment in guiding individualized, multidisciplinary management strategies for pain control and functional preservation.

Nonpharmacological pain interventions are widely used across clinical settings, yet it remains unclear why some approaches appear more therapeutically meaningful than others. Existing explanations often rely on broad concepts such as distraction, adherence, or patient engagement, but these terms do not adequately distinguish between superficial participation and forms of involvement that may meaningfully alter the pain experience. Flow, a state of absorbed, goal-directed, and intrinsically rewarding engagement, may offer a more precise way to conceptualize this difference. The aim of this work was to propose a new conceptual framework for nonpharmacological pain intervention design, using flow as a lens to identify the features of treatment experiences that may be most relevant for pain modulation, therapeutic participation, and clinical usefulness.

Irritable bowel syndrome (IBS) is the most prevalent disorder of gut-brain interaction, characterized primarily by recurrent chronic abdominal pain, which severely impacts the quality of life and productivity of affected individuals, particularly in young adults (1-3). However, the clinical management of IBS pain remains challenging due to the lack of objective biomarkers and the inherent difficulties in measuring its complex, multifaceted pathophysiology (3-8). This study aimed to examine Quantitative Sensory Testing (QST) phenotypes over 12 weeks, along with phenotype-associated symptoms and gut microbiome signatures, in comparison with healthy controls (HC).

The MMPI personality test and its revised version, the MMPI-2, reported the Conversion V pattern as a characteristic of chronic pain patients. However, due to significant overlap between scales in these versions, the MMPI-2-RF separated the common factor as demoralization and created 10 Restructured Clinical Scales. Assessments of psychosocial risk using these scales have been widely reported. The MMPI-3, released in 2020, added new scale groups measuring internalizing, externalizing, and somatization. The purpose of this study is to investigate the personality characteristics of chronic pain patients using the MMPI-3 and to clarify the relationship with other pain-related indicators.

In Japan, the number of individuals suffering from chronic pain is estimated to be nearly 27 million, and the annual productivity loss among workers with chronic pain has been reported to reach 1.953 trillion yen. Because multidisciplinary treatment has been shown to be effective for chronic pain management, our institution established a multidisciplinary chronic pain treatment team in 2019, which has functioned as an official in-hospital team since September 2021.
In this study, we retrospectively analyzed patients who received team-based interventions between September 2021 and the end of June 2025.

Osgood-Schlatter disease (OSD) is a common condition affecting children between the ages of 10 and 18, especially those who are active in sports. Approximately 10% of children aged 12 to 15 experience OSD, with the prevalence rising to as much as 20% among adolescent athletes. The condition is mainly characterized by pain, noticeable swelling, and deformity of the tibial tuberosity, often resulting in gait abnormalities and a decrease in physical activity.

Aim: To evaluate the effectiveness of taping in the rehabilitation of patients with OSD.

Back pain imposes an enormous burden on emergency departments (EDs) and inpatient services. In the United States, it accounts for 13% of hospital admissions [1]. In England, back pain was responsible for 365,327 ED presentations and 140,392 hospital admissions in 2023–24 [2]. In Australia, back pain was the 5th most common reason for ED visits in 2023–2024, with one third of the patients subsequently admitted to hospital [3]. Another concern is that 10% of the patients with back pain re-present to the ED within 12 months in Australia [4] and 14% in the United States [5]. Virtual care models, including home-based and outpatient services, have been proposed to reduce avoidable ED presentations and hospitalisations. This study evaluated the effectiveness of a virtual hospital model of care for back pain (Back@Home) in reducing hospital admissions and re-presentations to the ED.

The Implementation of Infant Pain Practice Change (ImPaC) Resource is an evidence-based, interactive online platform. ImPaC is designed to guide healthcare champions through multistep practice change cycles to improve pain assessment and nonpharmacological pain (NP) management practices in Neonatal Intensive Care Units (NICUs). In a hybrid type 1 effectiveness-implementation study, NICUs were asked to complete at least 1 change cycle; both clinical(1) and implementation(2) effectiveness were demonstrated after 6-months exposure to ImPaC. We evaluated the sustainability of improved clinical outcomes for an additional 12 months in relation to fewer versus greater numbers of completed ImPaC cycles.

Opioids continue to be prescribed for acute post-surgical pain management, posing a risk for persistent opioid use (1). In an opioid-sparing context, we identified risk factors predictive of acute opioid rescue medication use 1-2 days after surgery (2). Sex differences in perioperative reports of affect and pain intensity (3), as well as opioid consumption and efficacy (4) may affect this acute window of post-surgical opioid use. We aimed to investigate sex differences in known factors affecting acute opioid use two days after surgery. We hypothesized that the known risk factors predicting opioid use would differ by sex.

Pain insensitivity describes the lack of sensation of pain, while pain indifference describes the perception of a painful stimuli, without the affective response [1]. These two conditions highlight that for most individuals, pain is “an unpleasant sensory and emotional experience” and “pain and nociception are different phenomena” [2]. However, individuals with assumed congenital insensitivity pain, on clinical examination, may have unimpaired sensory responses. As Weisman et al. (2019) highlight, the term “insensitivity to pain conflates pain with nociception” [3]. Because these conditions may impact both longevity and quality of life, a comprehensive literature review is warranted.

Background: Children with suspected lymphoma and airway-compromising cervical lymphadenopathy present major anesthetic challenges. Sedation or general anesthesia risks airway collapse. This case highlights successful use of spinal anesthesia in a high-risk pediatric patient with severe airway compromise.
Case report: An 11-year-old boy presented with massive bilateral neck masses, and inability to lie supine. Lymphoma was strongly suspected, and urgent diagnostic procedures were required.
Clinical findings: Airway: Audible stridor, hoarseness, positional intolerance.
Neck: Large bilateral lymphadenopathy.
ENT: Kissing tonsils causing severe airway narrowing.

Despite advances in analgesia, cancer pain remains undertreated, especially in low-resource settings where prevalence and care gaps are greatest[1,2]. Barriers to effective pain control worsen functional decline and quality of life [3, 4]. Recent reviews and patient‑reported outcome studies recommend personalized, multimodal strategies and policy action [5,6]. Clinicians require better assessment tools that capture pain intensity and related outcomes to support implementation. We therefore investigated demographic and treatment factors linked to higher pain burden and poorer quality of life, and assessed how the prescription‑based pain management index (PMI) corresponds with patient-reported outcomes in a multi‑site Ghanaian oncology cohort.

In randomized controlled trials (RCTs), study participants and research personnel are often blinded to minimize bias related to knowing treatment allocation [1]. To determine if blinding was effective, participants and research personnel may be asked at the end of the study which treatment they believe they received (“treatment guess”). We conducted a descriptive review which aimed to characterize blinding assessment (BA) and its reporting in pharmacotherapy and neuromodulation neuropathic pain RCTs.

Lactylation is emerging as a critical link between cellular metabolism and gene regulation, yet its causal role in migraine pathophysiology remains unclear.

Partial rotator cuff tears are the most frequent acute soft tissue injuries of the shoulder (34%). Risk factors for this condition include age, a history of trauma, and functional demands on the shoulder. These demands have been linked to repetitive movements involving hyperabduction or hyper elevation of the shoulder, as occurs in the daily work activities of nursing staff. The aim of this study is to determine whether or not there is a correlation between acute rotator cuff injuries and the work activities of nursing staff in the orthopedic ward over at least three months.

Back pain is common in young athletes (1). Back pain is one of very few established risk factors for later episodes of back pain in emerging adults (2). Cohort studies of factors associated with the incidence of back pain in adolescent female football players is scarce. The objective was to investigate whether hip and trunk range of motion (ROM) and strength are associated with the incidence of low back pain (LBP) in adolescent female football players.

Musculoskeletal pain is extremely common, and distress is frequently experienced alongside it. There has been little research exploring the experience of pain-related distress for people at the onset of pain, how pain-related distress may change over time, or what predicts pain-related distress. This is important as psychological factors are known risk factors for the transition from acute to chronic pain.
This study aimed to explore how pain-related distress changes over time in people experiencing acute musculoskeletal pain, and what predicts these changes.

During pregnancy, women commonly experience discomfort related to physiological and hormonal changes, including low back pain (LBP). LBP affects up to half of pregnant women and significantly impairs daily functioning and quality of life, with some cases persisting after delivery. Pharmacological management is limited due to potential fetal risks, particularly during the first trimester, making non-pharmacological approaches preferable. Acupuncture has been widely used as a safe complementary therapy for musculoskeletal pain. This case report aims to describe the clinical outcome of acupuncture treatment in a pregnant woman with LBP and its potential role as a safe therapeutic option.

Low back pain (LBP) is a highly prevalent symptom worldwide. The recurrence nature of LBP is a major contributor to the impact experienced by individuals. Research has typically examined the recurrence of LBP as an isolated event rather than considering the impact to a repeating pattern over time. It is unclear whether specific patient features could be associated with a future disability following recovery from an episode of LBP. The current study aimed to explore candidate prognostic factors of future disability over the 12 months following recovery from an episode of LBP.

Manual therapy is widely used in the management of non-specific neck pain (NSNP); however, the neurobiological mechanisms underlying its analgesic effects remain incompletely understood. Beyond peripheral and spinal processes, supraspinal descending pain modulation has been proposed as a potential mechanism. Neuropeptides such as orexin-A and neurotensin play key roles in central pain modulation, yet human studies examining their acute responses to cervical manual therapy are limited. We aim to investigate the acute effects of cervical passive joint mobilization on pain intensity, cervical range of motion, pressure pain threshold, and serum levels of orexin-A and neurotensin in women with NSNP.

Musculoskeletal pain is common across the lifespan and can affect functioning. A third of children and adolescents’ population report having musculoskeletal pain. In children and adolescents, pain may interfere with school and physical activities and increase the risk of chronic pain in adulthood. Pain intensity is an relevant outcome in pediatric pain research. However, the evidence supporting measurement properties of the Pain Numerical Rating Scale (PNRS) in young populations with musculoskeletal pain, particularly in middle-income countries, remains limited. This study aimed to evaluate the reliability, construct validity, and interpretability of the PNRS in children and adolescents with musculoskeletal pain.

Primary dysmenorrhea is a common pain condition affecting adolescent girls and women of reproductive age. even through its mainly considered as gynecological issue, menstrual pain is now understood as a complex condition that significantly affects movement, sleep, emotional well-being, education, work, and overall quality of life. Current assessment tools available primarily focus on intensity and duration of Pain, neglecting the broader functional and psychosocial impacts. so the objective of this study was to develop and validate the Multidimensional Menstrual Pain Scale (MMPS), a comprehensive, patient-reported outcome measure designed to assess the multidimensional impact of menstrual pain.

Primary dysmenorrhea is a common condition in young women characterized by painful menstrual cramps without pelvic pathology, often accompanied by symptoms like nausea, fatigue, and low back pain that affect daily activities. While medications are commonly used, side effects encourage ,the use of non-pharmacological methods. Physiotherapy techniques such as Kinesio-taping (KT) and Connective Tissue Mobilisation (CTM) are increasingly applied however, limited research compares their effectiveness in managing primary dysmenorrhea.
AIM
This study aimed to compare the effectiveness of KT and CTM in reducing menstrual pain and associated symptoms in females with primary dysmenorrhea.

Intra-operative Methadone has gained increasing interest as a long-acting perioperative analgesic; however, concerns remain regarding delayed postoperative respiratory depression due to its prolonged elimination half-life and interpatient pharmacodynamic variability. In 2025, Austin Hospital introduced an institutional perioperative methadone guideline mandating increased postoperative ward observations (hourly for 4 hours). We sought to evaluate early prescribing patterns and respiratory safety outcomes following implementation.

Postoperative pain remains inadequately controlled for many surgical patients and is associated with greater morbidity, impaired function, delayed recovery, prolonged opioid use, increased healthcare costs, and elevated risk of chronic postsurgical pain1. Clinical hypnosis is increasingly proposed as an opioid‑sparing adjunct within multimodal analgesia, but its effectiveness in adults undergoing surgery under general, spinal, or regional anaesthesia remains uncertain. We aimed to synthesise randomized trial evidence on the effects of hypnosis on acute perioperative pain intensity, perioperative opioid and sedative consumption, and related psychological outcomes in adult surgical patients, and to identify key gaps and priorities for future research.

Postoperative pain following laparoscopic gynecological surgeries (LGS) could extends beyond the surgical site. LGS is considered minimally invasive. However, shoulder tip pain (STP) is a particularly distressing complication. It is thought to result from diaphragmatic irritation caused by carbon dioxide insufflation. Currently no standard preventive method is available.. The transverse abdominis plane (TAP) block is effective for treating anterior abdominal wall pain. Its role in STP, however, remains uncertain. Laparoscopic-guided TAP (LTAP) block has been described primarily in gastrointestinal surgery. Data on its use in gynecological laparoscopy are limited.

