Current Pain And Headache Reports[JOURNAL]
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200 papers
Biologic Therapies for Discogenic Pain.
Lou J, Ryan R, Wang D
Curr Pain Headache Rep · 2025 Feb · PMID 39932512 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this review is to provide an update on recent developments in the field of regenerative medicine, specifically focusing on emerging data related to biologics, including platelet-rich pla...
PURPOSE OF REVIEW: The purpose of this review is to provide an update on recent developments in the field of regenerative medicine, specifically focusing on emerging data related to biologics, including platelet-rich plasma and mesenchymal cells, for the treatment of discogenic back pain. RECENT FINDINGS: There has been a notable surge of interest in biologics, as evidenced by a wealth of recent reviews and studies. While serious adverse events are generally uncommon, considerable heterogeneity exists in study designs. More robust investigations are warranted to thoroughly evaluate the safety and efficacy of biologics in treating discogenic back pain. Continued research and funding are needed to better understand the underlying mechanisms of disc degeneration and to develop targeted therapies that can alleviate and reduce the burden of this debilitating condition. Biologics may offer effective treatments for discogenic pain; however, more multi-center, prospective, double-blinded, randomized placebo-controlled trials are essential to further establish their effectiveness.
Consenting for Spinal Cord Stimulation - the Pitfalls and Solution.
Mehta V, Munglani R, Eyre G … +3 more , Bajaj G, Abd-Elsayed A, Poply K
Curr Pain Headache Rep · 2025 Feb · PMID 39891805 · Full text
PURPOSE OF REVIEW: To discuss the importance of the consenting process for patients undergoing spinal cord stimulation (SCS) therapy and understanding related complications and effects. RECENT FINDINGS: Litigation for SC...
PURPOSE OF REVIEW: To discuss the importance of the consenting process for patients undergoing spinal cord stimulation (SCS) therapy and understanding related complications and effects. RECENT FINDINGS: Litigation for SCS/DRG related complications can be very costly, with the mean average settlement in cases relating to SCS being $303,173 dollars in the USA. According to the US Anaesthesia Closed Claims Project database, 10,546 claims related to pain medicine were made between 1990 and 2013; 43 of which were associated with SCS complications. This article will further explore consenting and complications within the context of SCS. Consenting for SCS is a crucial and very important step which potentially reflect on patients' expectations and outcomes.
Neuroimage Signature in Post-Stroke Pain: A Systematic Review.
Buzhanskyy A, Duarte IC, Patto AV … +4 more , Donato H, Castelo-Branco M, Abejas A, Lapa T
Curr Pain Headache Rep · 2025 Jan · PMID 39885090 · Publisher ↗
INTRODUCTION: Central Post-Stroke Pain (CPSP) is a debilitating condition with a significant prevalence in stroke survivors. Set apart by its refractory to treatment neuropathic pain, it appears to arise from lesions in...
INTRODUCTION: Central Post-Stroke Pain (CPSP) is a debilitating condition with a significant prevalence in stroke survivors. Set apart by its refractory to treatment neuropathic pain, it appears to arise from lesions in the spino-thalamo-cortical pathways, particularly in the thalamus. Despite advances in neuroimaging techniques, the pathophysiology of CPSP remains poorly understood, with limited diagnostic criteria and therapeutic approaches. OBJECTIVE: This systematic review aims to identify neuroimaging markers associated with CPSP, establish correlations between brain lesions and CPSP development, and explore the utility of neuroimaging techniques for diagnosis and prognosis. Secondary objectives involve establishing a link between CPSP and secondary brain area lesions and what type of pain patients with CPSP are more likely to experience. METHODS: A systematic review was conducted following PRISMA guidelines. Relevant articles were sourced from PubMed, Embase, and Web of Science, using a predefined search strategy targeting CPSP and neuroimaging studies (MRI, PET, SPECT). Studies involving adult CPSP patients with post-stroke neuroimaging were included. Data from 14 studies was analyzed, focusing on lesion locations, neuroimaging findings, and functional connectivity. Risk of bias was assessed using the QUADAS-2 tool. RESULTS: Key findings highlighted the association of CPSP with lesions in the ventral posterolateral and the ventral medial nuclei of the thalamus, spinothalamic pathway, and cortical areas like the insula and operculum. Functional connectivity studies highlighted the role of disrupted neural networks in pain perception. Limitations in the reviewed studies included small sample sizes, selection bias, and heterogeneity in study designs. CONCLUSIONS: Neuroimaging findings confirm the significance of thalamic and spinothalamic pathway lesions in CPSP pathophysiology. Despite these insights, gaps in research underline the need for larger, multicenter trials to identify reliable biomarkers for diagnosis and therapeutic targets. Advanced neuroimaging combined with machine learning could be the key to understanding and managing CPSP.
