Douleur chronique

Author Names: Abbasi, N.U.H.,Bilal, A.,Akram, B.,Altaf, S. Database Source: Embase Weekly Updates Journal Title: BMC psychology Article Title: Psychosocial etiology and management of chronic pelvic pain in women: a systematic review Year: 2026 Issue: 1 Volume: 14 Abstract: BACKGROUND: Chronic Pelvic Pain (CPP) in women is a complicated disease. Psychosocial elements like stress, trauma, and mental illnesses frequently impact CPP in women. A biopsychosocial strategy emphasizing the integration of psychosocial approach for conceptualizing and managing this condition is necessary for effective management. Therefore, this systematic review was conducted to propose the psychosocial etiology and management strategies for CPP in women. <br/>METHOD(S): Research databases, including PubMed/MEDLINE, Embase, PsycINFO, and the Cochrane Library, were used to search for relevant articles published from 2016 to 2025. The selected studies were Cross-Sectional Studies and Randomized Controlled Trials (RCTs). Of the 32 studies, 8 were chosen according to the inclusion criteria. <br/>RESULT(S): The data synthesis of the selected studies found that psychological distress, unhealthy coping style, early life experiences, and emotional trauma are significant etiological factors for CPP in women. On the other hand, psychosocial therapeutic approaches including psychoeducation, Cognitive Behavior Therapy, Acceptance and Commitment Therapy, stress management techniques and coping strategies were found effective for improving the chronic pain condition. <br/>CONCLUSION(S): The psychosocial etiology of CPP in women underscores the importance of a psychosocial approach to management, integrating psychological and social interventions. Addressing both the psychological and social dimensions of pain is essential for improving patient outcomes and quality of life. TRIAL REGISTRATION: This systematic review has been registered in PROSPERO with the Registration No. CRD420251179527.<br/>Copyright © 2026. The Author(s).

Author Names: Slotty, P.J.,Rasche, D.,Vesper, J. Database Source: Embase Weekly Updates Journal Title: Schmerz Article Title: German guideline on spinal cord stimulation for chronic neuropathic pain,Leitlinie zur epiduralen Ruckenmarkstimulation bei chronischen neuropathischen Schmerzen Year: 2026 Issue: 3 Volume: 40 Abstract: Epidural spinal cord stimulation (SCS) is a neuromodulatory, reversible procedure for the treatment of selected chronic pain conditions, primarily neuropathic in nature. The updated German S3 guideline provides evidence-based recommendations for the use of SCS and dorsal root ganglion stimulation (DRG-S). Key innovations include recent technical advances and increased integration into multimodal pain management. The guideline aims to enhance the care of patients with chronic pain by offering rational, scientifically substantiated recommendations. A systematic literature review was conducted, including meta-analyses and randomized controlled trials, with relevant case reports also taken into account. Publications were evaluated by topic, including fundamentals, indications, methods, complications, quality management, and psychosocial aspects. Recommendations are based on established evidence classifications. Major updates include strong evidence in favor of SCS for diabetic polyneuropathy. For other neuropathies, smaller studies indicate positive effects. SCS is considered the most effective therapy for chronic, postoperative back and leg pain. Additionally, SCS receives a strong recommendation for peripheral arterial occlusive disease (Fontaine stages IIb and III). For complex regional pain syndrome (CRPS), DRG-S demonstrates superiority over SCS and is preferentially recommended. The guideline addresses all professional groups involved in the care of pain patients and offers practical guidance for therapeutic decision-making in the management of chronic pain.<br/>Copyright © The Author(s) 2026.