Gender-affirming top surgery aligns chest aesthetics with gender identity and significantly improves quality of life. However, post-operative pain outcomes are understudied in gender diverse populations. Broader literature suggests that 20–30% of ciswomen undergoing prophylactic mastectomy develop chronic post-mastectomy pain. Established predictors of worse post-surgical pain include pre-operative anxiety, pain catastrophizing, and depression, as well as quantitative sensory tests (QST) such as conditioned pain modulation (CPM), temporal summation (TS), and pressure pain thresholds (PPTh). Here, we explored whether acute and chronic top surgery pain outcomes can be predicted by established psychological factors and QST.

The dual subsartorial block (DSB)—a combination of a distal femoral triangle block (FTB) and an adductor canal block (ACB)—is a motor-sparing regional anesthesia technique developed to optimize postoperative analgesia while preserving quadriceps function in total knee arthroplasty (TKA). While the FTB reliably covers anteromedial knee innervation, the optimal location for the ACB remains controversial. This study aimed to compare the analgesic efficacy of a DSB using either a proximal (pACB) versus a distal ACB (dACB), testing the hypothesis that the dACB would provide superior analgesia via better coverage of posterior knee sensory pathways.

Postoperative opioid use contributes to negative outcomes such as respiratory depression and persistent use, particularly for those undergoing bariatric surgery (1). However, studies have demonstrated that patients who receive video-based training on pain medications have reduced postoperative pain levels and opioid consumption (2). In addition, digital psychological and recreational interventions for acute pain show promise as safe and effective adjuncts to pain regimens (3). This pilot study sought to determine whether an educational video and digital media program, disseminated through a commercially available digital tablet device, were effective in mitigating pain and reducing opioid use.

Modified thoracoabdominal nerve block (M-TAPA) is a novel block for the anterolateral branches of thoracoabdominal nerves. M-TAPA offer extensive analgesic coverage, typically from thoracic segments T5–T12 and T7–T12, respectively. This study aims to investigate the effectiveness of ultrasound-guided Modified Thoracoabdominal nerve block through the Perichondral Approach (M-TAPA) for analgesia in laparoscopic abdominal surgeries. This systematic review of M-TAPA was conducted to comprehensively assess current clinical evidence, identify knowledge gaps, and explore implications for future research. The insights gained from this review will be instrumental in refining clinical guidelines and enhancing the utilisation of M-TAPA in perioperative pain management.

Objectives:
1, To compare the intraoperative and postoperative hemodynamics
2,requirement of nalbuphine for postoperative
analgesia in upper limb orthopedic surgeries.
3,utilized non-opioid analgesic adjuncts such as dexmedetomidine and lidocaine in the perioperative periods to curtail the use of opioids as a part of enhanced recovery after surgery protocol
4,minimize opioid-related adverse events.

Study Design
Comparative analytical study
Place and duration of study:
Department of Anesthesia, Fauji Foundation Hospital, Rawalpindi, Pakistan 7th Oct 2022 to 15th
July 2023.

Opioids are commonly prescribed to manage postoperative pain after anterior cruciate ligament (ACL) reconstruction. However, opioid overuse is a recognised global problem associated with important harms including dependence, overdose, and death. Despite multiple primary studies reporting opioid prescribing and consumption patterns following ACL reconstruction, no comprehensive synthesis of this evidence existed. This systematic review aimed to evaluate the prevalence and prescription of opioid analgesic after ACL reconstruction, and to determine associations between study and patient characteristics and opioid use, and geographical variation in use.

Opioids are widely used for pain management globally. Their average treatment effect is small to modest for different types of pain such as acute musculoskeletal pain, [1] chronic non-cancer pain, [2] and some types of cancer pain, such as breakthrough pain.[3] However, there is documented evidence of heterogeneity of treatment effects following opioid therapy, [4] and certain gene variants are known to influence opioid metabolism, efficacy, and safety.[5] However, this evidence includes studies of any design, from in vitro studies, to observational studies, and clinical trials. There has not been a systematic evaluation of whether gene variants formally moderate the effect of opioid therapy for pain in randomised controlled trials.

The primary aim of this review is to investigate whether gene variants relevant to the efficacy and toxicity of opioids moderate the effect of opioids on pain and adverse drug reactions (ADRs).

Laparoscopic cholecystectomy (LC) is a less invasive procedure and offers benefits compared with open surgeries. Even if LC is a minimally invasive, patients may experience a severe pain, postoperatively following surgery. One of the PROSPECT guideline recommendation is providing analgesia using a regional anaesthesia technique which is represented by the Th6-Th10 Thoracoabdominal nerve block as they play major roles in an acute pain following LC surgery. The Bilateral Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) represents valid alternatives to achieve this objective, as it provides wide dermatomal blockade in the anterior and lateral abdomen between the Th6-Th7 and Th12-L1 levels. This technique is easy to perform, and there is no difficulties or major potential complications were reported. We described a three serial case of patients who underwent LC surgery and have received USG guided bilateral M-TAPA as the postoperative analgesia.

Percutaneous transforaminal endoscopic discectomy (PTED) is a commonly used minimally invasive surgical procedure for the treatment of lumbar disc herniation, yet 87.9% of patients still complain of lumbogluteal pain after surgery, and its specific etiology remains unclear. This study aimed to systematically investigate the factors associated with post-operative lumbogluteal pain following PTED, with a focus on the impact of superior articular process resection and articular process injury during surgical manipulation on post-operative pain, so as to provide evidence for clinical precise treatment and rehabilitation management.

Effective management of early postoperative pain is critical to optimize recovery and reduce postoperative morbidity. Opioid analgesics remain widely used in this setting but are often limited by adverse effects and variability in clinical response. Taphalgin is a tetrapeptide administered by subcutaneous injection with preferential μ1-opioid receptor activity and modulation of calcium-dependent nociceptive signaling.
This Phase III, single-blind, randomized, multicenter, parallel-group study enrolled adults aged 18–65 years undergoing elective surgery associated with moderate surgical trauma (upper or lower abdomen or lesser pelvis).

Emerging evidence discourages the use of modified-release (MR) opioids for acute postoperative pain[1]. Despite this, MR opioids continue to be prescribed postoperatively[2-3]. This scoping review aimed to identify factors influencing clinicians’ decisions to prescribe oral MR opioids for postoperative pain.

Postoperative pain management is crucial in day-case micro lumbar spine surgery to enhance early recovery and patient satisfaction. This study evaluates the effectiveness of lumbar paravertebral block (LPVB) and erector spinae plane block (ESPB) in providing postoperative analgesia.

Nephrectomy, whether via open or laparoscopic approach, represents a crucial surgical intervention [1]. Unfortunately, acute postoperative pain following nephrectomy remains a formidable challenge, with approximately 20–26% of patients experiencing chronic pain, often leading to increased opioid consumption and associated adverse effects [2]. This unresolved pain can significantly impact various body systems, including endocrine, circulatory, immunological, neurological, and musculoskeletal [3]. Despite the advantages of laparoscopic nephrectomy, such as quicker recovery and reduced pain compared to open surgery, a subset of patients still experiences postoperative discomfort. In this study, we compared the analgesic efficacy of ultrasound guided continuous Erector Spinae plane block (ESPB) GroupI with Epidural block (EB) Group II in the subset of patients undergoing laparoscopic nephrectomy.
Primary objective: Time of use of first dose of rescue analgesia.
Secondary objective: Cumulative dose of rescue analgesics consumed in 24 hours postoperatively.
Post-operative VAS
Procedure related complications.

Surgical correction of scoliosis in children is crucial for preventing disease progression and lung function deterioration.

However, factors such as bone trauma, impaired circulation, and soft tissue edema contribute to significant postoperative pain, potential complications, including chronic pain syndromes.

This study aimed to compare three approaches to postoperative pain management in a pediatric population.

Quality of recovery is complex. However, it’s an important outcome measure of the early postoperative health status, with major emphasis on measuring patient-reported outcomes to better estimate the overall well-being of patients.
Quality of Recovery – 40 (QoR-40) is a globally used, patient-rated, validated questionnaire to assess patient-reported postoperative recovery outcomes in physical, psychological, social, and pain domains. In the absence of a culturally adapted and psychometrically tested patient-reported tool in the majority spoken Sinhala language in Sri Lanka, this study aims to evaluate the validity and reliability of the Sinhala-translated QoR-40 questionnaire among postoperative surgical patients.

Opioids remain essential for acute pain management in orthopaedic surgery. Danish national guidelines recommend morphine as first-line treatment, but still a significant number of inpatients at the Depart-ment of Orthopaedic Surgery at Hvidovre Hospital, continue to be prescribed non-morphine opioids. This is concerning given the risk of misuse and addiction potential associated with opioid such as tramadol and oxycodone. This study describes the clinical decisions leading to prescription of opioids other than morphine for acute pain management.

Patient-controlled analgesia (PCA) is widely used for postoperative pain control, yet early discontinuation frequently occurs due to inadequate analgesia or adverse effects. The demand-to-delivery (D/D) ratio reflects the relationship between patient requests and actual opioid delivery and has been proposed as an indicator of PCA adequacy, with an optimal value below 1.35. However, its association with PCA continuation remains unclear. This study aimed to evaluate the distribution characteristics of D/D ratio and examine whether elevated D/D ratio serves as a marker of early PCA discontinuation risk.

Preoperative anxiety affects up to 67.6% of surgical patients and is biologically linked to adverse perioperative outcomes through the anxiety-pain axis, including sleep disturbances, hyperalgesia, increased analgesic consumption, and delayed functional recovery [1,2]. Preoperative anxiety amplifies central pain sensitization and is an independent predictor of postoperative pain severity in orthopedic surgery [3]. Mixed reality (MR) technology has demonstrated potential to reduce perioperative anxiety through immersive preoperative simulation [4,5], though its downstream effects on postoperative pain remain unclear. This randomized controlled trial (RCT) evaluated whether MR-based preoperative intervention reduces severe preoperative anxiety and explored its secondary effects on postoperative pain and analgesic outcomes in patients undergoing orthopedic surgery.

Complementary and alternative medicine (CAM) is popular and considered as a safe alternative to standard care in women and especially in pregnant women or mothers. Auricular vagus nerve stimulation (aVNS) has emerged as a non-pharmaceutical treatment option. Innervation of the vagus nerve can lead to the release of endorphins and enkephalins, parasympathetic activation and activation of the cholinergic anti-inflammatory reflex This prospective double-blind randomized pilot study aims to explore the potential benefits of aVNS in post-caesarean pain, gastrointestinal motility, lactogenesis, and postpartal wellbeing.

The acute pain course after knee replacement (KR) may serve as an indicator of persistent postoperative pain (1). Moreover, distorted embodiment (e.g., “my knee was not part of my body”) is thought to interact with postoperative pain (2)(3). Therefore, this study aimed to identify subtypes in the dynamic interaction between postoperative pain and distorted embodiment, and to clarify their contribution to the course of pain.

Ultrasound guided subcostal transversus abdominal plane (TAP) block has come up as one of the promising modality to take care of postoperative pain after Laparoscopic cholecystectomy. The duration of analgesia depends upon duration of local anaesthetic used for the block. Various adjuvants are added to prolong the duration of local anaesthesia. So, the aim of our study is to find the efficacy of using dexmedetomidine as adjuvant to ropivacaine in subcostal TAP block for control of postoperative pain.

Throat pain is a significant post-operative complication associated with tonsillectomy and can be severe in up to 50% of patients. Post-tonsillectomy pain management in Ghana is usually achieved with analgesics like paracetamol and ibuprofen. Nebulisation can be employed in the peri-operative period especially in children without an intravenous access. Ketamine is an anaesthetic agent with analgesic and sedative properties at sub-anaesthetic doses and can be part of multi modal analgesic strategies.
The aim of this study was to primarily determine the effect of pre-operative nebulised ketamine on post-operative pain and pre-operative sedation and anxiolysis in children scheduled for tonsillectomy.

Movement-evoked pain (MEP) is often more severe than rest pain and correlates directly with functional recovery.
Current pain assessments often rely on single time-point measurements, overlooking the dynamic changes of pain over time.
Opioid-free anesthesia (OFA) is trending, but its impact on postoperative MEP trajectories remains controversial.
We aim to identify distinct trajectories of early postoperative MEP in patients undergoing major abdominal surgery, and to determine the perioperative factors associated with these trajectory patterns.

