Current Pain And Headache Reports[JOURNAL]
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200 papers
Efficacy and Safety of Sphenopalatine Ganglion Blocks to Treat Head and Neck Cancer-Related Pain: A Narrative Review.
Smith VS, Cheon SY, Ahmadzadeh S … +6 more , Burroughs CR, De Witt AB, Griffin P, Shekoohi S, Abd-Elsayed A, Kaye AD
Curr Pain Headache Rep · 2025 Dec · PMID 41396338 · Publisher ↗
PURPOSE OF REVIEW: Cancer is a devastating disease that affects many people across the world. Cancer has a variety of different locations and body systems it can affect, making it a complex disease to manage at times, es...
PURPOSE OF REVIEW: Cancer is a devastating disease that affects many people across the world. Cancer has a variety of different locations and body systems it can affect, making it a complex disease to manage at times, especially when dealing with cancer of the head and neck. RECENT FINDINGS: Patients suffering from this disease can experience significant levels of pain, and it is made worse by the treatments for the disease, causing additional pain. Sphenopalatine ganglion blocks are a form of pain management observed in head and neck cancer treatment. This technique aims to disrupt the signaling pathways of the sphenopalatine ganglion and serve as an efficient, minimally invasive form of acute pain management. In this review, we will discuss the pathophysiology of head and neck cancer-related pain, the details of the sphenopalatine ganglion block, and its efficacy in clinical use, particularly with head and neck cancer patients.
Assessment and Non-pharmacological Management of Chronic Pain in Pediatric Cancer Survivors: Current Practices and Recommendations for Next Steps.
Hayes L, Pabis JM, Millmann M … +2 more , Milligan CN, Daffin M
Curr Pain Headache Rep · 2025 Dec · PMID 41396232 · Publisher ↗
PURPOSE OF REVIEW: Chronic pain is a prevalent and debilitating late effect of pediatric cancer. It is also multifaceted and requires comprehensive assessment to guide optimal treatment. While pharmacological interventio...
PURPOSE OF REVIEW: Chronic pain is a prevalent and debilitating late effect of pediatric cancer. It is also multifaceted and requires comprehensive assessment to guide optimal treatment. While pharmacological interventions for chronic pain in this population are well summarized elsewhere, a current review of less invasive non-pharmacological interventions and assessments to guide them is needed. RECENT FINDINGS: Recent research has found the utility of biopsychosocial assessment of pain in pediatric cancer survivors using both validated measures such as the PROMIS and brief screeners. For intervention, preliminary studies found positive outcomes for physical activity interventions and biofeedback for pain in survivors. Advances in management of chronic pain in survivors are promising, though future research should refine identification and treatment. More research is needed on comprehensive biopsychosocial pain assessments and tailoring treatment. Further, promising interventions in broad chronic pain literature such as hypnosis should be explored for pediatric cancer survivors.
CSI and Musculoskeletal Pain: Clinical Validity and Neurophysiological Implications.
Anselmo A, Pagano M, Cappadona I … +7 more , Russo F, Laudisio A, Martello G, Papalia GF, Quartarone A, Calabrò RS, Corallo F
Curr Pain Headache Rep · 2025 Dec · PMID 41396224 · Publisher ↗
BACKGROUND AND AIM: Chronic pain affects about 20% of adults worldwide, severely impacting quality of life and functioning. Many chronic pain syndromes share symptoms such as fatigue, poor sleep, anxiety, and depression,...
BACKGROUND AND AIM: Chronic pain affects about 20% of adults worldwide, severely impacting quality of life and functioning. Many chronic pain syndromes share symptoms such as fatigue, poor sleep, anxiety, and depression, suggesting a common mechanism. Central sensitization, an abnormal amplification of pain by the nervous system, is considered a key underlying factor. Assessment tools like the Central Sensitization Inventory (CSI) and laser-evoked potentials (LEPs) may improve diagnosis and guide targeted treatment strategies. This review evaluates the validity of the CSI for assessing central sensitization in chronic musculoskeletal pain. It also explores integrating objective measures like LEPs to enhance diagnosis and treatment strategies. METHODS: A systematic review was conducted following PRISMA guidelines. Searches in PubMed, Web of Science, Cochrane Library, Embase, and Scopus included studies published before September 2025. After removing duplicates and non-English articles, titles and abstracts were screened, and full texts assessed for eligibility. Study quality was evaluated using the JBI checklists. RESULTS: From 557 retrieved studies, 8 met the inclusion criteria. All used the CSI, showing it as a valid and practical tool correlating with pain, disability, and impaired quality of life. However, limitations due to its subjective nature were noted. CONCLUSIONS: While CSI is valuable for initial screening, combining it with LEPs can provide a more precise and comprehensive assessment, improving diagnosis, management, and treatment personalization.