Author Names: Schmidt, A.F.,Wager, J.,Meyer, D.,Rau, L.-M.,Frosch, M.,Zernikow, B.,Hirschfeld, G.,Fruhwald, M.C.,Ahnert, R.,Hofel, L.,Storf, M.,Blankenburg, M.,Steinert, K.,Schneider, U.,Marschall, U. Database Source: Embase Daily Updates Journal Title: Psychotherapy and Psychosomatics Article Title: Clinical Effectiveness of Different Feedback Intensities in a Pain Management App: A Multicenter Randomized Controlled Trial with Youths with Chronic Pain and Their Caregivers Year: 2026 Issue: Volume: Abstract: Abstract - Introduction: Many children and adolescents suffer from high-impact chronic pain. While preliminary evidence suggests that intensive interdisciplinary pain treatment is effective, there is limited post-treatment support. Individualized support through a pain management app may help close this gap. <br/>Method(s): We conducted a multicenter randomized controlled trial with N = 453 youths with chronic pain aged 8-17 and their caregivers. Participants had access to the app MyBrainCity from admission until 6 months following discharge. Immediately after discharge, participants had access to either (1) app usage statistics (reference group), (2) plus push notifications and suggestions, (3) plus on-demand chat communication with a psychologist, or (4) plus psychologist-initiated chat communication. Data were collected up to 9 months after discharge. Outcomes included the functional disability inventory, the Revised Anxiety and Depression Scale, and numeric rating scales to assess pain intensity. <br/>Result(s): The primary analysis showed no significant differences in functional impairment between groups 9 months post-discharge (chi²(3) = 6.122, p = 0.106). Secondary analyses revealed that patients in Groups 3 and 4 showed significantly greater improvements in functional impairment compared to the reference group (-1.13 points, p < 0.001). Only patients in Group 4 demonstrated additional improvements in emotional burden (anxiety: -0.91 points, p < 0.001; depression: -0.72 points, p = 0.012). Patients in Group 2 had significantly greater reductions in both average (-0.24 points, p = 0.007) and maximum pain intensity (-0.33 points, p = 0.001) compared to the reference group. <br/>Conclusion(s): Pediatric pain […]

Author Names: Shi, W.,Zhang, L.,Zhao, E. Database Source: Embase Daily Updates Journal Title: Heart Lung and Circulation Article Title: The Impact of Chronic Pain on Cardiovascular Outcomes in Patients With Coronary Artery Disease: A Systematic Review Year: 2026 Issue: Supplement 3 Volume: 35 Abstract: Aim: We aimed to systematically review the prevalence, characteristics, and cardiovascular associations of chronic pain in adults with CAD, and to evaluate evidence for potential causal relationships using observational and Mendelian randomisation (MR) studies. <br/>Method(s): A systematic review was conducted across six databases from inception to July 2024. Observational and MR studies examining chronic pain in adults with CAD or acute coronary syndrome (ACS) were included. Data on pain prevalence, assessment methods, pain phenotypes, and cardiovascular outcomes were extracted. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT) for observational studies and the STROBE-MR checklist for mendelian randomisation studies. Due to heterogeneity in pain definitions and outcome measures, findings were synthesised narratively. <br/>Result(s): Eleven studies met the inclusion criteria, comprising eight observational studies and three MR studies. Across observational studies, chronic pain prevalence ranged from 15.4% to 35.5%, varying by pain phenotype, timing of assessment, and population. Musculoskeletal and inflammatory pain phenotypes were associated with adverse cardiovascular risk profiles and increased post-ACS mortality, whereas some post-surgical neuropathic pain syndromes showed no clear cardiovascular association. All MR studies demonstrated consistent evidence supporting a causal association between multisite chronic pain and CAD-related outcomes, including myocardial infarction and heart failure. <br/>Conclusion(s): Chronic pain is common among patients with CAD and is associated with adverse cardiovascular outcomes. Evidence from Mendelian randomisation supports a potential causal relationship, suggesting chronic pain may represent an under-recognised and modifiable cardiovascular risk factor. Systematic assessment and targeted management of chronic pain should be considered in CAD secondary prevention […]