Road traffic crashes cause 20-50-million non-fatal injuries annually[1]. Whiplash-associated disorders (WAD) are the most common non-hospitalised injury and although labelled “minor”, 50% of people develop persistent pain resulting in significant societal costs [>1-billion Australian Dollars (AUD) annually][2,3]. A randomized trial showed StressModex (physiotherapist-led integrated stress inoculation training and exercise) was clinically effective for neck pain-related disability in adults with acute WAD and elevated pain-related disability and stress symptoms[4]. While clinically effective, evidence on its cost-effectiveness is required to inform decision making, policy, and clinical guidelines. Using trial data, we aimed to evaluate cost-effectiveness of StressModex compared to guideline-based exercise.

This case series describes five Emergency Department (ED) patients who received Ultrasound-guided peripheral nerve blocks (USGPBNs) for severe upper and lower extremity trauma. The use of USGPNBs for pain management remains scarce in EDs across the Philippines. As of the writing, this report details the first case series of USGPNBs performed in EDs across the Philippines.

The bidirectional relationships between chronic musculoskeletal pain and poor sleep are widely acknowledged, with anxiety, depression, and stress-related processes, including hyperarousal, identified as psychological mechanisms underlying their interplay [1, 2]. However, little is known about how these relationships and underlying psychological pathways operate in the acute stage after minor-to-moderate motor vehicle crash (MVC) injuries. Understanding this will help to identify early intervention targets and optimal prevention strategies for chronic outcomes. The aims of this study were to investigate the sleep-pain relationship in the acute postinjury stage and the potential mediating roles of early anxiety, depression and hyperarousal.

Jagannath et al. (2018) discuss how patients with non-biliary recurrent acute pancreatitis (RAP) are prone to developing chronic pancreatitis (CP), suggesting a continuum from acute to recurrent to chronic pancreatitis. The role of pancreas divisum, sphincter of Oddi dysfunction, and anomalous pancreatobiliary junction in causing RAP is controversial. (2)
Gurakar et al. 2022, Approximately three-quarters of patients with pancreas divisum present with a risk factor for pancreatitis. .(1)
Bouwense SA (2015) acknowledges that persistent pain can induce alterations in central pain processing, targeted treatment should be initiated to address these changes (e.g., gabapentinoids, ketamine, or tricyclic antidepressants).(3)

Background and aims:
Pain is one of the most prevalent and distressing symptoms experienced by patients with cancer, particularly those with advanced malignancies. Pain management strategies in cancer patients include a range of pharmacologic, non-pharmacologic modalities and pain intervention procedures.
Aim of the study was to observe the effectiveness of pain management techniques, character and severity of pain, frequency of pain intervention procedures, and side effects in patients with chronic cancer pain presenting to pain management clinic.

To investigate the conversion ratios, indications, and clinical outcomes of intrathecal opioid rotation in patients with chronic refractory pain.

Survival after childhood cancer has improved substantially, yet chronic pain remains a prevalent and insufficiently characterized late effect. Pain presentations among survivors vary widely across affective, cognitive, sleep, and somatic symptoms, making the identification of risk factors and long‑term functional consequences challenging. No prior reports have applied a comprehensive multidimensional framework to characterize pain in this population, limiting opportunities for precision survivorship care. Leveraging pain models from non-cancer chronic pain populations, this project aimed to identify multidimensional pain phenotypes, their associations with clinical and sociodemographic predictors, and evaluate associations with social and health outcomes among adult survivors of childhood cancer.

Ketamine is used as an adjuvant for refractory cancer pain, most commonly as short inpatient infusions or intermittent outpatient protocols. Reports describing prolonged continuous ketamine infusion extending for months remain limited. This case describes refractory mixed cancer-related pain managed with continuous ketamine infusion for approximately 90 days, highlighting dose titration, tolerability, and changes in patient-triggered breakthrough analgesic demand during unusually prolonged exposure. The aim of this case report was to describe the feasibility and tolerability of ultra-prolonged ketamine infusion and to explore whether sustained NMDA receptor antagonism

Pain, impaired functioning, and reduced quality of life are common consequences of cancer and its treatment. Among adolescent and young adult cancer survivors, pain is both prevalent and persistent, affecting up to 44% of young survivors and often continuing years beyond treatment. Despite this, post-cancer pain is under-recognised and under-treated, especially in youth populations. This study aimed to evaluate the efficacy of EMBody (Exploring Mindsets about the Body), a novel digital mindset intervention co-designed with young cancer survivors, cancer clinicians, and documentary filmmakers to foster adaptive mindsets about the body and cancer and thereby improve health related quality of life (HRQoL) in young cancer survivors.

Pancreatic cancer is the most painful upper abdominal cancers. Nepal is the fifth most common country in the world for gall bladder cancer.[1] Local invasion by the tumor, metastasis, perineural invasion, chemotherapy induced pain are among the common causes of pain.[2] The use of drugs like NSAIDs, morphine, and adjuvants in high doses have side effects like sedation, constipation, nausea and vomiting.[3] The use of radiofrequency nerve ablation in intractable pain gives better results than oral medications.[4] We hypothesized that bilateral splanchnic nerve block reduces Numerical rating Scale (NRS) score and the daily dose of morphine.

Cancer pain remains inadequately controlled despite established guidelines and expanding pharmacologic and interventional options. Fragmented care pathways, unclear role delineation, and weak coordination across settings contribute to persistent undertreatment. Nurses and general practitioners (GPs) are strategically positioned to influence continuity, monitoring, and patient-centered analgesic decision-making, yet their integration within multidisciplinary tumor boards and structured care models remains inconsistent. This review aims to synthesize current evidence regarding the roles of nursing and primary care in multidisciplinary cancer pain management, with particular attention to tumor board configurations, communication infrastructure, and implementation barriers that influence analgesic outcomes and quality of care.

Cancer induced occipital neuralgia is a special type of cancer pain. It is often associated with pituitary tumors and nasopharyngeal carcinoma in clinic. This because that C2 dorsal root ganglion emits nerve fibers by passing through bony foramina of the skull to innervate the posterior cranial fossa. In this study, we investigated the effect of C2 continuous radiofrequency (CRF) to treat cancer induced occipital neuralgia.

A case of a 51 year old female, married, diagnosed with lung cancer stage 4 in 2019. She received 6 cycles of chemotherapy and 1 cycle of immunotherapy. Persistent aching pain over the left shoulder, left arm, radiating to the left anterior chest and back despite the pharmacologic therapy prompted referral to an interventional pain specialist. A minimally invasive procedure was contemplated using low volume neurolytic agent.

Advanced breast cancer produces complex, debilitating pain that often persists despite opioid-based regimens. Stellate Ganglion Block (SGB), a sympathetic blockade targeting cervicothoracic neural pathways, is emerging as an adjunct intervention for cancer-related pain and lymphedema, yet remains under-utilized in metastatic disease. This case presents Bataan General Hospital and Medical Center’s first documented application of SGB in a Stage IV breast cancer patient with severe refractory pain. The goal was to evaluate SGB’s effect on pain intensity, upper-limb swelling, sleep disturbance, and quality of life. This report aims to highlight interventional pain procedures as essential components of multimodal oncology care.

Malignant sacral involvement can cause severe pain that is challenging to manage with analgesics alone. Intrathecal drug delivery systems (IDDS) offer an effective alternative but often involve implanted pumps. We present a case where an intrathecal catheter, typically used as a lumbar drain, was successfully adapted for long-term use with an external pump to manage cancer pain.
A 54-year-old male with a recurrent rectosigmoid adenocarcinoma and sacral metastasis presented with severe, constant burning pain in the lower back, buttocks, and lower extremities, associated with feet paresthesia. Pain was exacerbated by movement and impacted his sleep and mood. Imaging revealed a 6cm recurrent tumor invading the sacral foramina and involving the sacral nerve roots. His pain remained poorly controlled despite high-dose opioids (Morphine Sulfate Tablet-Sustained Release (MST) 40 mg TID, Morphine Immediate Release (MIR) 10 mg, Methadone 5 mg PO BID) and adjuvants, leading to frequent hospital admissions and ER visits.

Advancements in diagnostic imaging have significantly improved early cancer detection and treatment outcomes, leading to increased survival rates (WHO, 2018; Siegel RL, 2019). However, this progress has also resulted in heightened pain experiences among cancer patients (Marieke H., 2018; World Cancer Report, 2020). Insufficient knowledge among healthcare providers and systemic barriers within the healthcare system contribute to this issue (Li Z., 2018). Given that pain is a common and complex symptom during cancer treatment (M. Evenepoel, 2022), addressing the barriers to effective pain management is crucial.
Aims: This research aims to identify barriers to pain management in cancer treatment and develop preventive measures.
Objectives:
Compare and characterize cancer incidence in Georgia between 2008 and 2015-2019.
Assess the frequency, intensity, prescribed analgesics, and outcomes of pain experienced by cancer patients.
Identify patient-associated barriers to pain management.
Identify physician-associated barriers to pain management.
Identify barriers associated with the regulation of medical opioid use.

Chemotherapy induced peripheral neuropathy (CIPN) is found in 68% of patients in the first month after chemotherapy, and then 60 and 30% after 3 and > 6 months respectively (1). The most frequent culprits are vinca alkaloids, paclitaxel, docetaxel, platinum-based antineoplastic drugs, bortezomib, and thalidomide derivatives (1,2). Pharmacological therapy with multimodal therapy that include duloxetine and ligands of the alpha-2-delta subunits of the voltage-gated Ca-channel have been shown to be successful in many patients (3). However, there is a small percentage of patients that do not achieve adequate pain control when using these combinations due to lack of response or side effects limiting quality of life. We have used intrathecal therapy (ITT) to treat this patients. The purpose of this study is to evaluate the long-term effectiveness of ITT in patients with chemotherapy induced peripheral neuropathy that failed optimized multimodal pharmacological therapy.

Chronic upper abdominal pain, particularly arising from malignancies, represents a major therapeutic challenge due to its intensity, refractory nature, and complex visceral pathways. Interventional treatments targeting splanchnic nerves have become a cornerstone of management when pharmacological therapy fails. Among the available modalities, chemical (Phenol) neurolysis and radiofrequency ablation (RFA) are widely used, yet evidence comparing their efficacy remains limited. This study aimed to compare analgesic efficacy, functional status improvement, sleep quality, and analgesic burden following RFA versus phenol neurolysis.

Cancer-related pain is a prevalent, complex, and multidimensional symptom that significantly impairs quality of life, particularly in patients with advanced disease.1 It may arise from direct tumor invasion, diagnostic or therapeutic procedures, or treatment-related adverse effects.
One of the primary goals of palliative care is effective pain relief. However, the subjective nature of pain necessitates accurate and systematic assessment for optimal management. Validated tools such as the Visual Analog Scale (VAS), Numerical Rating Scale (NRS), and Verbal Rating Scale (VRS), along with behavioural scales for non-communicative patients, are essential for evaluating pain. 2 Comprehensive assessment should include pain intensity, quality, duration, and its functional impact. Regular evaluation enables clinicians to individualize analgesic therapy and monitor treatment response.
Despite advances, cancer pain remains inadequately assessed, underscoring the need for continued research, refined strategies, and updated guidelines to improve pain severity evaluation and adequacy of analgesic management in palliative care.

Cancer pain remains inadequately managed globally, particularly in low-resource settings where workforce constraints, fragmented care, and limited access to medicines persist. Poor pain control is associated with reduced quality of life, psychological distress, and suboptimal medication adherence. Although pharmacists are increasingly recognised as important members of multidisciplinary teams, their role in cancer pain management has not been systematically translated into a theory-informed and contextually relevant intervention. This study aimed to co-plan and co-deliver an evidence- and theory-informed clinical pharmacy intervention for cancer pain management in Nepal through a multi-phase programme of evidence synthesis, contextual assessment, and feasibility testing.

400000 children are newly diagnosed with cancer each year [1]. Cancer and its treatments brings complex symptoms including pain and fatigue, as well as unwelcome changing in physicality such as weight, skin, and hair changes [2]. These changes are often thought of as ‘unfair’. Perceived injustice, the perception of unfairness has been association with pain and disability in other pediatric pain populations [3], but has not been investigated in oncology patients. We aimed to explore the journey to diagnosis and feelings about diagnosis in children with cancer and their parents, specifically trying to understand how perceived injustice plays a role.

Intravenous lidocaine is increasingly used for the management of chronic neuropathic pain. Current systematic reviews have a number of limitations, leaving uncertainty with regard to the benefits and harms of intravenous lidocaine for chronic neuropathic pain. We conducted a systematic review and meta-analysis to summarize the evidence for using intravenous lidocaine in the treatment of chronic neuropathic pain and the risk of associated adverse events.

