Douleur chronique

Author Names: Sabiroglu, M.,Celik, K.,Youssef, H.,de Sire, A.,Eser, H.Y.,Taskiran, O.O. Database Source: Embase Daily Updates Journal Title: Neuroscience Article Title: Non-invasive brain stimulation in chronic pelvic pain: a systematic review Year: 2026 Issue: Volume: Abstract: BACKGROUND: Chronic pelvic pain (CPP) is increasingly recognized as a disorder of altered central pain processing, providing a strong rationale for non-invasive brain stimulation (NIBS) as a therapeutic approach. However, use of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for CPP remains uncertain. This systematic review aimed to evaluate the evidence for NIBS in CPP. <br/>METHOD(S): A comprehensive search of PubMed, Web of Science, Ovid MEDLINE, Embase, Scopus, and Cochrane CENTRAL was conducted till July 2026. Studies evaluating tDCS or rTMS in adults with CPP were included. Cochrane RoB-2 and ROBINS-I were used to assess methodological quality. Owing to a low number of studies, substantial clinical and methodological heterogeneity, a structured narrative approach was used. <br/>RESULT(S): Fifteen studies involving 295 participants, of whom 264 completed the respective studies, met the inclusion criteria, including nine tDCS and six rTMS studies. Inter-rater agreement for data extraction was almost perfect (Cohen's kappa = 0.878). Considerable heterogeneity was observed across clinical conditions, protocols, comparator interventions, outcome measures, and follow-up durations. Most randomized controlled trials (RCT) were rated at high or some risk of bias. Across studies, tDCS demonstrated favorable effects in some conditions, although findings were inconsistent and benefits beyond the treatment period were not consistently demonstrated. Evidence for rTMS was more limited and heterogeneous. <br/>CONCLUSION(S): Current evidence is insufficient to support NIBS for routine CPP care because of methodological limitations, small samples, and substantial heterogeneity in stimulation protocols and populations. Well-designed RCT using standardized intervention protocols and outcome measures are needed. PROSPERO ID: CRD420251058830.<br/>Copyright © 2026 International Brain Research Organization (IBRO). Published by […]

Author Names: Leon-Hernandez, J.V.,Reina-Varona, A.,La Touche, R.,Cuenca-Martinez, F.,Paris-Alemany, A.,Sorrel, M.A. Database Source: Embase Daily Updates Journal Title: Pain Research and Management Article Title: Explicit Motor Imagery Deficits in Individuals With Chronic Pain: A Systematic Review and Meta-Analysis Year: 2026 Issue: 1 Volume: 2026 Abstract: Background: Chronic pain has been associated with disrupted sensorimotor integration and altered internal body representations. While implicit motor imagery (MI) has been explored in pain populations, explicit MI, defined as the deliberate mental simulation of movement, remains less well understood. <br/>Objective(s): This systematic review and meta-analysis aimed to examine differences in explicit MI ability, vividness, and mental chronometry between individuals with chronic pain and healthy controls. <br/>Method(s): We screened six databases for observational studies comparing explicit MI outcomes in chronic pain or clinically relevant persistent/recurrent pain-related conditions versus asymptomatic healthy populations. Random-effects and multilevel meta-analyses were conducted using standardized mean differences (SMD) and 95% confidence and prediction intervals. Methodological quality was assessed with the JBI and NOS tools. <br/>Result(s): Twelve studies (n = 1603) met inclusion criteria. Individuals with pain-related clinical conditions showed moderate-to-large deficits in MI ability (SMD = -0.96), vividness (SMD = 1.06 for kinesthetic vividness), and mental chronometry (SMD = 0.84), although heterogeneity varied across outcomes. Mental chronometry showed the most consistent pattern across studies, whereas imagery ability and vividness were associated with greater between-study variability. Correlational analyses identified perceived disability, self-efficacy, and kinesiophobia as relevant moderators. <br/>Discussion(s): Individuals with chronic pain appear to display significant impairments in explicit MI, particularly in temporal simulation and some kinesthetic dimensions. However, these findings should be interpreted in light of the clinical and methodological heterogeneity across included studies.<br/>Copyright © 2026 Roy La Touche et al. Pain Research and Management published […]

