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Differences Among Veterans With Chronic Overlapping Pain Conditions and Other Chronic Pain: Baseline Results From the LAMP Pain Management Trial.

BACKGROUND: Chronic overlapping pain conditions (COPCs) are a constellation of disorders posited to share an underlying pain mechanism (nociplastic pain). Unfortunately, individuals with COPCs are under-represented in clinical research. The current study aimed to determine COPC prevalence among participants enrolled in a pragmatic clinical trial and compare those with COPCs to those with non-COPCs across several domains. METHODS: Learning to Apply Mindfulness to Pain (LAMP) study baseline data of veterans with chronic pain (N = 811) were utilised. COPC diagnoses were determined using ICD-10 c

Indian Society for Study of Pain, Cancer Pain Special Interest Group Guidelines on Pharmacological Management of Cancer Pain (Part III).

The Indian Society for Study of Pain (ISSP), Cancer Pain Special Interest Group, guidelines on pharmacological management of cancer pain in adults provide a structured, step-wise approach which will help to improve the management of cancer pain and to provide patients with a minimally acceptable quality of life. The guidelines have been developed based on the available literature and evidence, to suit the needs, patient population, and situations in India. A questionnaire based on the key elements of each sub draft addressing certain inconclusive areas where evidence was lacking, was made avai

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… Do you follow WHO step ladder approach for cancer pain management? What do you prefer for step II and step III of WHO ladder? What non-pharmacological techniques do you use to manage Cancer Pain Do you screen all patients of substance abuse? If yes, which scale do you use. … Do you think current treatment guidelines for cancer pain management are sufficient? If no, what changes do you suggest? According to you, what steps need to be taken to spread the awareness regarding cancer pain management? …

Indian Society for Study of Pain, Cancer Pain Special Interest Group Guidelines on Palliative Care Aspects in Cancer Pain Management.

The Indian Society for Study of Pain (ISSP), Cancer Pain Special Interest Group guidelines on palliative care aspects in cancer pain in adul … ing, acute inpatient setting, and end-of-life care in hospice setting. We aim to expound the cancer pain management approaches in these settings. In an ambulatory palliative care setting, the WHO analgesic step ladder is used for cancer pain management. The patients with cancer pain require admission for acute inpatient palliative care unit for poorly controlled …

A tailored pain self-management intervention for patients with cirrhosis is acceptable and improves pain control.

BACKGROUND: Chronic pain is common and uniquely challenging to manage in people with cirrhosis. The purpose of this pilot study was to evaluate the feasibility and acceptability of a tailored pain self-management (PSM) intervention for people with cirrhosis and chronic pain. METHODS: This single-arm, single-site pilot study recruited patients with a diagnosis of cirrhosis and chronic pain to a virtual, health coach-led, modular PSM intervention. After 6 weekly one-on-one sessions, patients were invited to attend 6 weekly group sessions. Outcomes were measured at baseline, 6 weeks, 12 weeks (e

The transitional pain service: a narrative review on the approach to managing chronic post-surgical pain.

We conducted a narrative review of the Transitional Pain Service (TPS) to (1) synthesize current evidence on its effectiveness and (2) ident … ted by manual hand-searching, was performed using terms related to transitional pain, postoperative pain management, opioids, and chronic pain. Searches were restricted to English language human studies published from 2014 onward. Fourteen articles met inclusion criteria. Across the literature, TPS interventions consistently demonstrated reductions in postoperati …

Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain.

Pain is prevalent and a major source of disability after a traumatic brain injury (TBI) and a spinal cord injury (SCI). With a view of reducing the pain burden in neurotrauma, this study aimed to describe the use of pain management strategies and the adverse effects of opioids in patients with TBI and SCI. We collected data at hospital discharge (T1) and at 3 months post-injury (T2). A total of 70 patients, including 49 with TBI and 21 with SCI, with a mean age of 56 years (±21.1, ±17.9) were included. Almost a third of participants with TBI (33%) and SCI (29%) had a moderate average pain inte…

Pain relief in the palm of your hand: Harnessing mobile health to manage pediatric pain.

The development and implementation of mobile health (mHealth) interventions provide an opportunity for more optimal management of pediatric … althcare providers to promote and develop mHealth programs has the potential to transform pediatric pain management. This merger of evidence-based pain management strategies and digital technology positions pediatric mHealth to have a profound impact by effectively augmenting standard of care and benefiting healthcare providers, parents, and especially children i …

The Impact of Pain Invisibility on Patient-Centered Care and Empathetic Attitude in Chronic Pain Management.

OBJECTIVES: The use of interdisciplinary patient-centered care (PCC) and empathetic behaviour seems to be a promising avenue to address chronic pain management, but their use in this context seems to be suboptimal. Several patient factors can influence the use of PCC and empathy, but little is known about the impact of pain visibility on these behaviours. The objective of this study was to investigate the influence of visible physical signs on caregiver's patient-centered and empathetic behaviours in chronic pain context. METHODS: A convenience sample of 21 nurses and 21 physicians participat…

Botulinum toxin in orofacial pain management: INfORM/IADR recommendations.

