Current Pain And Headache Reports[JOURNAL]
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200 papers
A Systematic Review and Meta-Analysis of Randomized Controlled Trials of Epidural Regenerative Medicine Therapies in Managing Spinal Pain.
Manchikanti L, Abd-Elsayed A, Jin MY … +5 more , Kaye AD, Sanapati MR, Atluri S, Boddu N, Hirsch JA
Curr Pain Headache Rep · 2026 Jun · PMID 42334678 · Publisher ↗
PURPOSE OF REVIEW: This review aims to assess the effectiveness of epidural injections of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in treating chronic spinal pain. While existing literature has primar...
PURPOSE OF REVIEW: This review aims to assess the effectiveness of epidural injections of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in treating chronic spinal pain. While existing literature has primarily concentrated on intradiscal regenerative therapies, this systematic review focuses specifically on the efficacy of PRP and MSCs when administered into the epidural space for managing chronic spinal pain. RECENT FINDINGS: Due to their anti-inflammatory and regenerative properties, emerging studies underscore the therapeutic promise of epidural biologics, including MSCs, platelet-rich plasma, and alpha-2-macroglobulin. Epidural administration offers key advantages: it avoids the risk of discitis and minimizes the chance of disc injury from needle penetration. Moreover, this route enables simultaneous treatment of multiple affected discs without discography or multiple intradiscal injections. This is particularly relevant in elderly patients who often present with advanced disc degeneration and narrowed disc spaces, making intradiscal injections technically difficult. Clinical findings suggest notable improvements in pain reduction, physical functionality, and overall quality of life following these epidural treatments. A total of 9 randomized controlled trials (RCTs) were included in the review to evaluate epidural biologics for chronic spinal pain management. No RCTs investigating stem cells were identified. The quality of evidence was rated as fair (Level III), with moderate effect size and recommendation strength based on a qualitative synthesis and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology.
Artificial Intelligence in Neuropathic Pain: From Mechanisms to Neuromodulation and Regenerative Strategies.
Lo Bianco G, Deer TR, Occhigrossi F … +7 more , Diwan S, Mercieri M, D'Angelo FP, Martinez SM, Day MR, Navani A, Abd-Elsayed A
Curr Pain Headache Rep · 2026 Jun · PMID 42277490 · Publisher ↗
PURPOSE OF REVIEW: Neuropathic pain remains challenging due to its heterogeneous mechanisms and variable treatment response. This narrative review evaluates recent advances in artificial intelligence (AI) and machine lea...
PURPOSE OF REVIEW: Neuropathic pain remains challenging due to its heterogeneous mechanisms and variable treatment response. This narrative review evaluates recent advances in artificial intelligence (AI) and machine learning (ML) for patient phenotyping, treatment selection, outcome prediction, neuromodulation, and regenerative therapies. RECENT FINDINGS: ML-based phenotyping integrates genomic, neuroimaging, sensory, and behavioral data. Multimodal automatic pain assessment is approaching clinical deployment, supported by recent expert consensus. Large language models have been benchmarked against multidisciplinary teams for spinal cord stimulation (SCS) candidate selection. Real-world cohort data confirm sustained 24-month SCS benefit. AI is increasingly applied to regenerative interventions, including pulsed radiofrequency, which is now linked to epigenetic remodeling of dorsal root ganglion pathways. Most studies remain single-center and retrospective. AI may enable mechanism-based stratification, individualized neuromodulation programming, and rational integration of regenerative therapies in the treatment of neuropathic pain. Robust prospective validation, transparent reporting, and ethical safeguards are required before approaching translational maturity in selected settings.
Proposed Conditions for Pain Reprocessing Therapy Readiness: Beyond Phenotyping Neuroplastic Pain.
Thérond A, Starnino L, Robinson CL
Curr Pain Headache Rep · 2026 Jun · PMID 42277439 · Publisher ↗
PURPOSE: This paper examines the clinical gap between identifying neuroplastic pain and achieving treatment success with Pain Reprocessing Therapy (PRT), proposing a structured readiness framework to guide clinicians in...
