PAIN, 2026年6月号 Keyword: 痛みの画像(PainImages), 視覚化(Visualization), 疼痛評価(PainAssessment), 疼痛医学(PainMedicine) 口腔顔面痛(OrofacialPain), 三叉神経(TrigeminalNerve), 神経障害性疼痛(NeuropathicPain), 疼痛経路(PainPathways) 健康の社会的決定要因(SocialDeterminantsOfHealth), 移民(Migration), 小児疼痛(PediatricPain), 健康格差(HealthEquity) 鎮静(Sedation), 行動解析(BehavioralAnalysis), 疼痛緩和(PainRelief), 自動解析(AutomatedAnalysis) 痛みの画像(PainImages), 協働医療(CollaborativeCare), 疼痛医学(PainMedicine), 患者体験(PatientExperience) ハンセン病(Leprosy), らい性疼痛(LeprosyPain), 神経障害(Neuropathy), グローバルヘルス(GlobalHealth) 小児慢性疼痛(PediatricChronicPain), 移住(Migration), トラウマ(Trauma), 社会政治的要因(SociopoliticalTrauma) 交通外傷(MotorVehicleCrash), 外傷後疼痛(PostTraumaticPain), 予後因子(PrognosticFactors), メタ解析(MetaAnalysis) 慢性広範痛(ChronicWidespreadPain), 心血管疾患(CardiovascularDisease), リスク評価(RiskAssessment), メタ解析(MetaAnalysis) 経頭蓋直流電気刺激(tDCS), 慢性疼痛(ChronicPain), 神経調節(Neuromodulation), 疼痛治療(PainTreatment) 局所疼痛(RegionalPain), 疼痛分類(PainClassification), 慢性疼痛(ChronicPain), 疼痛概念(PainConcepts) 疼痛記憶(PainMemory), 持続痛(TonicPain), 神経画像(NeuralCorrelates), 連合学習(AssociativeLearning) 三叉神経節(TrigeminalGanglion), 口腔顔面痛(OrofacialPain), 神経障害性疼痛(NeuropathicPain), 三叉神経脊髄路核口側亜核(SubnucleusOralis) ノセボ(Nocebo), 痛覚過敏(Hyperalgesia), 条件づけ(Conditioning), 疼痛心理学(PainPsychology) 膀胱痛(BladderPain), 膀胱過活動(OveractiveBladder), DREADDs(DREADDs), 遺伝子治療(GeneTherapy) 掻痒(Itch), TASK3(TASK3), 感覚ニューロン(SensoryNeurons), ガストリン放出ペプチド(GRP) オンコスタチンM(OncostatinM), 慢性疼痛(ChronicPain), 侵害受容器(Nociceptors), 神経炎症(Neuroinflammation) ストレス(Stress), 音刺激(SoundStress), 痛覚過敏(Hyperalgesia), プライミング(Priming)