The Impact of Racial and Low Socioeconomic Status on the Implementation of Spinal Cord Stimulation for Chronic Pain in the United States.
Howard G, Guinand L, Xu E … +2 more , Kervyn A, Habibi B
Curr Pain Headache Rep · 2025 Jan · PMID 39883273 · Full text
OBJECTIVES: This study aims to review the societal, economic, and racial factors that impact the usage of spinal cord stimulation for chronic pain. Our working hypothesis is that patients of ethnic minority groups or of...
OBJECTIVES: This study aims to review the societal, economic, and racial factors that impact the usage of spinal cord stimulation for chronic pain. Our working hypothesis is that patients of ethnic minority groups or of lower socioeconomic status (SES) status may have lower implantation rates and usage of spinal cord stimulation (SCS). MATERIALS AND METHODS: Our study sourced publications from PubMed, Embase, and Cochrane Library on December 21st, 2023 for SCS for the purposes of pain management. Articles were excluded from the review if the study was not USA based, did not involve SCS for the purpose of pain or did not allow for the subgroup analysis. There were 1028 reports that resulted after the initial search with 184 duplicates which were removed. Six reports met the inclusion and exclusionary criteria and were included in the review. RESULTS: Several trends were able to be extrapolated from the pooled reviews. Orhurhu et al. found that Black and Hispanic minorities had a higher utilization rate of SCSs than their White and Asian counterparts in the inpatient setting. Jones and Missios et al. found that in the outpatient setting, White and privately insured patients were more likely to utilize SCS. Ovrom et al. observed an increased cost associated with Hispanic ethnicity and inpatient SCS utilization. Wondwossen et al. found that in the US military system White patients were more likely to receive SCS earlier in their care than Black patients. Labaran et al. concluded the Southern US completed more SCS implants, particularly in White patients with Medicare insurance. CONCLUSIONS: White patients are recipients of SCS earlier and more frequently than minority patients in the outpatient setting. There is mixed evidence regarding inpatient SCS and how household income relates to SCS usage. Insurance type and coverage may be more accurately predictive than simple household income for SCS utilization.
Anxiety Disorders, Anxious Symptomology and Related Behaviors Associated With Migraine: A Narrative Review of Prevalence and Impact.
Raudenská J, Macko T, Vodičková Š … +2 more , Buse DC, Javůrková A
Curr Pain Headache Rep · 2025 Jan · PMID 39878907 · Full text
PURPOSE OF REVIEW: The purpose of this study was to review the literature on the relationship between migraine, anxiety and related disorders, anxious symptomology and related behaviors. RECENT FINDINGS: Generalized anxi...
PURPOSE OF REVIEW: The purpose of this study was to review the literature on the relationship between migraine, anxiety and related disorders, anxious symptomology and related behaviors. RECENT FINDINGS: Generalized anxiety, other anxious disorders and migraine are comorbid. In addition, anxious symptomology and behaviors are common in people with migraine even if they do not meet diagnostic criteria or threshold. Anxiety including diagnosed disorders such as generalized anxiety, phobias, panic disorder, as well as behaviors such as catastrophizing, avoidance behaviors, and higher fear of headache/migraine or anxiety sensitivity are comorbid and/or common in migraine. Anxiety is associated with negative outcomes such as migraine progression, medication overuse, stigma and migraine-related disability. The association between migraine, anxiety, and fear and avoidance behaviors has an extensive empirical basis. Awareness of the high prevalence of comorbidity and symptomology as well as the negative outcomes associated with anxiety and related symptoms and behaviors is important in the comprehensive management of people with migraine. Better understanding the relationship between migraine and anxiety symptoms and behaviors and their effects on outcomes is essential to provide more effective treatment for people with migraine. The review emphasizes the necessity of screening and more comprehensive evaluation in patients with migraine using psychological diagnostic tools. Thus, prevention and management of anxiety, fear, and anxiety-related behaviors in the context of migraine management may be considered an essential treatment goal and strategies may include non-pharmacological and pharmacological approaches.
