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        <title>Frontiers in Pain Research | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/pain-research</link>
        <description>RSS Feed for Frontiers in Pain Research | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-13T22:55:45.29+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1727882</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1727882</link>
        <title><![CDATA[Evaluation of the usability of the spinal cord stimulator recharging procedure in the treatment of neuropathic pain. A quantitative and qualitative study]]></title>
        <pubdate>2026-05-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Delphine Durand</author><author>Pierre-Henri Garnier</author><author>Sylvain Durand</author><author>Julien Nizard</author><author>Vincent Wyart</author><author>Céline Brouillet</author><author>Jean-Pascal Lefaucheur</author><author>Jean-Paul Nguyen</author>
        <description><![CDATA[BackgroundRechargeable stimulators have improved the management of patients treated with spinal cord stimulation by avoiding numerous interventions to replace stimulator devices whose batteries are reaching the end of their life. However, the recharging procedure can be restrictive for some patients and affect their satisfaction.ObjectiveThe aim of this work is to evaluate the usability of the recharging procedure through a quantitative and qualitative approach to explore the experience of unsatisfied patients.MethodsThe evaluation began with a retrospective analysis of 50 patients with neuropathic pain who have had a rechargeable spinal cord stimulator for more than one year. Patients completed the French version of the System Usability Scale (F-SUS) which is a scientifically validated usability questionnaire. Ten patients who were not satisfied with the recharging procedure (F-SUS score <70) has been interviewed and their speech has been analysed thematically.ResultsThese were 26 women and 24 men, mean age 51.6 years, operated on in 2019 and 2020 for spinal cord stimulation using a rechargeable stimulator for the treatment of neuropathic pain refractory to medical therapy. Forty patients (80% of cases) were satisfied (F-SUS score ≥70/100) and 10 patients not satisfied (F-SUS score <70) with the recharging procedure. The numerical pain scale improved by an average of 52% over the long term (mean follow-up 3.6 years). Rechargement time averaged 59.6 min (±35) and the interval between rechargement sessions 4.2 days (±7.1). These data were not significantly different between satisfied and not satisfied patient groups. The qualitative study revealed that the duration of the rechargement session was the main cause of dissatisfaction among unsatisfied patients. This is linked to the fact that these patients must remain virtually motionless throughout the session, otherwise recharging is interrupted by loss of contact between the recharging box and the stimulator. This study also highlights the fact that patients who have improved well with spinal cord stimulation are better able to tolerate the inconvenience of recharging, which is not the case for patients whose pain has improved little or not at all. Overall, patients would like to be better prepared for the recharging procedure.ConclusionThe mixed quantitative and qualitative analysis indicates that most patients are satisfied with the recharging procedure. The problem of contact between the recharging device and the stimulator device needs to be improved, as it is the main cause of dissatisfaction among patients who are not satisfied with the recharging procedure.Ethics and disseminationThis study was approved by the French ethics committee (CPP Est I ID RCB: 2022-A00683-40) on June 3, 2022, and registered on ClinicalTrials.gov (NCT05373654) on May 9, 2022.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1834575</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1834575</link>
        <title><![CDATA[The life and times of Richard L. Rauck (1956–2025)]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>James C. Eisenach</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1812648</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1812648</link>
        <title><![CDATA[Observing and treating pain in people living with dementia in long-term care facilities]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sabine D. Kruijer</author><author>Wilco P. Achterberg</author><author>Annelore van Dalen-Kok</author><author>Monique A. A. Caljouw</author>
        <description><![CDATA[ObjectivesNeuropathological changes in dementia compromise communicative abilities, causing pain to present atypically and making assessment challenging. Although pain is highly prevalent in people with dementia and can be managed pharmacologically and non-pharmacologically, comprehensive studies on pain assessment and management in this population remain scarce. This study aimed to explore how pain is observed, assessed, and managed in people living with dementia in long-term care facilities.DesignMixed-methods sequential explanatory design.Setting and participantsMedical staff, healthcare professionals, nursing staff, and managers employed in long-term care facilities, as well as informal caregivers of residents with dementia in these facilities, in the Netherlands.MethodsBetween April 9 and July 1, 2024, participants completed a nationwide survey (N = 387) containing questions about pain observations and the use of non-pharmacological and pharmacological interventions. The number of questions varied from 4 (for the managers) to 15 (for informal caregivers), and additional in-depth interviews were conducted (N = 20). Quantitative data were analyzed descriptively using SPSS to calculate frequencies and distributions. The interview summaries were analyzed for recurring themes and illustrative quotes used to support survey findings.ResultsPain was most considered when medical and nursing staff observed non-verbal indicators such as behavioral changes, supported by physical examination and, in some cases, pain observation scales. Approximately half of respondents reported using observational pain scales in routine practice. Pain management relied predominantly on pharmacological treatment, primarily paracetamol, with less frequent and unsystematic use of non-pharmacological interventions such as distraction, exercise, and music therapy.ConclusionPain assessment and management for people with dementia in long-term care facilities remain predominantly pharmacological. The limited and inconsistent use of validated observational tools and non-pharmacological interventions highlights the need for systematic implementation in clinical practice and future research.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1780537</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1780537</link>