Author Names: Mohr, J.,Ketschau, J.,Grabenhorst, A.,Singer, H.,Pippich, K.,Krautkremer, N.,Wolff, K.-D.,Ritschl, L.M. Database Source: Embase Daily Updates Journal Title: Journal of Cranio-Maxillofacial Surgery Article Title: A systematic review and Meta-Analysis: Exploring the efficacy of self-managed treatments for Temporomandibular Disorders (TMD): The role of home exercise and digital therapies Year: 2026 Issue: 11 Volume: 54 Abstract: Temporomandibular disorders (TMD) are highly prevalent and frequently associated with chronic pain and functional impairment, forming part of the diagnostic spectrum in cranio-maxillofacial surgery. Scalable, self-managed interventions - including home-exercise programs, psychoeducational strategies, and digitally supported approaches - are increasingly used, yet their pooled effectiveness has not been systematically quantified. A systematic search of PubMed, Scopus, and Cochrane CENTRAL identified randomized controlled trials evaluating predominantly self-managed or remotely delivered interventions for TMD. Eligible studies were qualitatively synthesized, and trials providing sufficient numerical data were meta-analyzed. Standardized mean differences (Hedges' g) were calculated using random-effects models; heterogeneity, prediction intervals, robustness, and publication bias were assessed. Self-managed interventions produced a statistically significant and clinically meaningful reduction in pain (SMD = -0.78; 95% CI -1.33 to -0.24; p = 0.005; I² = 84%), with robust findings in sensitivity analyses. For maximal mouth opening, the pooled estimate showed a nonsignificant trend toward improved mandibular mobility (SMD = 0.63; 95% CI -0.11 to 1.37; I² = 91%). These findings support structured self-management strategies as effective components of contemporary TMD care pathways, with direct relevance for evidence-based indication setting and patient counseling in cranio-maxillofacial practice.<br/>Copyright © 2026 The Authors.

Author Names: Database Source: Embase Weekly Updates Journal Title: The American psychologist Article Title: Summary of the clinical practice guideline for psychological and other nonpharmacological treatment of chronic musculoskeletal pain in adults Year: 2026 Issue: Volume: Abstract: This article summarizes the American Psychological Association's (2024) clinical practice guideline to provide recommendations for the nonpharmacological treatment of chronic musculoskeletal pain in adults. Three systematic reviews and meta-analyses, along with other literature and observations from practitioners and patients, served as the basis for the guideline. The guideline development panel consisted of health professionals from psychology, occupational medicine, nursing, social work, and physical therapy, as well as community members who self-identified as having chronic musculoskeletal pain. The panel examined the efficacy of noninvasive, nonpharmacological treatments and complementary and integrative medicine treatments. The panel also considered the comparative effectiveness among noninvasive, nonpharmacological treatments and noninvasive, nonpharmacological treatments in relation to complementary and integrative medicine treatments or select nonopioid, pharmacologic treatments. First-line and second-line recommendations for the treatment of chronic musculoskeletal pain, presented in detail in the guideline, are summarized here. The target audience includes clinicians, researchers, patients, and policymakers. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Author Names: Wu, K.,Beckenkamp, P.R.,Zhang, H.,Ho, T.H.,Hall, M.,Puterflam, J.,Bruun, K.D.,Lin, J.,Gordon, C.,Grunstein, R.,Ferreira, M.L.,Ferreira, P. Database Source: Embase Weekly Updates Journal Title: Pain Article Title: Efficacy and effectiveness of melatonin for the management of musculoskeletal pain: a systematic review and meta-analysis of placebo and active controlled trials Year: 2026 Issue: 9 Volume: 167 Abstract: Melatonin may provide benefits for managing musculoskeletal (MSK) pain, and this review evaluated its efficacy and effectiveness on pain intensity and sleep quality. We searched 6 databases from inception to April 2025 and included randomized controlled trials in people with chronic or postoperative MSK pain reporting pain or sleep outcomes. Comparators included placebo or active controls (eg, analgesics). Random-effects meta-analyses were performed using mean differences with 95% confidence intervals. Subgroup analyses were conducted by comparator type. Sensitivity analyses included only low-risk studies. Certainty of evidence was assessed using GRADE. Twenty-three studies (2028 participants) were included. For people with chronic MSK pain, melatonin was not superior to placebo in reducing pain (mean difference [MD]: -6.76/100, 95% confidence interval [CI]: -15.89 to 2.36) but was superior to active controls (MD: -11.21/100, 95% CI: -14.29 to -8.13); in sensitivity analysis, melatonin was superior to placebo (MD: -10.04, 95% CI: -17.68 to -2.39). For people with postoperative pain, melatonin was superior to placebo, with effects similar to active controls. Sleep quality favoured melatonin in people with chronic MSK pain but not in those with postoperative pain. Adverse events were mild and transient. Melatonin may provide modest benefits for pain in people with chronic MSK pain, while evidence in postoperative pain remains limited. Although treatment effect estimates were comparable with conventional analgesics, most did not reach minimal clinically important difference thresholds and the certainty of evidence was low to moderate. Melatonin may be considered as a potential adjunct rather than a primary treatment, pending randomized controlled trials with standardised dosing and longer follow-ups.<br/>Copyright © 2026 The Author(s). […]

