Current Pain And Headache Reports[JOURNAL]
Sun
200 papers
The Application of Artificial Intelligence to Enhance Spinal Cord Stimulation Efficacy for Chronic Pain Management: Current Evidence and Future Directions.
Prunskis JV, Masys T, Pyles ST … +12 more , Abd-Elsayed A, Deer TR, Beall DP, Gheith R, Patel S, Sayed D, Moten H, Hagle T, Yaacoub CI, Anijar L, Gupta M, Dallas-Prunskis T
Curr Pain Headache Rep · 2025 May · PMID 40394275 · Publisher ↗
PURPOSE OF REVIEW: Chronic pain significantly impacts quality of life for millions globally, with spinal cord stimulation (SCS) as an established treatment for refractory chronic pain. However, traditional SCS therapies...
PURPOSE OF REVIEW: Chronic pain significantly impacts quality of life for millions globally, with spinal cord stimulation (SCS) as an established treatment for refractory chronic pain. However, traditional SCS therapies face limitations including inconsistent patient outcomes, challenges in patient selection, and difficulties in sustaining therapeutic efficacy. This review examines how artificial intelligence (AI) can enhance the efficacy and personalization of SCS therapy by optimizing patient selection, refining stimulation parameters, and enabling real-time adaptive adjustments. RECENT FINDINGS: Recent advances demonstrate that integrating AI with SCS significantly improves patient outcomes through predictive modeling for patient selection and real-time adaptive stimulation. Predictive analytics utilizing machine learning algorithms have successfully identified patient cohorts most likely to benefit from SCS therapy, enhancing response rates and reducing suboptimal outcomes. Closed-loop AI systems incorporating physiological feedback, such as evoked compound action potentials (ECAPs), dynamically optimize stimulation parameters, resulting in sustained pain relief, decreased programming burden, and improved device longevity. Despite these promising results, critical challenges persist, particularly related to data standardization, ethical considerations, and regulatory compliance. AI holds transformative potential for spinal cord stimulation, offering increased precision, personalization, and therapeutic efficiency in managing chronic pain. Although early results are encouraging, comprehensive clinical validation and multidisciplinary collaboration remain essential. Addressing ethical, regulatory, and data management challenges will be critical for widespread adoption of AI-enhanced SCS therapies in routine clinical practice.
Pecto-Intercostal Fascial Plane Block for Pain Management after Cardiothoracic Surgery.
Kaye AD, Vuong CA, Hawkins AM … +7 more , Serio MA, Dethloff DR, Hollander AV, Ahmadzadeh S, Skidmore KL, Palowsky ZR, Shekoohi S
Curr Pain Headache Rep · 2025 May · PMID 40375035 · Publisher ↗
PURPOSE OF REVIEW: Cardiac surgery is associated with significant postoperative pain. Compared to traditional analgesics, regional nerve blocks target specific anatomical areas to improve analgesia and to reduce postoper...
PURPOSE OF REVIEW: Cardiac surgery is associated with significant postoperative pain. Compared to traditional analgesics, regional nerve blocks target specific anatomical areas to improve analgesia and to reduce postoperative opioid consumption. RECENT FINDINGS: Pecto-intercostal fascial plane block (PIFB) is a novel analgesic technique that involves ultrasound-guided injection of anesthetic between pectoralis major and external intercostal muscles. Since PIFB is a relatively underexplored method of analgesia, to date, few manuscripts have reviewed and synthesized current literature related to PIFB. CONCLUSION: The present investigation focuses on relevant anatomy and physiology behind the PIFB, compares this novel technique with other traditional and novel methods of analgesia, and describes indications and contraindications for PIFB in cardiac surgery and other surgeries.
Epidural Contrast Patterns and Clinical Implications: An Educational Review.
Bianco GL, Shiferaw BT, Jin MY … +1 more , Abd-Elsayed A
Curr Pain Headache Rep · 2025 May · PMID 40369179 · Full text
PURPOSE OF REVIEW: The purpose of this educational review is to describe the contrast spread patterns that indicate accurate needle placement in the epidural space and spread patterns associated with erroneous needle ins...