Internal jugular vein (IJV) thrombosis is an underdiagnosed, condition, associated with suppurative thrombophlebitis, propagation of thrombus into intracranial sinuses and pulmonary embolism. Clinical presentation is often subtle and easy to miss due to varied presentation. Predisposing factors are infection, intrinsic abnormalities of coagulation, intravascular stasis, prolonged IJV catheterization. Symptomatic anterograde and retrograde extension of IJV thrombosis is rare. A research subject developed symptoms of venous stroke due to brainstem infarcts after Ultrasound Guided peristyloid Glossopharyngeal Nerve Block (GPNB).This was a rare presentation of preexisting, undiagnosed, IJV Thrombosis and Dural Sinus Thrombosis

Background
Postherpetic neuralgia (PHN), chronic neuropathic pain persisting beyond three
months after herpes zoster and impairs QoL. Pregabalin partially relieves but is limited by adverse effects. Mindfulness-Based
Intervention (MBI) has demonstrated benefits in chronic pain; its role in PHN
and its impact on gene expression remain unexplored.
Primary Objectives
• Compare NRS-Pain and NPSI scores
between groups at baseline and at 1st, 2nd, 4th, and 8th weeks.
• Assess changes in mRNA expression of mTORc1 and IL-6 genes.
Secondary Objectives
• Proportion of patients achieving NRS-Pain ≤3
• NRS-Sleep scores
• Pain Catastrophizing Scale (PCS)
• Quality of Life (SF-12)

Chronic neuropathic pain persists over years yet fluctuates markedly from day to day. How stable neural abnormalities give rise to these dynamic pain states remains unclear. The insular cortex plays a central role in integrating sensory and affective dimensions of pain, but its spectral organization during ongoing chronic pain has not been well characterized. We aimed to dissociate stable disease-related neural patterns from day-to-day symptom fluctuations in the human insula.

Post-implant spinal cord stimulation (SCS) management has traditionally relied on episodic, clinic-based visits, limiting visibility into day-to-day therapy use and delaying resolution of patient-reported issues. This can lead to periods of non-optimized stimulation impacting pain control and satisfaction.¹ Recent SCS platforms support remote device management, combining continuous, device-derived remote monitoring with remote programming.² These capabilities enable proactive therapy management and objective, longitudinal tracking of therapy utilization and implant status, creating real-world datasets for benchmarking and surveillance.²,³ However, published evidence describing post-implant utilization patterns and the practical impact of remote management in routine practice remains limited.³

Lowback pain, one of most common health problem - creates substantial burden globally. Disc herniation contributes only small fraction of chronic LBP. Clinical signs-symptoms and imaging abnormalities do not correlate often. In large studies, source of facet joint(s) 24-40%, disc herniation 13-20%, discogenic pain 26%, sacroiliac pain 4-6% and in 13-19% patients cause of pain remained elusive, grouped under non-specific LBP. It is important to emphasize on thorough weighing of clinical and MRI findings when diagnosing LBP.
AIMS: Diagnose & determine the prevalance of facet arthritis as a cause of LBP and confirmation by diagnostic block in MRI proved PIVD patients.

Chronic neuropathic pain is a prevalent and disabling condition characterised by marked inter-individual variability in treatment response and a paucity of reliable predictive markers. This heterogeneity hampers optimal treatment selection and contributes to prolonged trial-and-error prescribing and suboptimal outcomes. The present study applies machine learning techniques to multimodal neuroimaging data to identify objective biomarkers associated with treatment response. By delineating neurobiological signatures that predict therapeutic benefit, this work aims to advance precision medicine approaches in neuropathic pain and to support more informed, evidence-based clinical decision-making.

Thoracic neuropathic pain, including intercostal neuralgia, post-thoracotomy pain, and post-herpetic neuralgia (PHN), may remain refractory despite pharmacotherapy. Intercostal cryoneurolysis produces temporary axonal interruption and may provide prolonged analgesia following diagnostic block confirmation. We evaluated feasibility, safety, and clinical outcomes of image-guided thoracic intercostal cryoneurolysis in a small retrospective case series.

Meralgia paresthetica is a neuropathic pain syndrome caused by lateral femoral cutaneous nerve (LFCN) entrapment, resulting in burning pain and dysesthesia over the anterolateral thigh. While most cases respond to conventional therapies like medication or injections, some remain refractory. In lower middle-income countries (LMICs), as defined by the World Bank, access to surgical or implantable neuromodulation is limited. Pulsed radiofrequency (PRF) offers a minimally invasive alternative.

Ultrasound-guided hydrodissection (UGHD) has emerged as a minimally invasive treatment in carpal tunnel syndrome (CTS), but the optimal frequency of injection remains uncertain. This study compares the efficacy of single versus double injection hydrodissection of median nerve using 5% dextrose, in patients with CTS.

Mental neuralgia is a rare but debilitating peripheral neuropathic pain condition characterized by severe, electric shock–like pain in the distribution of the mental nerve, significantly impairing quality of life and daily functioning. Pharmacologic therapy is often limited by inadequate analgesia and intolerable adverse effects, while conventional interventional techniques, such as blind neurolysis or radiofrequency, carry risks of complications and inconsistent outcomes. Ultrasound guidance allows precise localization of the mental foramen and targeted intervention. This study aims to describe the technique and clinical outcome of ultrasound-guided percutaneous cryoneurolysis in refractory mental neuralgia

Phantom limb pain is defined as painful sensation referring to missing limb. Multiple modalities including medical and interventional therapies has been tried so far with minimal success. This single arm intervetional study aimed to evaluate the effect of pulsed radiofrequency (PRF) adjacent to cervical dorsal root ganglion (DRG) in patients with refractory upper extremity phantom limb pain.

Non-specific low back pain is a highly prevalent musculoskeletal condition associated with impaired neuromuscular control and trunk muscle function. Kinesio taping is a commonly used non-invasive intervention that may enhance proprioceptive input and muscle activation through cutaneous stimulation. However, evidence regarding the immediate effects of lumbar kinesio taping on proprioception and trunk muscle strength remains limited.

The aim of this study was to investigate the acute effects of lumbar kinesio taping on lumbar proprioception, muscle strength, and pain intensity in individuals with non-spesific low back pain, compared with sham taping.

Neuropathic pain, caused by a lesion or disease of the somatosensory nervous system, remains a major therapeutic challenge. First-line systemic treatments — gabapentinoids, tricyclic antidepressants, and serotonin–norepinephrine reuptake inhibitors — provide modest average benefit (NNT 4.6–8.9) and are frequently limited by dose-dependent adverse effects such as sedation, dizziness, and cognitive impairment. Topical therapies have therefore gained attention for localized neuropathic pain, targeting peripheral generators while minimizing systemic exposure. Current options include lidocaine 5% patches and capsaicin 8% patches, but each has limitations in efficacy or tolerability. Menthol, a natural TRPM8 agonist, exerts analgesic effects through desensitization of nociceptive nerve endings and additional multi-target mechanisms including TRPA1 inhibition, sodium channel blockade (Nav1.8/1.9), and GABA-A receptor potentiation. Despite this pharmacological rationale, clinical evidence remains scarce. We aimed to evaluate the real-world effectiveness and tolerability of a standardized stepwise titration strategy using compounded topical menthol (1%–10%) in refractory localized neuropathic pain.

Zoster-associated pain (ZAP) remains a challenging neuropathic condition with heterogeneous clinical outcomes. Pulsed radiofrequency (PRF) and short-term spinal cord stimulation (st-SCS) are commonly used interventional options, but comparative effectiveness data, particularly across different disease stages and dermatomal involvement, remain limited. This study evaluated real-world treatment outcomes of st-SCS versus PRF using a stratified clinical database analysis.

The global burden of stroke is expected to increase by 2050, dramatically impacting the vulnerable elderly population in low and middle income countries. Central post-sroke pain is a debilitating complication that is often refractory to pharmacologic interventions, occurring in 0.31% to 30.1% of stroke survivors. The management of central post-stroke pain can become extremely challenging when there is a concomitant metabolic or inflammatory condition, like pancreatic encephalopathy, that complicates the clinical picture by masking neurological changes and cognitive decline and narrowing the therapeutic window for certain analgesics. Escitalopram offers a promising and safer alternative in the elderly, potentially reducing the need for high-dose opioids. While clinical evidence remains limited, this case report highlights the considerable opioid-sparing effect of escitalopram in such clinically complex situations.

Post-surgical neuropathic pain (PSNP) is a major contributor to chronic post-surgical pain and carries a substantial functional and socioeconomic burden. While its prevalence is well recognized in high-income countries, evidence from low- and middle-income countries (LMICs) remains limited, despite marked disparities in perioperative care, pain assessment capacity, and postoperative follow-up. Understanding PSNP prevalence in LMICs is essential to guide global perioperative practice and address inequities in pain management.

This systematic review aims to determine the prevalence of PSNP across surgical specialties in LMICs and assess whether prevalence estimates differ between studies that utilize validated screening questionnaires versus the NeuPSIG criteria.

Spinal Cord Stimulation (SCS) is an established therapy for refractory chronic pain. While its efficacy in pain reduction is well-documented, real-world data regarding its multidimensional impact—including function, sleep, and emotional status—over long periods is still evolving. This study evaluates the one-year clinical outcomes and device retention among patients treated with SCS over a decade of clinical experience.

Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder that significantly affected quality of life. In trigeminal neuralgia, pain arises from the demyelination of trigeminal fibers, which triggers ectopic impulses and ephaptic transmission, leading to severe paroxysmal pain. Although medication is still becoming the first-line therapy, long-term medication may induce significant adverse effects, thus requiring further intervention.

Postherpetic neuralgia (PHN) is a prevalent and debilitating complication of herpes zoster, characterized by persistent neuropathic pain that often proves refractory to conventional pharmacotherapy, representing a significant clinical management challenge. Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive neuromodulatory intervention, has emerged as a promising approach due to its analgesic and anti-inflammatory mechanisms. This randomized controlled study aimed to evaluate the specific efficacy and safety of taVNS versus in alleviating pain and improving sleep in patients with PHN over a 12-week follow-up period.

Trigeminal neuropathic pain (TNP) is a rare, chronic, and highly disabling condition, with an estimated prevalence below 0.5% in the general population, and frequently refractory to standard pharmacological management, leading to substantial functional and quality-of-life impairment. Although cannabinoids have emerged as a complementary therapeutic option for neuropathic pain, evidence in orofacial pain remains limited and largely based on subjective outcomes. This pilot study aims to describe the clinical and functional effects of adjunctive cannabinoid therapy in refractory TNP, integrating validated pain and quality-of-life instruments with three-dimensional facial stereophotogrammetry to objectively document changes in sensitized facial areas.

This study aimed to evaluate the effectiveness, safety, and patient acceptability of topical amitriptyline spray（Amitriptyline spray has obtained invention patent certification, and this research project has received funding from the Chinese government.） for managing acute herpes zoster-related pain through a clinical trial.

Crohn’s disease (CD) is a chronic, idiopathic inflammatory bowel disease defined by transmural inflammation, which frequently penetrates the bowel wall leading to fibrotic strictures, fistulas, and abscesses. This case report details the multidisciplinary management of a 19-year-old male with a longstanding history of Crohn's disease who presented with severe abdominal pain, fever, and an active perianal enterocutaneous fistula.This case demonstrates the structural progression of the disease, necessitating an escalation in therapy from first-line mesalamine to a multimodal treatment strategy. This contemporary approach included necessary surgical source control (incision and drainage with Seton placement), targeted biologic therapy (vedolizumab), and a highly structured opioid-tapering pain management strategy utilizing scheduled paracetamol and gabapentinoids (pregabalin) to address severe visceral and neuropathic pain.

Individuals with painful diabetic peripheral neuropathy (PDPN) often have impaired nociceptive modulatory responses. Conditioned pain modulation (CPM) serves as a proxy measure for the net output of pain modulation. In fact, in studies on duloxetine use in people with PDPN, CPM has shown to predict treatment efficacy and to be a responsive measure of improvement. Thus, CPM demonstrates potential clinical utility. While promising, little is known regarding its test re-test reliability. Furthermore, expert consensus recommends testing at the symptomatic site. Given that individuals with PDPN have impaired sensory detection in these regions, this may impact the validity of CPM as a measure of pain modulation. Thus, this pilot study aims to assess the test re-test reliability of CPM responses and compare CPM capacity across proximal and distal sites in patients with PDPN. Here we report a preliminary analysis of an ongoing study with focus on site comparison of CPM capacity.

Phantom limb pain (PLP) after amputation or brachial plexus injury remains difficult to treat. Approaches aiming to re-engage sensorimotor networks (mirror therapy, motor imagery) show variable effects. We developed GHOST, a portable EEG-based brain–computer interface (BCI) coupled with immersive virtual reality (VR), enabling real-time neurofeedback through motor imagery–driven control of a virtual limb.