Author Names: Pasini, I.,Donisi, V.,Veneziani, E.,De Lucia, A.,Perlini, C.,Del Piccolo, L.,Humphris, G.,Schweiger, V. Database Source: Embase Weekly Updates Journal Title: Journal of Psychosomatic Research Article Title: The role of the patient-clinician relationship in Chronic Pain Interventions: A systematic review Year: 2026 Issue: Volume: 206 Abstract: This systematic review (PROSPERO 2024 CRD42024557180) aims to investigate the status of the current literature regarding the association between patient-clinician relationship and pain-related outcomes in clinical interventions targeting patients with chronic non-cancer pain (CNCP). Five electronic databases, PubMed, PsycINFO, Cochrane, Web of Science, and Scopus, were searched. All studies examining clinical interventions for CNCP that investigated the patient-clinician relationship-identified through MeSH terms such as interpersonal relationship, empathy, and therapeutic alliance- in relation to at least one pain outcome were included. The review adheres to the Joanna Briggs Institute methodology and adopts the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to report data. All eligible studies were evaluated against the 16-item quality assessment tool QATSDD. The first step of the search process identified 3109 studies. After the screening, 37 articles, involving 10,281 patients, were included in the current review. Different clinical interventions were considered (psychological, physical or medical therapy, acupuncture or integrated and miscellaneous interventions). The Clinician-patient relationship was measured through diverse quantitative scales to investigate different dimensions: therapeutic alliance, empathy, trust, clinician-patient interaction, and interpersonal dimensions. Even if the population considered in the review, as well as the measures adopted to evaluate the relationship were highly heterogeneous, findings confirmed that in most cases clinician-patient relationship contributed to ameliorate different pain-related outcomes.<br/>Copyright © 2026 Elsevier Inc.

Author Names: Diniz, L.S.M.,Andrade, S.M.M.D.S.,Santos, H.H.D.,Andrade, P.R.D.,Mousinho, R.R.D.S.,Cavalcante, L.L. Database Source: Embase Weekly Updates Journal Title: Journal of Bodywork and Movement Therapies Article Title: Effects of TDCS and TENS on chronic low back pain: A randomized controlled clinical trial Year: 2026 Issue: Volume: 46 Abstract: Introduction The objective of this study was to investigate whether transcranial direct current stimulation (tDCS) can enhance Transcutaneous Electrical Nerve Stimulation (TENS) outcomes in patients with chronic low back pain, and whether stimulating the primary motor cortex and dorsolateral prefrontal cortex results in distinct clinical effects. Method This study is a sham-controlled, double-blind, randomized clinical trial with a one-month follow-up. A total of 60 individuals (18 years or older) with low back pain for >=6 months were enrolled and randomized into one of three tDCS + TENS groups: primary motor cortex (n = 20), dorsolateral prefrontal cortex (n = 20), and sham stimulation (n = 20). The participants underwent transcranial direct current stimulation combined with TENS over the lumbar region versus simulated tDCS with active TENS for 30 min daily for 10 consecutive days. Assessments were performed at baseline, post-intervention, and 30 days follow-up. Outcomes were pain assessments, functional capacity evaluations, emotional state, and quality of life. Results No superior effects were observed at post-intervention with tDCS + TENS compared to sham tDCS + TENS (P > 0.05), regardless of stimulation site, for pain relief, functional capacity, quality of life, or emotional state in chronic low back pain patients. Conclusion The use of TENS alone in long-term protocols is sufficient for chronic low back pain patients, with few contraindications and the ability to reduce pain and improve functional capacity and emotional state over a 10-day intervention period.<br/>Copyright © 2025 Elsevier Ltd.

Author Names: Andrade, A.C.M.,Benso, B.,Felix, F.A.,Brauchi, S. Database Source: Embase Daily Updates Journal Title: International Journal of Molecular Sciences Article Title: Capsaicin for Orofacial Pain Management: Systematic Review and Meta-Analysis Year: 2026 Issue: 16 Volume: 27 Abstract: Orofacial pain is a multifactorial condition that severely impacts basic functions and overall quality of life in patients, underscoring the need for non-opioid therapeutic strategies. Targeting the Transient Receptor Potential Vanilloid 1 (TRPV1) pathway has emerged as a biologically plausible approach, given its central role in nociceptive transduction and peripheral sensitization. Capsaicin, a selective TRPV1 agonist, induces receptor desensitization and has shown potential in chronic pain modulation; however, its efficacy in orofacial conditions remains unclear. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of capsaicin in managing orofacial pain, compared to placebo or other pharmacological interventions. Following PRISMA guidelines, a comprehensive search of five databases (PubMed, Scopus, Web of Science, CDSR, and LILACS) was conducted without language or date restrictions. Studies involving human participants with orofacial pain treated with capsaicin were included. The protocol was registered in PROSPERO (CRD420251004538). Risk of bias was assessed using the RoB2, RoB2 crossover trial and ROBINS-I checklist, and meta-analyses were performed using random-effects models. Nine studies enrolling a total of 164 participants met the eligibility criteria and encompassed temporomandibular disorders, burning mouth syndrome, oral mucositis, trigeminal neuralgia, and neuropathic facial pain. Although placebo-controlled comparisons showed a trend toward pain reduction that did not reach statistical significance (MD = -1.87; [95% CI: -3.94, 0.19]; p = 0.08; I² = 86%), and no significant difference was found between capsaicin concentrations (MD = 0.46; [95% CI: -2.67, 3.60]; p = 0.77, I² = 66%), pre-post analyses of uncontrolled (single-arm) studies demonstrated a significant and clinically meaningful reduction in pain following capsaicin treatment (MD = -6.39; [95% CI: -7.40, -5.38; p < 0.001, […]