Author Names: Schneider, L.,Exner, C.,Wulfson, A.,Geidel, J.,Schenk, M.,Fritz, T.H. Database Source: Embase Daily Updates Journal Title: Pain physician Article Title: Modulation of Pain Perception Through Identifying Emotionally with Music Feedback During Physical Exercise for Patients with Chronic Pain: A Randomized Trial Year: 2026 Issue: 5 Volume: 29 Abstract: BACKGROUND: The emotional modulation of pain can be achieved through interventions in the form of music, which may therefore be valuable in regulating emotions and perceived pain during physical activity. <br/>OBJECTIVE(S): The present study aimed to investigate the effects of music feedback during physical exercise on chronic pain patients' emotional states, motivation, and pain levels during an acute clinic stay. STUDY DESIGN: A crossover design was used to test the effects of music feedback during an ergometer training (active condition) vs. music listening during an ergometer training (passive condition) on 43 patients with different chronic pain conditions during their acute clinical stay. SETTING: An acute clinic specializing in pain medicine. <br/>METHOD(S): Patients were recruited by clinical staff and randomly assigned to perform both conditions in different orders. The music was selected from 4 genres, and the same songs were used in the training sessions for both types of conditions. <br/>RESULT(S): The results showed that patients' motivation to exercise was stronger during the active condition than during the passive condition, as measured by active engagement during the training interval (t(39) = 3.013, P = 0.006; 95% CI: 0.0104; .0529). Those findings matched with patients' individual ratings of their motivation. For both conditions, anxiety levels decreased significantly from baseline (active condition: Z = -4.213; P < 0.001; passive condition: Z = -3.864; P < 0.001). The pain levels did not differ between conditions (Z = -0.137, P = 0.45). Interestingly, the reported match/congruency of the patients' moods and emotions expressed by the chosen music pieces correlated with changes in pain perception (r = -0.438, P = 0.007), and the match of the patients' own emotional state with the music was significantly higher during the active condition (Mdn = 7.7) than during the […]

Author Names: Navin, C.,Slattery, B.,Pilch, M.,Haugh, S.,Connor, L.O.,Malone, B.,Perez, C.,Egan, J.,McKenna, G.,McGuire, B.E.,Dear, B.F.,Bisby, M.A.,Gandy, M.,Titov, N. Database Source: Embase Daily Updates Journal Title: The Clinical journal of pain Article Title: An Internet-based Cognitive Behavioral Program, With Telephone Support, Improves Pain, Disability and Emotional Wellbeing in Adults with Chronic Pain: Randomized Controlled Trial of the Pain Course With 2-year Follow-up Year: 2026 Issue: Volume: Abstract: OBJECTIVES: To evaluate the efficacy of the online cognitive behavioral therapy (CBT)-based Pain Course on levels of pain, disability, and psychological wellbeing in adults with chronic pain living in Ireland, with two-year follow-up. <br/>METHOD(S): 133 people were randomly assigned (ISRCTN11292570) to either the Pain Course (n=66) comprising five lessons delivered over eight weeks with clinician support, or to delayed access with usual care in the interim (n=67). The primary outcome was pain-related disability while secondary outcomes were depression, anxiety and average pain, and tertiary outcomes were pain self-efficacy, fear of movement, and pain acceptance. Outcomes were collected at post-treatment, 3-month follow-up (n=55 [83% retention]) and 2-year follow-up (n=29 [44% retention]). <br/>RESULT(S): Course completion rate was 80%. Improvements were significantly greater for Treatment Group participants compared to Control Group on measures of disability, anxiety, depression, and average pain at post-treatment (Cohen's d =.48-1.00). Improvements in outcomes were in the range 12%-44% and benefits were maintained or improved at 3 month follow-up. All tertiary outcomes also improved in the treatment group. There was substantial attrition at 2-year follow-up, but for those who responded, treatment effects were largely maintained. High treatment satisfaction ratings were expressed by over 80% of participants. Average clinician contact, per participant, was 81.06 minutes. <br/>DISCUSSION(S): The findings of the current study in an Irish sample corroborate those of previous Pain Course efficacy trials and highlight the potential benefits of internet-based interventions for adults with chronic pain, with treatment effects maintained for up to […]