PURPOSE OF REVIEW: The purpose of this educational review is to describe the contrast spread patterns that indicate accurate needle placement in the epidural space and spread patterns associated with erroneous needle insertion. RECENT FINDINGS: Epidural injections are minimally invasive and commonly used for patients with acute and chronic back pain that does not respond to conservative management. Imaging with contrast is frequently used during this procedure to improve accuracy and reduce adverse events. Contrast spread patterns are an important tool that can help identify where the needle is placed and whether the placement is accurate. Despite this, there may be discrepancies in the interpretation of spread patterns which ultimately reduce the utility of contrast. Inaccurate needle placement may result in intrathecal/subarachnoid, subdural, fascial, or retrodural space of Okada injections. The correct interpretation of contrast spread patterns on imaging is crucial for confirming accurate epidural needle placement. Furthermore, understanding contrast patterns of improper needle placement can prevent adverse events that result from injection outside of the epidural space.
Atypical Applications of Neuromodulation for Non-Painful Conditions.
Brown A, Lam L, Huh B … +2 more , D'Souza RS, Javed S
Curr Pain Headache Rep · 2025 May · PMID 40317388 · Publisher ↗
PURPOSE OF REVIEW: This narrative review explores the expanding applications of neuromodulation beyond pain management, focusing on its use in treating non-painful conditions such as heart failure, renal failure, spinal...
PURPOSE OF REVIEW: This narrative review explores the expanding applications of neuromodulation beyond pain management, focusing on its use in treating non-painful conditions such as heart failure, renal failure, spinal cord injuries, overactive bladder syndrome, and cognitive impairment in neurodegenerative diseases. RECENT FINDINGS: Neuromodulation techniques, including dorsal root ganglion stimulation, sacral neurostimulation, and deep brain stimulation, have shown promising results in various non-painful medical conditions: Heart and Renal Failure: Dorsal root ganglion stimulation induces diuresis in diuretic-resistant patients, offering a novel approach to managing fluid overload. Spinal Cord Injuries: Epidural spinal cord stimulation and brain-spine interfaces have demonstrated the potential to restore motor function, enhancing mobility and quality of life for paralyzed individuals. Overactive Bladder Syndrome: Sacral neurostimulation and tibial nerve stimulation have proven effective in improving urinary continence and reducing symptoms in patients unresponsive to conventional treatments. Cognitive Impairment in Neurodegenerative Diseases: Techniques such as deep brain stimulation and transcranial magnetic stimulation are being investigated for their ability to enhance cognitive and motor functions in conditions like Parkinson's and Alzheimer's disease. The review highlights the transformative potential of neuromodulation in non-painful conditions, demonstrating its ability to address complex medical issues beyond its traditional scope. Continued research and optimization of these techniques may lead to broader therapeutic applications and improved patient outcomes.
The Ganglia of the Head and Neck: Clinical Relevance for the Interventional Pain Physician.
Millhouse PW, Bloom RW, Beckstrand JN … +4 more , McClure ML, Eckmann MS, Feeko KJ, Mojica JJ
Curr Pain Headache Rep · 2025 Apr · PMID 40304923 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this article is to provide a comprehensive review of the ganglia of the head and neck and their role in the interventional management of chronic headaches and facial pain disorders. RECE...
PURPOSE OF REVIEW: The purpose of this article is to provide a comprehensive review of the ganglia of the head and neck and their role in the interventional management of chronic headaches and facial pain disorders. RECENT FINDINGS: Interventions targeting the sphenopalatine, stellate and gasserian ganglia are well described in the literature for headaches and facial pain disorders. There is a growing body of evidence supporting use of these techniques for clinical conditions outside of pain such as post-traumatic stress disorder and Long COVID symptoms. These findings increase the potential applications of such procedures, making them more relevant to the interventional physician tasked with managing symptoms in difficult to treat medical conditions. Nerve blocks of the head and neck are used for diagnostic and therapeutic purposes in the management of headaches and facial pain disorders. Headaches, whether acute or chronic, are common pain conditions with a wide-range of etiologies and are often difficult to treat. Chronic facial pain can have a variety of underlying causes, including direct or indirect nerve damage, infection, inflammation, and muscle dysfunction. Traditional pain management strategies such as medications and physical therapy often fail or are associated with significant adverse effects. Interventions such as nerve blocks and neuroablative procedures have shown promise in managing headaches and facial pain by directly targeting the underlying causes. This review article summarizes the most recent evidence regarding the efficacy, safety, applications and limitations of these interventional pain management techniques.
A Promising Route for Established Indications: A Systematic Review of Nebulized Ketamine in Pain.
Kohaf NA, Khan TI, Elbana HH … +6 more , Hassouna RA, Elfattah MMA, Nasa P, Shekoohi S, Kaye AD, Shehata IM
Curr Pain Headache Rep · 2025 Apr · PMID 40304824 · Publisher ↗
BACKGROUND: Nebulized ketamine, an innovative route of drug delivery, has gained interest for its potential effectiveness in challenging clinical scenarios. The objective of this systematic review is to provide insights...