Association of ESR1 Polymorphisms with Susceptibility to Migraine: A Meta-Analysis and Trial Sequential Analysis.
Ranjan S, Paikaray A, Mishra A … +3 more , Sethi A, Dhurua D, Panda AK
Curr Pain Headache Rep · 2025 Jan · PMID 39878792 · Publisher ↗
BACKGROUND: Migraine is a highly prevalent and incapacitating neurological disorder mostly characterised by recurring attacks of moderate to severe throbbing and pulsating pain on one side of the head. The role of estrog...
BACKGROUND: Migraine is a highly prevalent and incapacitating neurological disorder mostly characterised by recurring attacks of moderate to severe throbbing and pulsating pain on one side of the head. The role of estrogen in migraine has been well documented. Although genetic variations in the ESR1 gene have been associated with an increased risk of developing migraine, the findings are inconsistent. We performed a meta-analysis of previously published articles considering four important single nucleotide polymorphisms in the ESR1 gene (rs1801132, rs2228480, rs2234693, and rs9340799) to explore their possible association with the development of migraine and its clinical phenotypes. MATERIALS AND METHODS: We thoroughly searched literature databases, including PubMed, Science Direct, and Scopus until March 14, 2024, to identify the relevant reports. We utilized GPower software v.3 to assess the power of each report included in the meta-analysis and Comprehensive Meta-analysis v4 for all meta-analysis-related analyses. We employed funnel plots and Egger's regression test to identify publication biases within each genetic comparison model. We used Cochrane Q statistics, probability value, and I to assess heterogeneity. RESULTS: After applying predefined criteria, a meta-analysis was conducted with 11 relevant studies comprising 3835 cases of migraine and 3655 healthy individuals. The analysis indicated a strong correlation between ESR1 polymorphisms (rs2228480 and rs9340799) and the likelihood of developing migraine. Furthermore, the subgroup analysis showed that rs2228480 is associated with susceptibility to migraine in both Caucasians and Asians. Additionally, rs2234693 variants were found to be linked with the development of migraine with aura. However, the trial sequential analysis suggested that more case-control studies are necessary to establish the definitive role of ESR1 variants in migraine. CONCLUSIONS: ESR1 variants (rs2228480, rs2234693, and rs9340799) are associated with an increased risk of migraine and related phenotypes. However, further studies are needed to establish a definitive conclusion.
Pain and Headache in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.
Diaz P, Nealon NE, Kaunzner UW
Curr Pain Headache Rep · 2025 Jan · PMID 39878785 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this review is to evaluate the current knowledge and recent findings on different pain and headache presentations associated with Myelin Oligodendrocyte Glycoprotein Antibody-Associated...
PURPOSE OF REVIEW: The purpose of this review is to evaluate the current knowledge and recent findings on different pain and headache presentations associated with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) disease. RECENT FINDINGS: MOGAD is an inflammatory autoimmune disease affecting mostly the central nervous system, presenting with optic neuritis, transverse myelitis and other forms of inflammatory demyelination. Pain and headache in MOGAD have been recognized more recently and acute and chronic forms of pain can occur in both the adult and pediatric population. An important recent observation is that MOGAD can affect the peripheral nervous system, which can contribute to pain symptoms. Acute and chronic forms of pain have been described in MOGAD, including ocular pain, different types of headaches and neuropathies, involving the central and peripheral nervous system. Awareness of these types of pain in both the pediatric and adult population is crucial, to ensure timely diagnosis and treatment.
Pudendal Neuralgia: A Review of the Current Literature.
Conic RRZ, Kaur P, Kohan LR
Curr Pain Headache Rep · 2025 Jan · PMID 39873912 · Publisher ↗
PURPOSE OF REVIEW: This paper aims to review pudendal neuralgia pathophysiology, risk factors, diagnosis, and treatment options. RECENT FINDINGS: Conservative and pharmacologic options are first line treatments for the t...