PURPOSE: This paper examines the clinical gap between identifying neuroplastic pain and achieving treatment success with Pain Reprocessing Therapy (PRT), proposing a structured readiness framework to guide clinicians in determining when patients are appropriately positioned to engage with this intervention for chronic primary pain. RECENT FINDINGS: Despite a randomized controlled trial demonstrating that approximately 66% of PRT participants achieved pain-free or nearly pain-free status at one year, no implementation guidelines exist for establishing patient readiness prior to initiating treatment. This paper proposes ten conditions across four domains: patient cognitive readiness, patient behavioral readiness, provider alignment, and system-level factors. Evidence from pain neuroscience education, the fear-avoidance model, stages of change literature, and therapeutic alliance research supports the theoretical grounding of each condition. Emotional Awareness and Expression Therapy is proposed as an adjunctive intervention for patients whose pain is sustained by unresolved trauma or emotional inhibition beyond the reach of cognitive reattribution alone. Neuroplastic pain identification is necessary but may be insufficient for PRT success. Unmet readiness conditions spanning cognition, behavior, provider practice, and healthcare systems may explain a meaningful proportion of limited treatment responses. These proposals require empirical validation before clinical adoption and should be treated as hypotheses to guide implementation research rather than established practice guidelines.
Treatment of Headache in Children and Adolescents with POTS.
Nayak K, Rahman S, Oakley C
Curr Pain Headache Rep · 2026 Jun · PMID 42257809 · Publisher ↗
PURPOSE OR REVIEW: This review provides an overview of POTS in children and adolescents with headaches, with a focus on the pharmacologic and non-pharmacologic treatment approaches. RECENT FINDINGS: Current research in h...
PURPOSE OR REVIEW: This review provides an overview of POTS in children and adolescents with headaches, with a focus on the pharmacologic and non-pharmacologic treatment approaches. RECENT FINDINGS: Current research in headache and POTS focuses on an individualized management that includes a multi-tiered patient-centric approach that selects treatments to match specific phenotypes. The management of pediatric POTS and headache requires the individualized characterization of a patient's phenotype, an assessment of an individual's contributing lifestyle factors, the use of non-pharmacologic interventions, and the consideration of pharmacologic options.
Pediatric Headache in the Age of Social Media: A Topical Review.
Pickup E, Takle M, Langdon R
Curr Pain Headache Rep · 2026 May · PMID 42213272 · Publisher ↗
PURPOSE OF REVIEW: The aims of this topical review are to (1) summarize existing literature over the last 5 years investigating the effects of social media use on headaches in children and adolescents; (2) propose potent...
PURPOSE OF REVIEW: The aims of this topical review are to (1) summarize existing literature over the last 5 years investigating the effects of social media use on headaches in children and adolescents; (2) propose potential risks and benefits of social media use relevant to pediatric headache; and (3) offer future directions for research and clinical care in this area. RECENT FINDINGS: Few studies have examined social media effects in youth with headache disorders. Limited available survey data suggests increased duration social media use may be associated with increased pediatric headache incidence and intensity, though with significant limitations identified in study designs and methodological approaches. Notably, no studies found examined potential benefits of social media for youth with headaches. We propose considering both risks and benefits of social media effects for youth with headache given their potential to influence key pain-related and lifestyle domains including physical activity, sleep, mental health, and health-related knowledge. Further research utilizing longitudinal study designs and objective measures are needed to better understand the effects of social media on pain and health-related outcomes in youth with headaches.
Radiopharmaceuticals for the Treatment of Chronic Cancer Pain.
Anwar AI, Nytes GM, Shiferaw BT … +3 more , Shekoohi S, Abd-Elsayed A, Kaye AD
Curr Pain Headache Rep · 2026 May · PMID 42213224 · Publisher ↗
PURPOSE OF REVIEW: Cancer-induced bone pain is a frequent, debilitating complication seen in metastatic cancers and often poorly controlled with conventional analgesics. Radiopharmaceutical therapy offers a targeted pain...