BACKGROUND: Nebulized ketamine, an innovative route of drug delivery, has gained interest for its potential effectiveness in challenging clinical scenarios. The objective of this systematic review is to provide insights into the safety and effectiveness of nebulized ketamine in pain management. METHOD: A systematic search was performed on online databases including WOS, Cochrane, Scopus, and PubMed, using a specific search strategy. Our review focused on primary studies about the utilization of nebulized ketamine in various contexts regarding pain management. Additionally, we incorporated relevant secondary research, such as reviews presenting diverse perspectives. RESULTS: Nebulized ketamine in pain management included nine studies. CONCLUSION: The advantages of nebulized ketamine over other forms of administration include its rapid absorption and effective delivery. The smaller volume required for nebulization can result in fewer side effects and enhanced patient compliance thereby facilitating efficient drug delivery while minimizing the systematic impact. Emerging evidence supports the administration of nebulized ketamine as a safe and efficacious treatment for acute pain. However, further investigations are needed for a better understanding of its pharmacokinetics, optimal dosing and efficacy across different populations.
Efficacy of Erector Spinae Plane Block for Pain Management after Hip Surgery: A Narrative Review.
Kaye AD, Nguyen A, Thomassen AS … +8 more , Picou AM, Thomas NL, Johnson CD, Fox CJ, Ahmadzadeh S, Torres YL, Kim J, Shekoohi S
Curr Pain Headache Rep · 2025 Apr · PMID 40272620 · Publisher ↗
PURPOSE OF REVIEW: Managing pain after hip surgery can be challenging, especially with the need to balance effective relief and early movement. Traditional pain management methods, such as opioids and nerve blocks, have...
PURPOSE OF REVIEW: Managing pain after hip surgery can be challenging, especially with the need to balance effective relief and early movement. Traditional pain management methods, such as opioids and nerve blocks, have been demonstrated to be efficacious but come with risks, including side effects, potential for opioid dependency, and the possibility of delays in mobility. RECENT FINDINGS: The erector spinae plane block (ESPB) has recently gained attention as a newer option that may offer unique benefits. ESPB is an ultrasound-guided technique targeting nerves along the spine, providing broad and long-lasting pain relief without significant muscle weakness. This allows patients to start moving sooner, which is critical to recovery. Studies suggest ESPB can reduce opioid use and maintain motor strength better than other approaches, although more research is needed to confirm these findings across larger groups. CONCLUSION: ESPB's technique, however, still needs standardization to ensure consistent results, as variations in dosage and application can impact its effectiveness. Further research focusing on larger, controlled studies could better clarify ESPB's role compared to traditional methods, especially regarding long-term recovery and quality of life. As more evidence accumulates, ESPB may become a valuable addition to pain management plans for hip surgery, especially for patients needing effective, low-risk analgesia.
Optimization of Postoperative Opioids Use Following Spine Surgery.
Kaye AD, Tong VT, Islam RK … +10 more , Nguyen I, Abbott BM, Patel C, Muiznieks L, Bass D, Hirsch JD, Urman RD, Ahmadzadeh S, Allampalli V, Shekoohi S
Curr Pain Headache Rep · 2025 Apr · PMID 40266417 · Publisher ↗
PURPOSE OF REVIEW: The present investigation evaluated the use of opioids for postoperative pain relief in spinal surgery patients. RECENT FINDINGS: Pain management is a crucial component of postoperative care that great...
PURPOSE OF REVIEW: The present investigation evaluated the use of opioids for postoperative pain relief in spinal surgery patients. RECENT FINDINGS: Pain management is a crucial component of postoperative care that greatly impacts patient outcomes. Postoperative pain management has been shown to allow for earlier mobility, discharge, and return to normal life. Opioids are the standard treatment for postoperative pharmacologic pain relief, but they are associated with the same adverse effects that pain management strives to mitigate. Opioids are associated with a large side effect profile, including a higher risk of various postoperative complications. Opioids are potentially highly addictive and postoperative use is associated with dependence, tolerance, and the current opioid epidemic. Some studies indicate that there are similar surgical outcomes amongst patients independent of whether opioids were prescribed opioids for pain relief. CONCLUSION: Opioids should only be recommended for postoperative pain management under strict guidance and supervision from physicians. All 50 states have acute pain guidelines in place limiting opioid prescribing. One of the strategies of reducing postoperative opioid consumption is the emphasis on opioid alternatives that should be actively considered and explored prior to resorting to opioids. There are pharmacological and non-pharmacological options available for pain relief that can provide similar levels of analgesia as prescription opioid without unwanted effects such as tolerance and dependency. Proper assessment of patient history and risk factors can aid physicians in tailoring a pain management regimen that is appropriate for each individual patient. More research into efficacy and safety of alternative treatments to opioids is warranted.