PURPOSE OF REVIEW: This paper aims to review pudendal neuralgia pathophysiology, risk factors, diagnosis, and treatment options. RECENT FINDINGS: Conservative and pharmacologic options are first line treatments for the treatment of pudendal neuralgia. Interventional treatment such as, pudendal nerve blocks can be tried if first line treatments feel to provide adequate analgesia. If pudendal nerve blocks provide sufficient relief but have a short duration, decompressive surgery may be considered. Neuromodulation is also a viable option. Emerging techniques such as pulsed radiofrequency ablation, cryotherapy, lipofilling, and repetitive transcranial magnetic stimulation are promising; however, more studies are needed to evaluate safety and effectiveness. Current study data is generally poor, and unstandardized. Further research is needed to identify the optimal treatment approach and evaluate the effects of pudendal neuralgia on mental health and quality of life.
Trigeminal Neuralgia: Disease Characterization and Prediction of Response to Surgical Intervention.
Lam JLW, Sankar T, Sekula RF … +2 more , Senatus PB, Patil PG
Curr Pain Headache Rep · 2025 Jan · PMID 39873810 · Publisher ↗
PURPOSE OF REVIEW: Trigeminal neuralgia (TN) is a highly heterogeneous condition with a wide choice of successful treatment options. However, differences between subtypes are poorly understood and it remains unknown whic...
PURPOSE OF REVIEW: Trigeminal neuralgia (TN) is a highly heterogeneous condition with a wide choice of successful treatment options. However, differences between subtypes are poorly understood and it remains unknown which patients will respond to different treatments. This review aims to summarize the current state of the TN field and explore the problem of predicting surgical outcomes. RECENT FINDINGS: Attempts have been made to standardize classification, outcome reporting, and treatment guidelines. Identification of risk factors for poor surgical treatment outcomes has led to the development of prognostic scoring systems to predict outcomes and guide management. Advances in imaging techniques including diffusion tensor imaging show promise in better understanding the underlying pathophysiology and predicting surgical outcomes. Progress is hampered by lack of understanding of the pathophysiology in TN and differences between disease subtypes. Further work needs to be done to create accurate prediction tools for widespread use, including use of advanced imaging and computing tools, multicenter collaboration, and prospective validation.
The Potential of Spinal Cord Stimulation in Treating Spinal Cord Injury.
Forouzan EJ, Rashid MY, Nasr NF … +2 more , Abd-Elsayed A, Knezevic NN
Curr Pain Headache Rep · 2025 Jan · PMID 39869234 · Publisher ↗
PURPOSE OF THE REVIEW: In the United States, spinal cord injuries affect approximately 18,000 individuals annually, most commonly resulting from mechanical trauma. The consequent paraplegia severely impairs motor functio...
PURPOSE OF THE REVIEW: In the United States, spinal cord injuries affect approximately 18,000 individuals annually, most commonly resulting from mechanical trauma. The consequent paraplegia severely impairs motor functions, creating an urgent need for innovative therapeutic strategies that extend beyond traditional rehabilitation and pharmacotherapy. This review assesses the effectiveness of Spinal Cord Stimulation (SCS) in improving motor function in patients with spinal cord injuries, with a particular focus on paraplegia. SCS, an emerging intervention, has gained attention for its ability to activate paralyzed muscles and enhance the effects of physical therapy. RECENT FINDINGS: Our review demonstrates that SCS can lead to significant functional improvements when optimally combined with rehabilitation strategies. The success of SCS depends largely on the precise placement of electrodes with individualized parameters and the integration of stimulation with intensive physical training. This review underscores the considerable potential of SCS to improve motor outcomes in individuals with paraplegia caused by spinal cord injury, emphasizing the need for further research to optimize SCS parameters, electrode placement, and its integration with rehabilitation protocols. This review highlights the potential of SCS as a therapeutic intervention for improving motor function in individuals with paraplegia caused by spinal cord injuries.
An Algorithmic Overview of Advanced Pain Therapies: A Narrative Review.
Vu PD, D'Souza RS, Javed S
Curr Pain Headache Rep · 2025 Jan · PMID 39869170 · Publisher ↗
PURPOSE OF REVIEW: Quickly referenceable, streamlined, algorithmic approaches for advanced pain management are lacking for patients, trainees, non-pain specialists, and interventional specialists. This manuscript aims to...