Exploring Pain Phenotyping in Cervicogenic Headache Management.
Cropes M, Deacon A, Nelson EO … +4 more , Deuel D, Sandgren A, Abd-Elsayed A, Houdek T
Curr Pain Headache Rep · 2025 Dec · PMID 41389321 · Full text
PURPOSE OF REVIEW: Intervention trials for cervicogenic headache (CGH) often yield equivocal results with marked treatment effect heterogeneity, possibly reflecting variations in underlying pain mechanisms throughout the...
PURPOSE OF REVIEW: Intervention trials for cervicogenic headache (CGH) often yield equivocal results with marked treatment effect heterogeneity, possibly reflecting variations in underlying pain mechanisms throughout the CGH population. Pain phenotyping or classifying patients into subgroups based on their predominant pain mechanism may facilitate more precise CGH treatment. This review aims to explore the role of pain phenotyping in CGH management. RECENT FINDINGS: Clinical evidence suggests two predominant pain mechanisms in the CGH population: nociceptive and nociplastic. Arguably, treatments for nociceptive pain should address the source of peripheral nociception, and treatments for nociplastic pain should address factors contributing to maladaptive central pain modulation. Due to centrally mediated analgesic effects, muscle relaxants are strongly recommended for managing both nociceptive and nociplastic CGH pain. Antidepressant medications may be most relevant for nociplastic CGH pain. Cervical spinal mobilization and manipulation interventions are strongly recommended for both nociceptive and nociplastic CGH pain. Nociplastic CGH pain may benefit from educational interventions regarding lifestyle factors such as physical activity, diet and weight management, sleep hygiene, and stress reduction. The anesthetic blockade, glucocorticoid injection, and radiofrequency denervation are strongly recommended for nociceptive CGH pain. Patients with persistent nociplastic CGH pain may benefit from neuromodulation interventions. Pain phenotyping may facilitate more precise clinical management of patients with CGH. This review provides evidence-informed recommendations for CGH pain phenotyping, including specific subgroups, clinical criteria, and stratified treatment approaches. Further prospective investigation is needed to determine the effects of pain phenotyping on clinical outcomes in patients with CGH.
Peripheral Nerve Stimulation for Low Back Pain: A Review of the Recent Literature.
Xiao JT, Rana N, Rana M
Curr Pain Headache Rep · 2025 Dec · PMID 41348377 · Publisher ↗
PURPOSE OF REVIEW: This article aims to evaluate and summarize the current literature surrounding peripheral nerve stimulation (PNS) as a management modality for chronic axial low back pain (CLBP). CLBP physiology as wel...
PURPOSE OF REVIEW: This article aims to evaluate and summarize the current literature surrounding peripheral nerve stimulation (PNS) as a management modality for chronic axial low back pain (CLBP). CLBP physiology as well as delivery of PNS and mechanisms of analgesia will be reviewed. Finally, we will evaluate the two current on-market PNS devices (SPRINT and ReActiv8) and the recent literature on both devices. RECENT FINDINGS: While CLBP can be difficult to treat, recent literature demonstrates that PNS reduces pain scores and disability. The literature on PNS and the currently available devices (SPRINT and ReActiv8) is sparse, predominately comprised of case studies with limited randomized control trials. CLBP is one of the most common pain complaints and can be difficult to treat. PNS is emerging as a new treatment modality in the management of CLBP and shows promise in terms of reduction of pain and function. More research is necessary on PNS and the current principal devices available to evaluate its long-term impact on CLPB and how it can supplement or even replace current treatment modalities.
Capsaicin in the Management of Peripheral Neuropathy: A Review.
Ryan R, Judge R, Lou J … +1 more , Ng A
Curr Pain Headache Rep · 2025 Dec · PMID 41348254 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the efficacy and safety of capsaicin in the treatment of neuropathic pain. RECENT FINDINGS: Capsaicin can provide prolonged relief from pain in var...