PURPOSE OF REVIEW: Cancer-induced bone pain is a frequent, debilitating complication seen in metastatic cancers and often poorly controlled with conventional analgesics. Radiopharmaceutical therapy offers a targeted pain relief with beta emitters providing sustained analgesia and alpha emitters offering potent cytotoxicity and survival benefits. RECENT FINDINGS: Emerging agents such as Lu-EDTMP show promising pain palliation with manageable toxicity. Radiopharmaceutical therapy enables systemic treatment of bone metastases and reduces opioid dependence while complementing local therapies. This review aims to summarize the mechanisms, clinical evidence, advantages, limitations, and future directions of radiopharmaceutical therapy in the management of cancer-induced bone pain.
Erythromelalgia: Pathophysiology and Clinical Treatment Options, a Narrative Review.
Noble RK, Duplechin MO, Anwar AI … +3 more , Fox CJ, Shekoohi S, Kaye AD
Curr Pain Headache Rep · 2026 May · PMID 42207226 · Publisher ↗
PURPOSE OF REVIEW: Erythromelalgia (EM) is an uncommon, multifaceted neurovascular pain disorder. The distal extremities are typically affected, with symptoms of overwhelming warmth, burning pain, and erythema. There is...
PURPOSE OF REVIEW: Erythromelalgia (EM) is an uncommon, multifaceted neurovascular pain disorder. The distal extremities are typically affected, with symptoms of overwhelming warmth, burning pain, and erythema. There is a wide range of presentations with varying severities and courses, including occasional flares, intermittent episodes, and chronic debilitating discomfort. In this narrative review, we aim to raise awareness of EM and synthesize the current state of knowledge through exploring pathophysiology, clinical presentation, differential diagnoses, and treatment options for EM. RECENT FINDINGS: Patients adapt by avoiding triggers, such as excessive heat exposure and exercise, and utilizing various cooling and relaxation methods to seek relief. Physicians individualize treatment based on the unique patient presentation to focus on symptom management: lifestyle changes, pharmacologic methods, pain-relieving medication (aspirin), sodium channel blockers (lidocaine, bupivacaine), and procedural strategies such as botulinum toxin injection or dorsal root ganglion stimulation. EM is classified as either primary, secondary, or idiopathic. Customized approaches for pain management are necessary for the differing presentations of EM. However, diagnosing EM is challenging because there are many overlapping features with other conditions, for example, cellulitis and complex regional pain syndrome. Differential diagnoses and the process of elimination are crucial to the diagnosis of EM. Future investigations should more clearly outline the diagnostic criteria and develop effective targeted treatments for EM. While large-scale clinical trials may be unattainable related to the rarity of EM, the field requires smaller studies and further research to fill these knowledge gaps.
The Multifaceted Role of Social Media in Pain Medicine: Innovation, Education, Patient Engagement, and Challenges.
Therond A, Robinson C, Viswanath O … +2 more , Hasoon J, Yazdi C
Curr Pain Headache Rep · 2026 May · PMID 42176057 · Publisher ↗
PURPOSE OF REVIEW: This article reviews the expanding role of social media in pain medicine, examining its impact on professional education, innovation dissemination, and patient engagement, with a focus on low back pain...
PURPOSE OF REVIEW: This article reviews the expanding role of social media in pain medicine, examining its impact on professional education, innovation dissemination, and patient engagement, with a focus on low back pain-related content and the need for training clinicians to evaluate online health content. RECENT FINDINGS: Social media platforms such as YouTube, Instagram, TikTok, Facebook, and Twitter now play a central role in pain medicine for education, professional networking, patient engagement, practice promotion, and the dissemination of innovations in pain management. Within pain medicine, particularly in the context of prevalent conditions such as chronic low back pain, these platforms directly influence patient beliefs, expectations, and treatment decisions. A growing number of patients with limited access to specialist care rely on social media as a primary source of clinical guidance, raising concerns about health equity and the quality of information encountered. Research demonstrates that structured social media-based pain education can improve pain neuroscience understanding and self-management, while analyses of platform content reveal that a significant proportion of videos addressing pain-related topics are inaccurate or misaligned with established clinical guidelines. Misinformation about pain medications and opioid treatments circulates widely, and algorithmic recommendation systems may amplify engagement-driven content over accurate content. Financial conflicts of interest are frequently undisclosed in clinician-produced posts, and patients generally cannot distinguish reliable from unreliable material. Social media presents substantial opportunities and risks for pain medicine. Its low cost, speed, and wide reach can enhance knowledge sharing, support patient communities, and accelerate dissemination of clinical innovations. However, these same qualities facilitate misinformation, unregulated content, and ethical challenges. To maximize benefit and minimize harm, clinicians and healthcare institutions should produce accurate, evidence-based content; follow professional guidelines; direct patients toward reliable sources; and incorporate digital and social media literacy into formal training curricula.