Author Names: Antcliff, D.,Holden, M.A.,Marriott-Smith, J.,Jinks, C.,Burns, L.,English, E.,MacKenzie, R.,Geraghty, A.W.A.,Stansfield, R.,Storms, K. Database Source: Embase Weekly Updates Journal Title: Clinical Journal of Pain Article Title: Operant Approach Activity Pacing Interventions for the Management of Chronic Pain: A Systematic Review Year: 2026 Issue: 9 Volume: 42 Abstract: Objectives: - Operant approach activity pacing (undertaking activities according to quotas, eg, amount/time/goal rather than according to symptom severity) is advised for chronic pain. There is no standardised intervention that addresses all the components of operant approach activity pacing. This systematic review aimed to identify operant approach activity pacing interventions for chronic pain and explore their components, effectiveness, feasibility, and acceptability. <br/>Method(s): - Eligible studies included any type of evaluation (eg, randomised controlled trials, feasibility/pilot, and qualitative) among adults with chronic pain. Ineligible studies included interventions based on energy conservation/envelope theory/adaptive pacing therapy/symptom-contingency, and non-English language. Databases included: MEDLINE, Embase, CINAHL, AMED, PsycINFO, Cochrane CENTRAL, PEDro, OTseeker, and Web of Science (from database inception to March 26, 2025). Two independent reviewers extracted data, including descriptions of interventions (TIDieR checklist), appraised risk of bias (Joanna Briggs Institute checklists) and evaluated confidence in the research (GRADE). Findings were synthesised narratively. <br/>Result(s): - Nine studies (10 interventions; 11 papers) were included (873 participants). Interventions were heterogeneous in content, length (2 to 11 sessions) and tailored/untailored to participants' baseline behaviors. Common intervention components were preplanning, activity-rest cycling/using rests and alternating activities/positions. Direction of effect (vote counting) was towards improved function, but mixed findings for pain/fatigue. <br/>Discussion(s): - Studies showed mixed findings across outcomes, syntheses were limited to vote counting, with very low confidence in the evidence, limiting conclusions about effectiveness. The multiple components of activity pacing can […]

Author Names: Bajinka, O.,Li, N.,Jallow, L.,Kuhn, C.,Kuhn, W.,Stetkarova, I.,Golubnitschaja, O.,Zhan, X. Database Source: Embase Daily Updates Journal Title: EPMA Journal Article Title: Evidence-based recommendations for advancing the chronic pelvic pain syndrome management by the paradigm change from reactive symptom suppression to proactive 3PM-guided patient-centered care Year: 2026 Issue: Volume: Abstract: Chronic pelvic pain syndrome (CPPS) encompasses a heterogeneous group of debilitating conditions including interstitial cystitis/bladder pain syndrome (IC/BPS), chronic abacterial prostatitis, endometriosis, and pelvic congestion syndrome, among others. Despite advances in symptomatic management, CPPS remains challenging due to its multifactorial etiology, complex phenotypes, and poor response to conventional reactive treatments. On the other hand, sympathetic overdrive phenotype (SOP) carriers frequently suffer from increased stress sensitivity, chronic sterile inflammation, pain chronification, and mitochondrial stress - all considered the key CPPS/SOP shared pathomechanisms. Further, the dominant vasoconstriction, altered sense regulation (e.g. the reduced feeling of thirst potentially resulting in systemic dehydration) as well as altered multi-drug resistance protein profiles characteristic for SOP (e.g. exemplified by the Flammer syndrome) may predispose affected individuals to the therapy resistance such as CPPS patients with vulvar-vaginal dryness and abacterial prostatitis. This review article highlights the central role of SOP, systemic mitochondrial stress as well as gut and urinary microbiome alterations - all, per evidence, are considered systemic modifiable risk factors of the CPPS manifestation, disease progression, and therapy resistance. The article introduces 3PM-guided patient-centered solutions aiming to improve life quality and individual outcomes in the CPPS patient cohort. Non-invasive mitochondria-based biosensorics, e.g. applied via the tear fluid analysis, and digital health monitoring, per evidence, enable early health risk assessment and patient stratification at the level of reversible damage to health. Recommended targeted preventive strategies encompass individually adapted lifestyle modifications, modulation of the stress-associated […]