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the efficacy and safety of capsaicin in the treatment of neuropathic pain. RECENT FINDINGS: Capsaicin can provide prolonged relief from pain in various neuropathies. One proposed mechanism is the ability to cause degeneration of hypersensitized nerve tissue and incite regeneration of healthy nerve fibers. Capsaicin provides more significant relief than placebo and is non-inferior to pregabalin in the treatment of peripheral neuropathy. It is emerging as an alternative but effective and well-tolerated treatment for neuropathy due to diverse pathologic conditions. Capsaicin, a natural agonist at the TRPV1 receptor, has been studied for its therapeutic role in neuropathic pain. Capsaicin is an effective treatment with significant reduction in both diabetic and non-diabetic neuropathic pain. Due to its topical application, it is associated with fewer systemic adverse events and therefore, an attractive option in the treatment of peripheral neuropathy.
Expanding the Lens: Recent Developments at the Intersection of Pediatric Chronic Pain and Gender Diversity.
Smith AM, Silvia M, Farr G … +1 more , Rogan H
Curr Pain Headache Rep · 2025 Dec · PMID 41324834 · Full text
PURPOSE OF REVIEW: This report aims to synthesize the literature at the intersection of pediatric chronic pain and gender diversity, highlighting recent conceptual and empirical developments. REVIEW OF FINDINGS: Recent t...
PURPOSE OF REVIEW: This report aims to synthesize the literature at the intersection of pediatric chronic pain and gender diversity, highlighting recent conceptual and empirical developments. REVIEW OF FINDINGS: Recent theoretical frameworks expand upon the biopsychosocial model by integrating minority stress, ecological-systems, and intersectional perspectives to better understand the chronic pain experiences of transgender and gender-diverse (TGD) youth. While TGD youth experience disproportionate pain-related risks, influenced by intersecting identity-based stressors, structural inequities, and systemic barriers to affirming care, this group remains underrepresented in pain research and intervention development. To promote equitable care, pain researchers and clinicians must adopt inclusive assessment tools, enhance provider education, implement strengths-based interventions, and advocate for policies that reduce disparities and affirm the identities of TGD youth with pain. Promoting gender-affirming, trauma-informed, and intersectional approaches may offer a clear path toward more inclusive and equitable pediatric pain management.
Comparative Efficacy of Nerve Blocks for Post-Operative Analgesia Following Robot-Assisted Prostatectomy: A Systematic Review.
Shah SS, Johnson CD, Howe CA … +6 more , Pelto AW, Grant C, Shekoohi S, Kallurkar A, Abd-Elsayed A, Kaye AD
Curr Pain Headache Rep · 2025 Dec · PMID 41324711 · Publisher ↗
BACKGROUND: Robot-assisted prostatectomy (RAP) can cause significant post-operative pain. Opioids are commonly used for relief, but they pose risks such as side effects and potential dependence. To reduce opioid usage, r...
BACKGROUND: Robot-assisted prostatectomy (RAP) can cause significant post-operative pain. Opioids are commonly used for relief, but they pose risks such as side effects and potential dependence. To reduce opioid usage, regional anesthesia approaches, especially various nerve block techniques, have been developed. However, evidence comparing the effectiveness of these different nerve blocks remains limited. METHODS: A systematic review was conducted to evaluate the effectiveness of different nerve block techniques on post-operative pain control after RAP. Databases were searched for randomized controlled trials (RCTs) that compared nerve blocks with either standard care or other regional anesthesia techniques. The primary outcomes assessed were pain scores, opioid consumption, recovery metrics, and treatment-related adverse effects. RESULTS: Eight studies comprising 696 participants were included. Intrathecal morphine consistently demonstrated the most significant reduction in post-operative pain and opioid use, though with increased incidence of pruritus and other side effects. Erector spinae plane blocks (ESPB) and rectus sheath blocks (RSB) were also effective, offering a favorable balance of analgesia and safety. Quadratus lumborum blocks (QLB) and pudendal nerve blocks (PNB) were found to effectively reduce pain, opioid usage, and side effects when they were used in a multimodal analgesic protocol. Alternatively, transversus abdominis plane blocks (TAPB) and caudal blocks were found to have mixed or no opioid-sparing effects. Because of methodological heterogeneity between studies, direct comparisons between blocks were limited. CONCLUSION: Regional anesthesia techniques improve post-operative pain control and reduce opioid use after RAP. Given the lack of definitive superiority among techniques, analgesia should be individualized and incorporated into multimodal, opioid-sparing protocols. More large-scale, head-to-head trials are needed to guide optimal nerve block selection.