Author Names: Pahari, S.,Hazra, S.,Das, P.P. Database Source: Embase Daily Updates Journal Title: Pain medicine (Malden, Mass.) Article Title: Intravenous Lidocaine Does Not Provide Additional Pain Reduction Beyond Placebo in Probable Nociplastic Chronic Low Back Pain: A Randomized Controlled Trial- An Infographic Year: 2026 Issue: Volume: Abstract:

J Oral Rehabil. 2026 Jul 24. doi: 10.1111/joor.70275. Online ahead of print.ABSTRACTBACKGROUND: Burning Mouth Syndrome (BMS) is a type of chronic orofacial pain characterised by a burning sensation inside the mouth without an apparent cause. Capsaicin has been used to manage the symptoms of this syndrome, but there is still no consensus on its effectiveness.OBJECTIVE: To assess whether capsaicin, when used topically or systemically, is able to alleviate the symptoms of BMS.METHODS: An extensive search was carried out in seven databases and grey literature up to November 2025. There were no restrictions regarding the date or language of publication.RESULTS: The search resulted in 782 articles, of which 4 were included. The methodological quality of the studies was assessed using the Risk of Bias in Systematic Reviews (ROBIS) tool and the certainty of evidence was performed according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Regarding capsaicin administration, 3 studies used topical application and 1 used systemic application. Concentrations ranged from 0.000354% to 0.25%, three times a day, for 1-8 weeks. Regardless of the administration method, a reduction in patient-reported pain scores was observed. Risk of bias assessment showed that three randomised studies presented a moderate risk, while the only non-randomised clinical trial presented a critical risk. The overall certainty of the evidence was low or very low for the outcomes assessed.CONCLUSION: Evidence suggests that capsaicin is effective in relieving BMS symptoms. However, this result should be interpreted with caution due to the low quality of the evidence obtained to support its use.PMID:42499217 | DOI:10.1111/joor.70275

Neuromodulation. 2026 Jul 18:S1094-7159(26)01306-1. doi: 10.1016/j.neurom.2026.07.642. Online ahead of print.ABSTRACTBACKGROUND: Spinal Cord Stimulation (SCS) is a therapeutic option for chronic pain conditions, such as persistent spinal pain syndrome, complex regional pain syndrome, painful diabetic peripheral neuropathy, and radiculopathy. The treatment typically involves a temporary trial phase before permanent implantation. Despite showing efficacy, trial phase failure and long-term SCS outcomes remain important considerations. The aim of this review was to quantify three key SCS outcomes-(1) trial phase nonresponse, (2) annual explantation rates after permanent implantation up to three years, and (3) annual <50% pain reduction rates among patients who retain their implant up to three years.MATERIALS AND METHODS: A systematic literature review was conducted across PubMed, Embase, and Cochrane data bases to identify studies reporting on SCS outcomes. Studies were included if they reported quantitative data on at least one of the three outcomes. Data were extracted and summarized across studies. A three-level binomial generalized linear mixed model with logit link was used to calculate pooled rates across included studies. Risk of bias was assessed using the Risk of Bias 2 tool and National Institutes of Health quality assessment tools as appropriate, and certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation framework.RESULTS: A total of 38 studies were included in the analysis. The pooled trial phase failure rate was 16.2%. Pooled explant rates were 4.0%, 7.0%, and 11.9% at one, two, and three years respectively. Pooled rates of <50% pain reduction were 24.2%, 27.0%, and 32.8% at one, two, and three years respectively.CONCLUSIONS: We aggregate and analyze the durability of SCS outcomes according to a defined rubric. Outcomes were not stratified by factors that could influence response, such as waveform. 16.2% of patients assessed for SCS eligibility did not proceed past the trial phase. On average, at three years post implantation, 44.7% of patients with permanent implants had undergone explantation or reported <50% pain relief.PMID:42573547 | DOI:10.1016/j.neurom.2026.07.642