Author Names: Bilska, A.,Skorupska, E.,Fracz, W.,Matuska, J.,Herrero, P. Database Source: Embase Weekly Updates Journal Title: Diagnostics Article Title: Magnetic Resonance Imaging Segmentation of Soft Tissue in the Diagnosis of Chronic Low Back Pain: A Scoping Review Year: 2026 Issue: 12 Volume: 16 Abstract: Background/Objectives: Despite the substantial clinical and socioeconomic burden of chronic low back pain (CLBP), objective diagnostic biomarkers remain limited. Structural alterations of the lumbosacral muscles, particularly muscle atrophy and fatty infiltration (FI), have been proposed as imaging correlates of chronic pain. This scoping review aimed to synthesize current evidence on these alterations in CLBP and characterize the imaging and segmentation methods used. <br/>Method(s): The review was conducted in accordance with PRISMA-ScR guidelines and guided by the Population-Concept-Context framework. Population: adults with CLBP. Concept: MRI segmentation techniques are used to evaluate morphological soft-tissue changes. <br/>Context: clinical and research settings using MRI for CLBP evaluation. A comprehensive search of PubMed, Scopus, Embase, and Web of Science was performed for studies published between January 2014 and October 2024. <br/>Result(s): Twelve observational studies met the inclusion criteria. Degenerative alterations were consistently observed in CLBP and were not reported in control groups. Muscle atrophy was reported in ten studies (multifidus [MF]: 9; erector spinae [ES]: 7; psoas major [PM]: 2; paraspinal muscles [PPM]: 1; and increased FI in all studies (MF: 9; ES: 5; PM: 2; PPM: 2). Considerable heterogeneity between studies was noted. <br/>Conclusion(s): Lumbosacral muscles assessment may provide useful objective information for a more objective characterization of CLBP. Degenerative alterations were reported in all examined muscles except QL, with the MF most consistently affected. Changes in ES and PM may be specific for CLBP. The frequent co-occurrence of muscle atrophy and FI suggests that their combined evaluation may provide complementary information.<br/>Copyright © 2026 by the authors.

Author Names: Wongwitwichote, K.,Yu, C.W.G.,Devecchi, V.,Mansfield, M.,Falla, D. Database Source: Embase Daily Updates Journal Title: European Journal of Pain Article Title: Physical, Psychophysical and Psychological Predictors of Persistent or Recurrent Non-Specific Low Back Pain: A Systematic Review and Meta-Analysis Year: 2026 Issue: 8 Volume: 30 Abstract: Background and Objective: Non-specific low back pain (LBP) frequently becomes persistent or recurrent. This systematic review and meta-analysis determined whether physical, psychophysical or psychological variables can predict persistent or recurrent non-specific LBP. Database and Data Treatment: Studies investigating physical, psychophysical or psychological predictors of persistent/recurrent LBP, pain intensity or disability were included. MEDLINE, EMBASE, APA PsycINFO, PubMed, CINAHL Plus, Web of Science, Scopus, ZETOC and OpenGrey were searched until January 2025. Risk of bias of individual studies was assessed using QUIPS and the certainty of evidence using GRADE. <br/>Result(s): Fifteen studies were included, all addressing persistent LBP, examining one physical predictor domain (trunk kinematics), one psychophysical predictor domain (pain sensitivity) and seven psychological domains (depression-distress, anxiety, fear avoidance, catastrophising, somatisation, pain coping strategy, pain self-efficacy). Depression and distress significantly predicted persistent LBP and disability (n = 15,778; beta = 0.28, 95% CI: 0.04 to 0.53, p = 0.024), and fear avoidance also significantly predicted persistent LBP and disability (n = 1105; beta = 0.24, 95% CI: 0.00 to 0.49, p = 0.049), albeit both with low certainty of evidence. Enhanced temporal summation of pain was not a significant predictor of pain outcomes (n = 192; beta = 0.10, 95% CI: -0.37 to 0.57), with very low certainty of evidence. Physical predictors showed limited and inconclusive evidence. Overall, the certainty of evidence ranged from very low to low across all predictor domains. <br/>Conclusion(s): Psychological factors, particularly depression-distress and fear avoidance, may predict LBP persistence, although higher quality studies are needed. Significance Statement: Depression-distress and fear avoidance are significant predictors of […]

Author Names: Zhang, J.,Su, Y. Database Source: Embase Daily Updates Journal Title: Journal of back and musculoskeletal rehabilitation Article Title: Efficacy of Pilates on chronic low back pain in women: A systematic review and meta-analysis Year: 2026 Issue: Volume: Abstract: BackgroundChronic low back pain (CLBP) is the most frequent musculoskeletal disorder with many influencing factors, impairing the individual's pain and function management.ObjectiveWe conducted this study to explore the effect of Pilates exercise on pain and function in women with CLBP, especially in postmenopausal women.MethodsPubMed, Embase, Web of Science, Cochrane Library, PEDro and CINAHL were searched up to April 11, 2026. Randomized controlled trials on the effect of Pilates exercise on women with CLBP vs. no intervention or other interventions were included. SMDs with 95% CIs were estimated by a random-effects model. Subgroup analyses were conducted by age, follow-up time, and region. In addition, subgroup analyses based on follow-up time and region were performed among postmenopausal individuals. We assessed the included studies for risk of bias by the NIH Quality Assessment Tool for Controlled Intervention Studies, sensitivity analysis by the leave-one-out method, and for publication bias by the funnel plot and Egger's test.ResultsThe meta-analysis revealed that Pilates achieved pain relief (SMD -1.88, 95% CI -2.46 to -1.31) and functional improvement (SMD -1.08, 95% CI -1.43 to -0.74). Both menopausal (pain: SMD -2.07, 95%CI -2.90 to -1.25) (function: SMD -1.11, 95% CI -1.53 to -0.7 0) and non-menopausal (pain: SMD -1.58, 95%CI -2.13 to -1.03) (function: SMD -1.03, 95% CI -1.75 to -0.31) women benefited from Pilates, with pain relief and functional improvements. P < 0.001.ConclusionsPilates exercise can achieve pain relief and functional improvement in women both in postmenopausal and non-postmenopausal populations.