Supporting Students with Migraine: Examining Current Practices and Identifying Strategies for Educational Success.
Turnage C, Balmaseda A, Greene K … +2 more , Leininger A, Heierle J
Curr Pain Headache Rep · 2025 Nov · PMID 41307788 · Publisher ↗
PURPOSE OF THE REVIEW: Pediatric migraine contributes to disability with significant interference on academic success. This review aims to explore the evidence of school-based accommodations and provide clinicians with g...
PURPOSE OF THE REVIEW: Pediatric migraine contributes to disability with significant interference on academic success. This review aims to explore the evidence of school-based accommodations and provide clinicians with guidance on how to support academic success. RECENT FINDINGS: Many clinicians support the implementation of school-based accommodations for youth with migraine; however, there has been little research exploring efficacy despite wide-spread acceptance. Findings from anxiety literature offer insight into prospective issues with certain accommodations, warranting consideration for potential best practices for youth with migraine. Despite significant academic challenges and the generally accepted use of school-based supports, most accommodations have few or no experimental studies and fail to show evidence of clear benefits for youth with migraine. This review offers clinicians guidance on selecting appropriate accommodations, recognizing that each patient is unique and suggested supports are best when they are based on a thorough assessment and tailored to the individual student’s needs and specific goals. Further research on the effectiveness of academic accommodations would help guide clinicians in supporting students with migraine.
Efficacy and Safety of Retroclavicular Brachial Plexus Block for Pain Management after Shoulder Surgeries: a Narrative Review.
Duplechin DP, Folds GT, De Witt AJ … +6 more , Ahmadzadeh S, Herron E, McGregor DW, Shekoohi S, Abd-Elsayed A, Kaye AD
Curr Pain Headache Rep · 2025 Nov · PMID 41307787 · Publisher ↗
PURPOSE OF REVIEW: Postoperative pain following shoulder surgeries, including rotator cuff repair and arthroplasty, can be severe and impede early mobilization, prolong recovery, and increase opioid consumption. Regional...
PURPOSE OF REVIEW: Postoperative pain following shoulder surgeries, including rotator cuff repair and arthroplasty, can be severe and impede early mobilization, prolong recovery, and increase opioid consumption. Regional anesthesia has emerged as a cornerstone of multimodal pain management for these procedures, offering targeted analgesia with fewer systemic side effects. Among the various techniques, the retroclavicular approach to the brachial plexus, known as the retroclavicular brachial plexus block (RCB) or retroclavicular approach to the infraclavicular brachial plexus (RAPTIR), has gained attention for its promising efficacy and safety profile. This narrative review evaluates current evidence surrounding the retroclavicular block's clinical utility in postoperative shoulder pain control. We examine anatomical and technical considerations, analgesic efficacy, safety, and comparative advantages over traditional approaches such as the interscalene and supraclavicular blocks. RECENT FINDINGS: Literature suggests that RCB provides effective pain relief with reduced risk of phrenic nerve involvement and diaphragmatic paralysis, a critical advantage in patients with respiratory compromise. Additionally, its favorable ergonomic profile and improved needle visibility under ultrasound make it an appealing alternative in elective and emergent settings. The present investigation explores RCB's integration into multimodal analgesia protocols and applicability in obese and geriatric patients, highlighting current research's limitations. Although data remains limited, emerging evidence supports the retroclavicular block as a safe and effective option for shoulder analgesia, warranting further comparative studies and broader clinical adoption.
Radiation Exposure for Interventional Pain Management Physicians: A Review of Recent Literature.
Encinas N, Wie C, Covington S … +6 more , Shaeffer P, Freeman J, Pew S, Eells A, Cornidez E, Maloney J
Curr Pain Headache Rep · 2025 Nov · PMID 41307766 · Publisher ↗
PURPOSE OF REVIEW: Interventional pain physicians are routinely exposed to radiation during diagnostic and therapeutic procedures. With the commonplace use and utility of C-arm fluoroscopy, it has become increasingly imp...