Does Chemotherapy-Induced Peripheral Neuropathy Fall Within the Spectrum of Complex Regional Pain Syndrome? A Narrative Review.
Malik A, Javed S
Curr Pain Headache Rep · 2025 Apr · PMID 40257707 · Publisher ↗
PURPOSE OF REVIEW: Peripheral neuropathies and complex regional pain syndrome (CRPS) result in a similar clinical picture including shared sudomotor and vasomotor symptomatology. Chemotherapeutic agents can precipitate c...
PURPOSE OF REVIEW: Peripheral neuropathies and complex regional pain syndrome (CRPS) result in a similar clinical picture including shared sudomotor and vasomotor symptomatology. Chemotherapeutic agents can precipitate chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients akin to development of CRPS following trauma. Below we review the areas of overlap between CRPS and CIPN including their shared pathophysiology, clinical presentation, diagnostics, and treatment options. RECENT FINDINGS: The features of autonomic dysfunction, motor impairment, and reduced proprioception observed in both CRPS and CIPN may result from shared mechanisms include inflammatory reactions, immune dysregulation, autonomic changes, as well as central and peripheral sensitization. Both conditions are a clinical diagnosis of exclusion, and demand a personalized, multidisciplinary therapeutic approach inclusive of psychosocial interventions to reduce deleterious effects on an individual's quality of life. CIPN is recognized as a separate clinical entity albeit sharing a similar underlying pathology and clinical presentation with CRPS. It may be plausible to include CIPN on the CRPS clinical spectrum as our mechanistic understanding of its development and progression evolves.
Efficacy and Safety of Posterior Minimally Invasive Sacroiliac Joint Fusion: A Narrative Review of Recent Evidence.
Serio MA, Aucoin MC, Davis J … +2 more , Shekoohi S, Kaye AD
Curr Pain Headache Rep · 2025 Apr · PMID 40257675 · Publisher ↗
PURPOSE OF REVIEW: Chronic low back pain is one of the top three causes of diminished quality of life in well-developed countries. There are many etiologies of lower back pain, and sometimes, the pain is of true spinal p...
PURPOSE OF REVIEW: Chronic low back pain is one of the top three causes of diminished quality of life in well-developed countries. There are many etiologies of lower back pain, and sometimes, the pain is of true spinal pathology. However, this is not always the case, and sacroiliac joint (SIJ) pain has been described as an etiology in 15-30% or more of patients who are experiencing low back pain. Overlooking SIJ dysfunction as the cause of low back pain has considerable consequences on the patient's quality of life and healthcare-associated costs. SIJ dysfunction has been gaining recognition through well-described algorithms and reports on how to diagnose and differentiate types of low back pain. RECENT FINDINGS: When conservative management fails in patients with SIJ dysfunction, fusion of the SIJ is a possibility. SIJ fusion was introduced as an open procedure but was often seen as a "last resort" related to the high complication rates and intensity of the procedure consistent with long operative time, high blood loss, and extended hospital stays. Minimally invasive surgical techniques for SIJ fusion were developed and have produced quality relief for some patients. Most minimally invasive SIJ fusion procedures are performed through a lateral approach. However, newer studies have shown evidence of a posterior or posterior oblique approach that may be more desirable for patients. The posterior approach to SIJ fusion has demonstrated a shorter operative time, smaller incision, and quicker return to activities of daily living. This narrative review aims to highlight up to date evidence on the efficacy and safety posterior minimally invasive SIJ fusion.
SCS for CRPS: A Review of Cost-Effectiveness Models.
Briggi DR, Reilly J, Garcia J … +1 more , Kupperman W
Curr Pain Headache Rep · 2025 Apr · PMID 40257598 · Publisher ↗
PURPOSEOF REVIEW: The provision of a review of current literature on the cost-effectiveness of employing SCS in the treatment of CRPS. RECENT FINDINGS: Four studies were included in this review, with authorship in the Un...