Author Names: Eerdekens, M.H.,Both, C.,Freitas, R.L. Database Source: Embase Daily Updates Journal Title: Pain and Therapy Article Title: Long-Term Efficacy and Safety of Treatments for Chronic Peripheral Neuropathic Pain: A Systematic Review and Narrative Synthesis Year: 2026 Issue: Volume: Abstract: Introduction: Peripheral neuropathic pain (PNP) is a chronic condition that often requires long-term treatment. In 2025, the Neuropathic Pain Special Interest Group (NeuPSIG) updated its recommendations for treatment of neuropathic pain based on data from double-blind, randomized controlled trials (RCTs) with a duration of >= 3 weeks. To complement the existing body of evidence, we reviewed the long-term efficacy/safety of NeuPSIG-recommended treatments for PNP. <br/>Method(s): We conducted a systematic literature review including clinical trials and observational studies of any design. Two literature searches were performed using PubMed and Embase (December 2024, May 2025). We included studies that enrolled >= 50 adult patients with PNP receiving >= 1 treatment recommended in the 2025 NeuPSIG guidance and with duration of >= 13 weeks. A supplemental search for long-term studies on high-concentration capsaicin 8% patch (HCCP) was performed. Results were synthesized narratively due to heterogeneity in study designs and outcomes. <br/>Result(s): We included 34 articles in our analysis (31 studies) varying in design, including interventional (RCTs and open-label studies) and observational studies. Most studies had a duration of 26-52 weeks. Four treatments (HCCP, duloxetine, gabapentin, pregabalin) were evaluated in >= 5 studies. HCCP was evaluated in the greatest number of long-term studies (n = 13) and in various PNP conditions, followed by duloxetine (n = 7) in painful diabetic peripheral neuropathy (pDPN) only, gabapentin (n = 6) in various PNP conditions and pregabalin (n = 5) mostly in pDPN. Collected data support long-term efficacy of all products. The lowest rates of discontinuations due to adverse events were reported with HCCP. <br/>Conclusion(s): The findings from this literature review emphasize the importance of expanding long-term evidence for chronic pain therapies. The review determined that the largest body of evidence is […]

Author Names: Leon-Hernandez, J.V.,Reina-Varona, A.,La Touche, R.,Cuenca-Martinez, F.,Paris-Alemany, A.,Sorrel, M.A. Database Source: Embase Daily Updates Journal Title: Pain Research and Management Article Title: Explicit Motor Imagery Deficits in Individuals With Chronic Pain: A Systematic Review and Meta-Analysis Year: 2026 Issue: 1 Volume: 2026 Abstract: Background: Chronic pain has been associated with disrupted sensorimotor integration and altered internal body representations. While implicit motor imagery (MI) has been explored in pain populations, explicit MI, defined as the deliberate mental simulation of movement, remains less well understood. <br/>Objective(s): This systematic review and meta-analysis aimed to examine differences in explicit MI ability, vividness, and mental chronometry between individuals with chronic pain and healthy controls. <br/>Method(s): We screened six databases for observational studies comparing explicit MI outcomes in chronic pain or clinically relevant persistent/recurrent pain-related conditions versus asymptomatic healthy populations. Random-effects and multilevel meta-analyses were conducted using standardized mean differences (SMD) and 95% confidence and prediction intervals. Methodological quality was assessed with the JBI and NOS tools. <br/>Result(s): Twelve studies (n = 1603) met inclusion criteria. Individuals with pain-related clinical conditions showed moderate-to-large deficits in MI ability (SMD = -0.96), vividness (SMD = 1.06 for kinesthetic vividness), and mental chronometry (SMD = 0.84), although heterogeneity varied across outcomes. Mental chronometry showed the most consistent pattern across studies, whereas imagery ability and vividness were associated with greater between-study variability. Correlational analyses identified perceived disability, self-efficacy, and kinesiophobia as relevant moderators. <br/>Discussion(s): Individuals with chronic pain appear to display significant impairments in explicit MI, particularly in temporal simulation and some kinesthetic dimensions. However, these findings should be interpreted in light of the clinical and methodological heterogeneity across included studies.<br/>Copyright © 2026 Roy La Touche et al. Pain Research and Management published […]