Phantom limb pain is a chronic pain condition with difficult management and a heterogeneous response. Non-invasive motor cortex stimulation and mirror therapy are potential treatments; however, the predictors of patient response remain unclear. This study aims to use machine learning (ML) algorithms to predict responses to non-invasive brain stimulation and mirror therapy in patients with phantom limb pain (PLP). This was a secondary analysis of a randomized, blinded, sham-controlled, 2 × 2 factorial trial. 112 participants with traumatic lower limb amputation were randomized into treatment groups (active or sham M1 tDCS combined with Mirror therapy).

Painful radiculopathy is a common neuropathic pain condition. Patients with chronic painful radiculopathy may present with bilateral nerve impairments. A comparison of both sides of a patient with a matched control could clarify whether the sciatic nerve is impaired bilaterally. This study aimed to compare the cross-sectional area (CSA) and skin-to-nerve distance (SKN) of the sciatic nerve between patients with probable neuropathic pain and matched asymptomatic controls.

Pregabalin and gabapentin are widely used in Malaysia for neuropathic pain, fibromyalgia, and partial epilepsy, and are generally considered to have favorable safety profiles. Although manufacturer data report low incidences of liver enzyme elevation, anecdotal reports and real-world clinical observations suggest variable findings, with limited comparative evidence on their long-term hepatic effects. This study aims to evaluate and compare the impact of pregabalin and gabapentin on liver function, focusing on changes in AST and ALT levels to assess potential hepatotoxicity in routine clinical practice.

Low back pain (LBP) is the leading contributor to the need for rehabilitation services in at least 134 countries (1). Besides revolutionising healthcare, digital breakthroughs also catalysed a mismatch between the widespread deployment of mobile health applications (apps) and the prevailing lack of scientific and regulatory endorsement (2). The purpose of this umbrella review was to provide an overview of the effectiveness of mobile health applications in reducing pain intensity in people with LBP.

The volume of research relevant to pain has increased rapidly in recent years, spanning basic neuroscience, preclinical models, and clinical studies. While this growth reflects major advances, it also creates a substantial challenge for researchers and clinicians attempting to remain current with the literature (Landhuis, 2016). Here, we aimed to quantify the scale and variability of newly published neuroscience research relevant to pain and to develop a system to support efficient discovery and evaluation of new studies. Our goal was to address the growing burden of literature surveillance while enabling more structured and personalized engagement with the rapidly expanding evidence base.

Wearable technology and artificial intelligence advances have expanded use of patient-generated health data in clinical care . Nurses remain responsible for interpreting data, integrating caregiver reports, and making time-sensitive decisions to determine risk and need for escalation of concerns . The primary aim of this study is to understand nurses’ lived experiences and clinical decision making in outpatient postoperative care. A secondary aim is examining how AI outputs from sensor data are used, interpreted, and questioned in practice .

Chronic pain is a well-established independent risk factor for suicidality, and psychological comorbidities are highly prevalent in this population and also linked to an increased risk of suicidal behavior. Individuals with fibromyalgia have a risk of death by suicide up to 10.5 times higher than the general population and 3.3 times higher than those with other chronic pain types. This study aimed to develop and validate machine learning (ML) models to predict suicidal behavior (ideation, planning and attempts) among individuals with fibromyalgia.

Chronic pain is a multidimensional sensory and emotional experience that persists beyond tissue healing and represents a major global public health challenge. Despite its high prevalence, population-based data in low- and middle-income regions remain scarce, particularly at subnational levels. Understanding regional patterns of chronic pain is essential for guiding health policies, prevention strategies, and resource allocation. This study aimed to estimate the prevalence of chronic pain among adults residing in the state of Paraná, southern Brazil, and to characterize its demographic and clinical features, with special attention to sex, age distribution, and educational level.

Patients increasingly turn to Large Language Models (LLMs) for medical advice, yet these models often struggle with providing evidence-based answers and can generate "hallucinations." This study aims to develop and validate evidence grading algorithm designed to integrate the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework into LLMs, enhancing their ability to address complex patient medical queries with optimal evidence supporting.

Describing subjective sensations creates a universal "communication gap" [1]. Clinically, the Japanese term “Shibire” represents a significant distress distinct from pain or itch, necessitating specific intervention. However, the meaning of this term is remarkably unstable, varying among individuals by indiscriminately conflating Positive Sensory Symptoms (PSS; e.g., tingling), Negative Sensory Symptoms (NSS; e.g., numbness), and Perceived Motor Weakness (PMW; e.g., subjective motor complaints) [2]. We aimed to quantify this semantic variability in both general and clinical populations to demonstrate how a single linguistic label can obscure the precise profile of this distinct distress.

Knee osteoarthritis is one of the leading causes of pain and disability worldwide, particularly among older adults(1). In Brazil, knee osteoarthritis is also high prevalent(1). Despite its high prevalence, evidence on the economic burden of knee osteoarthritis remains limited in low- and middle-income countries(2). Cost-of-illness studies are essential to estimate economic burden, identify major cost drivers, and support healthcare system in resource allocation(3). Thus, the aim of this study is to estimate the outpatient and inpatient care costs of knee osteoarthritis in the Brazilian Public Healthcare System (SUS) in 2024.

Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain¹. Fibromyalgia affects 2–4% of the population and is associated with substantial utilization, with annual per-patient estimates of US$1,750 to US$35,920 in the United States and US$1,250 to US$8,504 in Europe². Fibromyalgia is associated with up to three times higher healthcare costs than other chronic pain conditions³. Although there is evidence of the economic burden of fibromyalgia in high-income countries, this information is scarce in low- and middle-income countries. This study aimed to estimate healthcare costs of fibromyalgia in the Brazilian healthcare system in 2023.

Patients with low back pain (LBP) often seek emergency care1, although this health condition should primarily be managed in primary care settings. Patients believe their symptoms are related to serious pathologies2. LBP is the leading cause of disability worldwide3, affecting a large portion of the population, increasing the consumption of health services, and absenteeism costs. However, the evidence on absenteeism of patients with LBP seeking care in emergency departments remains underexplored. This study aims to estimate the absenteeism costs associated with LBP and identify factors associated with these costs among patients with LBP seeking care in emergency departments.

Contemporary clinical guidelines for addressing complex regional pain syndrome (CRPS), a disabling condition, recommend multimodal, mechanism-informed rehabilitation. [1,2] To date, evidence remains insufficient to conclusively support rehabilitative intervention. [3,4] Translation of guideline principles into clinical practice is thus challenging. While multinational surveys have described rehabilitation practices, national-level data are scarce in Japan. We aimed to (1) describe reported rehabilitation practices and perspectives for CRPS among Japanese physical therapists (PTs) and occupational therapists (OTs), (2) compare these with multinational survey data, and (3) examine whether reported implementation differs from therapists’ CRPS case experience.

The more than fifty-year history of modern pain medicine shows that the prevalence of chronic pain continues to increase. Therefore, it is possible that the biopsychosocial complexity of chronic pain is underrepresented in undergraduate medical curricula. The aims of this study: to identify current issues in pain education in undergraduate studies and compare them with the Lithuanian curriculum. The objectives: 1) to find out the status of implementation of pain education programs worldwide; 2) to assess the distribution of biopsychosocial components; 3) to specify the Lithuanian undergraduate pain teaching program.

PgCert is a university-accredited neuromodulation programme developed to establish consistent global educational standards across diverse clinical specialties. We present 4 years progression data focusing on enrolment, candidate demographics, professional background, and academic outcomes. The aim is to assess programme reach, performance, and relevance to contemporary clinical practice.

Pain is the most common complaint among the general population to healthcare workers globally. Pain assessments are routinely carried out in the National Rehabilitation Hospital (NRH) daily by staff during routine evaluations and when the patient highlights their suffering as worsening or otherwise intolerable.
The Trakcare electronic healthcare record (EHR) includes a simple built-in pain assessment which is routinely used in clinical practice to assess pain for further clinical evaluation and accurate record keeping by all team members. Early work by the authors revealed substantial deficits in this tool and the implementation within the clinical environment of the NRH, as well as persistent reliance on facets of the dualistic model of pain (1).
This prompted the development of a new proforma and a series of educational events to promote biopsychosocial approaches to pain assessment and management by staff, along with a new proforma for pain assessment. This prompted retrospective review.

To explore the effects of a systematic self-efficacy intervention on rehabilitation adherence, joint function, activities of daily living, and quality of life in patients with knee osteoarthritis after knee arthroscopy, and to provide evidence-based support for optimizing postoperative rehabilitation management.

Misconceptions about back pain are common among the general public and may drive disability, ineffective self-management, and low-value healthcare use [1-3]. While individual beliefs (e.g., causes of back pain) have been described [4], a comprehensive overview of population-level beliefs and their measurement remains lacking. This scoping review aimed to map the prevalence, types, and assessment tools of back pain–related beliefs in population-based studies, and to identify key gaps in contemporary evidence.

Pain is a leading cause of disability worldwide, yet inadequate professional training remains a major barrier to effective pain care. The International Association for the Study of Pain (IASP) recommends a competency-based pain curriculum for health professionals, including physical therapists. However, evidence suggests that pain education in undergraduate physical therapy programs is often insufficient, particularly in low- and middle-income countries. This study aimed to investigate Brazilian physical therapy faculty members’ perceived knowledge of the IASP pain curriculum and to identify gaps across its core domains.

Pain education for entry-level healthcare providers is deficient, despite pain being one of the most common reasons people seek medical care. The best practice treatment for complex chronic pain conditions involves interprofessional care. Healthcare simulation can provide an authentic, structured method for teaching interdisciplinary pain care and may offer a scalable strategy to improve future providers' preparedness to manage pain. The purpose of this study is to determine whether an IPE event using an interdisciplinary team approach to pain management affects interprofessional learning outcomes, regardless of learners' roles (participant vs. observer) in the simulation.

Non-specific low back pain (NSLBP) is a leading cause of disability worldwide and in Singapore. The biopsychosocial (BPS) model provides a comprehensive framework for NSLBP management, yet translation into practice remains inconsistent, with limited evidence from Asian contexts.
Objective:
To explore how physiotherapists in Singapore understand and apply the BPS model in when managing individuals with NSLBP, and to identify perceived barriers and facilitators to its integration into practice.

Chronic pain in youth is a complex issue, with up to a quarter of students estimated to be affected¹. Chronic pain can limit students’ ability to engage academically and socially at school, with potential long-term consequences for wellbeing, educational attainment, and future opportunities¹˒². Schools are recognised as key settings for supporting this population³. However, there remains a lack of standardised school-based support strategies and accessible resources to guide school staff in responding to chronic pain⁴˒⁵. This scoping review aimed to synthesise strategies and resources used to support youth with chronic pain in school and identify gaps to inform future development.

National pain strategies consistently emphasize the urgent need to improve how health professionals are initially trained to understand and manage pain.1,2 These calls are based on the assumption that increasing the time and content dedicated to pain management within pre-licensure curriculum will improve pain management competency among graduating health professionals. However, this relationship has yet to be evaluated. This study aimed to fill this gap by conducting the first standardized assessment of pain management competency across health professional programs that varied in pre-licensure pain management curriculum.

Pain science education has evolved over more than two decades. This study employs bibliometric and visual analysis to examine the developmental trajectory and current global landscape of research in related fields of pain science education. By exploring future trends and characteristics, we aim to provide new insights for the advancement of pain education worldwide.

In North America, opioid-related harms remain a leading cause of drug-related mortality due to the direct relationship with opioid prescriptions. Despite the availability of national guidelines, considerable variability and non-adherence persist in opioid prescribing practices. Educational interventions are crucial to improve the knowledge gaps, low clinical confidence, and inconsistent guideline adherence among opioid prescribers. While multi-modal continuing medical education (CME) has shown promise, few studies have rigorously evaluated the impact of scalable digital-provided CME. This study evaluates the effectiveness of the Online Opioid Self-Assessment Program, a self-guided, accredited digital CME module designed to improve knowledge of the Canadian Opioid Guideline.

Neuropathic pain is associated with persistent disability and reduced quality of life despite pharmacological treatment. Beyond neural injury and central sensitization, fear-avoidance behaviours and maladaptive cognitive responses contribute significantly to functional decline. Contemporary pain science emphasizes mechanism-based assessment integrated with biopsychosocial rehabilitation strategies.

The International Association for the Study of Pain (IASP) guidelines for physical therapy (PT) pain education have been successfully integrated into entry-level physical therapy didactic education; however, there is no literature describing how IASP pain education guidelines are operationalized in PT clinical settings or how clinical learning environments can support the IASP guidelines. The purpose of this case series is to describe a novel clinical education framework to apply the IASP guidelines in a PT pain management clinic.