PURPOSE OF REVIEW: Quickly referenceable, streamlined, algorithmic approaches for advanced pain management are lacking for patients, trainees, non-pain specialists, and interventional specialists. This manuscript aims to address this gap by proposing a comprehensive, evidence-based algorithm for managing neuropathic, nociceptive, and cancer-associated pain. Such an algorithm is crucial for pain medicine education, offering a structured approach for patient care refractory to conservative management. RECENT FINDINGS: A comprehensive literary review with PubMed and regulatory documents from the United States Food and Drug Administration were searched for a variety of interventions. Pain syndromes were categorized into nociceptive and neuropathic pain, and an algorithm was constructed. Serving as an educational tool for patients, trainees, and non-pain specialists, and as an accessible reference for pain specialists, this algorithm bridges knowledge gaps, promotes interdisciplinary collaboration, and streamlines the learning curve for new practitioners. The strength of this algorithm lies in integrating extensive clinical data, emphasizing the latest clinical evidence, and providing a structured decision-making pathway.
How Painful are Lumbar Hernias? A Comprehensive Review of Intervention Strategies.
Moreno-Gómez-Toledano R, Méndez-Mesón I, Aguado-Henche S … +2 more , Sebastián-Martín A, Grande-Alonso M
Curr Pain Headache Rep · 2025 Jan · PMID 39862368 · Full text
PURPOSE OF REVIEW: Low back pain (LBP) is considered an important issue of public health, with annual prevalence estimations almost achieving 60% of the worldwide population. Available treatments have a limited impact on...
PURPOSE OF REVIEW: Low back pain (LBP) is considered an important issue of public health, with annual prevalence estimations almost achieving 60% of the worldwide population. Available treatments have a limited impact on this condition, although they allow to alleviate pain and recover the patient's quality of life. This review aims to go deeper on the understanding of this condition, providing an updated, brief, and concise whole picture of this common musculoskeletal problem. RECENT FINDINGS: Scientific literature, current clinical practice and clinical guidelines are summarized, focusing on three key aspects: classification of LBP, diagnosis of symptomatic lumbar hernia, and intervention strategies (conservative, surgical, and pharmacological). Benefits and drawbacks of each approach are tackled. The most appropriate intervention for LBP suffers is hitherto a conservative treatment based on therapeutic exercise, manual therapy and therapeutic education on the neurophysiological mechanisms of pain. Whether patient's condition is severe, does not improve with conservative treatment, or presents neurological symptoms, then surgical intervention is recommended. The efficiency of pharmaceutical approaches for LBP lacks high-quality evidence-based studies, and still needs to be in-depth explored. Current treatments help to improve symptoms and patient's perspectives. However, further research in the field of herniated discs is essential in order to seek a therapy that could definitely cure or eliminate this condition.
Nutraceuticals and Headache 2024: Riboflavin, Coenzyme Q10, Feverfew, Magnesium, Melatonin, and Butterbur.
Tepper SJ, Tepper K
Curr Pain Headache Rep · 2025 Jan · PMID 39853578 · Publisher ↗
Nutraceuticals are not regulated by the US Food and Drug Administration, so a careful literature review is essential to make clinical decisions. Riboflavin or vitamin B2 can be recommended for migraine prevention in adul...
Nutraceuticals are not regulated by the US Food and Drug Administration, so a careful literature review is essential to make clinical decisions. Riboflavin or vitamin B2 can be recommended for migraine prevention in adults, but pediatric use is not proven. Adverse events are minimal. Coenzyme Q10 has Level C evidence for migraine prevention and low adverse events. Feverfew may be effective for migraine prevention, but the absence of clear safety studies, the differences in doses and characteristics of dried leaf preparations, and the myriad of feverfew cellular effects suggest caution in recommendation for use. Magnesium is recommended for migraine prevention and intravenous acute use, with the potential for generally mild gastrointestinal tolerability adverse events. Melatonin has very low certainty for evidence of efficacy, and is weakly recommended in those with sleep problems. However, purity of US sold melatonin is very poor. Butterbur or petasites preparations have strong evidence for efficacy and concern for hepatotoxicity. Please see the US National Center for Complementary and Integrative Health/NIH online site https://www.nccih.nih.gov/health/butterbur for up-to-date recommendations on whether to use this nutraceutical.
