Explore the vast range of titles available.

Neuropathic pain conditions severely and chronically affect the quality of life in a large human population, but the pain conditions are not adequately managed due to poor understanding of their underlying mechanisms. There is a pressing need for further research into this field to help develop effective and nonaddictive medications to treat neuropathic pain. This article first describes general clinical classification of pain, types and symptoms of neuropathic pain, and current practices of clinical management for neuropathic pain. This is followed by a discussion of various cellular and molecular mechanisms responsible for the development and maintenance of neuropathic pain. In this review, we highlight the loss of function of Kv7 voltage-gated potassium as a mechanism of neuropathic pain and the potential use of Kv7 channel activator as subsequent treatment.

Headache disorders are among the most prevalent and disabling neurological conditions worldwide, affecting more than three billion individuals and contributing to a substantial socioeconomic burden. Despite the availability of pharmacologic treatments such as triptans, NSAIDs, and CGRP monoclonal antibodies, a significant proportion of patients remain refractory or intolerant to these therapies. The sphenopalatine ganglion (SPG), a parasympathetic neural structure in the pterygopalatine fossa, is increasingly recognized as a critical node in the pathophysiology of primary headache disorders. SPG blocks—using local anesthetics, neurolytic agents, or electrical neuromodulation—offer a minimally invasive therapeutic approach by disrupting nociceptive transmission and autonomic activation. This narrative review synthesizes the anatomical and physiological rationale for SPG intervention, details various procedural techniques, evaluates clinical evidence across headache subtypes, and explores future research directions. Conditions covered include migraine, cluster headache, tension-type headache, trigeminal neuralgia, and persistent idiopathic facial pain. With expanding evidence and evolving technologies, SPG-targeted interventions have the potential to reshape the management of refractory headaches and facial pain syndromes.

Although the number of SARS-CoV-2 new cases may be declining due to the implementation of the vaccine in the USA, there is a rising cohort of people with long-term effects from the virus. These long-term effects include loss of taste, heart palpitations, and chronic pain syndromes. In this commentary, we assess the current literature to appraise the knowledge of long-term COVID-19 effects related to long-term pain syndromes including testicular pain, headache, chronic pain, and chest pain.

Background: Chronic pain affects a significant proportion of the population in the United States and poses a significant public health concern. Beyond physical discomfort, chronic pain has been increasingly linked to cognitive dysfunction, including impairments in memory, attention, executive function, and decision-making. The relationship is particularly pronounced in older adults and may contribute to the onset or progression of neurodegenerative diseases. Objective: This comprehensive review explores the relationship between chronic pain and cognitive function, emphasizing the underlying neurobiological mechanisms, structural brain changes, and associated comorbidities. Methods: A review was conducted using peer-reviewed studies that began with the earliest pain and cognition mechanisms, followed by further investigation of cognitive effects of chronic pain, neuroimaging findings, and comorbid neuropsychiatric and neurodegenerative conditions. Sources included large-scale cohort studies, functional MRI analyses, and neurobiological investigations focusing on prefrontal cortex activity, default mode network alterations, and gray matter atrophy. Results: Chronic pain is associated with cognitive deficits through multiple converging pathways. It contributes to measurable impairments in cognitive function and is linked to structural and functional brain alterations. Regions of interest include the dorsolateral prefrontal cortex, medial prefrontal cortex, and default mode network, which can be connected to the neural resource hypothesis because of their cognitive domain impairments. A better understanding of these mechanisms highlights the importance of early recognition and multidisciplinary management strategies, including neuromodulation and cognitive rehabilitation. Future research should prioritize longitudinal studies and integrated interventions targeting both pain and cognitive health.

Background: Chronic pain is a major contributor to a reduced quality of life in the United States, with chronic shoulder pain comprising a sizeable portion of complaints. Multiple techniques are utilized in the treatment of chronic shoulder pain, but many patients report significant pain refractory to these modalities. For these patients, the suprascapular nerve’s radiofrequency ablation (RFA) offers a potential long-lasting solution. Methods: This retrospective analysis used data from UW Health HealthLink records of patients who received suprascapular RFA from June 2017 to May 2024. Data were collected across 31 procedures, covering demographics, RFA technique, procedure efficacy, duration of relief, adverse events, and relevant medical history. The data were analyzed using a paired t-test. Results: The average pre-RFA pain score was 6.08/10, and the average post-RFA pain score was 2.95/10. The average percentage improvement was 63.3%, with a mean duration of improvement of 3.12 months. Five procedures yielded no improvement in pain. Conclusions: This study demonstrated that RFA is an effective alternative therapy for chronic shoulder pain refractory to conventional pain management strategies, with a potential for long-term relief. Limitations of this study are due to the inherent challenges of retrospective analyses.