        <title><![CDATA[Case Report: Isolated lingual pain: a rare and atypical presentation of trigeminal neuralgia successfully treated with microvascular decompression]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Yang Xu</author><author>Yuqian Li</author><author>Yansong Zhang</author><author>Yongyan Chen</author><author>Zhiyi He</author><author>Shuaishuai Zhu</author><author>Zhengxiang Luo</author>
        <description><![CDATA[BackgroundTrigeminal neuralgia (TN) typically presents with paroxysmal, shock-like, or stabbing pain in the unilateral facial region corresponding to the trigeminal nerve distribution. However, cases manifesting solely as isolated tongue pain are exceedingly rare.Case presentationA 63-year-old female presented with a two-year history of left-sided tongue pain. She was initially suspected of having glossopharyngeal neuralgia (GPN) and treated with oxcarbazepine at the local hospital, which provided suboptimal relief. Over the past two months, her pain intensified significantly. Upon referral to our department, a comprehensive evaluation was conducted—including a detailed history, neurological examination and high-resolution magnetic resonance imaging (MRI). However, we ruled out the diagnosis of glossopharyngeal neuralgia and strongly believe the patient suffered from trigeminal neuralgia. First, MRI imaging revealed vascular compression of the trigeminal nerve. Then, glossopharyngeal nerve block helped rule out glossopharyngeal neuralgia. Most importantly, intraoperative exploration confirmed definite vascular compression of the trigeminal nerve, while vessels were observed adjacent to the glossopharyngeal nerve without significant compression. The patient subsequently underwent left microvascular decompression (MVD) of the trigeminal nerve. Postoperatively, her pain resolved completely.Discussion and conclusionTrigeminal neuralgia and glossopharyngeal neuralgia share overlapping clinical features, pathogenesis, imaging findings and triggering factors. These two diseases are typically distinguished by their characteristic pain locations. This case illustrates a diagnostically challenging presentation of TN, with pain confined exclusively to the tongue, which is highly prone to being misdiagnosed as glossopharyngeal neuralgia. The definitive identification of neurovascular compression on imaging, coupled with the complete resolution of pain following MVD, conclusively confirmed the diagnosis of TN. This report emphasizes that clinicians should meticulously analyze pain distribution and correlate it with imaging evidence of vascular compression to accurately differentiate between these two entities, thereby avoiding misdiagnosis and mitigating the risk of unnecessary interventions or secondary injury.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1760721</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1760721</link>
        <title><![CDATA[Efficacy and safety of low- and high-intensity magnetic field therapies for orthopedic pain: a systematic review]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Ludimila Dias Silva</author><author>Joelington Dias Batista</author><author>Jobson Dias Batista</author><author>Gabrielly Santos Pereira</author><author>Marcelo Lourenço da Silva</author>
        <description><![CDATA[Introduction:Orthopedic and musculoskeletal pain is a leading cause of disability worldwide, and many patients continue to experience suboptimal relief despite advances in pharmacological and physical therapies. Magnetic field–based interventions, including pulsed electromagnetic field therapy (PEMF) and repetitive peripheral magnetic stimulation (rPMS), have emerged as non-invasive approaches for pain modulation and functional improvement. This systematic review aimed to evaluate the efficacy and safety of low-intensity (PEMF) and high-intensity (rPMS) magnetic field therapies in adults with musculoskeletal conditions.MethodsRandomized controlled trials published between 2015 and 2025 were identified through searches in PubMed, Embase, Scopus, and Web of Science. Eligible studies compared PEMF or rPMS with sham, placebo, or standard care and reported outcomes related to pain intensity, functional performance, and safety.ResultsEight RCTs met the inclusion criteria. Most included studies reported reductions in pain and improvements in functional outcomes, including the Oswestry Disability Index and WOMAC. No serious adverse events were reported. PEMF was primarily linked to sustained analgesic and anti-inflammatory effects, whereas rPMS showed faster pain reduction, likely related to neuromuscular activation and modulation of descending inhibitory pathways. Some studies reported greater benefits using higher stimulation intensities or combining therapy with exercise.DiscussionMagnetic field therapies appear to be safe and well tolerated, with potential benefits for pain and function for the management of musculoskeletal pain. Their complementary mechanisms suggest potential clinical synergy; however, larger and more standardized trials are needed to establish optimal protocols and long-term effectiveness.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251170876, PROSPERO CRD420251170876.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1764444</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1764444</link>
        <title><![CDATA[Research on paclitaxel in chemotherapy-induced neuropathic pain: a bibliometric analysis integrating multiple databases]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Rui Zeng</author><author>Min Xue</author><author>Mingxia Pan</author><author>Shuang Wang</author><author>Wenxi Xie</author><author>Weihong Ge</author><author>Han Xie</author>