PURPOSEOF REVIEW: The provision of a review of current literature on the cost-effectiveness of employing SCS in the treatment of CRPS. RECENT FINDINGS: Four studies were included in this review, with authorship in the United States, Canada, Europe, and Australia. Each study individually supported the cost-effectiveness of SCS in the treatment of CRPS, with the incremental cost of one quality-adjusted life year found to be AUD 2,321 - USD 22,084, all below a willingness to pay estimated at USD 50,000. One of the four studies was rated American Academy of Neurology (AAN) Grade II, three of the four studies were rated AAN Grade III, and an overall Class C evaluation was assigned to this evidence. SCS can be cost-effective in the treatment of patients with CRPS when considering a time horizon of at least ten years. Current evidence, however, remains weak and less invasive options remain first-line.
Acupuncture for the Management of Chronic Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Lan L, Wang L, Sadeghirad B … +5 more , Tang J, Liu Y, Couban RJ, Ma W, Busse JW
Curr Pain Headache Rep · 2025 Apr · PMID 40220243 · Publisher ↗
AIM: Diabetic peripheral neuropathy (DPN) affects up to half of all patients with diabetes mellitus. Acupuncture is often used to manage chronic pain, but its' effects on DPN are uncertain. We conducted a systematic revi...
AIM: Diabetic peripheral neuropathy (DPN) affects up to half of all patients with diabetes mellitus. Acupuncture is often used to manage chronic pain, but its' effects on DPN are uncertain. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) to assess the effectiveness of acupuncture for DPN. METHODS: We searched databases from inception to September 30, 2024. Paired reviewers independently extracted data and assessed risk of bias. We used random effects models for all meta-analyses and the GRADE approach to assess the certainty of evidence. RESULTS: We included 14 RCTs (1,169 participants, 45% female). Low certainty evidence suggests that, compared to sham, acupuncture may reduce pain (weighted mean difference [WMD] -1.44 cm on a 10 cm VAS, 95%CI -1.72 to -1.15; modelled risk difference [RD] for achieving the minimally important difference [MID] of 1.5 cm: 45%, 95%CI 35-54%). Comparted to sham or usual care, low certainty evidence suggests that acupuncture may reduce overall neurological symptom severity (WMD - 1.22 [95%CI -1.85, -0.59] on the 19-point Toronto Clinical Scoring System [TCSS]), and provide little to no difference in physical functioning, mental functioning, or adverse events. Low certainty evidence suggests that, compared to amitriptyline or pregabalin, acupuncture may reduce pain associated with DPN. CONCLUSIONS: Acupuncture for DPN may reduce pain when compared to sham acupuncture and may reduce neurologic symptom severity and result in little to no difference in physical functioning, mental functioning or adverse events, when compared with sham acupuncture or usual care.
Neuropathic Pain: A Comprehensive Bibliometric Analysis of Research Trends, Contributions, and Future Directions.
Leoni MLG, Mercieri M, Viswanath O … +5 more , Cascella M, Rekatsina M, Pasqualucci A, Caruso A, Varrassi G
Curr Pain Headache Rep · 2025 Apr · PMID 40183995 · Full text
BACKGROUND: Neuropathic pain represents a significant public health concern due to its complex pathophysiology and the disability it can cause. Despite advancements in understanding its underlying mechanisms and potentia...
BACKGROUND: Neuropathic pain represents a significant public health concern due to its complex pathophysiology and the disability it can cause. Despite advancements in understanding its underlying mechanisms and potential treatments, challenges persist in achieving effective management. This bibliometric analysis aims to offer a comprehensive overview of research trends, key contributors, and existing gaps in the literature on neuropathic pain, providing valuable insights to guide future studies and enhance clinical approaches. METHODS: A bibliometric analysis was conducted using the Web of Science Core Collection (WoSCC) database. Key metrics, including publication trends, citation patterns, co-authorship networks, and keyword co-occurrence, were evaluated. Statistical analyses included average annual percentage change (APC) assessments and trend forecasting with an Auto Regressive Integrated Moving Average (ARIMA) model. RESULTS: A total of 9,974 studies published between 2005 and 2024 were included. Publications peaked between 2021 and 2022 but showed a slight decline thereafter, with forecasts predicting a steady increase from 2025 to 2030. Most papers were published in high-impact Q1 journals, reflecting the quality of research. Co-authorship analysis revealed central hubs of collaboration in the USA and China, with limited integration of smaller countries into the global research network. Keyword analysis identified multiple thematic clusters, including "chronic pain," "molecular mechanisms," and "clinical management." Specific gaps were noted in understanding personalized therapeutic approaches, and non-pharmacological interventions. CONCLUSIONS: This analysis underscores the critical need for continued research to address gaps in diagnosis, treatment, and management of neuropathic pain. Strengthening international collaborations and fostering multidisciplinary efforts will be pivotal in advancing this field.