In this article, we propose a new diagnostic paradigm known as Chronic Abdominal Discomfort Syndrome (CADS). Patient's presentation centers around chronic abdominal pain not explained by acute pathology with or without accompanying dyspepsia, bloating, nausea and vomiting among other symptoms. The pathophysiology is noted to be neurogenic, possibly stemming from visceral sympathetic nerves or abdominal wall afferent nerves. Diagnosis is supported by signs or symptoms traversing clinical, diagnostic and functional criteria. Included is a tool which can assist clinicians in diagnosing patients with CADS per those domains. We hope to facilitate primary care physicians' and gastroenterologists' utilization of our criteria to provide guidance for selecting which patients may benefit from further interventions or evaluation by a pain physician. The pain physician may then offer interventions to provide the patient with relief.

Purpose This work aims at describing a technique “The ALblation technique” for treating migraine headache. This technique describes radiofrequency ablation for supraorbital, supratrochlear, lesser occipital and greater occipital nerves bilaterally for treating migraine headache. This is a novel procedure that was not described before. Recent findings Author published some articles on radiofrequency ablation for the pericranial nerves for treating different types of headache with consistent positive outcomes. Success of this procedure depends on identifying the appropriate nerves to treat the headache and associated neuralgia.

This article examines the biological, genetic, and environmental aspects of fibromyalgia that may have an impact on its pathogenesis. Symptoms of fibromyalgia may be related to aberrations in the endogenous inhibition of pain as well as changes in the central processing of sensory input. Genetic research has revealed familial aggregation of fibromyalgia and other related disorders like major depressive disorder. Dysfunctional pain processing may also be influenced by exposure to physical or psychological stressors, abnormal biologic reactions in the autonomic nervous system, and neuroendocrine responses. With more research the pathophysiology of fibromyalgia will be better understood, leading to more logical and focused treatment options for fibromyalgia patients.

Background Hyperexcitability of nociceptive afferent fibers is an underlying mechanism of neuropathic pain and ion channels involved in neuronal excitability are potentially therapeutic targets. KCNQ channels, a subfamily of voltage-gated K+ channels mediating M-currents, play a key role in neuronal excitability. It is unknown whether KCNQ channels are involved in the excitability of nociceptive cold-sensing trigeminal afferent fibers and if so, whether they are therapeutic targets for orofacial cold hyperalgesia, an intractable trigeminal neuropathic pain. Methods Patch-clamp recording technique was used to study M-currents and neuronal excitability of cold-sensing trigeminal ganglion neurons. Orofacial operant behavioral assessment was performed in animals with trigeminal neuropathic pain induced by oxaliplatin or by infraorbital nerve chronic constrictive injury. Results We showed that KCNQ channels were expressed on and mediated M-currents in rat nociceptive cold-sensing trigeminal ganglion (TG) neurons. The channels were involved in setting both resting membrane potentials and rheobase for firing action potentials in these cold-sensing TG neurons. Inhibition of KCNQ channels by linopirdine significantly decreased resting membrane potentials and the rheobase of these TG neurons. Linopirdine directly induced orofacial cold hyperalgesia when the KCNQ inhibitor was subcutaneously injected into rat orofacial regions. On the other hand, retigabine, a KCNQ channel potentiator, suppressed the excitability of nociceptive cold-sensing TG neurons. We further determined whether KCNQ channel could be a therapeutic target for orofacial cold hyperalgesia. Orofacial cold hyperalgesia was induced in rats either by the administration of oxaliplatin or by infraorbital nerve chronic constrictive injury. Using the orofacial operant test, we showed that retigabine dose-dependently alleviated orofacial cold hyperalgesia in both animal models. Conclusion Taken together, these findings indicate that KCNQ channel plays a significant role in controlling cold sensitivity and is a therapeutic target for alleviating trigeminal neuropathic pain that manifests orofacial cold hyperalgesia.

Purpose of Review Examining the efficacy of radiofrequency ablation in treating headache conditions. Recent Findings The efficacy of radiofrequency ablation in treating headache conditions is not well studied. Summary Chronic headache conditions can be difficult to treat with little consensus on management of headaches associated with pericranial neuralgias. In this retrospective study, we found that radiofrequency ablation is an effective and safe treatment for resistant headache conditions. This study is important as it describes a novel treatment for chronic headache which can benefit a large number of patients.