🌉 𝐁𝐫𝐢𝐝𝐠𝐢𝐧𝐠 𝐏𝐚𝐢𝐧, 𝐍𝐨𝐭 𝐉𝐮𝐬𝐭 𝐓𝐫𝐞𝐚𝐭𝐢𝐧𝐠 𝐈𝐭: 𝐓𝐡𝐞 𝐌𝐢𝐬𝐬𝐞𝐝 𝐋𝐢𝐧𝐤 𝐢𝐧 𝐓𝐫𝐚𝐧𝐬𝐢𝐭𝐢𝐨𝐧𝐚𝐥 𝐏𝐚𝐢𝐧 𝐂𝐚𝐫𝐞 #TransitionalPain #BeyondTheBlock #PainContinuum #MedTwitter #ChronicPainPrevention #RAInsights #RegionalAnesthesia #PainMedicine #AcuteToChronic #PainPathways #MultimodalAnalgesia #TPS #PainTrajectory #GrayZonesInRA #GrayAreasInRA 𝐆𝐑𝐀𝐘 𝐙𝐎𝐍𝐄𝐒 𝐢𝐧 𝐑𝐀 ➤ Transitional Pain Services (TPS) were never meant to be a formality. ➤ They were designed as a continuum of care, preventing the silent drift from acute pain to chronic suffering. ➤ Yet, what we often witness is the rise of Transitional Pain Syndromes - where pain lingers, evolves, and embeds itself into the patient’s life. ➤ Regional anesthesia is excellent for blocking pain, but not always for modulating long-term pain trajectories. Whats going 𝐖𝐑𝐎𝐍𝐆? 👇 🔵 👤 𝐏𝐀𝐓𝐈𝐄𝐍𝐓 𝐅𝐀𝐂𝐓𝐎𝐑𝐒 - 𝐓𝐡𝐞 𝐈𝐠𝐧𝐨𝐫𝐞𝐝 𝐅𝐨𝐮𝐧𝐝𝐚𝐭𝐢𝐨𝐧 🔹Pre-existing chronic pain, opioid tolerance, anxiety, catastrophizing, poor compliance. 🔹These are not side notes, they are primary drivers. 🔹Ignoring them is like treating symptoms while fueling the disease. 🔴 🔪 𝐒𝐔𝐑𝐆𝐈𝐂𝐀𝐋 𝐃𝐄𝐂𝐈𝐒𝐈𝐎𝐍𝐒 - 𝐔𝐧𝐢𝐧𝐭𝐞𝐧𝐝𝐞𝐝 𝐇𝐚𝐫𝐦 🔸 Abrupt stoppage of essential medications (antidepressants, anticonvulsants, baseline opioids) disrupts neurochemical balance. 🔸In trying to “simplify,” we often complicate recovery. ⚫ 💉 𝐀𝐍𝐄𝐒𝐓𝐇𝐄𝐒𝐈𝐎𝐋𝐎𝐆𝐘 𝐆𝐀𝐏𝐒 - 𝐀𝐜𝐮𝐭𝐞 𝐋𝐞𝐧𝐬, 𝐂𝐡𝐫𝐨𝐧𝐢𝐜 𝐂𝐨𝐧𝐬𝐞𝐪𝐮𝐞𝐧𝐜𝐞𝐬 ◾Brilliant at managing immediate pain, yet often limited by a 24-hour VAS mindset. ◾Pain relief is celebrated early, while long-term pain evolution goes untracked. 🟣 🧠 𝐊𝐍𝐎𝐖𝐋𝐄𝐃𝐆𝐄 𝐃𝐄𝐅𝐈𝐂𝐈𝐓- 𝐏𝐚𝐢𝐧 𝐈𝐬 𝐍𝐨𝐭 𝐎𝐧𝐞-𝐃𝐢𝐦𝐞𝐧𝐬𝐢𝐨𝐧𝐚𝐥 🔹 Nociceptive ≠ Neuropathic ≠ Nociplastic. 🔹Without understanding pain pathways and phenotypes, we end up applying uniform solutions to diverse problems. 💠 🎯 𝐒𝐇𝐎𝐑𝐓-𝐓𝐄𝐑𝐌 𝐆𝐎𝐀𝐋𝐒 - 𝐓𝐡𝐞 𝐁𝐢𝐠𝐠𝐞𝐬𝐭 𝐓𝐫𝐚𝐩 🔹 A low VAS score at 24 hours is not success - it’s just a snapshot. 🔹 True success lies in functional recovery, prevention of central sensitization, and avoiding chronicity. 🔘 📚 𝐅𝐑𝐀𝐆𝐌𝐄𝐍𝐓𝐄𝐃 𝐋𝐈𝐓𝐄𝐑𝐀𝐓𝐔𝐑𝐄 - 𝐌𝐢𝐬𝐥𝐞𝐚𝐝𝐢𝐧𝐠 𝐒𝐢𝐦𝐩𝐥𝐢𝐜𝐢𝐭𝐲 ➜ Short, procedure-focused, and outcome-limited studies create half-knowledge. ➜ This leads to miscommunication, inconsistent practices, and silo-based decision-making. ✳️ 🤝 𝐋𝐀𝐂𝐊 𝐎𝐅 𝐈𝐍𝐓𝐄𝐆𝐑𝐀𝐓𝐈𝐎𝐍 - 𝐓𝐡𝐞 𝐂𝐨𝐫𝐞 𝐅𝐚𝐢𝐥𝐮𝐫𝐞 ✅ Surgeons, anesthesiologists, and pain physicians often work in parallel, not in sync. ✅ TPS fails when care is episodic instead of continuous. ⚪ 🚀 𝐓𝐡𝐞 𝐖𝐚𝐲 𝐅𝐨𝐫𝐰𝐚𝐫𝐝 ✔️ Shift from Pain Scores → Pain Trajectories ✔️ Shift from Protocol → Personalization ✔️ Shift from Acute Relief → Long-Term Recovery ✔️ Shift from Isolated Care → Integrated TPS Model 🔥 𝐅𝐈𝐍𝐀𝐋 𝐓𝐀𝐊𝐄𝐀𝐖𝐀𝐘𝐒 👉 Pain is not a 24-hour event. It is a biological journey, influenced by neural plasticity, psychology, and perioperative decisions. 👉 If we continue to measure success in hours, we will continue to create suffering for months… even years. 👉 Transitional Pain Care is not about crossing the bridge quickly - it’s about making sure the patient never falls off it. 👉 Even a “perfect block” can fail the patient if: ▫️ TPS is absent ▫️ Baseline meds are stopped ▫️ Pain phenotype is misunderstood 👉 Move from: “Did my block work?” To: “Did my intervention alter the patient’s pain journey?” 👉 RA may start the story… but transitional pain care decides the ending.