        <description><![CDATA[BackgroundPaclitaxel-induced peripheral neuropathy (PIPN) significantly impairs the quality of life of cancer survivors. A systematic visualization of global research trends in this domain is currently lacking.ObjectiveThis study aims to delineate the global research landscape, emerging hotspots, and evolutionary trends of PIPN research from 2000 to 2025.MethodsRelevant literature was retrieved from Web of Science Core Collection and Scopus. Bibliometric analyses, including co-occurrence and thematic evolution, were performed using VOSviewer and CiteSpace.ResultsA total of 1,795 eligible publications were analyzed, exhibiting an exponential growth trend (R2 = 0.9675R2 = 0.9675). The United States led with 718 publications and the highest citation impact. Supportive Care in Cancer was the most prolific journal. Research focus has shifted from initial toxicity descriptions to underlying mechanisms (e.g., oxidative stress) and quality of life. Cluster analysis identified emerging interests in “anxiety” and psychosocial comorbidities.ConclusionPIPN research is rapidly expanding, moving from phenomenological observation to mechanistic elucidation and holistic management. Future directions include precision medicine and comprehensive biopsychosocial interventions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1786437</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1786437</link>
        <title><![CDATA[Is histamine intolerance a treatable subtype of fibromyalgia? evidence and clinical implications—narrative review]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Review</category>
        <author>João Protásio Netto</author><author>José Fábio Lana</author><author>Alexandre Parma</author><author>Fábio Ramos Costa</author><author>Rubens Martins de Andrade</author><author>Mariana Garcia Martins Castro</author><author>Claudia Tambelli</author>
        <description><![CDATA[BackgroundFibromyalgia affects 2%–8% of the global population with suboptimal treatment outcomes. Emerging evidence suggests histamine intolerance, mediated by diamine oxidase (DAO) deficiency, may contribute to fibromyalgia pathophysiology in specific patient subgroups.MethodsWe conducted a comprehensive narrative review of literature published 2000–2025, examining genetic polymorphisms, biochemical markers, and clinical studies investigating relationships between histamine intolerance, DAO deficiency, and fibromyalgia. Studies included genetic association analyses, randomized controlled trials, and population-based observational research.ResultsKey findings revealed 74.5% prevalence of DAO deficiency-associated genetic variants in fibromyalgia patients vs. 66% in general population (p = 0.014), with cumulative variants correlating with increased symptom severity (∼7-point FIQ increase per allele). A randomized controlled trial (n = 100) demonstrated significant improvements with DAO supplementation: Pain Catastrophizing Scale decreased 8.4 points vs. 2.1 (placebo), and Fibromyalgia Impact Questionnaire improved 12.3 vs. 4.6 points (p < 0.003). Population studies showed strong associations with histamine-mediated conditions: 29% fibromyalgia prevalence among chronic pruritus patients and odds ratios of 1.30–2.50 for allergic comorbidities among 15,869 fibromyalgia patients.ConclusionCurrent evidence supports systematic histamine intolerance assessment in fibromyalgia patients presenting with gastrointestinal symptoms, chronic pruritus, or treatment resistance. This review provides a practical clinical framework for identifying and managing this potentially treatable fibromyalgia subtype, though larger multicenter replication studies are needed to confirm findings and establish standardized diagnostic protocols.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1760356</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1760356</link>
        <title><![CDATA[Decoding pain and mental health patterns in youth with chronic pain during COVID-19]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Fareha Nishat</author><author>Sarah Brennenstuhl</author><author>Nicole E. MacKenzie</author><author>Sakib Tariq</author><author>Kathryn A. Birnie</author><author>Melanie Noel</author><author>Chitra Lalloo</author><author>Sabine Soltani</author><author>Jennifer N. Stinson</author>
        <description><![CDATA[BackgroundThe COVID-19 pandemic led to major disruptions in healthcare services, resulting in increased pain and co-occurring mental health issues among youth with chronic pain. However, heterogeneity in these symptoms has not been explored, overlooking the possibility of distinct subgroups. This study aimed to: (1) identify latent profiles of youth based on pain and mental health symptoms; and (2) examine whether sociodemographic and pandemic-related factors were associated with profile membership.MethodsA cross-sectional study of 357 youth aged 8–18 years with chronic pain was conducted during the first three waves of the COVID-19 pandemic (August 2020–April 2021) in Canada. Data on pain, mental health (anxiety, depression, post-traumatic stress disorder, insomnia), and COVID-19 impact were collected using validated questionnaires, alongside self-reported age, sex, and ethnic identity. Latent profile analysis was used to identify unobserved subgroups based on pain and mental health symptoms, and the optimal model was selected based on statistical fit and clinical interpretability. Multinomial logistic regression examined associations between profile membership and covariates.ResultsFive distinct subgroups of youth with chronic pain based on co-occurring mental health symptoms were found. The largest group (42.2%) reported sub-clinical mental health symptoms with the lowest pain, while 12.5% fell into a “sub-clinical mental health symptoms/high pain” group. About one-third (34.6%) were in a “moderate mental health symptoms/moderate pain” profile. Two smaller but clinically concerning groups emerged: “high mental health symptoms/high pain without clinical PTSD” (6.6%) and “high mental health symptoms/high pain” (4.1%). Multinomial logistic regression showed that older youth, female youth and higher perceived COVID-19 impact were associated with membership in nearly all elevated mental health symptom/pain profiles.DiscussionYouth with chronic pain showed heterogeneous experiences of mental health during the first three pandemic waves, shaped by sociodemographic and contextual factors. Findings underscore the need for person-centered approaches to pain management, particularly in periods of acute stress, that address both individual vulnerabilities and broader contextual stressors.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1814480</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1814480</link>