Author Names: Duarte, R.V.,Copley, S.,Eldabe, S.,Batterham, A.,Hall, N.,Buchser, E. Database Source: Embase Daily Updates Journal Title: Regional anesthesia and pain medicine Article Title: Systematic review and meta-analysis of intrathecal drug delivery systems for the treatment of chronic refractory non-cancer pain Year: 2026 Issue: 9 Volume: 51 Abstract: BACKGROUND/IMPORTANCE: Intrathecal drug delivery (ITDD) is an established intervention for chronic non-cancer pain, cancer pain, and spasticity. However, ITDD is not routinely commissioned for non-cancer pain in some countries, including England. A comprehensive synthesis of its clinical impact and safety profile in this population is lacking. <br/>OBJECTIVE(S): To investigate the clinical outcomes and adverse events (AEs) associated with ITDD in adults with chronic non-cancer pain. EVIDENCE REVIEW: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a registered protocol (CRD42024581505). Searches across MEDLINE, EMBASE, CENTRAL, and WikiStim until September 2024 were performed to identify studies reporting pain intensity, function, health-related quality of life (HRQoL), and AEs in ITDD recipients with non-cancer pain. Risk of bias was assessed using National Institutes of Health and Cochrane tools. A random-effects meta-analysis was performed on the pain intensity outcome (0-10 scale equivalent) at the 12-month time point. FINDINGS: 39 studies (n=2652) were included; 20 single-arm comparisons contributed to meta-analysis. The pooled mean reduction in pain from baseline was 2.64 (95% CI 2.19 to 3.08). Accounting for between-study heterogeneity in effect size, the 95% prediction interval is 0.734 to 4.54 units. The probability that the change from baseline in a new, similar study would be greater than the minimum clinically important difference of 2 units is 75% (95% CI 68% to 83%). All studies reported improvements from baseline in function and HRQoL. Reporting of AEs or discontinuation of ITDD due to AEs was inconsistent. Risk of bias was moderate or high for cohort studies and pre-post studies, low for two crossover randomized trials and one parallel-arm randomized trial, and high for one parallel-arm randomized trial. […]

Author Names: Nurmukhamed, B.,Baizhanova, A.,Inayat, S.,Ismailov, T.,Viderman, D.,Gaipov, A. Database Source: Embase Daily Updates Journal Title: Current Neuropharmacology Article Title: Gabapentinoids for Neuropathic Pain Management: A Systematic Umbrella Review Year: 2026 Issue: Volume: Abstract: Introduction: This umbrella review aimed to evaluate the effectiveness of gabapentinoids, including dosing and risk profile, for the management of neuropathic pain. <br/>Method(s): 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 neuropathic pain, refractory neuropathic pain, and sciatica. <br/>Result(s): 22 systematic reviews and meta-analyses were included, and 19 out of 22 studies were of critically low quality. Mirogabalin reduced lower limb neuropathic pain better than pregabalin. Drugs other than gabapentinoids were better in pain reduction among post-herpetic neuralgia patients. Pregabalin had a higher short-term pain-reducing effect compared to gabapentin. Dizziness and somnolence were more closely linked to gabapentin and pregabalin. <br/>Discussion(s): The limitations of this review included the small number of studies, limited variability in the study populations and locations, and small sample sizes. <br/>Conclusion(s): Gabapentinoids showed efficacy in diabetic peripheral neuropathic pain, cancer-related neuropathic pain, and spinal cord injury. Gabapentinoids also showed efficacy in patients with the following types of refractory neuropathic pain, including refractory diabetic peripheral neuropathic pain, trigeminal neuralgia, complex regional pain syndrome, and lower back pain. However, in the case of post-herpetic neuralgia, the results were controversial. Most of the included studies were of critically low quality, which reduces confidence in the efficacy of gabapentinoids. Their use was highly associated with drowsiness, somnolence, peripheral edema, and weight […]

Author Names: Goel, A.,Diep, C.,Zahin, A.,Rosenblat, J.D.,Pereira, S.M.,Teja, B.,Rao, K.,Pazmino-Canizares, J.,Mattina, G.,Nayar, R.,Thomas, Z.,Pritlove, C.,Hodwitz, K.,Clarke, H.,Katz, J.,Wijeysundera, D.N.,Dang, K.,Ladha, K.S.,Ritvo, P. Database Source: Embase Daily Updates Journal Title: Med (New York, N.Y.) Article Title: Ketamine assisted psychotherapy to reduce chronic neuropathic pain: A mixed-methods randomized pilot trial Year: 2026 Issue: Volume: Abstract: BACKGROUND: Intravenous ketamine can provide short-term analgesia in chronic neuropathic pain but benefits often wane after treatment. We conducted a randomized pilot trial to assess the feasibility of combining ketamine infusions with psychotherapy to inform future efficacy trials. <br/>METHOD(S): In this single-center, randomized, outcome-assessor-blinded pilot trial at a Canadian tertiary pain clinic, adults with moderate-to-severe chronic neuropathic pain were randomly assigned in 1:1:1 ratio to the ketamine, psychotherapy, or combined ketamine plus psychotherapy arm. Ketamine was delivered as three intravenous infusions over 16 weeks; psychotherapy consisted of 16 weekly cognitive behavioral therapy and mindfulness-based meditation sessions. The primary outcome was feasibility, assessed using prespecified progression criteria. Exploratory outcomes included changes in pain interference (PROMIS 6a T-score), pain intensity, mood, and qualitative interview findings at week 20 (ClinicalTrials.gov: NCT05639322). FINDINGS: Between October 23, 2023, and March 31, 2025, 30 participants were randomized, and 26 (87%) completed 20-week follow-up. Most feasibility criteria, including consent, retention, data completeness, and absence of study-related serious adverse events, were met; adherence targets were partially met. Exploratory pain outcomes showed numerical improvement across groups, with clinically meaningful reductions observed for pain interference and pain intensity. Sixty-four adverse events were recorded, mostly mild and in ketamine-containing groups; no serious study-related adverse events occurred. <br/>CONCLUSION(S): Combined ketamine and psychotherapy was feasible and acceptably safe in this pilot trial, supporting evaluation in a larger efficacy-powered study. FUNDING: The study was […]