Nervus Intermedius Neuralgia.
Robblee J
Curr Pain Headache Rep · 2025 Jan · PMID 39847207 · Publisher ↗
PURPOSE OF REVIEW: This review discusses the diagnosis and treatment of nervus intermedius neuralgia (NIN) and identifies gaps in the literature. RECENT FINDINGS: The nervus intermedius is a branch of the facial nerve. N...
PURPOSE OF REVIEW: This review discusses the diagnosis and treatment of nervus intermedius neuralgia (NIN) and identifies gaps in the literature. RECENT FINDINGS: The nervus intermedius is a branch of the facial nerve. NIN presents as a rare neuralgia of this nerve, causing deep ear pain, which may radiate to the auditory canal, auricle, mastoid, soft palate, temple, and angle of the jaw. NIN most commonly presents in middle-aged women; neurovascular compression involving the anterior inferior cerebellar artery is the most common etiology described. Despite its diagnostic criteria in the International Classification of Headache Disorders, 3rd edition (ICHD-3), NIN may lack a trigger zone and may manifest as achy or neuralgiform pain instead of the typically described sharp or shooting pain. Like trigeminal neuralgia, NIN can be divided into classic, idiopathic, secondary, or painful neuropathy. Although there are no established guidelines for treating NIN, many possible treatments are used. Experience from treating trigeminal neuralgia suggests that carbamazepine or oxcarbazepine can be considered first-line. Patients with medically refractory NIN may benefit from neurosurgery referral for microvascular decompression or nerve sectioning. More research is needed to elucidate the range of clinical presentations in patients with NIN. Current data are limited and suggest that symptoms may diverge from the ICHD-3 diagnostic criteria. Although various treatments have been attempted, they often lack solid evidence and are typically derived from approaches used for other neuralgias. Proper diagnosis is crucial, particularly when considering surgical referral, due to the potential overlap of NIN with other neuralgias affecting the head and neck.
Weathering the Pain: Ambient Temperature's Role in Chronic Pain Syndromes.
Jevotovsky DS, Oehlermarx W, Chen T … +6 more , Ortiz CC, Liu A, Sahni S, Kessler JL, Poli JJ, Lau R
Curr Pain Headache Rep · 2025 Jan · PMID 39847186 · Full text
PURPOSE OF REVIEW: Chronic pain is highly prevalent and involves a complex interaction of sensory, emotional, and cognitive processes, significantly influenced by ambient temperature. Despite advances in pain management,...
PURPOSE OF REVIEW: Chronic pain is highly prevalent and involves a complex interaction of sensory, emotional, and cognitive processes, significantly influenced by ambient temperature. Despite advances in pain management, many patients continue to experience inadequate pain relief. This review aims to consolidate and critically evaluate the current evidence on the impact of ambient temperature on chronic pain conditions such as fibromyalgia (FM), multiple sclerosis (MS), complex regional pain syndrome (CRPS), and osteoarthritis (OA). RECENT FINDINGS: Patients with FM often report pain exacerbations due to temperature changes, with studies showing lower thresholds for heat and cold-induced pain compared to healthy controls. In MS, the Uhthoff phenomenon, characterized by temperature-induced neurological deterioration, underscores the significance of ambient temperature in pain management. CRPS patients exhibit heightened pain sensitivity to temperature changes, with both warm and cold stimuli potentially aggravating symptoms. OA patients frequently report increased pain and rigidity associated with lower temperatures and higher humidity. Understanding the mechanisms through which temperature influences pain can enhance pain management strategies. This review highlights the need for further research to elucidate these mechanisms and develop targeted interventions, ultimately improving the quality of life for individuals with chronic pain conditions.
A Review of Leveraging Artificial Intelligence to Predict Persistent Postoperative Opioid Use and Opioid Use Disorder and its Ethical Considerations.
Gabriel RA, Park BH, Hsu CN … +1 more , Macias AA
Curr Pain Headache Rep · 2025 Jan · PMID 39847176 · Full text
PURPOSE OF REVIEW: Artificial intelligence (AI) offers a new frontier for aiding in the management of both acute and chronic pain, which may potentially transform opioid prescribing practices and addiction prevention str...