Risks and Benefits of Cervical Transforaminal Epidural Steroid Injections: A Comprehensive Review.
Hasoon J, Brown A, Moauro A … +2 more , Viswanath O, Abd-Elsayed A
Curr Pain Headache Rep · 2025 Apr · PMID 40172800 · Publisher ↗
PURPOSE OF REVIEW: Cervical transforaminal epidural steroid injections (CTFESIs) are widely used for the treatment of radicular pain caused by cervical spine pathology, including disc herniations and foraminal stenosis....
PURPOSE OF REVIEW: Cervical transforaminal epidural steroid injections (CTFESIs) are widely used for the treatment of radicular pain caused by cervical spine pathology, including disc herniations and foraminal stenosis. This review aims to analyze the risks and benefits of CTFESIs, address their efficacy and safety profile, improve clinical decision-making, and educate interventional pain medicine physicians. RECENT FINDINGS: CTFESIs have demonstrated benefits such as pain relief, functional improvement, and the potential to avoid surgical interventions. However, their use is limited by safety concerns due to the proximity of vascular structures in the cervical spine. Complications, including neurological injuries, infections, and vascular injuries, though rare, can be severe. Recent studies emphasize the importance of using advanced procedural techniques, such as fluoroscopic guidance and non-particulate corticosteroids, to minimize risks. CTFESIs remain a valuable tool for managing cervical radiculopathy in selected patients. While they provide substantial therapeutic and diagnostic benefits, careful patient selection and adherence to safety protocols are crucial to minimizing serious complications. This review compiles current evidence to assist clinicians in evaluating the risks and benefits of CTFESIs in clinical practice.
Epidemiology of Pediatric Chronic Pain: An Overview of Systematic Reviews.
Lo Cascio A, Cascino M, Dabbene M … +4 more , Paladini A, Viswanath O, Varrassi G, Latina R
Curr Pain Headache Rep · 2025 Apr · PMID 40167860 · Full text
PURPOSE OF REVIEW: Chronic non-cancer pain in children and adolescents represents a significant public health issue, affecting physical, psychological, and social well-being. Defined as pain persisting for over three mon...
PURPOSE OF REVIEW: Chronic non-cancer pain in children and adolescents represents a significant public health issue, affecting physical, psychological, and social well-being. Defined as pain persisting for over three months, this condition is influenced by developmental, socioeconomic, and cultural factors. However, its prevalence remains uncertain and debated. A comprehensive literature search was conducted across electronic databases, including Medline, Embase, CINAHL, PsycINFO, and the Cochrane Library. Eligible systematic reviews were critically appraised using the AMSTAR-2 tool to assess methodological quality. This overview synthesises evidence from existing systematic reviews to provide an updated understanding of the epidemiology and burden of paediatric non-cancer chronic pain. RECENT FINDINGS: Findings revealed substantial variability in the reported prevalence of specific pain types: headaches (4-83%), abdominal pain (4-53%), musculoskeletal pain (4-40%), and back/low-back pain (14-24%). Prevalence was generally lower in low- and middle-income countries, likely due to barriers in healthcare access. Methodological heterogeneity was observed across studies, and AMSTAR-2 assessment identified critical limitations in some systematic reviews, impacting the reliability of findings. This overview highlights the urgent need for standardised research methodologies to accurately monitor the prevalence of paediatric non-cancer chronic pain. Standardisation is essential for informing policies aimed at mitigating the long-term impact of chronic pain in children and adolescents. Addressing these issues, particularly in resource-limited settings, is crucial for improving health outcomes and reducing societal and economic burdens.
Prophylactic Fibrin Glue Application for Immediate Management of Dural Puncture during Spinal Cord Stimulation Lead Placement: a Simple and Effective Technique.
Gazzeri R, Galarza M, Occhigrossi F … +3 more , Viswanath O, Varrassi G, Leoni MLG
Curr Pain Headache Rep · 2025 Mar · PMID 40131573 · Publisher ↗
BACKGROUND: Accidental dural puncture during epidural lead insertion for Spinal Cord Stimulation (SCS) is a recognized surgical complication that may lead to cerebrospinal fluid (CSF) leakage and subsequent postdural pun...