Clin Breast Cancer. 2026 Jul 18;26(9):31-38. doi: 10.1016/j.clbc.2026.07.023. Online ahead of print.ABSTRACTWith improved survival rates in breast cancer, managing long-term morbidity of breast cancer patients is becoming increasingly relevant. Chronic pain after breast cancer surgery affects 20% to 60% of patients, of which 30% to 68% are neuropathic in nature. However, there is an existing gap in the literature concerning the exact prevalence of neuropathic pain, specifically regarding surgical axillary procedures in breast cancer patients. This systematic review and meta-analysis aimed to investigate the prevalence of neuropathic pain after axillary procedures, including axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB). The electronic bibliographic databases Embase, Medline, and Web of Science were searched from inception until February 2025. Inclusion and exclusion criteria were defined to include studies reporting on neuropathic pain prevalence following axillary procedures in breast cancer patients. Meta-analyses were performed to quantify pooled prevalences. Overall, 15 studies met the inclusion criteria, of which 14 were included in the meta-analyses, encompassing 2725 patients. A pooled neuropathic pain prevalence after axillary procedures of 22.6% (95% confidence interval [CI], 15.5-30.6) was estimated in the meta-analysis. The meta-analyses on ALND (10 studies, 1253 patients) and SLNB (5 studies, 860 patients) revealed an estimated pooled prevalence of 26.9% (95% CI, 17.1-37.9) and 18.8% (95% CI, 10.5-28.5), respectively. Neuropathic pain affects approximately 1 in 5 breast cancer patients following axillary surgery, with higher rates after ALND than SLNB.PMID:42574818 | DOI:10.1016/j.clbc.2026.07.023

Neuromodulation. 2026 Jul 15:S1094-7159(26)00662-8. doi: 10.1016/j.neurom.2026.07.002. Online ahead of print.ABSTRACTBACKGROUND: Chronic nonsurgical low back pain, or persistent spinal pain syndrome type 1 (PSPS-T1) with predominant axial pain, remains an important burden on patient quality of life, with significant economic consequences. The outcome of conservative treatments or surgery in chronic low back pain is often unsatisfactory, and spinal cord stimulation (SCS) has emerged as a promising treatment in this patient population, with multiple randomized trials published in the past decade. Outcome synthesis has primarily been focused on pain relief.MATERIALS AND METHODS: Randomized controlled trials (RCTs) published in the English language, between January 1, 1990 and December 31, 2025 evaluating the effectiveness of SCS in patients with PSPS-T1 with predominant low back pain were identified in MEDLINE, Limo LIBIS, and Cochrane data bases. Objective outcome parameters including quality of life, functionality, perceived effect, patient satisfaction, pain medication usage, and adverse events were collected.RESULTS: Five RCTs met the inclusion criteria. SCS significantly improves functionality, quality of life, and patient satisfaction and significantly reduced pain medication usage in patients with chronic nonsurgical low back pain. Adverse events were reported in 8% to 29% of patients, with most classified as minor or moderate. Severe adverse events, causing explantation, only occurred in a minority of patients.CONCLUSION: SCS significantly improves holistic outcomes parameters in patients with PSPS-T1 with predominant low back pain and can therefore be considered in well-selected patients with refractory pain unresponsive to conventional management. A multidisciplinary approach remains key in this patient group.PMID:42578901 | DOI:10.1016/j.neurom.2026.07.002