"Shifting the Pain Paradigm in TKA" #TKAInsights #PainPathways #RegionalAnesthesia #PostoperativePain #KneeSurgery #GenicularBlock #ExtraArticularPain #PeriarticularTargets #SmartAnalgesia #OrthoAnesthesia #AnesthesiaTips #PainManagement #PrehabToRehab Tip of the Day: Before TKA, The Pain source is primarily intra-articular—originating from structures inside the knee joint such as cartilage degeneration, inflamed synovium, and subchondral bone changes. This makes targeting intra-articular and capsular innervations, especially the genicular nerves, a logical approach for preoperative pain management and delaying surgery. However, After TKA, the native joint is removed and replaced with prosthetic components. Now, the pain no longer comes from inside the joint. Instead, it becomes an iatrogenic, extra-articular issue—arising from surgical trauma to soft tissues, the joint capsule, periosteum, quadriceps tendon, and skin. These are structures that lie outside the replaced joint. Bottom line: Patients don't feel pain in the joint post-TKA—it’s the pain around it that matters! Tailor your analgesia accordingly. Watch this video to understand it better, youtu.be/aBO-b73ZH6M?si=t8qF…

#FrequencyWaveTheory #PainPathways #GenderDifferences #Neuroscience #ChronicPainRelief #InnovativeTherapies #CellularScience #PainManagement #ScientificBreakthrough #HealthResearch Image depicting the concept of Frequency Wave Theory influencing the different pain pathways in men and women. The intricate wave patterns and glowing lines symbolize the scientific exploration of pain at the cellular level.

Certified, accredited, effective patient counseling on proper use, safeguarding disposal of opioids to help HCPs address this crisis feat. Amanda Zimmerman PA-C. Video and slides➡️ bit.ly/387MOGk💊 #painpathways #painmanagement #Painweek #opioids #chronicpain #heroin

We're partnering on a Risk Evaluation and Mitigation Strategy (REMS) project. Learn to maximize safety and efficacy when prescribing for pain feat. Dr. Friedman. Video and slides➡️ bit.ly/3tPBAOY #painpathways #painmanagement #opioids #chronicpain #axcutepain #opioid

Learn strategies for counseling patients and caregivers on safe opioid use, storage, and disposal feat. Amanda Zimmerman PA-C. Video and slides➡️ bit.ly/37R6NZU #IASP2022 #painpathways #painmanagement #Painweek #opioids #chronicpain #axcutepain #opioid

#POLL How often do you discuss opioid safety (including use, storage, and disposal) with your patients with chronic pain? ➡️ bit.ly/3vI1Ryj 💊#IASP2022 #painpathways #painmanagement #Painweek #opioids #chronicpain #axcutepain #opioid #TwitterRX

Learn to maximize safety and efficacy when prescribing for pain feat. Dr. Friedman. Video and slides➡️ bit.ly/3uZuw1J #IASP2022 #painpathways #painmanagement #Painweek #opioids #chronicpain #axcutepain #opioid

Great, timely session to help my thinking around the work we're doing to improve #painpathways for patients in Shetland, with @skepticine et al

📢 STARTING NOW: industry symposium - Role of #CGRP in #PainPathways: #Migraine and Other #Headache Disorders Join us LIVE ➡️ iasp-pain.org/virtual-series #IASPVirtualSeries

⏰ Starting in 1 hour: industry symposium - Role of #CGRP in #PainPathways: #Migraine and Other #Headache Disorders 💻 Tune in live: iasp-pain.org/virtual-series #IASPVirtualSeries

Pain facts #PainAwarenessmonth from @asra_society Resident & med student pain edu SIG #painedu #meded #painpathways Thanks @VinitaSinghMD Share pain facts you think all medical trainees should know in response or tweet #ASRAtraineepaineduSIG More at members.asra.com/resident-an…

Cutaneous #TRPV1 Neurons Trigger Protective Innate Type 17 Anticipatory #Immunity @CellCellPress cell.com/cell/pdf/S0092-8674… #CGRP How general is this phenomenon? How commonly are #painpathways networked w immunity? See also @claudiamcarrera - x.com/claudiamcarrera/status… #PAIN

What a day! Crash course session, one-on-one tutoring, work - now off to the lab. 😊 #physiology #painpathways #neurotransmission

Have started using #painPathways app for my #chronicpain Even if the activities don't work, it contains a lot of very interesting stuff. Knowledge is power! I'm recommending it!

When It Hurts to Be Touched - PainPathways Magazine ow.ly/Z4q730n3oaV

One more day until the chat #DysSupportChat @inspire @patientchat @savvy_coop @TheEDSociety @DysSupport @DysNurse @DSNNurseAdvoc @CSFinfo @brkthrough_crew @Prettyill @brookeoshea @PainPathways @PainPathwaysMag @ConquerChiari #POTS #dysautonomia #EDS

Access to Care - PainPathways Magazine ow.ly/NN9S30cvl57