Regional Anesthesia for Penile Inversion Vaginoplasties.
Davis JS, Ogunsakin A, Ashiru B … +3 more , Haywood A, Patel A, Adams C
Curr Pain Headache Rep · 2026 May · PMID 42171957 · Publisher ↗
PURPOSE OF REVIEW: Penile inversion vaginoplasty is a complex procedure performed as part of gender-affirming care. It is a highly complex procedure involving extensive genital deconstruction and reconfiguration. As a re...
PURPOSE OF REVIEW: Penile inversion vaginoplasty is a complex procedure performed as part of gender-affirming care. It is a highly complex procedure involving extensive genital deconstruction and reconfiguration. As a result, effective post-operative pain control is a central component of perioperative care in this patient population. This review aims to synthesize and consolidate the current evidence on regional anesthesia techniques for postoperative pain management in patients undergoing penile inversion vaginoplasty. RECENT FINDINGS: Effective pain management is critical, as inadequate control has been associated with decreased patient satisfaction, prolonged hospital stays, increased opioid consumption, delayed ambulation, and higher overall healthcare costs. Pain management strategies emphasize multimodal analgesia, incorporating acetaminophen, nonsteroidal anti-inflammatory drugs, opioids (oral and intravenous), local anesthetic infiltration by surgeons, nerve blocks, and neuraxial anesthesia. Within Enhanced Recovery After Surgery (ERAS) protocols, regional anesthesia, including neuraxial techniques and peripheral nerve blocks, has gained prominence and popularity, with substantial evidence demonstrating a reduction in overall opioid consumption and opioid-related adverse effects across a wide range of surgical procedures. Regional anesthesia is a key component of multimodal analgesia and ERAS pathways in penile inversion vaginoplasty. Consolidating current evidence may help clarify its role in optimizing postoperative pain control, reducing opioid exposure, and improving recovery and patient-centered outcomes in this population.
Correction: Brain-Centered Interventions for Nociplastic Pain: From Symptom Management to Pain Resolution.
Thérond A, Yuan C, Aiyer R … +6 more , Hasoon JJ, Yong RJ, Inbar AS, Starnino L, Kulich RJ, Robinson CL
Curr Pain Headache Rep · 2026 May · PMID 42171855 · Publisher ↗
Abstract loading — click title to view on PubMed.
Healing from the Inside Out: Vitamins and Nutritional Strategies for Complex Regional Pain Syndrome and Chronic Postsurgical Pain.
Lopez-Ruiz AA, Anastopulos FD, Trinchet LP … +4 more , Maloney J, Wie C, Viswanath O, Misra L
Curr Pain Headache Rep · 2026 May · PMID 42159818 · Publisher ↗
INTRODUCTION: Complex regional pain syndrome (CRPS) and chronic postsurgical pain (CPSP) are postoperative outcomes that present with debilitating symptoms for patients. The recovery of patients with these conditions is...