Decades of research on nurses’ knowledge and attitudes toward pain management have shown little meaningful improvement, with little change over 20 years.1,2 While nursing students’ knowledge and attitudes regarding pain appear to improve throughout their undergraduate program, significant knowledge deficits remain that impede their ability to assess and manage pain in clinical practice.3 The current tools used to assess this knowledge are not well-suited to a nursing student perspective and are not aligned with IASP nursing curricula.
This study aims to determine the pain knowledge required of nursing students and to develop a student-focused assessment tool.

Work-related musculoskeletal disorders (WMSDs) are a leading cause of work disability, accounting for around 30–50% of occupational illnesses and 2% of the gross domestic product in terms of economic costs, but region-specific guidance in Southeast Asia remains limited. Clinicians often rely on a patchwork of condition-specific guidelines and occupational standards, resulting in fragmented care and under-recognition of work-related factors. A multidisciplinary expert panel from Singapore, Malaysia, Thailand, the Philippines, and Indonesia developed practical, regionally relevant recommendations. This abstract describes a tiered framework for screening, diagnosis, treatment, referral, and return-to-work (RTW) planning for patients with WMSDs in Southeast Asia.

Low back pain (LBP) is a leading cause of work disability and productivity loss in Malaysia and globally. Although national prevalence within the country is about 12%, rates are higher among office workers due to prolonged sitting. LBP contributes to activity limitation, sick leave, and long-term disability, affecting both employees and employers. This study evaluates the effectiveness of an employer-funded, community-based support program for non-specific LBP, assessing pain intensity, functional status, quality of life, healthcare utilisation, pain perception, and participant satisfaction.

Diabetic peripheral neuropathy (DPN) is the most prevalent chronic complication of diabetes.1 Diabetes is a risk factor for pain in patients with distal sensory polyneuropathy, and approximately 50% of DPN patients in some samples report pain and associated reduction in quality of life (QoL) and activity interference.1,2 Optimal pain relief using a shared decision-making approach requires concordant priorities among patients and clinicians.3 When implemented effectively, patient-centered care improves treatment adherence, patient satisfaction, QoL, and other clinical outcomes.4 This analysis describes physician-and patient-reported prescription treatment satisfaction for painful DPN (pDPN) and identifies factors associated with treatment satisfaction.

Localized chronic musculoskeletal pain is pain lasting three months or more. Musculoskeletal pain is characterized by localized, focal pain reproducible on palpation of a taut muscle band. Musculoskeletal disorders affect approximately 1.7 billion people worldwide. Prolotherapy, aimed at stimulating healing of muscle and connective tissue, has been shown to reduce pain compared with control interventions. Additionally, patient–clinician interaction, including therapeutic touch, can influence pain perception and perceived benefit. The primary objective of this study is to evaluate the feasibility, safety, and short-term effectiveness of low-volume dextrose prolotherapy for adults with localized myofascial pain within a pain fellowship training environment.

In 2023, the Japan Society of Pain Clinicians (JSPC) published a consensus statement on the treatment of chronic pain in cancer survivors. The statement is currently available in Japanese on the JSPC website, with an English version published in 2025.
To promote understanding of this statement, the JSPC conducted a series of eight online seminars from October 2024 to May 2025. The seminar program received an educational grant from Pfizer Pharmaceuticals. Five months after the seminar, we conducted a follow-up survey to evaluate whether participants had experienced changes in their clinical practice.

This study explores the effectiveness of the Knowledge-Attitude-Practice (KAP) model in providing comprehensive nursing care for patients with herpes zoster neuralgia (HZN) who have undergone short-term spinal cord stimulation (st-SCS).

Neurological disorders and neuropathic pain contribute significantly to the disease burden in sub-Saharan Africa, where a substantial "treatment gap" persists. In this region, systemic challenges in conventional medicine (CM) and cultural beliefs have contributed to the widespread use of traditional medicine (TM). Data on TM and those who use it in the treatment of neurological disorders are scarce. Here, we systematically analyze its role as a therapeutic modality for the treatment of pathologies in Mali. We examine the sociodemographic characteristics of its users and propose next steps to optimize the dual use of TM and CM for patients with NT

Female Sexual Dysfunction (FSD), particularly Genito-Pelvic Pain/Penetration Disorder, is a prevalent condition that negatively affects sexual function, well-being and quality of life.¹⁻³ Despite its impact, it remains underdiagnosed and inadequately managed.⁴ ⁵ Pain Neuroscience Education (PNE) has been shown to improve pain-related beliefs and outcomes, including in sexual dysfunction.⁶⁻¹⁰ Educational materials can further enhance knowledge, treatment engagement and clinical outcomes.¹¹ ¹² However, there is a lack of educational resources specifically addressing female sexual pain.¹³ Integrating evidence, women’s perspectives and healthcare professionals’ input has been recommended to support the development of relevant and effective educational content.¹⁴⁻¹⁷ Therefore, this study aimed to identify and integrate key educational concepts for female sexual pain using a multi-source approach.

Fibromyalgia is a complex and heterogeneous primary chronic pain condition that requires multimodal and person-centered care strategies. Pain education is a central component of management; however, validated and accessible educational materials developed with the participation of people living with the condition remain scarce. This study aimed to develop and validate educational narratives on pain for individuals with fibromyalgia and to adapt them into a podcast format, integrating contemporary pain models, health communication principles, and lived experience.

Poorly controlled acute postoperative pain is correlated with poor patient satisfaction, increased the length of stay in the hospital, increased cost, and it can progress to chronic pain. The aim of the study was to explore the knowledge and practices of nurses in the surgery unit in a tertiary care hospital in Belgrade, Serbia.

Chronic pain imposes a significant global burden, requiring structured multidisciplinary care. However, many programs lack systematic evaluation, hindering quality improvement and long-term sustainability. Logic models are essential tools to organize program components, clarify expected outcomes, and guide implementation.
This project aims to describe the development of a monitoring and evaluation (M&E) plan for a chronic pain follow-up program in a public tertiary orthopedic hospital using a logic model.

Marked variation persists in how newly qualified clinicians feel prepared to work with people living with pain,1,2 despite increased attention to pain-related content in professional training.3 Prior national work has demonstrated substantial differences in pain-related preparedness across entry-level programs,4,5 yet little is known about how graduates themselves interpret their training or how educational and clinical environments shape the uptake and enactment of pain-related learning. This study explored recent graduates’ experiences of preparation for pain management and examined personal, contextual, and systemic influences that help explain differences in readiness during the transition to practice.

To analyze the quality of community home based palliative care(CHBPC) services / model toward HIV/AIDS patient care and support in Zomba District of Malawi. With focus to impact of strengthening Community based organizations(CBO) or faith based organizations ( FBO), extent of sustainability, unmet need/whish list and standard measure for organization capacity required by service Providers ,actors. Are the service rendered effective and efficient to the beneficiaries

Nurses are frontline healthcare professionals who assess patients’ pain throughout hospitalization and play a central role in implementing pain management plans. Therefore, adequate pain knowledge and positive attitudes among nurses are essential for effective pain assessment and management. However, knowledge gaps may persist despite increasing educational resources. This study evaluated nurses’ knowledge and attitudes regarding pain assessment and management using the Thai Knowledge and Attitudes Survey Regarding Pain (Thai-KASRP) among nurses at Siriraj Hospital, a tertiary care center in Thailand, and identified factors associated with higher scores.

Burnout is relevant to medical settings due to its high global prevalence among physicians (1), association with medical error (2), and its personal and systemic costs (3, 4). US pain physicians have experienced increasing levels of burnout since the COVID-19 pandemic (5). To combat this trend, a wellness program was developed and implemented in an ACGME-accredited pain fellowship. Over the course of the training year, fellows participate in scheduled sessions designed to cultivate a sense of community, increase awareness of well-being threats, and develop skills to enhance resilience and minimize burnout. Analysis of program impact is presented in the current poster.

Chronic itch represents a common yet underestimated public health problem due to its prevalence of ~20%, the negative impact on quality of life and the lack of optimal treatments. According to the biopsychosocial model, internal and external factors are involved in itch perception 1. Although placebo effect is well established in pain treatment, little is known about this phenomenon in chronic itch 2. Evidence suggests placebo can improve pruritus, overall symptoms, and quality of life in chronic itch conditions 3.
This study aimed to evaluate the placebo effect on itch perception in healthy volunteers and its relationship with psychological factors.

Pain is a complex, subjective experience influenced by contextual, affective, and cognitive factors1,2. Recently, machine learning has been increasingly applied to EEG data to identify pain biomarkers3,4. However, several methodological limitations have hindered their development, such as small sample sizes and the lack of external validation across independent datasets. While large datasets are increasingly made publicly available, most focus on a single pain modality and do not offer adequate non-painful aversive control conditions. We therefore present a dataset combining multimodal physiological signals with diverse painful and aversive control conditions.

Transcranial Magnetic Stimulation coupled with electroencephalography (TMS-EEG) targeting the primary motor cortex (M1) enables the study of cortical excitability, oscillatory dynamics and cortical complexity during pain [1]. Experimental pain reduces cortical excitability [2] and alters oscillatory dynamics [3], while reduced cortical complexity has been reported in fibromyalgia [4]. Cortical excitability is known to be affected by age [5], but not by sex. Furthermore, it remains unclear whether cortical oscillatory dynamics and complexity show age and sex- related differences. Understanding the effect of age and sex is relevant when building normative data and designing pain studies where TMS-EEG is employed.

Borderline personality disorder (BPD) is a severe psychiatric disorder characterized by reduced pain sensitivity (1) and non-suicidal self-injurious behavior (NSSI) as dysfunctional emotion-regulation strategy (2). While some individuals report no pain during NSSI, for others, the experience of pain during NSSI serves an emotion-regulatory function (3). This study examines whether the nociceptive input or rather the perception of pain contributes decisively to the soothing effect of NSSI in BPD. To this aim, we use the thermal grill illusion (TGI), an experimental paradigm to induce a painful heat sensation evoked by an alternating pattern of non-nociceptive warm and cold stimuli (4).

Experimental models of secondary hyperalgesia in humans suggest that nociceptive sensitization modulates the processing of non-nociceptive stimuli [1, 2]. After high-frequency electrical stimulation (HFS), vibrotactile stimuli delivered to the hyperalgesic area elicit enhanced cortical responses, reflected in increased N140 event-related potentials [1]. However, N140 amplitude is also modulated by spatial attention [3], a factor not controlled in previous studies. Consequently, the reported increase may partly reflect attentional allocation to the stimulated arm rather than sensitization alone. Therefore, the present study aimed to replicate these findings [1] while explicitly controlling attentional allocation to vibrotactile stimuli presented after HFS.

Repetitive transcranial magnetic stimulation (rTMS) to the primary motor cortex and dorsolateral prefrontal cortex reduces pain and affects oscillatory alpha activity. The primary objective of this pre-registered secondary analysis was to investigate whether rTMS delivered to the posterior superior insula (PSI), an emerging target in rTMS pain treatment, has modulatory effects on specific resting-state oscillatory alpha features (i.e. peak alpha frequency (PAF), power, and frontal alpha asymmetry). Secondary objectives explored associations between alpha features and effects of PSI-rTMS on experimental pain, and whether baseline alpha features predict individual responses to PSI-rTMS.

Background

Transcranial direct current stimulation (tDCS) is widely used to probe causal links between cortical excitability and cognition, but reliable single-session effects in healthy adults remain debated. Emotion–attention tasks are especially useful for testing neuromodulatory claims because task-irrelevant emotional stimuli can interfere with goal-directed behavior. Event-related potentials (ERPs) provide temporally precise markers of this processing cascade, from early perceptual gain to later emotional evaluation. However, repeated exposure to the same task can itself alter ERP amplitudes, making it important to separate stimulation-specific effects from repetition-related neural dynamics.

Aims

This study examined whether a single session of anodal tDCS modulates behavioral performance and ERP markers of emotion–attention processing in healthy adults. A second aim was to test whether a within-subject, double-blind crossover design could dissociate acute neuromodulatory effects from changes driven by task repetition.

Inter-individual differences in electrophysiological markers of adaptive neuronal responses to pain, may be related to pain processing and perception. Reduced neuro-adaptability of motor and somatosensory cortical excitability has been associated with prolonged pain and increased susceptibility to chronic pain. Multimodal electroencephalography (EEG) provides comprehensive insights into pain-related cortical excitability changes. This study integrates assessments of cortical motor, nociceptive and sensory excitability before and during tonic experimental pain, using transcranial magnetic stimulation-evoked potentials (TEPs), somatosensory-evoked potentials (SEPs), contact heat-evoked potentials (CHEPs), and auditory-evoked potentials (AEP). Integrating markers of cortical excitability may enable a more detailed characterisation of individual neuro-adaptability to pain.