PURPOSE OF REVIEW: Artificial intelligence (AI) offers a new frontier for aiding in the management of both acute and chronic pain, which may potentially transform opioid prescribing practices and addiction prevention strategies. In this review paper, not only do we discuss some of the current literature around predicting various opioid-related outcomes, but we also briefly point out the next steps to improve trustworthiness of these AI models prior to real-time use in clinical workflow. RECENT FINDINGS: Machine learning-based predictive models for identifying risk for persistent postoperative opioid use have been reported for spine surgery, knee arthroplasty, hip arthroplasty, arthroscopic joint surgery, outpatient surgery, and mixed surgical populations. Several machine learning-based models have been described to predict an individual's propensity for opioid use disorder and opioid overdose. Natural language processing and large language model approaches have been described to detect opioid use disorder and persistent postsurgical opioid use from clinical notes. AI holds significant promise in enhancing the management of acute and chronic opioids, which may offer tools to help optimize dosing, predict addiction risks, and personalize pain management strategies. By harnessing the power of AI, healthcare providers can potentially improve patient outcomes, reduce the burden of opioid addiction, and contribute to solving the opioid crisis.
A Systematic Review and Meta-Analysis of Stem Cell Therapies for Pain in Diabetic Neuropathy, Osteoarthritis, and Spinal Cord Injuries.
Kataria S, Inggas MAM, Patel U … +12 more , Wijaya JH, Yabut K, Ayub MA, Maniyar P, Upadhyay N, Davitashvili B, Patel J, Shah S, Turjman T, Turjman H, Shekoohi S, Kaye AD
Curr Pain Headache Rep · 2025 Jan · PMID 39841308 · Publisher ↗
PURPOSE OF REVIEW: The use of stem cell therapy is a rapidly evolving and progressing frontier of science that has been used to treat illnesses such as malignancies, immunodeficiencies, and metabolic syndromes. This revi...
PURPOSE OF REVIEW: The use of stem cell therapy is a rapidly evolving and progressing frontier of science that has been used to treat illnesses such as malignancies, immunodeficiencies, and metabolic syndromes. This review aims to give an overview of the use of stem cell therapy in the treatment of pain caused by diabetic neuropathy, osteoarthritis, and other spinal cord pathologies. RECENT FINDINGS: Pain is defined as a generalized or localized feeling of distress related to a physical or emotional stimulus and can be caused by a multitude of pathologies. The field of pain management has explored many strategies such as gene therapies, neuromodulation, platelet-rich plasma, and numerous pharmacotherapies. The approach to the delivery of these strategies has varied, with the method of stem cell therapy delivery being the focus of this present investigation. In addition, we combined several different studies to analyze the effects of stem cell therapies and improvement in pain scores quantified by the visual analog scale (VAS). The overall results showed a mean difference of -2.58, suggesting that the stem cell treatment group had a lower VAS score at 6 months compared to the control group. The use of different types of stem cells, such as pluripotent and mesenchymal stem cells, play a critical role in the care of cases suffering from pain. Effective delivery methods are evolving and can transform treatment options in the future, for which large cohort studies are warranted.
Exploring the Potential of Psychedelics in the Treatment of Headache Disorders: Clinical Considerations and Exploratory Insights.
Henderson I, Elsaadany R, Chan G … +6 more , Bajaj V, Duarte D, Goodman S, Grunstein M, Vadhan NP, Duarte RA
Curr Pain Headache Rep · 2025 Jan · PMID 39820774 · Publisher ↗
PURPOSE OF REVIEW: Exploration of the potential of serotonergic psychedelic drugs, such as psilocybin and LSD, as potential treatments for headache disorders. This review addresses the need for well-informed physician gu...