INTRODUCTION: Complex regional pain syndrome (CRPS) and chronic postsurgical pain (CPSP) are postoperative outcomes that present with debilitating symptoms for patients. The recovery of patients with these conditions is complicated by the lack of standardized prevention and treatment strategies. Current literature suggests that vitamin C may prevent the development of CRPS. Due to the overlapping proposed mechanisms of CRPS and CPSP, the aim of this review is to summarize the available data on the benefits of vitamin supplementation on CRPS and CPSP. METHODS: A search of the literature for articles published in the last 10 years was conducted. Systematic reviews, meta-analyses, case reports, and articles that were not published in English were excluded. Ultimately, 10 articles met inclusion criteria. RESULTS: The data suggests that systemic vitamin C plays a significant role in preventing CRPS following various orthopedic surgeries and may possess therapeutic benefit as well. Vitamin B12 improved short-term functional and mental health outcomes as well as decreased neuropathic analgesic consumption. While no clinical studies have been performed on alpha-lipoic acid (ALA), preclinical studies suggest that administration decreases cold allodynia and pain in mice models. Moreover, while no studies have evaluated the effects of vitamin D on CRPS and CPSP, retrospective analysis reveals that CRPS incidence is increased in patients with low vitamin D levels. CONCLUSION: The literature reviewed reveals that there may be value in considering nutritional supplementation through vitamins in CRPS and CPSP, however, large-scale, randomized controlled clinical trials are warranted to evaluate the potential beneficial effects of these supplements in patients.
Decentralized Science Supported by Decentralized Finance to Support Pain Research: A Merger of Giants.
Palumbo P, Kruger J, Robinson CL
Curr Pain Headache Rep · 2026 May · PMID 42154184 · Publisher ↗
PURPOSE OF REVIEW: Costing nearly three quarters of a trillion dollars annually, the funding for pain research pales in comparison to that spent on cancer, diabetes, and heart disease despite consuming more resources tha...
PURPOSE OF REVIEW: Costing nearly three quarters of a trillion dollars annually, the funding for pain research pales in comparison to that spent on cancer, diabetes, and heart disease despite consuming more resources than the three aforementioned summed together. Decentralized science (DeSci) supported by decentralized finance (DeFi) provides a complementary framework for funding and conducting pain research by addressing longstanding limitations in traditional grant systems. RECENT FINDINGS: Reliance on federal funding often results in structural bottlenecks, transparency gaps, and restricted access to early stage or high-risk scientific ideas. DeSci-DeFi systems employ decentralized ledgers, tokenized utility for governance, and smart contracts to enhance transparent research funding allocations, verifiable workflows, and tamper resistant data management. Decentralized Autonomous Organizations (DAOs) enable community-driven participation in scientific research, can help support milestone-based resource distribution, and facilitate open data dissemination through interoperable infrastructure. Case studies, including longevity focused initiatives, demonstrate the ability of DAOs to support projects that face constraints in conventional channels. Despite technical, regulatory, and governance challenges, DeSci-DeFi represents a practical complement to legacy models and may broaden participation, strengthen reproducibility, and expand the scope of fundable pain research.
P2X7 Receptor as a Therapeutic Target for Neuropathic Pain: From Mechanisms to Translational Strategies.
Chen D, Zhang S, Guo Y … +5 more , Zhao X, Mao P, Hai X, Yang Z, Zhao G
Curr Pain Headache Rep · 2026 May · PMID 42151670 · Publisher ↗
PURPOSE OF REVIEW: Neuropathic pain (NP) remains a therapeutic challenge due to the limited efficacy of conventional pharmacotherapies. This review aims to systematically consolidate the pathogenic role of the P2X7 recep...
PURPOSE OF REVIEW: Neuropathic pain (NP) remains a therapeutic challenge due to the limited efficacy of conventional pharmacotherapies. This review aims to systematically consolidate the pathogenic role of the P2X7 receptor (P2X7R) in NP and to evaluate emerging translational strategies targeting this channel, including natural compounds, selective antagonists, drug repurposing, cell-based therapies, and neuromodulation. RECENT FINDINGS: Recent studies indicate that P2X7R is highly expressed in the spinal cord or dorsal root ganglia across multiple preclinical models of neuropathic pain, including peripheral nerve injury, diabetic neuropathy, chemotherapy-induced neuropathy, and postherpetic neuralgia, underscoring its pivotal role in the pathogenesis of neuropathic pain. In preclinical studies, targeting P2X7R with agents such as Brilliant Blue G, A-438079, botulinum toxin A, mesenchymal stem cell-derived secretomes, and high-frequency spinal cord stimulation produces marked, P2X7R-dependent analgesic effects. P2X7R stands out as a promising therapeutic target for neuropathic pain. Future priorities should focus on optimizing P2X7R-targeted pharmacodynamics, developing CNS-penetrant oral antagonists, and exploring combination strategies to maximize analgesic outcomes in NP patients.