Beyond pain itself, managing a long-term condition places ongoing cognitive and emotional demands on patients [1]. Many people with report difficulties with concentration, attention, memory, and executive functions. These cognitive difficulties can be distressing and may hinder a patient’s ability to manage their condition [2]. Research has shown that patients who struggle to recall treatment, advice and self-management strategies accurately often have poor adherence with medical advice [3,4]. We aimed to investigate whether recounting autobiographical memories of validating (vs invalidating) medical consultations influences recall of health-related information, and to examine whether changes in pain-related fear mediate this effect.

Offset Analgesia (OA) exhibits significant individual variability, yet the underlying mechanisms remain unclear. This study examined whether autonomic reactivity during nociception and specific personality facets predict analgesic efficacy in healthy volunteers.

Homeostatic plasticity maintains neuronal activity within a physiological balance, preventing excessive excitability[1]. In humans, cortical homeostatic-like plasticity (HP-like) can be investigated with two blocks of anodal transcranial direct current stimulation (tDCS). A normal HP-like response is characterized by e.g. decreased motor-evoked potential (MEPs) after two blocks of anodal tDCS (i.e., reversal of excitability) over the primary motor cortex (M1)[2]. The latter HP-like response is impaired during chronic and experimental pain, suggesting a role in pain pathophysiology [3]. Yet, motor and nociceptive HP-like responses have not been examined in parallel. This study aimed to investigate the HP-like response of the motor and nociceptive system using different neurophysiological methods during the same session.

Nocebo hyperalgesia, an increase in pain following an inert intervention, can be acquired through observational learning [1]. Previous studies demonstrate that symbolic modeling (observing a model in a video) induces nocebo hyperalgesia under laboratory conditions [2]. It remains unclear, however, whether similar responses can be triggered by social media, such as TikTok, which frequently spreads treatment-related expectancies, including negative ones [3]. Furthermore, the reversibility of observationally acquired nocebo effects through direct experience is largely unknown. This study aims to test TikTok-based induction of nocebo hyperalgesia, compare it with standard symbolic modeling, and examine modification of these effects by classical conditioning.

Placebo analgesia has recently been conceptualized within the Bayesian brain framework, in which the brain integrates prior expectations with incoming nociceptive signals to generate perceptual experience (Buchel et al 2014). Within this view, expectations function as top-down priors that can bias sensory inference, leading to considerable modulations in perceived pain. A growing body of evidence implicates the dorsolateral prefrontal cortex (dlPFC) in the formation and maintenance of placebo-related expectations (Krummenacher et al. 2010, Koban et al. 2012). However, such evidence is largely correlational (Romanella et al., 2023), leaving the causal contribution of dlPFC activity still a matter of debate.

Animal research suggests fasting attenuates pain arising from sensitization of nociceptive pathways [1], but evidence in humans is scarce. Using established experimental models of nociceptive sensitization, we examined whether overnight fasting reduces secondary mechanical hypersensitivity in healthy volunteers and whether effects depend on fasting duration or sensitization model.

Effective pharmacological pain management remains important to lessen the individual or societal impacts of pain. Despite wide-spread use, however, pharmacological treatments of pain, especially for chronic pain, are only moderately effective at best. To explain variability in painkiller effectiveness, we tested a psychosocial moderation hypothesis of pharmacological analgesia (Gharavi & Mischkowski, 2025) which suggests that dispositional psychosocial factors modulate painkiller effectiveness. Interpersonal attachment style constitutes such an important psychosocial factor – not only regulating pain but likely also pain management (Meredith et al., 2008). We therefore tested whether attachment style modulates the analgesic effects of acetaminophen (paracetamol), a popular over-the-counter painkiller.

Listening to music effectively relieves pain and reduces patients need for analgesics, but the underlying mechanisms of this effect are not well understood. However, music that is considered pleasant, favorite, and preferred is the most effective (1,2). These results suggest the mediating involvement of evaluative and reward processes in the brain in response to music (3). The aims of this study were to 1. Investigate the hypoalgesic role of reward in an fMRI task paradigm through a series of mediation path models 2. Link the effects of music to other pain modulatory processes by assessing changes in expression of pain neurosignatures.

The Reinforcement Learning (RL) framework of pain proposes that nociceptive perception is dynamically optimized to minimize anticipated future harm. Emerging anatomical models, including the Embodied Predictive Interoceptive Coding (EPIC) framework, posit that this optimization is implemented within a hierarchical, layer-dependent architecture of the insular cortex. Cytoarchitectural work suggests that superficial layers of the hypergranular posterior insula (pINS) preferentially project to deep layers of the agranular anterior insula (aINS), supporting feedforward prediction signalling. While this laminar organization has been demonstrated in non-human primates, its functional implementation in humans—and its relevance to pain learning—remains unclear.

The insula shows enhanced high-frequency oscillations under periodic thermonociceptive stimuli perceived as painful, an effect not observed for innocuous non-nociceptive stimuli. [1] Multicontact depth electrodes implanted in epileptic patients offer the unique opportunity to modulate oscillations through Intracerebral Periodic Stimulation (iPS), consisting of biphasic squared pulses delivered to neural tissues at a specific frequency. In this study, insular iPS will be delivered while recording intracerebral EEG to validate entrainment effects on insular oscillations [2] and assess whether the iPS-induced modulation of neural activity affects pain perception. This approach aims to directly test the causal relationship between insular oscillations and pain.

Conditioned pain modulation (CPM) is widely used to assess endogenous pain inhibition and has been proposed as a tool to estimate risk and predict treatment response in chronic pain. However, increasing evidence suggests that CPM assessment and interpretation are more complex than often assumed, potentially
limiting its contribution to pain phenotyping. It is commonly proposed that inhibitory capacity is transiently suppressed following CPM exposure. Here, we examined the stability and variability of CPM responses under repeated testing.

Reduced adaptive responses of the nervous system, i.e., neuro-adaptability, in specific brain regions have been linked to the development of chronic pain, suggesting that restricted cortical flexibility may increase vulnerability to persistent pain. Transcranial Magnetic Stimulation combined with Electroencephalography (TMS-EEG) enables direct assessment of cortical excitability and connectivity. However, consensus is lacking on which TMS-EEG measures best capture neuroadaptive changes associated with pain. This study applies machine learning (ML) to extract complex patterns within the TMS-EEG data beyond classical data analysis approaches. The goal is to establish reliable markers of cortical neuro-adaptability during and following experimental tonic pain.

The intrinsic endogenous capacity to modulate pain has been suggested to be linked with better treatment outcomes and less vulnerability to persistent pain. Examples of ways in which pain perception adapts are Conditioned Pain Modulation (CPM), Offset analgesia (OA), and analgesia driven by cognitive and affective engagement. However, the interaction between the different methods of modulating pain is uncertain. This study examines whether OA and CPM are altered following affective or cognitive tasks.

Developing novel anabolic agents for bone regeneration is a clinical priority due to the adverse effects and limited long-term efficacy of existing treatments. Polydeoxyribonucleotide (PDRN), a tissue-regenerative agent widely used in chronic pain management, has shown promise in tissue repair; however, its specific mechanisms within bone metabolism remain poorly understood. This study aimed to elucidate the direct cellular effects and molecular mechanisms of PDRN on osteoblasts and osteoclasts and to evaluate its therapeutic efficacy in an in vivo osteoporosis model.

Pain corresponds to electrical brain oscillations across frequency bands. Greater alpha (8-12 Hz) power and faster (10-12 Hz) peak alpha frequency (PAF) correspond to lower pain sensitivity[1], theta (4-8 Hz) power is greater in low-back pain patients than controls[2], and gamma (30-90 Hz) power correlates with pain intensity[3]. Neural pain signals may be integrated across frequencies via phase-amplitude coupling (PAC) – alignment between low-frequency (alpha/theta) phase and high-frequency (gamma) amplitude[4]: Decreased alpha-gamma, and increased theta-gamma coupling is present in neuropathic pain[5]. Here, we tested whether the relationship between PAC and pain generalizes to acute experimental pain in healthy controls.

Persistent pain has been associated with alterations in brain oscillations, particularly peak alpha frequency (PAF), where slower PAF in some individuals is linked to chronic pain and increased pain sensitivity during experimental tonic pain [1, 2, 3]. This may involve individual degrees of brain neuroadaptability to pain (NAP), defined as the brain’s ability to adjust to acute pain exposure [4]. Individual differences in NAP are here exemplified by alterations in the pain regulatory system such as variable pain sensitivity and efficacy of conditioned pain modulation (CPM). Further, preliminary studies show that entrainment of PAF is possible through transcranial alternating current stimulation (tACS) [5]. Whether the entrainment effects of tACS can be increased when combined with sensory entrainment (SE) is unknown. Therefore, this study aims to investigate tACS, SE, and a combination of the two, for increasing PAF, and whether such modulation positively affects the CPM-effect.

The Social Communication Model of Pain (SCM; Craig, 2015) proposes that judgements made about individuals experiencing pain are influenced by both characteristics of the person in pain and characteristics of the observer. This study investigated whether: (1) individuals displaying high pain behavior (HPB) would be perceived more negatively than those displaying low pain behavior (LPB), and (2) observers’ psychopathic traits would be associated with their ratings of individuals with chronic pain. It was hypothesized that: (1) individuals displaying HPB would be perceived as vulnerable to exploitation, and (2) observers’ psychopathic traits would be positively associated with ratings of exploitability.

The transition from acute to chronic pain may depend on an individual’s brain response to acute pain [1], herein referred to as brain neuro-adaptability to pain. One region known to exhibit such neuro-adaptability is the primary motor cortex (M1), which undergoes a net inhibitory excitability shift during tonic experimental pain [2,3,4]. However, how M1 neuro-adaptability relates to individual pain sensitivity and risk factors for chronic pain development remains unclear. This study combines measures of cortical excitability and local neurotransmitter levels, specifically glutamatergic and γ-aminobutyric acid (GABA)ergic, assessed via transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) and magnetic resonance spectroscopy (MRS), before and during tonic capsaicin-induced pain. The aim is to characterize M1 neuro-adaptability to pain by means of cortical excitatory and neurotransmitter changes occurring during tonic experimental pain and how they relate to an individual’s pain sensitivity.

Chronic neck pain (CNP) is a common musculoskeletal condition worldwide. Psychological symptoms such as anxiety, depression, kinesiophobia and pain catastrophizing are frequently observed in individuals with CNP; however, their relationship with patient-reported outcomes remains unclear. This systematic review aimed to examine the associations between these psychological factors and patient-reported outcomes, including pain intensity and neck disability, in individuals with CNP.

Pain facilitates defensive responses aimed at preventing further bodily harm, often by avoiding potentially painful actions. Although avoidance behaviour has been extensively studied, the contribution of motor preparation processes in the brain to pain-related avoidance is poorly understood. This study investigated motor preparation in a virtual reality (VR) motor choice task in which movements to one side resulted in experimentally induced pain and movements to the other side not. We hypothesized that avoidance (i.e., choosing movements not resulting in pain) would be associated with stronger motor preparatory activity in the brain.

Repetitive transcranial magnetic stimulation (rTMS) to primary motor cortex (M1) has been used to treat chronic neuropathic pain and fibromyalgia [1,2]. However, fewer than 50% of patients experience pain relief. Factors determining why a chronic pain patient respond to rTMS are not fully understood. Pre-treatment electroencephalographic combined with TMS (TMS-EEG) can be used to assess TMS-evoked oscillatory dynamics and cortical reactivity such as inter-trial coherence (ITC) and local mean field power (LMFP) [3]. In 90 chronic pain patients a baseline TMS-EEG assessment was used to investigate if such parameters predict the analgesic response to 12 sessions of 10Hz rTMS.

Pain memories are not mere reproductions of past sensations but reconstructions shaped by how bodily and emotional signals are perceived and regulated. Interoceptive processes may therefore play a crucial role in how painful experiences are encoded and recalled. Dancers, through years of training that demand continuous attention to internal states and precise motor control, represent a valuable model for investigating the relationship between interoception, pain, and memory. This study examined whether individuals with dance training differ from non-dancers in interoceptive abilities, pain perception, and recall of a previous painful episode.

Astronauts have 21 times higher risk of cervical intervertebral disc (IVD) herniation [1], yet there is limited data on potential causes and existing data predominately focus on the lumbar spine [2]. We aimed to examine alterations in the cervical spine after spaceflight that may be associated with the risk for disc herniation development [3].