        <title><![CDATA[Resting-state cortical activity, biomarkers and functional performance identify distinct biopsychosocial phenotypes in young adults with chronic postsurgical pain]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Guillermo Ceniza-Bordallo</author><author>Ziyan Wu</author><author>Caitlin Curry</author><author>Christine B. Sieberg</author>
        <description><![CDATA[BackgroundChronic postsurgical pain (CPSP) is a prevalent and disabling condition in young adults (AYAs) yet marked variability in symptoms and functional impact is poorly explained by pain severity alone. This study aimed to (1) compare psychological symptoms, physical performance, hair cortisol concentration, and resting-state cortical hemodynamic activity between AYAs with CPSP and healthy controls; (2) examine associations among these variables within the CPSP group; and (3) derive clinically meaningful CPSP phenotypes anchored in physical performance using hierarchical clustering.MethodsIn this cross-sectional study, AYAs aged 18–30 years with CPSP and healthy controls were enrolled. Psychological symptoms and pain interference were assessed using standardized self-report measures. Physical performance was evaluated using the 1 min sit-to-stand test, with concurrent physiological responses to exertion. Resting-state cortical hemodynamic activity was assessed using functional near-infrared spectroscopy (fNIRS).ResultsA total of 67 AYAs (33 with CPSP and 34 healthy controls) were included. Compared with healthy controls, AYAs with CPSP reported significantly greater pain interference and exhibited dysregulated physiological responses to exertion, despite comparable objective physical performance. Within the CPSP group, psychological distress, hair cortisol concentration, physical performance, and resting-state prefrontal and somatosensory cortex (SMC) (S1) activity were significantly interrelated. Clustering analyses identified two distinct CPSP phenotypes, low functioning and high functioning, which differed in pain catastrophizing, autonomic reactivity, and resting state SMC (S1) activity.ConclusionsCPSP in AYAs is associated with distinct autonomic, neuroendocrine, and cortical signatures that co-vary with functional performance. Integrating physiological biomarkers and resting-state neuroimaging with performance-based assessments may improve mechanistic understanding and phenotyping of CPSP.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1826942</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1826942</link>
        <title><![CDATA[Interventions to reduce pharmacologic opioid exposure in neonatal opioid withdrawal syndrome: a systematic review and meta-analysis of randomized studies]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Muhammad Ahmad</author><author>Ayoola Awosika</author><author>Chinenye Iguh</author><author>Wagma Khan</author><author>Neha Choudhary</author><author>Marya Aisha</author><author>Fatima Shaukat</author><author>Soura Rajeshwara</author><author>Maheen Zahid</author><author>Muneeba Shaukat</author>
        <description><![CDATA[BackgroundNeonatal opioid withdrawal syndrome (NOWS) is increasingly prevalent and is frequently managed with pharmacologic opioid therapy, raising concerns regarding early-life opioid exposure and prolonged hospitalization. Interventions aimed at reducing pharmacologic exposure while maintaining safety have emerged, most notably care-model–based approaches. This study aims to systematically review the evidence evaluating interventions designed to reduce pharmacologic opioid exposure in neonates with NOWS compared with standard care.MethodsA systematic review was conducted in accordance with PRISMA guidelines. PubMed/MEDLINE, Cochrane CENTRAL, and Google Scholar were searched from inception through the final search date. Randomized controlled trials, comparative observational studies, and quality-improvement studies evaluating exposure-reduction strategies were included. Interventions of interest primarily comprised care-model approaches such as Eat–Sleep–Console (ESC). Outcomes included duration of opioid therapy, cumulative opioid exposure, length of hospital stay, and safety outcomes. Due to substantial heterogeneity across studies, findings were synthesized narratively.ResultsSix studies met inclusion criteria, comprising three randomized studies and three observational or quality-improvement studies. Meta-analysis of randomized evidence showed ESC-based care significantly reduced hospital stay length (MD −6.50 days; 95% CI −9.63 to −3.36; p < 0.0001; I2 = 0%) and decreased opioid therapy duration (MD −3.06 days; 95% CI −3.74 to −2.38; p < 0.00001; I2 = 36%) compared to standard care. A subgroup analysis showed lower cumulative opioid exposure (MD −4.1 MME/kg; p = 0.001). Observational and quality-improvement studies consistently reported substantial reductions in opioid exposure and hospitalization following ESC implementation. Across all included studies reporting safety outcomes, no increase in adverse events or hospital readmissions was observed.ConclusionsCare-model interventions emphasizing functional assessment and nonpharmacologic support—particularly the ESC approach—are associated with reduced pharmacologic opioid exposure and shorter hospitalization for infants with NOWS without compromising short-term safety. These findings support evolving guideline recommendations favoring exposure-reduction strategies in NOWS management.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1804665</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1804665</link>
        <title><![CDATA[Meta-analysis of the therapeutic effects of different core muscle training on pain and function in patients with chronic non-specific low back pain]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Yang Liu</author><author>Haoyang Li</author><author>Yueyong Yu</author><author>Chenyuan Zhang</author><author>Zhou Zhou</author>