Clinical Efficacy and Risks of Clonidine Infusion for Sedation and Analgesia: A Narrative Review.
Feeney JM, Noble RK, Bautista TB … +5 more , Patel M, Abd-Elsayed A, Ahmadzadeh S, Shekoohi S, Kaye AD
Curr Pain Headache Rep · 2026 May · PMID 42144510 · Publisher ↗
PURPOSE OF REVIEW: Since its introduction in 1966, clonidine, an α adrenergic receptor agonist, has been widely used in clinical practice as an antihypertensive, nasal decongestant, ADHD medication, sedative, and analges...
PURPOSE OF REVIEW: Since its introduction in 1966, clonidine, an α adrenergic receptor agonist, has been widely used in clinical practice as an antihypertensive, nasal decongestant, ADHD medication, sedative, and analgesic. When α adrenergic receptors are stimulated, sympathetic outflow is decreased. This leads to reduced norepinephrine release from the presynaptic neuron, which modifies pain through the dorsal horn and induces sedation through the locus coeruleus. RECENT FINDINGS: Clonidine preparations have been utilized for various purposes in anesthesia over the past few decades. In this regard, infusions can be used perioperatively as a sedative and analgesic, a one-time bolus, or a continuous infusion. Clonidine infusion reduces opioid requirements and can be used to treat both nociceptive and neuropathic pain after surgical procedures. There is a lack of research on isolated efficacy and risk for sedation related to prominent use as adjunctive therapy. Future research is warranted to investigate clonidine unaccompanied to determine performance and potential. Furthermore, there is a gap in our literature between the efficacy, risk, and side effects of continuous clonidine compared to non-continuous clonidine for analgesia. This narrative review aims to highlight the current state of knowledge of clonidine's pharmacology, indications, efficacy, sedative properties, analgesic ability, and side effects.
Epidural and Intrathecal Catheter Use at the End of Life for Cancer Pain.
Kuang A, Conner B, Cho JS … +2 more , Topiwala P, Hao D
Curr Pain Headache Rep · 2026 May · PMID 42142193 · Publisher ↗
PURPOSE: More than 80% of patients with advanced malignancy experience pain as they approach death, and up to 30% fail to achieve adequate relief from systemic analgesics or cannot tolerate their side effects. For these...
PURPOSE: More than 80% of patients with advanced malignancy experience pain as they approach death, and up to 30% fail to achieve adequate relief from systemic analgesics or cannot tolerate their side effects. For these patients, externalized epidural or intrathecal catheters offer a targeted alternative, delivering analgesic agents directly to the neuraxis. This narrative review examines patient selection, technical approaches, pharmacological regimens, clinical outcomes, and complications associated with externalized epidural and intrathecal catheter systems for refractory cancer pain at end of life. RECENT FINDINGS: The available literature comprises predominantly small, single-center retrospective cohort studies and prospective case series, with one double-blind randomized controlled trial identified. Neuraxial analgesia was consistently associated with three benefits: reductions in pain intensity from severe baseline levels (NRS 7-10) to mild-to-moderate ranges (NRS 2-5), with some patients achieving near complete relief; opioid-sparing effects, including systemic opioid discontinuation in a subset of patients; and functional improvements sufficient to support discharge to home or hospice. Infectious complications were the leading cause of early catheter removal, with epidural abscess rates as high as 12% reported in one cohort; tunneled subcutaneous port systems appeared to confer lower infectious risk than percutaneous catheters. Externalized catheters provide meaningful pain relief, opioid sparing, and functional benefits for carefully selected patients with refractory cancer pain at the end of life. Given the heterogeneity of study designs and inconsistent outcome reporting, prospective multicenter studies employing standardized pain, functional, and complication metrics are needed to better define the role of neuraxial analgesia in this population.