BACKGROUND: Accidental dural puncture during epidural lead insertion for Spinal Cord Stimulation (SCS) is a recognized surgical complication that may lead to cerebrospinal fluid (CSF) leakage and subsequent postdural puncture headache (PDPH). The optimal technical approach to prevent CSF leakage remains controversial. This study aimed to evaluate a simple and efficient intraoperative technique for managing accidental dural puncture during SCS lead placement. MATERIALS AND METHODS: A retrospective review was conducted of the medical records and imaging studies of all patients who underwent SCS procedures between January 2020 and April 2024. Signs or symptoms associated with dural puncture were recorded, including subcutaneous fluid collections, pseudomeningocele formation, PDPH, wound infection, and meningitis. RESULTS: Among 107 patients who underwent SCS implantation, involving a total of 194 lead insertions, 4 cases (3.7%) of intraoperative CSF leakage due to iatrogenic dural puncture were identified. Each case was managed by injecting fibrin glue through the introducer needle into the epidural space, directly over the dural lesion. CONCLUSIONS: Prophylactic application of fibrin glue following dural puncture appears to be highly effective in sealing the damage and preventing CSF leakage. This technique offers a valuable intraoperative solution for surgeons to immediately address dural injuries during SCS lead placement, potentially minimizing postoperative complications and improving patient outcomes.
Efficacy and Safety of Thoracic Epidural vs. Paravertebral Block for Analgesia in Thoracotomy: A Systematic Review of Randomized Controlled Trials.
Eaves GK, Ware EE, Touchet DR … +6 more , Hamilton WK, Netterville SS, Stevens JR, Ahmadzadeh S, Shekoohi S, Kaye AD
Curr Pain Headache Rep · 2025 Mar · PMID 40126729 · Publisher ↗
PURPOSE OF REVIEW: This systematic review aimed to compare the efficacy and safety of thoracic epidural block (TEB) and thoracic paravertebral block (TPB) for managing postoperative pain following thoracotomy for pulmona...
PURPOSE OF REVIEW: This systematic review aimed to compare the efficacy and safety of thoracic epidural block (TEB) and thoracic paravertebral block (TPB) for managing postoperative pain following thoracotomy for pulmonary procedures. RECENT FINDINGS: A comprehensive search of PubMed, Embase, Web of Science, and Google Scholar identified randomized controlled trials (RCTs) published prior to April 10, 2024. Studies were eligible if they compared TEB and TPB in adult patients undergoing thoracotomy for pulmonary procedures and reported outcomes on postoperative pain, opioid consumption, hemodynamic parameters, or complications. Two reviewers independently screened studies, extracted data, and assessed quality using the Cochrane Risk of Bias tool. The review adhered to PRISMA guidelines. From 1,114 records screened, 7 RCTs comprising 429 patients met the inclusion criteria. TEB demonstrated superior pain relief in the immediate postoperative period, particularly when continuous infusions with opioids were utilized. TPB, however, provided greater hemodynamic stability, with significantly lower rates of hypotension and more stable mean arterial pressure and heart rate during the first 24 h. Beyond 24 h, both techniques offered comparable pain relief and opioid consumption. While the incidence of nausea, vomiting, and urinary retention was similar between groups, TPB was associated with fewer respiratory complications. Both TEB and TPB are effective for postoperative pain management following thoracotomy, each with distinct advantages. TEB provides optimal early pain control, making it suitable for patients with significant early postoperative pain. TPB, with its superior hemodynamic profile, is better suited for patients at risk of hypotension or cardiovascular instability. Tailoring analgesic strategies to patient-specific needs can optimize outcomes. Future large-scale RCTs are necessary to confirm these findings across broader thoracic surgical populations. REGISTRATION AND PROTOCOL: This review was registered with PROSPERO prior to initiation (Registration Number: CRD42024578768).
Reviewing Psychological Practices to Enhance the Psychological Resilience Process for Individuals with Chronic Pain: Clinical Implications and Neurocognitive Findings.
Çalışkan E, Gökkaya F
Curr Pain Headache Rep · 2025 Mar · PMID 40119957 · Full text
PURPOSE OF REVIEW: Psychological practices have emerged as promising treatments for coping with chronic pain (CP) as a psychological resilience (PR) enhancer mechanism. These practices contain cognitive, behavioral and e...