J Adolesc. 2026 Jul 22. doi: 10.1002/jad.70236. Online ahead of print.ABSTRACTBACKGROUND: Adolescence is a high-risk period for co-occurring conditions like chronic pain, anxiety, and depression. Although digital psychological interventions offer a scalable and accessible alternative to traditional care, their comprehensive efficacy in addressing these interconnected symptoms remains underexplored. This meta-analysis evaluates the effects of digital interventions on pain in adolescents with comorbid emotional problems, with secondary outcomes including anxiety and depressive symptoms.METHODS: We systematically searched five databases for randomized controlled trials through October 5, 2025, ultimately including 12 studies. Statistical analyses were performed in Review Manager 5.4 and Stata 17.0 using a random-effects model and specifically focused on adolescents with comorbid conditions. The review protocol was registered with PROSPERO. Subgroup analyses were conducted based on intervention type (Internet-based Cognitive Behavioral Therapy [iCBT], self-management, and Internet-based Acceptance and Commitment Therapy [iACT]).RESULTS: A total of 12 studies involving 1403 adolescents were included. Meta-analysis indicated that digital interventions significantly improved pain (SMD = -0.21, 95% CI: [-0.35, -0.06]) and anxiety (SMD = -0.15, 95% CI: [-0.21, -0.10]). The effects of digital psychosocial interventions on depression were not statistically significant.CONCLUSION: Digital interventions show potential in managing pain and anxiety among adolescents with comorbidities. Future efforts should prioritize integrated intervention programs that combine pain management with emotion regulation, establishing them as foundational components within the broader care system to complement routine clinical practice.TRIAL REGISTRATION: This systematic review was prospectively registered with PROSPERO (CRD420251270961) on 12 December 2025.REGISTRATION DETAILS: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251270961.PMID:42484278 | DOI:10.1002/jad.70236

Anaesthesia. 2026 Jul 21. doi: 10.1111/anae.70301. Online ahead of print.NO ABSTRACTPMID:42478268 | DOI:10.1111/anae.70301

Brain Spine. 2026 Jul 1;6:106157. doi: 10.1016/j.bas.2026.106157. eCollection 2026.ABSTRACTINTRODUCTION: Treatment-refractory chronic pain is a prevalent condition affecting a significant portion of the population. Available treatment strategies range from non-invasive to invasive approaches, including several surgical procedures. The most commonly reported intracranial neurosurgical interventions are deep brain stimulation (DBS) and ablative techniques such as cingulotomy, thalamotomy, and mesencephalotomy.RESEARCH QUESTION: This study aimed to evaluate the efficacy of different intracranial surgical treatments for refractory chronic pain through a systematic review and meta-analysis, focusing on quantitative trends in clinical pain outcomes.MATERIAL AND METHODS: A systematic literature search was conducted in PubMed according to PRISMA guidelines.RESULTS: In total, 75 studies including 666 patients that underwent at least one surgical procedure, with nearly half achieving significant pain reduction (>50%). A meta-analysis compared surgical treatments; where mesencephalotomy was excluded due to insufficient data. Pain levels at baseline were compared at four follow-up periods: T1 (≤1 month), T2 (>1-≤6 months), T3 (>6-≤12 months), and T4 (>12 months). Wilcoxon tests demonstrated statistically significant differences between baseline and the latest follow-up for all included methods: DBS: p < 0.001, g = 1.44 85-90%; cingulotomy: p < 0.001, g = 2.6 > 95%; thalamotomy: p < 0.001, g = 0.92 ≈ 74%. Comparisons between follow-up time points were possible only for DBS, which also showed significant differences (p < 0.05).DISCUSSION AND CONCLUSION: Our findings indicate that intracranial surgical procedures for chronic pain are effective/safe and may maintain their clinical benefit for months following treatment. Furthermore, substantial variability in clinical outcomes was observed, even after stratification according to etiology and target groups.PMID:42472183 | PMC:PMC13380498 | DOI:10.1016/j.bas.2026.106157