Cooled Radiofrequency Ablation of Cervical Nerves for Treating Cervicogenic Headache.
Abd-Elsayed A, Hashimoto N, Reilly M … +2 more , Shiferaw B, Henjum L
Curr Pain Headache Rep · 2026 May · PMID 42142191 · Publisher ↗
BACKGROUND: Cervical facet arthropathy, a degenerative condition of the facet joints, is a leading cause of cervicogenic headaches. First-line therapies such as physical therapy and pharmacology often fail to provide las...
BACKGROUND: Cervical facet arthropathy, a degenerative condition of the facet joints, is a leading cause of cervicogenic headaches. First-line therapies such as physical therapy and pharmacology often fail to provide lasting relief. Cooled radiofrequency ablation (RFA) offers a minimally invasive alternative with potential for significant pain reduction. OBJECTIVE: This retrospective study evaluates the efficacy and safety of cooled RFA for patients with cervicogenic headaches. METHODS: This retrospective analysis consisted of 232 procedures from 137 patients who received cooled RFA of the third occipital nerve (TON) and C3 with/out C4, with/out C5 medial branches, between 2015 and 2025 at UW Health. Data collected include pre- and post-operative pain scores assessed through the Visual Analogue Scale (VAS), duration of pain relief, and adverse events. Paired t-tests were used to analyze the data, with p-values ≤ 0.05 considered statistically significant. RESULTS: A significant reduction in VAS pain scores was observed (p < 0.001). Pain improvement occurred in 62.2% of procedures, with 18.4% achieving complete remission and 19.4% showing no change in pain. Among effective procedures, the average pain reduction was 58.5 ± 32.2%, with a mean duration of 10.1 ± 8.3 months. Twelve procedures were reported to have self-limiting adverse events that resolved within five months. CONCLUSIONS: Cooled RFA of cervical medial branches provides effective, durable, and safe pain relief for chronic neck pain and cervicogenic headaches refractory to conservative care. Broader clinical use may benefit from standardized treatment protocols and further study of long-term outcomes.
Current Research on the Diagnosis and Management of Persistent Post-Traumatic Headache.
Gallivan LMA, Kacperski J
Curr Pain Headache Rep · 2026 May · PMID 42133249 · Publisher ↗
PURPOSE OF REVIEW: Headache is a common symptom in patients with concussion and mild traumatic brain injury. While many patients experience spontaneous resolution of symptoms following injury, a subset develop persistent...
PURPOSE OF REVIEW: Headache is a common symptom in patients with concussion and mild traumatic brain injury. While many patients experience spontaneous resolution of symptoms following injury, a subset develop persistent post-traumatic headache, and evidence-based guidance for the management of this condition remains limited in current clinical practice. RECENT FINDINGS: Persistent post-traumatic headache (PPTH) is likely underrecognized, with evidence suggesting that individuals with a prior history of headache disorders or previous concussion may be at increased risk. Scheduled analgesics in the first 72 hours following injury or utilizing infusions can help reduce symptom severity in the acute period following injury. Pharmacological studies are limited but suggest treating based on the headache phenotype. Anti-CGRP therapies have shown promise in a variety of chronic headache types including PPTH, and non-pharmacological interventions including introduction of early exercise programs, cognitive behavioral therapy, and biofeedback can improve long term patient outcomes. Although the available evidence is limited, current research supports phenotype-guided pharmacologic treatment alongside a multidisciplinary approach incorporating early exercise and cognitive behavioral therapy.
Optimizing Recovery After Thoracotomy: Evidence-Based Non-Opioid and Multimodal Analgesia - A Narrative Review.
Ali S, Sohail F, Fazal F … +3 more , Jauhar V, Kashaf S, Bansari S
Curr Pain Headache Rep · 2026 May · PMID 42133208 · Publisher ↗
PURPOSE OF REVIEW: After open thoracic surgery, post-thoracotomy pain remains an important postoperative problem affecting nearly half of patients. It can give rise to respiratory problems, delayed rehabilitation, prolon...