PURPOSE OF REVIEW: Psychological practices have emerged as promising treatments for coping with chronic pain (CP) as a psychological resilience (PR) enhancer mechanism. These practices contain cognitive, behavioral and emotional modulation of pain. In this regard, classical cognitive-behavioral therapy (CBT) and current trends in CBT, including acceptance and commitment therapy and mindfulness-based practices may demonstrate significant improvements in pain perception, physical functioning, catastrophic beliefs and fear-avoidance behaviors among patients with CP. However, understanding the neurocognitive mechanisms of these practices includes challenges, such as the need to identify associated brain regions with PR to CP. Our review explored psychological practices to enhance PR as a dynamic neurocognitive process (e.g., changing affect) rather than only being a static trait. RECENT FINDINGS: Psychological practices have promising results in improving positive outcomes for CP sufferers. To illustrate, along with superior PR scores, higher positive affect, adaptive pain beliefs, and physical functioning were reported after these practices. Conversely, lower pain catastrophizing, pain-related fear-avoidance, and self-reported pain ratings were seen as PR factors. Moreover, enhanced PR process may be associated with increased activity of the brain regions, including prefrontal cortex and orbitofrontal cortex, whereas diminished activity, reactivity, and functional connectivity in the anterior cingulate cortex, amygdala and insula. This review discusses the neurocognitive modulation of CP through psychological practices and highlights the role of enhancing the PR process for individuals with CP. As the field continues to evolve, understanding the importance of psychological practices to develop PR-related factors is crucial for increasing pain management outcomes.
Fasting and Headache.
Ebbert PT, Natbony LR
Curr Pain Headache Rep · 2025 Mar · PMID 40117066 · Publisher ↗
PURPOSE OF REVIEW: This review synthesizes the latest updates in the literature on the connection between fasting and migraine, examining both clinical outcomes and underlying pathophysiological mechanisms. RECENT FINDIN...
PURPOSE OF REVIEW: This review synthesizes the latest updates in the literature on the connection between fasting and migraine, examining both clinical outcomes and underlying pathophysiological mechanisms. RECENT FINDINGS: Although no studies have specifically explored fasting as a therapeutic intervention for migraine, various retrospective analyses suggest that fasting might worsen migraine symptoms in the short term. On the other hand, recent investigations, including several randomized controlled trials, have shown that ketogenic diets significantly reduce the number of migraine days and decrease inflammation markers. Additional research has shown improvements in disability assessments, as indicated by VAS, MIDAS, and HIT-6 scores. These benefits are not replicated by merely administering ketone bodies. Furthermore, genetic studies have found a link between glycemic processing and the occurrence of migraine. There is accumulating evidence that ketogenesis can reduce both the frequency and disability associated with migraine, likely through the reduction of systemic inflammatory markers and diminished cortical excitability. However, the potential benefits of intermittent fasting on migraine prevention remain underexplored and warrant further investigation.
Ultrasound Guided Genicular Nerve Blocks for Pain Management Following Total Knee Replacement: A Narrative Review.
Kaye AD, Upshaw WC, Tassin JP … +10 more , Corrent JM, D'Antoni JV, Frolov MV, Ahmadzadeh S, Patel H, Armstrong CJ, Behara R, Patil S, Kataria S, Shekoohi S
Curr Pain Headache Rep · 2025 Mar · PMID 40106042 · Publisher ↗
PURPOSE OF REVIEW: Total knee replacement (TKR) is a common procedure to alleviate pain in patients with severe osteoarthritis of the knee after failed conservative treatment. While generally safe, postoperative pain is...
PURPOSE OF REVIEW: Total knee replacement (TKR) is a common procedure to alleviate pain in patients with severe osteoarthritis of the knee after failed conservative treatment. While generally safe, postoperative pain is a significant issue many patients experience following surgery. RECENT FINDINGS: To control postoperative pain, numerous treatments may be administered which may be given preoperatively, intraoperatively, or postoperatively. These treatments include medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and opioids. Additionally, peripheral nerve blocks (PNB) may be performed prior to total knee replacement to limit pain after the surgery. A specific type of PNB done prior to total knee replacement is the genicular nerve block (GNB) which targets five genicular nerves that innervate different parts of the knee joint. This type of block is designed to prevent pain impulses from being sent to the central nervous system from the knee without affecting movement of the lower extremity by sparing efferent nerves innervating muscles. PubMed was used to identify the studies found in this review that are less than 5 years old using the search term "genicular nerve block clinical studies." Most studies compared GNB alone compared to other blocks, however some used GNB in combination with other blocks, most at a maximum of 48 h postoperative. GNB is typically performed by anesthesiologists under ultrasound guidance to ensure accurate placement of the block. Clinical studies have shown that GNB is effective in controlling pain following TKR leading to lower pain scores following surgery as well as a reduced level of opioid consumption. Additionally, GNB has shown reduced motor weakness following TKR compared to other types of PNBs allowing earlier mobilization of patients. However, more studies are needed to further investigate the efficacy of GNB compared to other PNBs to treat postoperative pain following TKR.
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