        <description><![CDATA[ObjectiveTo compare the effects of specific core muscle training modalities—core stability training, sling exercise therapy (SET), Pilates, and breathing training—vs. non-core-training controls on pain and function in patients with chronic nonspecific low back pain (CNLBP).MethodsRandomized controlled trials (RCTs) from PubMed, Web of Science, and Cochrane Library were systematically searched. Thirty-three RCTs involving 1,757 patients were analyzed using random-effects meta-analysis in RevMan, with subgroup analyses by training type, mode, and duration.ResultsCore stability training significantly reduced pain (SMD = −0.95, 95% CI: −1.35 to −0.55) and improved function (SMD = −1.09, 95% CI: −1.63 to −0.55), despite high heterogeneity (I2 = 93%–95%).For pain relief, SET (SMD = −1.43) and Pilates (SMD = −1.48) showed the strongest effects, followed by breathing training (SMD = −0.75); conventional core stability training was less effective (SMD = −0.36). For functional improvement, SET (SMD = −2.60) and combined interventions (SMD = −1.07) outperformed single training. Short-term (<8 weeks) SET yielded prominent benefits, while long-term (≥8 weeks) breathing training sustained effects.ConclusionCore muscle training alleviates pain and enhances function in CNLBP. SET and Pilates offer notable short-term analgesia, whereas combined interventions improve function more effectively. Clinical protocols should be individualized, and future studies must standardize parameters and examine multimodal synergies.<br>Systematic Review Registration: identifier: CRD420251031252.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1652567</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1652567</link>
        <title><![CDATA[Impulsivity and pain attentional bias in veterans receiving care for chronic non-malignant pain]]></title>
        <pubdate>2026-04-23T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>James M. Bjork</author><author>Peter J. Norris</author><author>Zina Trost</author>
        <description><![CDATA[IntroductionA prevailing biopsychosocial model of chronic non-malignant pain (CNMP) includes psychological drivers of disability such as pain catastrophizing or negative mood symptomatology, such that preoccupation with pain or pain signals might be manifested at even the subconscious level and could also interact with trait impulsivity to prioritize immediate relief using opioids over safer pain management strategies. However, studies of impulsivity and cognitive biases in CNMP have often not controlled for current opioid use. Moreover, despite the ubiquity of CNMP in military veterans, pain attentional bias in veterans has not been explored.MethodsWe administered computerized tasks to probe attentional capture by visual pain-related stimuli in signal detection tasks, myopic delay-discounting behavior and general symptomatology in n = 61 veterans who were receiving Veterans Health Administration (VHA) care for CNMP (CNMP Group) with no histories of chronic opioid use and in n = 38 veterans who reported no CNMP (Controls).ResultsWe replicated in veterans previous findings of significantly greater depression and anxiety and higher levels of pain-related disability and kinesiophobia, lower quality of life, and more severe delay discounting than Controls. However, the CNMP group did not show greater motoric impulsivity, nor greater attentional capture by distress-related visual stimuli or frustration tolerance in other tasks. Follow-up analyses indicated that across all participants, individual differences in attentional bias toward pain also did not relate to scores on a latent factor of mood and pain-related symptomatology. In contrast, psychological distress correlated positively with motoric impulsivity in a stop-signal task, specifically under conditions with a pain-related visual distractor, and high values of a negative mood factor showed a trend toward a correlation with more severe discounting of delayed rewards.DiscussionThese data extend to veterans previous findings of greater psychological distress and delay discounting in adults with CNMP but offer only modest evidence that persons with CNMP who do not manage pain with opioids show increased attentional capture by pain-related visual stimuli.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1760192</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1760192</link>
        <title><![CDATA[Parental upheaval experienced in childhood and its effect on pain-related cognitions across the lifespan: an exploratory investigation]]></title>
        <pubdate>2026-04-23T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Caitlin Curry</author><author>Guillermo Ceniza-Bordallo</author><author>Emma Costello</author><author>Dirichi Ezeh</author><author>Margaret Moreland</author><author>Christine B. Sieberg</author>
        <description><![CDATA[BackgroundChronic post-surgical pain (CPSP), pain lasting at least three months past the expected recovery time of a surgery, affects up to 30% of post-surgical populations. It is multifaceted and influenced by biological and psychological factors. One such factor is exposure to adverse childhood experiences (ACEs), with previous research indicating that exposure to a greater number of ACEs increases the risk of chronic pain development. One of the most frequently experienced types of ACEs is parental upheaval, including divorce and separation, yet its impact on pain-related cognitions and experiences remains understudied.Methods65 individuals with CPSP were included in this cross-sectional analysis. Individuals provided self-reported data on their childhood trauma history, as well as measures related to pain perception. Individuals were sorted into two groups based on parental upheaval status: upheaval (n = 18) and non-upheaval (n = 47).ResultsParticipants in the upheaval group demonstrated a more globally connected pattern with pain-related cognitions, anxiety, and somatic arousal contributing to pain interference, while in the non-upheaval group, pain catastrophizing was the central factor influencing interference. Across the sample, pain catastrophizing not parental upheaval status was the most significant variable related to CPSP development. Finally, age and perceived trauma intensity (of the parental upheaval) were positively correlated.ConclusionCPSP is a complex condition and warrants biopsychosocial research to elucidate the mechanisms contributing to its onset and maintenance. This study indicates that parental upheaval, one of the more common traumatic events that can happen in childhood, may play an indirect role in pain experiences, potentially increasing vulnerability to maladaptive pain-related cognitions. These findings highlight the importance of considering the influence of ACEs and how they can impact development and subsequently lead to pain-related outcomes across the lifespan.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1786367</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1786367</link>