PURPOSE OF REVIEW: After open thoracic surgery, post-thoracotomy pain remains an important postoperative problem affecting nearly half of patients. It can give rise to respiratory problems, delayed rehabilitation, prolonged hospitalizations, and chronic post-thoracotomy pain syndrome. Despite the reality that opioids are currently the primary source of anesthesia after surgery, their consumption is restricted by complications, including prolonged dependency, tolerance, and respiratory impairment. RECENT FINDINGS: To maximize recovery after the thoracotomy, this narrative review incorporates some of the most current studies on opioid-free strategies. In addition to local anesthetic techniques, which include thoracic epidural analgesia, paravertebral block, and erector spinae plane block, the current study highlights the effectiveness of non-opioid pharmaceutical agents, which include acetaminophen, non-steroidal anti-inflammatory drugs, gabapentinoids, ketamine-based, steroids, and intravenous lidocaine. Physical therapy, respiratory therapy, and psychological assistance are examples of complementary non-pharmacologic interventions that improve postoperative recovery. By integrating such techniques as Enhanced Recovery. After Surgery (ERAS) pathways, individualized multidisciplinary analgesic procedures that reduce opioid consumption, promote the recovery process, and perhaps decrease the probability of chronic postoperative pain.
Addressing the Treatment Gap for Pediatric Headache in Underserved Regions.
Wang Y, Lu G, Gao S … +2 more , Gao Y, Yang W
Curr Pain Headache Rep · 2026 May · PMID 42118419 · Publisher ↗
PURPOSE OF REVIEW: This review explores innovative strategies to address the treatment gap for pediatric headache disorders in underserved regions worldwide. RECENT FINDINGS: Global Burden of Disease studies indicate tha...
PURPOSE OF REVIEW: This review explores innovative strategies to address the treatment gap for pediatric headache disorders in underserved regions worldwide. RECENT FINDINGS: Global Burden of Disease studies indicate that the fastest growth in pediatric headache burden occurs in low- and middle-income countries, where reported prevalence likely underestimates true disease burden due to healthcare access barriers. Telemedicine demonstrates comparable efficacy, safety, and satisfaction to in person care. Artificial intelligence based diagnostic models achieve high accuracy for pediatric migraine identification. School-based interventions leveraging existing educational infrastructure improve headache knowledge and coping behaviors. Task shifting and integrated care delivery models are increasingly recognized as essential components of sustainable care. Telemedicine, artificial intelligence, school-based interventions, task shifting, and integrated care networks represent scalable solutions for extending headache care to underserved pediatric populations. Realizing their potential requires integrating technological innovation with workforce capacity building, community engagement, and policy advocacy.
Telemedicine in Pediatric Headache in a Post-COVID-19 World: A Narrative Review and Practical Implementation.
Schultz T, Rosenthal S
Curr Pain Headache Rep · 2026 May · PMID 42105073 · Publisher ↗
PURPOSE OF REVIEW: Pediatric migraine is a leading cause of disability worldwide, yet access to pediatric headache specialists remains limited due to workforce scarcities and geographic disparities. This review examines...
PURPOSE OF REVIEW: Pediatric migraine is a leading cause of disability worldwide, yet access to pediatric headache specialists remains limited due to workforce scarcities and geographic disparities. This review examines the evolution of telemedicine in headache care, evaluates current evidence for safety and efficacy, and explores its role in improving access and multidisciplinary management. RECENT FINDINGS: Randomized trials and observational studies demonstrate that telemedicine provides clinical outcomes comparable to in-person visits with high patient satisfaction and reduced logistical burden. Emerging data support its safety in non-acute headache evaluation as well as benefit of supporting multidisciplinary care. Professional societies, including the American Headache Society and the American Academy of Pediatrics, endorse telemedicine as an appropriate modality for headache management. Telemedicine has matured into a sustainable, evidence-based approach for pediatric headache care. When implemented thoughtfully, it expands access, supports multidisciplinary treatment, and maintains safety, positioning it as an essential component of future headache care delivery models.
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