PURPOSE OF REVIEW: Interventional pain physicians are routinely exposed to radiation during diagnostic and therapeutic procedures. With the commonplace use and utility of C-arm fluoroscopy, it has become increasingly important for physicians to maintain an understanding of the foundational principles and associated risks of radiation. This review highlights recent literature regarding radiation exposure to assist interventional pain physicians in their efforts to attenuate occupational risk. RECENT FINDINGS: Recent studies continue to call attention to the importance of radiation safety awareness and adherence to established protective measures. The literature emphasizes variability in exposure based on technique, procedure type, and use of shielding. Safety protocols and the principles that guide these recommendations are reviewed, with attention to the ALARA principle, or keeping radiation exposure "as low as reasonably achievable." There are many variables that affect the amount of radiation a given provider is exposed to and numerous ways to limit dose and associated risk. The use of protective equipment, proper technique, and clinical instruction remain essential to reducing exposure. This review underscores the value of physician adherence to safety protocols and the continued need for research in the field of radiation safety and risk reduction.
The Mechanism of Action of Remote Electrical Neuromodulation (REN) in Treating Migraine and Potentially Other Idiopathic Pain Conditions.
Birlea M, Robinson CL, Mama E … +4 more , Stark-Inbar A, Ironi A, Atashsokhan D, Berk T
Curr Pain Headache Rep · 2025 Nov · PMID 41307755 · Full text
PURPOSE OF REVIEW: This review provides evidence for the mechanism of action (MOA) of Remote Electrical Neuromodulation (REN), a non-pharmacological therapeutic technology for treating migraine and other symptoms manifes...
PURPOSE OF REVIEW: This review provides evidence for the mechanism of action (MOA) of Remote Electrical Neuromodulation (REN), a non-pharmacological therapeutic technology for treating migraine and other symptoms manifested by certain idiopathic pain diseases. It discusses the main physiological and anatomical aspects associated with conditioned pain modulation (CPM), and how REN is applied for the treatment of migraine pain and other symptoms. RECENT FINDINGS: The REN wearable device (Nerivio) is FDA cleared for acute and preventive treatment of migraine in patients aged 8 years and above, and CE marked in patients aged 12 and above. In brief, the REN MOA is formulated on the observed concept that one of the descending pain inhibition mechanisms in the brain, known as CPM, is deficient among people diagnosed with certain idiopathic pain disorders, such as migraine. Hence, these people are more vulnerable to otherwise innocent external stimuli, which are misinterpreted in the brain as painful and can thus trigger a migraine attack, often presenting with increased pain sensitivity (hyperalgesia) and headache. Research has revealed that descending inhibitory mechanisms can be externally activated under certain conditions. REN operates through applying electrical stimulation with parameters designed to activate A-delta and C nociceptive nerve fibers in the skin to optimize this response, thereby enhancing CPM and increasing pain inhibition by releasing norepinephrine and serotonin. Based on current evidence, the review presents medical practitioners and researchers with a detailed explanation of the REN MOA in treating and preventing migraine, and potentially other idiopathic pain disorders.
Clinical Efficacy of Magnesium in Perioperative Pain Management: A Narrative Review.
Ahmadzadeh S, Wentling JG, Ford BM … +6 more , Yew JAT, Barrie SA, Bernhardt FY, Shekoohi S, Abd-Elsayed A, Kaye AD
Curr Pain Headache Rep · 2025 Nov · PMID 41307749 · Publisher ↗
PURPOSE OF REVIEW: Postoperative pain is a prevalent clinical challenge that often leads to high opioid consumption, delayed hospital discharge, and associated side effects. Inadequate pain control can delay recovery and...