Author Names: Herrero Babiloni, A.,Sangalli, L.,Boggero, I.A.,Goldfarb, C.,King, C.D.,Lavigne, G.J. Database Source: Embase Daily Updates Journal Title: Pain Article Title: The influence of chronotype on pain: a systematic review and meta-analysis Year: 2026 Issue: 8 Volume: 167 Abstract: Sleep and circadian rhythms play critical roles in pain regulation, yet the influence of chronotype remains underexplored. This systematic review and meta-analysis synthesized evidence across 43 studies (cross-sectional, cohort, and Mendelian randomization designs) investigating associations between chronotype and pain outcomes. Participants ranged from small clinical cohorts to large-scale biobanks and represented diverse pain conditions, including fibromyalgia, temporomandibular disorders, migraine, musculoskeletal pain, and rheumatoid arthritis. Qualitative synthesis indicated that evening chronotypes were more frequently associated with adverse pain outcomes, including higher pain prevalence, greater intensity, and increased interference. These associations were particularly consistent in musculoskeletal pain and headache disorders, although some studies reported worse outcomes in morning types or bimodal chronotypes. A meta-analysis of 10 studies revealed that evening chronotypes had significantly higher odds of reporting chronic pain than non-evening types (odds ratios = 1.67, 95% confidence intervals: 1.40-1.99). In contrast, pooled results for pain intensity across 6 studies showed only a nonsignificant trend toward greater pain in evening chronotypes, with substantial heterogeneity and sensitivity to influential studies. Certainty of evidence was graded as moderate for pain prevalence and low for pain intensity. Findings support chronotype as a relevant circadian marker of pain vulnerability, likely mediated by circadian misalignment, sleep disturbance, and affective dysregulation. Future research should integrate objective circadian phase measures, longitudinal designs, and disorder-specific chronobiological profiles. Recognizing evening chronotype and misalignment as modifiable risk factors may inform tailored interventions, such as light therapy or behavioral schedule adjustments, to reduce pain burden.<br/>Copyright © 2026 International Association for the Study of […]

Author Names: Tenti, M.,Cilenti, F.,Raffaeli, W.,Proietti, S.,Fagnani, C.,Medda, E.,Camoni, L.,Toccaceli, V.,Sampaolo, L.,Varallo, G.,Malafoglia, V. Database Source: Embase Daily Updates Journal Title: Journal of Clinical Medicine Article Title: Mediators of the Pain-Depression Relationship in Adults with Chronic Pain: A Systematic Review and Exploratory Meta-Analyses Year: 2026 Issue: 15 Volume: 15 Abstract: Background/Objectives: Pain intensity and depressive symptoms are closely associated in adults with chronic pain (CP), contributing to greater disability, poorer treatment outcomes, and increased healthcare costs. However, the mechanisms underlying this symptom-level relationship remain incompletely understood. This systematic review and meta-analysis aimed to (i) identify all candidate factors mediating the effect of pain intensity on depressive symptoms, or vice versa, in adults with CP and (ii) estimate the magnitude of indirect, direct and total effects reported across eligible studies. <br/>Method(s): Seven databases were searched in May-July 2023 and updated in May-June 2024. Observational studies and randomized controlled trials evaluating mediators of the relationship between pain intensity and depressive symptoms, or vice versa, in adults with CP were eligible. Data extraction and methodological appraisal were performed independently by three reviewers. Findings were synthesized narratively using vote counting and displayed using harvest plots. When appropriate, meta-analyses were conducted using regression coefficients, standard errors and sample sizes to estimate pooled indirect, direct and total effects. <br/>Result(s): The search identified 6826 studies, of which 34 (47 mediation models) met the inclusion criteria. Twenty-nine studies (combined n = 13,587) examined the effect of pain intensity on depressive symptoms, identifying 24 candidate mediators. Exploratory meta-analyses were feasible only for pain catastrophizing (indirect effect [IE]: beta = 0.150; 95% confidence interval [CI]: 0.066, 0.233) and helplessness (IE: beta = 0.101; CI: 0.066, 0.137). The pooled estimate for pain catastrophizing showed substantial heterogeneity and was highly influenced by a single study. Sleep quality, pain self-efficacy and pain interference showed […]