        <title><![CDATA[Non-pharmacological pain treatments as neuro-epigenetic revalidation strategies: integrating chronobiology, acupuncture, and pharmaco-nutrition]]></title>
        <pubdate>2026-04-23T00:00:00Z</pubdate>
        <category>Hypothesis and Theory</category>
        <author>Agnès Mazic de Sonis</author><author>Corinne Granger</author>
        <description><![CDATA[BackgroundChronic pain is increasingly conceptualized as a disorder of maladaptive neural plasticity sustained by central sensitization, neuroinflammation signalling, disrupted biological rhythms, metabolic dysregulation and environmentally mediated epigenetic modulation, and altered gut–brain interactions. While pharmacological approaches remain central to pain management, their long-term efficacy is limited by tolerance, adverse effects, opioid-induced hyperalgesia, and inter-individual variability. Growing evidence suggests that non-pharmacological interventions may modulate pain not only symptomatically, but through deeper neurobiological and epigenetic mechanisms.HypothesisWe propose that selected non-pharmacological pain treatments, particularly chronobiology-informed acupuncture and targeted pharmaco-nutrition, may be considered as neuro-epigenetic revalidation strategies. These interventions may restore adaptive gene expression profiles and neural, immune, metabolic and circadian regulation disrupted in chronic pain, thereby reducing nociceptive sensitization and improving treatment responsiveness.RationaleAcupuncture has been shown to modulate central pain networks, including prefrontal, limbic, and sensorimotor regions, with effects distinct from sham procedures. Chronobiological regulation of sleep–wake cycles, hormonal rhythms, and feeding timing influences inflammatory pathways and epigenetic regulation. In parallel, the gut–brain axis, through intestinal barrier integrity, microbiome composition, and immune–glial signalling, plays a critical role in pain chronification and drug metabolism. Nutritional and nutraceutical interventions can influence these pathways and have been associated with changes in inflammatory tone, opioid tolerance, and neuroimmune interactions.Testable predictionsThis framework generates testable predictions linking multimodal interventions to dynamic modulation of epigenetic signatures (DNA methylation, microRNA expression), chronobiological and sleep parameters, inflammatory mediators, gut-brain markers and clinically meaningful outcomes. Longitudinal, multimodal study designs are required to evaluate association between regulatory recalibration and sustained clinical improvement.ConclusionViewing non-pharmacological pain treatments within a neuro-epigenetic revalidation model provides a coherent system-level perspective model that bridges neuroscience, chronobiology, epigenetics, and integrative pain medicine. This integrative model supports the development of personalized, mechanism-based strategies for chronic pain management while encouraging biomarker-informed translational research.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1817373</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1817373</link>
        <title><![CDATA[Case Report: Intravenous fosphenytoin successfully treated acute exacerbation of secondary trigeminal neuralgia due to petroclival meningioma]]></title>
        <pubdate>2026-04-22T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Yoshiki Mochizuki</author><author>Masahito Kobayashi</author><author>Sachiko Hirata</author><author>Kazuhiko Takabatake</author><author>Yutaka Mine</author><author>Takamitsu Fujimaki</author>
        <description><![CDATA[IntroductionTrigeminal neuralgia (TN) is a severe paroxysmal neuropathic pain disorder. While various strategies have been proposed for managing acute exacerbations of classical TN, treatment approaches for secondary TN remain largely undocumented. Here, to the best of our knowledge, we present the first reported case of secondary TN crisis due to a petroclival meningioma, successfully managed with intravenous fosphenytoin.Case descriptionA 62-year-old woman developed right-sided TN secondary to a petroclival meningioma. Her facial pain resolved after tumor resection but recurred six years later with slight tumor regrowth. Despite escalation of carbamazepine (CBZ) and CyberKnife radiosurgery, she experienced a TN crisis, presenting with persistent severe pain and impaired oral intake. Intravenous fosphenytoin was administered at loading dose over 20 min, resulting in nearly complete pain relief. Because of symptom recurrence, fosphenytoin was continued at maintenance dose for seven days, in parallel with CBZ titration to 800 mg/day and addition of baclofen. Oral intake improved rapidly thereafter, and no further acute exacerbations were observed over three months of follow-up.ConclusionThis case highlights the potential of intravenous fosphenytoin as an effective and rapid treatment for acute crisis of secondary TN, especially when oral therapy is not feasible.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1810867</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1810867</link>
        <title><![CDATA[Sex, gender, and sociodemographic factors associated with repeated prescription refills in chronic pain: insights from a prescription claims cohort study]]></title>
        <pubdate>2026-04-22T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Marimée Godbout-Parent</author><author>Nancy Julien</author><author>Hermine Lore Nguena Nguefack</author><author>M. Gabrielle Pagé</author><author>Line Guénette</author><author>Lucie Blais</author><author>Nancy Ménard</author><author>Sylvie Beaudoin</author><author>Anaïs Lacasse</author>