PURPOSE OF REVIEW: Postoperative pain is a prevalent clinical challenge that often leads to high opioid consumption, delayed hospital discharge, and associated side effects. Inadequate pain control can delay recovery and contribute to the risk of chronic postsurgical pain and opioid dependence. Magnesium, an essential cation with diverse physiological roles, has gained attention as a non-opioid adjunct for perioperative analgesia related to multimodal mechanisms of action and a favorable profile. RECENT FINDINGS: Pharmacologically, magnesium acts as an N-methyl-D-aspartate (NMDA) receptor antagonist and calcium channel blocker in the central nervous system, dampening excitatory neurotransmission and reducing central sensitization to pain. It also exhibits anti-inflammatory and anti-nociceptive effects and is inexpensive and easy to administer intravenously. These properties make magnesium a cost-effective and simple addition to multimodal pain management protocols. When used as a preoperative or intraoperative adjunct, magnesium has demonstrated reduced postoperative pain intensity and decreased opioid requirements across various surgical populations. Trials and meta-analyses report that patients receiving perioperative magnesium experience lower pain scores and need fewer opioids in the first 24-48 hours after surgery, translating into an opioid-sparing effect and potentially less opioid-related nausea and sedation. Importantly, magnesium has a favorable safety profile at recommended doses and generally is well-tolerated with minimal side effects apart from infrequent hypotension or mild sedation. No significant respiratory depression occurs in patients with normal renal function. The present investigation highlights magnesium-mediated analgesic mechanisms, summarizes clinical evidence for efficacy as a preoperative pain adjunct, and describes implications for improving postoperative pain outcomes and reducing opioid reliance in perioperative care.
A Sociological Framework for Improving Palliative Pain Care in Low-Resource Nations.
Christo AP, Zein M, Robinson CL
Curr Pain Headache Rep · 2025 Nov · PMID 41307736 · Publisher ↗
This paper applies institutional theory to palliative pain care in low resource nations (LRNs), suggesting that three interdependent pillars shape access: regulative (laws and rules), normative (professional standards an...
This paper applies institutional theory to palliative pain care in low resource nations (LRNs), suggesting that three interdependent pillars shape access: regulative (laws and rules), normative (professional standards and values), and cultural-cognitive (shared beliefs). Biomedical solutions alone are insufficient. Lasting progress requires coordinated legal reform, professional accountability, and culturally sensitive engagement. RECENT FINDINGS: Restrictive regulations, stigmatizing policy language, and administrative bottlenecks limit access to essential analgesics, while the inverse care law magnifies inequity. Effective regulative responses include a balanced opioid policy and pooled procurement, local analgesic production, and task-shifting to non-physicians. Normative levels such as pain competencies in training/licensure, stewardship with audit/monitoring, and quality indicators improve delivery. Capacity building with Project ECHO (Extension for Community Healthcare Outcomes) shows knowledge and practice gains. Cultural strategies that design education with community leaders and traditional healers, reframing opioids as compassionate care, and routine pain assessment all shift beliefs and behaviors positively. CONCLUSION: A sociological, three pillar approach reframes pain relief as a health system obligation and human right. Multi-pronged interventions such as simplifying policies and financing, mandated competencies and stewardship, and culturally grounded engagement can transform pain care from a neglected option to an expected standard across LRNs.
Chronic Pain in the Cancer Survivor.
Maloney J, Kraus M, Strand N … +8 more , Paramanandam G, Garcia R, Badwal A, Viswanath O, Freeman J, Wie C, Misra L, Harbell MW
Curr Pain Headache Rep · 2025 Nov · PMID 41307648 · Publisher ↗
PURPOSE OF REVIEW: As cancer survivorship continues to rise, attention has increasingly turned to the long-term sequelae of oncologic treatment. While interventions such as chemotherapy, radiation therapy, and surgery ha...
PURPOSE OF REVIEW: As cancer survivorship continues to rise, attention has increasingly turned to the long-term sequelae of oncologic treatment. While interventions such as chemotherapy, radiation therapy, and surgery have significantly improved survival outcomes, they are frequently associated with chronic pain syndromes that can profoundly impact quality of life. This review synthesizes current evidence and therapeutic approaches for three prevalent pain conditions in cancer survivors: chemotherapy-induced peripheral neuropathy, post-radiation pain syndromes, and post-surgical pain syndromes. Emphasis is placed on pathophysiology, diagnostic considerations, and emerging management strategies to guide clinicians in optimizing survivorship care. RECENT FINDINGS: Evidence supports the use of duloxetine for chemotherapy-induced peripheral neuropathy. Despite the wide use of gabapentinoids and tricyclic antidepressants for chemotherapy-induced peripheral neuropathy the data is limited on efficacy. For post-radiation and post-surgical pain syndromes related to cancer, current evidence supports a multimodal approach of physical therapy, injections, and pharmacologic agents. A personalized and multimodal approach is recommended for chronic pain in cancer survivors. Further investigations into the treatment for chronic pain syndromes in cancer survivors are critical to improve the long-term outcomes and quality of life for cancer survivors.