BMJ Open. 2026 Jul 16;16(7):e105106. doi: 10.1136/bmjopen-2025-105106.ABSTRACTOBJECTIVE: To assess the effects of radiofrequency (RF) denervation for chronic low back pain (LBP) from facet joint, sacroiliac joint, discogenic and non-specific pain.DESIGN: Systematic review and meta-analysis.DATA SOURCES: We searched Medline, Embase, Cochrane Library, CINAHL, PsycINFO, ClinicalTrials.gov and WHO ICTRP up to 18 February 2025 for randomised controlled trials (RCTs).STUDY SELECTION, DATA EXTRACTION AND SYNTHESIS: Pairs of reviewers independently selected studies, extracted data and assessed risk of bias (Cochrane RoB 2). Meta-analyses with clinically homogeneous studies were performed and certainty of evidence was assessed using Grades of Recommendation, Assessment, Development and Evaluation.RESULTS: 55 RCTs (n=4394) were included; many outcomes were at some risk of bias. Low to moderate certainty evidence suggested small improvements in pain and function with RF denervation versus sham for facet joint pain, sacroiliac, discogenic and non-specific chronic LBP. None exceeded predefined minimally clinically important between-group differences, suggesting limited clinical relevance.CONCLUSIONS: RF denervation showed small improvements in pain and function compared with sham, steroid injection or standard care, but the effects did not reach clinically meaningful thresholds and the certainty of evidence was very low to moderate. Additional research is needed to clarify the effects of RF denervation and guide clinical decision-making.PROSPERO REGISTRATION NUMBER: CRD42023460743.PMID:42463214 | DOI:10.1136/bmjopen-2025-105106

J Gen Intern Med. 2026 Jul 16. doi: 10.1007/s11606-026-10613-1. Online ahead of print.ABSTRACTBACKGROUND: Chronic pain and posttraumatic stress disorder (PTSD) have shared, often overlapping pathophysiology. Treatment options include complementary and integrative health (CIH) interventions, which have been summarized in numerous systematic reviews and meta-analyses (SR/MAs).OBJECTIVE: This umbrella review describes and evaluates SR/MAs of self-managed CIH modalities for chronic pain or PTSD.METHODS: We registered our protocol and conducted a literature search in October 2022 of Ovid MEDLINE ALL, Ovid APA PsycInfo, and Ovid EBM Reviews Cochrane Central Register of Controlled Trials; an updated search was conducted in January of 2026 of Ovid MEDLINE, Cochrane Database of Systematic Reviews, and APA PsycInfo. Reviews of RCTs published in or after 2017 involving adults with chronic pain or PTSD and limited to CIH interventions that do not require the presence of a provider were retrieved. Two reviewers independently conducted selection, data extraction, and assessment of SR/MA quality using the Revised Assessment of Multiple Systematic Reviews Tool. We extracted study aims, search dates, number of articles and subjects, patient population, interventions, dose, adverse events, comparators, outcomes, and summary estimates for symptom reduction. We followed PRISMA reporting guidelines.RESULTS: We included 27 (chronic pain (n = 16) and PTSD (n = 11) SR/MAs of yoga, meditation/mindfulness, and tai chi/qigong. Methodological quality scores ranged from 29 to 42 out of 44 points. Efficacy of CIH varied by condition, intervention, and comparator type. Mild adverse events and increases in existing symptoms may arise temporarily when practicing mindfulness, yoga, or tai chi. The length of each intervention session ranged from 30 to 150 min for 8-54 sessions depending on the CIH modality.CONCLUSIONS: Self-managed CIH for chronic pain and PTSD is well documented and may be effective for individuals with comorbid chronic pain and PTSD with low risk of adverse events. CIH approaches that could be used for simultaneous treatment of CP + PTSD should consider interventions that include mindfulness and movement.TRIAL REGISTRATION: PROSPERO Trial CRD42022369478.PMID:42463629 | DOI:10.1007/s11606-026-10613-1

J Mil Veteran Fam Health. 2025 Aug 28;11(4):62-71. doi: 10.3138/jmvfh-2024-0078. eCollection 2025 Sep.ABSTRACTINTRODUCTION: This study explored the experiences of military personnel with chronic pain accessing care during their service and their transition to civilian life.METHODS: Database and grey literature searches were conducted on December 2, 2022 and January 5, 2024. The analysis was structured in three stages: pilot, initial, and focused coding, following the qualitative meta-synthesis methodology. Each stage involved analysis, synthesis, and discussion of themes and findings among four researchers and a Veteran partner.RESULTS: Themes were synthesized from 19 studies on the impact of military lifestyle, culture, and mindset on military personnel with chronic pain. The findings showed how military lifestyle and culture create different challenges and experiences for military personnel with chronic pain. Chronic pain onset is often linked to prolonged exposure to high-stress environments, strenuous activities, and combat zones. The military has a prevalent culture of pain avoidance, often leading personnel to minimize their symptoms to fit the ideal soldier image. A mission-first ethos and the military's hierarchical structure can sometimes conflict with personal health needs. As military personnel transition to civilian life, they encounter challenges in a health care system that is not always attuned to their unique needs. The analysis also underscores the importance of tailored care and robust social support networks, with other Veterans playing a pivotal role in facilitating smoother transitions.DISCUSSION: Recognizing the unique challenges and needs of military personnel navigating military culture and lifestyle is crucial for developing tailored health care interventions and ensuring person-centred care during and after service.PMID:42534065 | PMC:PMC13391189 | DOI:10.3138/jmvfh-2024-0078