        <description><![CDATA[PurposeChronic pain (CP) disproportionately affects women and gender-diverse individuals, raising questions about how sociodemographic factors influence medication use. Yet, the interplay between sex, gender, and prescribed medication use in CP remains poorly understood, limiting optimization, safety, and equity of care. We examined how sex and gender are associated with repeated prescription refills of pain medications among individuals with CP.MethodsThis study was conducted among individuals living with CP and links self-reported data to public and private prescription claims (n = 561). Repeated prescription refills of medications prescribed for CP and related comorbidities in the year following questionnaire completion were analyzed (≥40% days covered; yes/no; sensitivity analyses were performed using alternative cut-offs). Main independent variables were sex, gender identity, and gender-stereotyped personality traits (Bem Sex-Role Inventory). Cluster analysis was used to create intersecting sociodemographic subgroups (incorporating sex, gender, and other sociodemographic factors). Multivariable logistic regression was achieved to examine associations between these subgroups and repeated prescription refills.ResultsMost commonly used medications prescribed for CP and related comorbidities were antidepressants (48%), anticonvulsants (35%), opioids (19%), and nonsteroidal anti-inflammatory drugs (18%) (repeated refills). Between clusters, statistically significant differences were found for the subgroups labelled: (1) ‘Women with private drug insurance’, who had lower odds of repeated opioid prescription refills (aOR:0.38; 95%CI:0.15–0.95), and (2) ‘Unemployed older men’, who had lower odds of repeated antidepressant prescription refills (aOR: 0.45; 95%CI:0.24–0.87) (vs. ‘Unemployed women’).ConclusionOur results highlight how sex, gender, and intersecting sociodemographic factors are associated with repeated prescription refills, particularly opioids and antidepressants, among individuals living with CP.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1661536</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1661536</link>
        <title><![CDATA[A mechanistic hypothesis: osteopathic manipulative therapy may modulate immune cell function in chronic low back pain]]></title>
        <pubdate>2026-04-21T00:00:00Z</pubdate>
        <category>Hypothesis and Theory</category>
        <author>Lily Tehrani</author><author>Jackson Gamer</author><author>Sarah Ballarin</author><author>Sebastian Arango</author><author>Nathan Widboom</author><author>Patrick Barry</author><author>Mark Sandhouse</author><author>Jill Wallace-Ross</author><author>Yasmin Qureshi</author><author>Lubov Nathanson</author>
        <description><![CDATA[Chronic low back pain (CLBP) remains a leading cause of disability worldwide and is increasingly recognized as a condition that involves immune-mediated neuroinflammatory mechanisms. Osteopathic manipulative therapy (OMT) is a widely used non-invasive, non-pharmacological treatment for chronic pain; however, the molecular mechanisms underlying OMT effectiveness are not fully understood. We propose a mechanistic hypothesis of how OMT may influence circulating immune-cell gene expression and immune-cell distribution, with downstream effects on inflammatory signaling and neuroimmune sensitization. The mechanical forces applied during OMT could affect immune cell function, including leukocyte trafficking and cytokine activity. These mechanical influences may alter transcriptional activity within peripheral blood mononuclear cells, and over time, contribute to changes in gene expression patterns. This hypothesis article synthesizes current evidence from immunology, mechanobiology, and osteopathic clinical research to outline a proposed transcriptomic framework linking OMT to neuroimmune regulation in CLBP. This hypothesis supports a possible role for OMT in chronic pain management and suggests that immune modulation may represent one potential mechanism contributing to therapeutic benefit in persistent pain conditions. While current evidence suggests that OMT may influence immune function, direct transcriptomic validation remains limited and warrants further investigation through larger mechanistic studies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1794069</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1794069</link>
        <title><![CDATA[Adverse effects and perceived benefits of medications in children with chronic noncancer pain]]></title>
        <pubdate>2026-04-20T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Kacper Niburski</author><author>Nada Mohamed</author><author>Dominique Dundaru-Bandi</author><author>Victor Hugo Gonzalez Cardenas</author><author>Marie Vigouroux</author><author>Rebecca Pitt</author><author>Pablo Ingelmo</author>
        <description><![CDATA[BackgroundThere has been limited research in assessing the risk–benefit profile of pharmacological interventions for pediatric chronic pain.AimsThis quality-improvement analysis evaluated the incidence of adverse effects within the first month of initiating pharmacologic therapy in children and adolescents with chronic non-cancer pain receiving pharmacological treatment. In addition, we assessed perceived benefits of pharmacologic interventions during the same period.MethodsWe included pediatric patients with chronic primary or secondary pain enrolled in tertiary care interdisciplinary pain program. The primary endpoint was the proportion of patients reporting adverse effects within four weeks of starting a new medication (antiepileptics, antidepressants, nonsteroidal anti-inflammatory drugs, Tramadol or other drugs). Patients were provided with a tabulated adverse effects (5% or higher) for each medication they were receiving. We quantified the incidence of adverse effects, but severity of the adverse effects, causality or pharmacological interactions were not assessed. The secondary outcome was the proportion of patients reporting benefit as a dichotomous variable (Yes or No) in pain, sleep, physical function and mood. Each domain