Practice Patterns of Physicians Who Perform Lumbar Transforaminal Epidural Steroid Injections.
Hasoon J, Spatz M, Garcia RA … +8 more , Ho JS, Gill J, Simopoulos TT, Gutierrez G, Caylor J, Mouch T, Yong RJ, Robinson CL
Curr Pain Headache Rep · 2025 Nov · PMID 41307623 · Publisher ↗
PURPOSE OF REVIEW: Lumbar transforaminal epidural steroid injections (TFESIs) are a widely used interventional procedure for managing lumbosacral radicular pain and other spinal conditions. TFESIs help reduce inflammatio...
PURPOSE OF REVIEW: Lumbar transforaminal epidural steroid injections (TFESIs) are a widely used interventional procedure for managing lumbosacral radicular pain and other spinal conditions. TFESIs help reduce inflammation and enhance function by delivering corticosteroids into the nerve root and epidural space. The transforaminal approach is commonly utilized for its precise targeting, offering both diagnostic and therapeutic benefits. Furthermore, this technique can be performed in patients with a history of laminectomy or contraindications to performing an interlaminar approach at the targeted levels. This study reviews current practice patterns, technical preferences, and procedural experiences of interventional pain physicians performing lumbar TFESIs. RECENT FINDINGS: A survey was distributed to interventional pain physicians via email, web links, and social media platforms. Respondents included academic physicians in ACGME-accredited fellowship programs, as well as hospital-based and private practice physicians. The survey contained questions focusing on fluoroscopic views used for TFESIs, frequency of one-level versus two-level injections, and the occurrence of paresthesias during lumbar TFESIs. Data were collected anonymously, and descriptive statistics were used to analyze responses. A total of 87 respondents completed the survey. For fluoroscopic guidance, 60.9% (53/87) preferred using a combination of AP, oblique, and lateral views. Regarding injection levels, 63.2% (55/87) reported sometimes performing two-level injections, while 27.6% (24/87) always performed two levels, and 9.2% (8/87) exclusively performed one-level injections. The frequency of paresthesia during TFESIs varied, with 73.6% (64/87) reporting paresthesia occurring sometimes, 18.4% (16/87) reporting it most of the time, and 6.9% (6/87) stating it never occurred. This study highlights diverse practice patterns among interventional pain physicians performing lumbar TFESIs. Most physicians prefer multi-view fluoroscopic guidance and adapt the number of injection levels based on clinical need. Paresthesia during TFESIs is commonly reported but varies in frequency. These findings provide preliminary insights into procedural techniques and decision-making in lumbar TFESIs, offering a foundation for future research to refine best practices and improve patient outcomes.
Hemiplegic Cluster Headache.
Riso IL, Peres MFP, Cohen F
Curr Pain Headache Rep · 2025 Nov · PMID 41307608 · Publisher ↗
PURPOSE OF REVIEW: Cluster headache (CH) is a debilitating type of headache disorder, relatively rare and can be presented with atypical patterns. Aura is well determined in migraine patients, and recently it has been ac...
PURPOSE OF REVIEW: Cluster headache (CH) is a debilitating type of headache disorder, relatively rare and can be presented with atypical patterns. Aura is well determined in migraine patients, and recently it has been accepted to appear with other primary headache disorders, or even occurring in isolation. Hemiplegic Cluster Headache (HCH) is a rare variant of CH, defined and reported in patients presenting typical symptoms of CH along with reversible hemiparesis or hemiplegia, like reported in Migraine with Unilateral Motor Symptoms (MUMS). RECENT FINDINGS: We identified eight published HCH cases with convergent clinical features and treatment responses based on the possible shared pathophysiology in HCH and hemiplegic migraine. We proposed diagnostic criteria in this review, based on literature findings. HCH is rare but may be undiagnosed, aura features with concurrent motor unilateral weakness can be present due to associated comorbidity, motor aura, or in a secondary case. The proposed diagnostic criteria are useful for better recognizing the condition and afford improvement on treatment and future investigations.