PURPOSE OF REVIEW: Exploration of the potential of serotonergic psychedelic drugs, such as psilocybin and LSD, as potential treatments for headache disorders. This review addresses the need for well-informed physician guidelines and discusses mechanisms, safety, and efficacy of these treatments. Further research, including the consideration of combination with psychotherapy, is needed. RECENT FINDINGS: Psychedelics demonstrate promising outcomes as treatments for headache disorders. Recent findings indicated that some patients who underwent brief periods of treatment with psychedelics experienced a reduction in headache attack frequency, severity, or duration. When prescription medications are ineffective at treating headache disorders, or are habit-forming, patients often turn to alternative options. There is anecdotal evidence that psychedelic drugs like LSD and psilocybin can effectively treat and prevent pain in patients with headache disorders, such as migraine or cluster headache. It is vital that physicians treating patients who self-treat with psychedelics be well-informed about the mechanisms and their effects to best advise their patients and coordinate their care well. This is a review assessing the literature on the mechanisms, safety, and efficacy of psychedelic drugs as a headache management intervention. We believe there is evidence that may support further investigation into the clinical use of psychedelic medications to treat cluster headache and migraine, including the consideration of use in conjunction with other interventions like cognitive behavioral therapy or acceptance and commitment training.
Functional Magnetic Resonance Imaging of Post-Traumatic Headache: A Systematic Review.
Christensen RH, Al-Khazali HM, Iljazi A … +2 more , Szabo E, Ashina H
Curr Pain Headache Rep · 2025 Jan · PMID 39812946 · Publisher ↗
PURPOSE OF REVIEW: To evaluate existing functional magnetic resonance imaging (fMRI) studies on post-traumatic headache (PTH) following traumatic brain injury (TBI). RECENT FINDINGS: We conducted a systematic search of P...
PURPOSE OF REVIEW: To evaluate existing functional magnetic resonance imaging (fMRI) studies on post-traumatic headache (PTH) following traumatic brain injury (TBI). RECENT FINDINGS: We conducted a systematic search of PubMed and Embase databases from inception to February 1, 2024. Eligible fMRI studies were required to include adult participants diagnosed with acute or persistent PTH post-TBI in accordance with any edition of the International Classification of Headache Disorders. We identified five eligible fMRI studies: two on acute PTH and three on persistent PTH. These studies assessed resting-state functional connectivity involving comparisons with one or more of the following groups: people with migraine, those with mild TBI but no PTH, and healthy controls. In acute PTH, studies focused exclusively on functional connectivity between the periaqueductal gray or hypothalamus and other brain regions. In persistent PTH, evidence of altered functional connectivity was identified primarily within cingulate, sensorimotor, and visual regions, indicating a hypersensitivity to sensory stimuli in PTH. Despite these insights, the fMRI data remains sparse and is limited by inconsistent results and small samples. The paucity of fMRI studies on PTH limits our understanding of its neurobiological basis. The available evidence suggests that alterations in functional connectivity occur within brain areas involved in emotional and sensory discriminative aspects of pain processing. However, inconsistent results and small sample sizes underscore a critical need for larger, more rigorous fMRI studies. Future studies should also consider using task-based fMRI to investigate possible hypersensitivity to different sensory stimuli in PTH after TBI.
Ketamine Infusion for Complex Regional Pain Syndrome Treatment: A Narrative Review.
Kaye AD, Tynes BE, Johnson CD … +9 more , Strong BC, Abbott BM, Vučenović J, Viswanath O, Fox CJ, Ahmadzadeh S, Amarasinghe SN, Kataria S, Shekoohi S
Curr Pain Headache Rep · 2025 Jan · PMID 39808363 · Publisher ↗
PURPOSE OF REVIEW: Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder characterized by pain disproportionate to the inciting event that is constant for an extended duration. Numerous treatment options f...
PURPOSE OF REVIEW: Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder characterized by pain disproportionate to the inciting event that is constant for an extended duration. Numerous treatment options for this condition have been explored with unsatisfactory results in many cases. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist typically used as an anesthetic and analgesic, presents a promising potential treatment for CRPS in patients who fail to respond to traditional therapies. RECENT FINDINGS: Numerous studies report significant improvement in the degree of pain, mobility of extremities, and other parameters after ketamine infusion in patients with CRPS. Although adverse effects were not reported often, some subjects experienced nausea, vomiting, headache or psychotropic or psychomimetic symptoms which could be mitigated with cessation of the drug. Although more research is needed to determine optimal dosing and duration, ketamine seems to be a safe and effective treatment for refractory cases of CRPS. CONCLUSION: The present investigation summarizes existing knowledge and research surrounding ketamine infusions for CRPS to provide a well-rounded depiction of advantages and disadvantages for physicians who may be considering it for patients with this challenging and complex condition.
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