OBJECTIVE: To present a list of key points to summarize the standard of care based on the available evidence for the appropriate use of botulinum toxin (BTX) in the management of orofacial pain conditions, including temporomandibular disorders (TMDs), on behalf of the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) of the International Association for Dental, Oral and Craniofacial Research (IADR). METHODS: An open working group discussion was held at the IADR/AADOCR General Session in San Diego (March 2026), where members of the INfORM group debated and fin

Mixed pain phenotypes in musculoskeletal disorders: mechanisms and management.

Pain is categorized into three pain phenotypes: nociceptive, neuropathic and nociplastic, with overlapping pain referring to the coexistence of more than one pain phenotype. Overlapping pain occurs in more than one-third of individuals with musculoskeletal conditions, including inflammatory arthritis, osteoarthritis, spinal disorders and soft-tissue conditions. Whereas nociceptive pain is associated with identifiable tissue pathology and often responds to anatomically focused treatments, the presence of an additional pain phenotype, most commonly nociplastic pain, contributes to clinical compl

Multimodal Perioperative Pain Management for Children with Medical Complexity.

Children with medical complexity (CMC) experience poor perioperative pain outcomes. To improve their pain assessments and treatment, CMC require multidisciplinary pain management across the perioperative period. This includes engaging CMC and/or their caregivers in pain assessments, attempting to mitigate pain issues preoperatively, and developing treatment plans based on children's unique histories and the types of pain anticipated by the specific surgery. Multimodal analgesia is the gold standard for perioperative pain management, and providers should consider nonpharmacologic methods and an…

Intrathecal Ziconotide Long-Term Management in Chronic Postamputation Pain.

The clinical case of a young patient with intractable residual limb pain is presented. Following the initial administration of opioids and subsequent overuse, the patient was switched to intrathecal (IT) ziconotide infusion with complete opioid withdrawal. After 15 years of treatment with ziconotide infusion, the patient achieved sustained analgesic control and excellent functional recovery. IT ziconotide showed good long-term tolerability and safety.

Multimodal Pain Management in Emergency Medicine: A Narrative Review.

Pain is one of the most common reasons for presentation to the emergency department, yet it remains frequently undertreated despite effective therapies. Emergency physicians must provide timely analgesia while accounting for diagnostic uncertainty, patient heterogeneity, and safety concerns, particularly related to opioid use. This narrative review synthesizes contemporary evidence on multimodal pain management in emergency medicine. A focused literature search of PubMed and Scopus was conducted to identify studies published between 2015 and 2025, as well as selected landmark studies and major…

Successful Management of Chest Pain Through Cardiac Autonomic Rehabilitation.

BACKGROUND: Some patients experience persistent chest pain after complete coronary revascularization without evidence of ischemia. Dysautonomia may be the underlying cause. CASE SUMMARY: A 43-year-old man with recurrent chest pain after multivessel revascularization showed poor response to standard cardiac rehabilitation. Evaluation revealed significant autonomic dysfunction (sympathetic overactivation), not ischemia. After implementing an integrated autonomic-regulation protocol (low-intensity aerobic exercise combined with abdominal breathing, standing meditation, and mindful walking), his

Pain Management in Pediatric Patients with Sickle Cell Disease.

Sickle cell pain is a complex and multifaceted condition that varies widely across individuals, necessitating a personalized approach informed by a comprehensive history and careful consideration of the biopsychosocial context. Although opioids remain the mainstay of pain management for individuals experiencing acute pain during a vaso-occlusive episode (VOE), multiple disease-modifying therapies have emerged and are demonstrating promise in helping to reduce the frequency and duration of VOEs. In addition, nonopioid analgesics and nonpharmacologic interventions show potential as adjunct thera…

Gabapentinoids for Neuropathic Pain Management: A Systematic Umbrella Review.

BACKGROUND/OBJECTIVES: This umbrella review aimed to evaluate the effectiveness of gabapentinoids, including dosing and risk profile, for the management of neuropathic pain. METHODS: Eligibility criteria were restricted exclusively to systematic reviews and meta-analyses conducted under PRISMA reporting standards. Methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) instrument. The scope of the review comprised six distinct pain conditions: spinal cord injury, post-herpetic neuralgia, cancer-related neuropathic pain, diabetic peripheral neuropa

AAV vectors: an emerging strategy for chronic pain management.

Chronic pain affects millions of people worldwide and represents a crucial public health issue. A growing body of preclinical evidence suggests that adeno-associated virus (AAV) vectors are a powerful gene therapy tool for chronic pain management. We systematically summarize how AAV vectors, by targeting molecular pain pathways in neuronal and non-neuronal cells, may offer precise and sustained pain relief. We provide an overview of the latest findings and emerging concepts in this area, and discuss preclinical innovations in neuropathic, inflammatory and cancer-related pain. We also present c…

Improving management of abdominal pain in inflammatory bowel disease.

INTRODUCTION: Abdominal pain remains a major challenge in inflammatory bowel disease (IBD), due to its frequency and relative impact on healthcare costs and patient well-being. Although significant steps have been taken to better understand pain and how to manage this important symptom, a great deal is still unknown regarding the nature of abdominal pain, including in IBD. AREAS COVERED: In this critical perspective, we review current major issues related to abdominal pain in IBD, along with the contemporary strategies utilized to address this symptom. Additionally, we discuss approaches that