was treated as an independent, non-composite variable without graded scales.Results142 patients aged 7–17 with chronic, predominantly female (90%) received 291 prescriptions (mean 2.0 per patient). Adverse effects occurred in 115/142 patients (81%), totaling 572 events (mean 2.0 per patient). Gastrointestinal (62%) and attention-related (61%) were the most common reported adverse effects. Adverse effects increased with more concomitant medications (72% on one drug, 81% on two drugs, 95% on three or more). Perceived benefits were reported by 109 patients (77%), including analgesic benefit (64%), sleep benefits (49%), physical function (27%), and mood (22%). The mean number of benefited domains per patient increased with polypharmacy. However, the number of perceived benefits per prescription decreased with the number of medications prescribed.ConclusionsAdverse effects are common in the first four weeks of treatment, particularly with polypharmacy, alongside patient-perceived benefits in a real-world setting. These results are descriptive and do not establish causality, drug-specific efficacy, or interactions, but highlight the need for safety monitoring and engaged decision-making.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1729225</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1729225</link>
        <title><![CDATA[Moving for relief: a meta-analysis on traditional Chinese exercise and nonspecific low back pain]]></title>
        <pubdate>2026-04-20T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Zixiang Jin</author><author>Qianqian Zhang</author><author>Meng Wang</author><author>Xianglong Zhai</author><author>Jiaxin Xi</author><author>Yingfei Bai</author><author>Jiajia Sang</author><author>Hui Ye</author><author>Xuezhi Zhang</author>
        <description><![CDATA[ObjectiveA meta-analysis was conducted to evaluate the efficacy of Traditional Chinese Exercise in reducing pain intensity, improving dysfunction and quality of life, and increasing the overall treatment effectiveness rate in patients with nonspecific low back pain (NLBP), so as to provide evidence for its clinical application.MethodsFollowing the PRISMA guidelines, this study systematically searched eight databases—CNKI, Wanfang, VIP, Sinomed, PubMed, Embase, the Cochrane Library, and Web of Science—for randomized controlled trials published up to January 19, 2026. A total of 38 studies involving, 3,054 patients were included. The Cochrane Risk of Bias Tool was used to evaluate the quality of the included studies. Based on heterogeneity, either a fixed-effects or random-effects model was selected to synthesize the standardized mean difference (SMD) or weighted mean difference (WMD), Subgroup analysis and meta-regression were performed to explore the sources of heterogeneity.ResultsThe meta-analysis demonstrated that traditional Chinese exercise significantly reduced pain intensity [WMD = −1.21; 95% CI (−1.66, −0.76)], improved dysfunction [WMD = −6.80; 95% CI (−10.18, −3.41)], and enhanced quality of life [SMD = 1.64; 95% CI (0.33, 2.96)] in patients with nonspecific low back pain (NLBP). The overall treatment response rate was increased by 17% [RR = 1.17; 95% CI (1.10, 1.24)]. Subgroup analysis indicated that Liu Zi Jue (a specific Qigong breathing exercise) demonstrated the greatest analgesic effect (SMD = −1.71) and the most significant improvement in functional disability (WMD = −13.35). Additionally, patients younger than 45 years of age showed a more favorable response to treatment (SMD = −1.52). Substantial heterogeneity was observed across studies, attributed primarily to the diversity of intervention protocols, including variations in exercise types, treatment durations, and differences in the measurement instruments used.ConclusionTraditional Chinese exercise is an effective, low-cost, and safe intervention for NLBP patients and may be recommended as a complementary approach in clinical management. Future research should include large-sample, standardized studies incorporating biomechanical and imaging techniques to elucidate underlying mechanisms, and develop evidence-based practice guidelines.Systematic Review Registrationidentifier: CRD42025649466 (https://www.crd.york.ac.uk/PROSPERO/).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fpain.2026.1746977</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fpain.2026.1746977</link>
        <title><![CDATA[Non-invasive brain stimulation for neuropathic orofacial pain: a mini-review]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Xiaoying Lin</author><author>Xiaomin Niu</author><author>Ting Hu</author><author>Jun Zhang</author><author>Yingxiu Diao</author><author>Jinqian Li</author><author>Qinjie Yang</author><author>Chunyang Liao</author><author>Tiantian Xin</author><author>Shuqin Li</author><author>Xiaying Fu</author><author>Ketao Du</author><author>Jianghua Cheng</author>
        <description><![CDATA[Neuropathic orofacial pain (NOP) can seriously affect the quality of life of patients. Due to the concentration of pain in the central area of the craniofacial region, it is not only highly invasive but also easily distracts the patient's attention, resulting in its destructive nature far exceeding that of distal limb pain. As emerging non-invasive therapies, Repetitive Transcranial Magnetic Stimulation (rTMS) and Transcranial Direct Current Stimulation (tDCS) are bringing hope for the treatment of NOP. This brief review summarizes existing evidence on their efficacy, highlighting that pain phenotype may be a key determinant of treatment response and warrants further investigation. High-frequency (10–20 Hz) rTMS over the primary motor cortex (M1) reduces trigeminal and postherpetic neuralgia pain by 30%–45%, with effects lasting weeks to months. Non-somatotopic hand M1 stimulation appears to produce comparable facial analgesia via descending pain pathways. For tDCS, preliminary evidence suggests pure paroxysmal pain may respond more robustly than persistent pain, implicating central sensitization as a potential negative predictor. Current evidence is limited by small samples and heterogeneous protocols. Future research should prioritize phenotype-stratified trials, optimal parameters, and synergy with pharmacotherapy.]]></description>
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