Hemoglobin. 2026 Aug 5:1-9. doi: 10.1080/03630269.2026.2712396. Online ahead of print.ABSTRACTAdvances in transfusion regimens and iron chelation have transformed transfusion-dependent thalassemia (TDT) into a chronic condition, revealing chronic pain as an important but under-recognized morbidity. Despite its substantial effect on health-related quality of life, pain in TDT remains poorly characterized and is rarely addressed in clinical protocols. We systematically searched PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, and the Cochrane Library from inception to January 2026 for original studies, reviews, and guidelines addressing chronic pain in TDT. Two independent reviewers screened studies, extracted data, and synthesized evidence on prevalence, pathogenesis, and management. Chronic pain affects approximately 32% to 55% of adults with TDT, and more than 90% of affected patients report moderate-to-severe pain. Its pathogenesis is multifactorial, with major contributors including thalassemia-associated osteoporosis, chelation-related arthropathy, extramedullary hematopoiesis, iron-overload-related endocrinopathies, and treatment-associated abdominal pain, particularly with deferasirox. Management remains empirical and fragmented. Bisphosphonates, including zoledronic acid, may improve skeletal pain, whereas NSAID and opioid use is often limited by hepatic and renal comorbidities. A disease-specific approach should combine correction of metabolic abnormalities, targeted anti-resorptive therapy, validated pain assessment, and cautious pharmacological treatment. Chronic pain is a major but neglected component of the contemporary TDT phenotype. Randomized trials and standardized clinical guidelines are needed to support effective pain management and improve quality of life.PMID:42557797 | DOI:10.1080/03630269.2026.2712396

Pain Manag. 2026 Aug 6:1-7. doi: 10.1080/17581869.2026.2713531. Online ahead of print.ABSTRACTINTRODUCTION: Coccydynia is characterized by persistent tailbone pain that significantly impairs quality of life. Despite conservative treatments, many patients experience inadequate symptom relief. Prolotherapy, a regenerative injection technique for chronic musculoskeletal pain, shows promise; however, its efficacy for coccydynia has not been evaluated in controlled comparative studies. To the best of the authors' knowledge, this is among the first such studies.AREAS COVERED: This retrospective comparative study evaluated 56 patients with primary chronic coccydynia refractory to conservative management. Twenty-nine patients received ultrasound-guided 10% dextrose prolotherapy combined with therapeutic exercises and patient education; 27 patients received exercises and education alone. Mean pain duration was 20.7 ± 17.3 months (prolotherapy) and 26.9 ± 17.3 months (control). Primary outcomes were pain intensity and functional disability at baseline, 1-month, and 3-month follow-up. Secondary outcomes comprised the Paris Functional Coccydynia Impact Questionnaire.EXPERT OPINION: Ultrasound-guided dextrose prolotherapy combined with therapeutic exercises demonstrated superior efficacy compared to exercises alone. The prolotherapy group achieved a 73% pain reduction at 3 months versus 26% in controls. An 82.8% clinical response rate and 37.9% complete pain resolution were observed, with a favorable safety profile. These results support prolotherapy as an effective, minimally invasive option for chronic coccydynia following failed conservative management.PMID:42561091 | DOI:10.1080/17581869.2026.2713531