Pain becomes more likely and prevalent with advancing age, as does the likelihood of receiving pain therapy; yet research on placebo hypoalgesia, which takes into account age effects, remains limited. The few existing studies directly comparing younger and older individuals suggest largely preserved placebo responses in later life [1]; however, the potentially altered underlying mechanisms, as well as possible compensatory processes, have yet to be systematically elucidated.
To this end we employed a placebo cream paradigm comparing younger and older participants and assessed treatment expectancy in addition to indicators of placebo hypoalgesia.

Increasing evidence shows that atypical sensory responsiveness is associated with altered somatosensory processing, including increased pain responses, atypical temporal summation, and abnormal aftersensations, suggesting involvement of central modulatory mechanisms rather than peripheral changes alone. Additionally, aversive responsiveness has been identified as a major contributor to individual differences in daily pain sensitivity and psychological distress, further underlining its relevance to somatosensory functioning. This study examines how sensory responsiveness relates to tactile and pain sensitivity measures to clarify whether specific traits of sensory modulation are linked to primary perceptual and discrimination acuity, central sensory gain, or affective touch processing.

Spinal cord stimulation has previously shown to mitigate pain (1,2), but the analgesic potential of non-invasive repetitive spinal magnetic stimulation (rsMS) remains under investigated (3). Experimental pain is associated with sensorimotor alpha power attenuation in electroencephalographic (EEG) recordings (4). In this protocol, rsMS is hypothesized to decrease experimental pain and effect pain-related cortical power attenuation by rsMS. This study aims to compare the effects of active and sham cervical rsMS on EEG oscillatory activity and pain ratings during experimentally induced pain in healthy participants.

The menstrual cycle is associated with changes in mood, sleep, and pain. Menstrual pain has a prevalence of 71.1% and has a substantial impact on disability and public health. Yet we have limited knowledge about the dynamics of how pain, health outcomes, and behavior change throughout the menstrual cycle, and how these are related to hormonal fluctuations. Here we used ecologically momentary assessment (EMA) to assess daily changes in various parameters throughout a full menstrual cycle. We compared women with natural menstruation (NM group) with women using combined hormonal oral contraceptives (CC group).

Pain is commonly interpreted as a direct indicator of tissue damage, despite evidence that pain is shaped by contextual and expectancy-related factors. Laboratory studies demonstrate placebo and nocebo effects on pain experiences using precise experimental stimuli (e.g., thermal laser). However, it remains unclear whether these expectancy effects extend to ecologically valid, threat-relevant tasks that more closely resemble real-world experiences. Therefore, this study examined expectancy framing associated with stepping on LEGO® bricks while barefoot. Biomechanical measurements were used to determine whether changes in perceived pain and perceived tissue damage occurred independently of altered loading strategies.

Chronic pain is often intractable and treatment requires a significant amount of time and effort. However, patient satisfaction is often not commensurate with treatment contribution. Patient satisfaction is difficult to obtain with treatment efficacy in cases of chronic pain. However, patient satisfaction with treatment can affect treatment strategy and prognosis. This study aimed to examine the factors associated with treatment satisfaction in patients with chronic pain using a pain-related scale.

Trigeminal neuralgia (TN) is a severe pain disorder without any new approved therapies since 1968. The metabotropic glutamate 5 receptors (mGluR5) play a key role in the development and expression of neuropathic pain. Following nerve injury or inflammation, mGluR5 is overexpressed in central (spinal cord, brainstem) and peripheral (trigeminal and dorsal root ganglia, primary afferent terminals) components of pain pathways, further amplifying nociceptive signaling and contributing to pain hypersensitivity.
Basimglurant, a selective, potent, and potential first-in-class mGluR5 negative allosteric modulator (NAM), targets central sensitization and peripheral pain mechanisms.

Triple-negative breast cancer (TNBC), defined by the absence of hormone receptors and HER2 expression, represents a highly aggressive subtype with limited therapeutic options, underscoring the urgent need to elucidate novel mechanisms governing its progression. Accumulating evidence suggests that sensory neurons innervating the tumor microenvironment exert functions beyond nociception, actively modulating cancer cell behavior and immune landscapes through activity-dependent release of neuropeptides. However, the temporal dynamics of neuron-derived molecular changes during TNBC progression, and their stage-specific functional implications, remain entirely undefined. This study aimed to evaluate time-dependent changes in sensory neuronal remodeling during breast cancer progression.

Descending pain modulation, commonly assessed using dynamic quantitative sensory testing (QST) paradigms such as conditioned pain modulation (CPM), temporal summation of pain (TSP), and offset analgesia (OA), reflects the balance between inhibitory and facilitatory processes in the central nervous system [1-4]. Dysregulation of these mechanisms is a hallmark of chronic pain [5-8]. Beyond pain perception, emerging evidence suggests a functional link between pain modulation and the motor system [9-11]. However, existing research has only focused on CPM effects at reflex-level outcomes in healthy individuals [11], with limited synthesis of other types of QST and voluntary motor responses. This systematic review and meta-analysis aimed to evaluate how descending pain modulation influences motor responses in individuals with clinical or experimentally induced pain.

Patients with peripheral arterial disease (PAD) often suffer from chronic pain symptoms including intermittent claudication. However, pathophysiology of peripheral ischemic pain in PAD has not been fully understood. We have previously demonstrated that P2X3,2/3, ASIC3 regulated by nerve growth factor and Vascular endothelial growth factor (VEGF)-A165a-VEGFR1 signaling may play important roles in ischemic muscle hyperalgesia associated with PAD. It has been reported that there is a significant increase in the number of macrophages in dorsal root ganglion (DRG) after peripheral nerve injury, suggesting the crosstalk between nociceptors and non-neuronal cells such as macrophages in DRG. In this study, we investigated the role of　DRG　macrophages on developing muscle hyperalgesia in a rat model of PAD.

Early discovery programs in pain require rapid strategies to de‑risk efficacy and tolerability before committing to fully powered, single‑model studies. SPIDAR (Screening Paradigm to Identify Drug Analgesic Response) was developed as a streamlined in vivo screening platform delivering a decision‑ready “analgesic fingerprint” to support early GO/NO‑GO decisions.

The mechanosensitive ion channel Piezo2 is essential for light touch perception, as deletion in sensory neurons results in profound deficits in innocuous mechanical sensation while sparing nociceptive responses [3]. The voltage‑gated sodium channel NaV1.8 is predominantly expressed in nociceptive neurons and plays a central role in peripheral pain signaling. In nociceptor‑associated neurons, Piezo2 knockdown has been reported to alleviate pain‑related behaviors in osteoarthritis models [2]; however, it remains unclear whether similar effects extend to other pain contexts or neuronal populations. Importantly, behavioral baseline phenotyping is required to distinguish primary genetic effects from model‑specific pain alterations. Prior to applying Piezo2 conditional knockout models in disease‑specific pain paradigms, it is therefore essential to establish baseline sensory and pain‑related behaviors. Here, we assessed behavioral outcomes following Piezo2 deletion in NaV1.8 and in Advillin‑positive sensory neurons.

Perioperative pain management modality potentially influences psychiatric morbidity and healthcare utilization. The opioids have been most commonly used for managing postoperative pain and carry a high degree of risk for creating mood disorders, anxiety, sleep disturbances, and healthcare burdens. A novel non-opioid analgesic, Suzetrigine, may be able to effectively manage postoperative pain without some of the psychological and economic risks that come from the use of opioids. In this study, we measured psychiatric outcomes and emergency department (ED) usage among postoperative patients who received either suzetrigine or opioids.

Sleep and pain are bidirectionally related, yet despite consistent day-to-day evidence, within-person dynamics at longer timescales remain poorly understood. We examined bidirectional sleep–pain coupling quarterly in adults from a knee pain study, and tested whether baseline pain-evoked brain activation in a priori regions moderated this coupling.

Knee osteoarthritis (OA) is the most prevalent form of OA and a leading cause of years lived with disability worldwide [1]. Clinical diagnosis is based on symptoms such as pain, stiffness, and functional limitations [2,3]. How an individual thinks about and interprets the condition can be crucial in explaining variations in pain and disability in patients with OA, since pain is a complex and subjective experience influenced by biological, psychological, and social factors [4-8]. Among these, psychosocial factors, such as beliefs about the condition, can influence how individuals interpret and respond to their symptoms, potentially affecting the experience of pain and disability and leading to avoidance of physical activity, which can limit physical function in the long term [6-8]. The Osteoarthritis Conceptualization Questionnaire (OACQ) assesses beliefs about the disease. This study aimed to investigate the association between beliefs about osteoarthritis and disability in individuals with knee osteoarthritis (OA).

This study aimed to evaluate clinical characteristics, magnetic resonance imaging (MRI) findings, and treatment outcomes of patients presenting with trigeminal neuralgia (TN), with a focus on differences between dental procedure–associated and spontaneous onset cases, as well as the role of neurovascular compression (NVC).

Pain is a leading reason for seeking medical care worldwide1, yet access to adequate assessment and management remains uneven, particularly for deaf patients2. Evidence shows that deaf individuals face increased risks of misdiagnosis, inadequate treatment, and poorer health outcomes3,4 — disparities further exacerbated in chronic pain, a complex condition affecting over 30% of people worldwide5. Pain communication remains a central challenge for both deaf patients and clinicians, directly shaping assessment, clinical decision-making, and care quality6. In this context, digital health technologies offer significant—yet underexplored—potential to support pain communication by enabling more accessible, multimodal, and patient-centred interactions that better capture lived experience. However, there is limited systematic knowledge on the barriers and facilitators of pain communication in this population, and existing digital solutions neither address these factors nor adopt user-centred approaches. This study addresses this gap by co-developing an evidence-based digital intervention – SIGNPAIN - designed to enhance pain communication.

Vitamin D deficiency has been linked to a wide range of chronic conditions, including chronic pain. In my clinical practice, I have routinely investigated vitamin D status and advised supplementation for patients found to have low 25-hydroxyvitamin D levels.
Over years of clinical experience and continued learning, I have come to understand that vitamin D is only one part of a much larger picture. It does not function in isolation. For vitamin D to work optimally, the body also requires a range of other essential micronutrients many of which are commonly neglected, depleted through modern lifestyle factors, or insufficiently obtained through diet alone.
These two case reports highlight the benefits of appropriate nutritional assessment and targeted nutritional advice.

Chronic pain remains a leading cause of disability worldwide, imposing substantial individual and societal burdens and underscoring the need for non-pharmacological strategies that target endogenous pain modulation¹,². Athletes consistently demonstrate higher pain thresholds and tolerance than non-athletes, an adaptation attributed to repeated high-intensity training and the phenomenon of exercise-induced hypoalgesia (EIH)³⁻⁵. Impaired conditioned pain modulation (CPM) is a hallmark of many chronic pain conditions, making interventions that engage descending inhibition particularly clinically valuable. Beyond physiological mechanisms, psychological factors, including optimism, pain catastrophizing, and perceived social marginalization, influence pain sensitivity and may affect how individuals respond to exercise-based interventions⁶⁻⁹. However, whether repeated high-intensity interval training (HIIT) affects pain sensitivity and its association with psychological factors in non-athletic populations remains poorly understood. Therefore, we examined whether HIIT sessions, single or repeated, would (1) reduce experimental pain sensitivity, (2) enhance conditioned pain modulation efficiency, and (3) alter psychological factors in pain-free, non-athletic adults.

Pain is a multidimensional experience explained by the biopsychosocial model, involving biological, psychological, and social factors [1,2]. Current pain assessment relies mainly on subjective self-report tools, which have limitations, particularly in non-verbal populations [3]. This has increased interest in objective measures based on, e.g. autonomic nervous system responses, including electrodermal activity (EDA), heart rate, and respiration, with EDA considered one of the promising biomarkers [4–6].
This study aims to examine whether smartwatch-derived EDA can objectively reflect pain intensity during experimental thermal heat stimulation and to investigate the relationship between psychological factors (catastrophizing, depression, anxiety, and stress) and EDA responses.

Driving is a complex task that requires focus, decision-making, and spatial awareness, all of which can be disrupted by pain. Our previous findings demonstrated that drivers with chronic low back pain (CLBP) frequently experience discomfort from prolonged sitting, movement restrictions, and pain-associated emotional distress, which may significantly affect their driving experience and safety. While existing research links CLBP with objective/quantitative driving deficits, such as delayed response times and increased crash risk, there is a deficit of qualitative research to facilitate a deeper understanding of the lived experiences of drivers with CLBP. In order to address this gap, this study utilized qualitative methods to examine how individuals with CLBP experienced driving-related pain and the strategies they use to cope behind the wheel.