Efficacy of Transversus Abdominal Plane Block for Post-Operative Pain Management in Laparoscopic Appendectomy: A Narrative Review.
Ahmadzadeh S, Godke RE, Broocks KM … +4 more , Mills MB, Howard JT, Shekoohi S, Kaye AD
Curr Pain Headache Rep · 2025 Nov · PMID 41307592 · Publisher ↗
PURPOSE OF REVIEW: A transverse abdominal plane (TAP) block is a type of peripheral nerve block where local anesthetic agents are injected into the nerve fibers of the anterior abdominal wall to provide pain relief durin...
PURPOSE OF REVIEW: A transverse abdominal plane (TAP) block is a type of peripheral nerve block where local anesthetic agents are injected into the nerve fibers of the anterior abdominal wall to provide pain relief during gastric surgery. An appendectomy is one of the most common surgical procedures performed in the US, indicated for the treatment of acute appendicitis, and involves the surgical removal of the appendix. RECENT FINDINGS: The TAP block is one of many pain management options available to patient care teams during laparoscopic appendectomy procedures, so its efficacy must be weighed against alternative pain management options. While there is strong evidence that the TAP block is either equivalent to or superior to, alternative methods of pain management for the broad discussion of abdominal surgeries, we could not identify a clear answer on whether the TAP block is the most efficacious option for the specific purpose of laparoscopic appendectomy post-operative pain management. The decision to use the TAP block will be influenced by specific patient circumstances and the individual clinical expertise of the patient provider.
Perioperative Management of Patients Receiving Interventional Techniques and Antiplatelet and Anticoagulant Therapy: A Balancing Act.
Manchikanti L, Kaye AD, Nampiaparampil DE … +4 more , Sanapati MR, Abd-Elsayed A, Shekoohi S, Hirsch JA
Curr Pain Headache Rep · 2025 Sep · PMID 40965759 · Publisher ↗
PURPOSEOF REVIEW: This article aims to evaluate current evidence and guidelines on anticoagulant and antiplatelet therapy for patients undergoing interventional procedures. It provides recommendations for managing these...
PURPOSEOF REVIEW: This article aims to evaluate current evidence and guidelines on anticoagulant and antiplatelet therapy for patients undergoing interventional procedures. It provides recommendations for managing these therapies with either continuation or withholding of these drugs in the perioperative period to minimize the risk of bleeding and thromboembolism in clinical practice. RECENT FINDINGS: Newly published guidelines and research underscore the crucial role of antiplatelet and anticoagulant therapy in interventional procedures, emphasizing the importance of decisions regarding whether to continue or temporarily stop these medications. Studies have categorized procedures into low-, moderate-, and high-risk groups, offering specific guidance on managing anticoagulant and antiplatelet therapy accordingly. The American Society of Interventional Pain Physicians (ASIPP) has developed consensus guidelines based on a synthesis of the best available evidence, incorporating risk stratification and practical recommendations. This review provides an in-depth analysis of medical, surgical, and interventional pain management literature. It highlights the updated ASIPP guidelines and summarizes the society's evidence-based recommendations for clinical practice.
Part Of the Process, or Adverse Event? Considering the Benefits and Potential Risks of Mindfulness-based Interventions for Migraine.
Dresdner T, Seng E
Curr Pain Headache Rep · 2025 Sep · PMID 40956537 · Publisher ↗
PURPOSE OF REVIEW: This goal of this paper is to identify the need to report adverse events (AEs) in mindfulness-based interventions (MBIs) for migraine and highlight conceptual issues related to their reporting. This pa...
PURPOSE OF REVIEW: This goal of this paper is to identify the need to report adverse events (AEs) in mindfulness-based interventions (MBIs) for migraine and highlight conceptual issues related to their reporting. This paper reviews the benefits and AEs in MBIs broadly and considers their application to a migraine population. RECENT FINDINGS: Due to a lack of standardized protocol for measuring and reporting, there is little published information on AEs in MBIs for migraine. Several recent trials have reported individual cases of AEs, including one instance of posttraumatic re-experiencing. The increasing popularity of MBIs in the treatment of chronic pain conditions, including migraine, makes it necessary for providers to understand which AEs occur. Patients with migraine may be at an elevated risk of experiencing AEs in MBIs.
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