Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 0 0 2026 06 28 1703 1703 Shiva Bahrehmand Department of General Surgery, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran. Omid Mehrazin Bashkir State Medical University, Ufa, Russia. Nafiseh Mehri Khotbehsara Bashkir State Medical University, Ufa, Russia. Firooze Abolhasani zade Cancer & Breast Surgery fellowship, Kerman University of Medical Sciences, Kerman, Iran. Mohammadreza Lashkarizad Department of Thoracic Surgery, Afzalipoor Hospital, Kerman University of Medical Sciences, Kerman, Iran. 2025 12 05 2026 05 02 Objective: Chronic pain after blunt thoracic trauma remains a frequent and debilitating problem driven by complex neuropathic mechanisms and insufficient acute pain control. Pregabalin has emerged as a potential non‑opioid option, though evidence remains inconsistent. Given these gaps, the present study aims to evaluate the therapeutic efficacy of oral pregabalin in managing chronic post‑traumatic thoracic pain. Methods: This randomized, double‑blind clinical trial was conducted from early 2024 to the end of September 2025 at Shahid Bahonar Hospital in Kerman. A total of 50 patients (25 in each group) were enrolled through convenience sampling. Participants received pregabalin or a placebo alongside naproxen for 12 weeks. The primary outcome was chronic pain intensity, while secondary outcomes included changes in pain scores, additional naproxen use, the 30% treatment‑response rate, adverse events, and quality of life. Results: Across the 12‑week follow‑up, additional naproxen use remained consistently lower in the pregabalin group, with significant between‑group differences from week 2 onward (P=0.042 to P=0.001). Pain intensity similarly declined more steeply with pregabalin (repeated measures P=0.001) compared with the control group (P=0.236). Persistent chronic pain was markedly less frequent with pregabalin (8 vs. 19 patients; P=0.001). SF‑36 scores improved significantly across all subscales in the pregabalin group (P<0.05) and remained higher than in controls post‑treatment (P=0.018–0.025). Conclusion: Adjunctive pregabalin significantly reduced the severity and persistence of chronic post‑traumatic chest pain when added to naproxen therapy. Its effects are likely mediated through modulation of neuropathic pathways and central sensitization, resulting in decreased analgesic requirements. While no major safety concerns emerged, conclusions regarding tolerability are limited by sample size and warrant confirmation in larger trials. https://fem.tums.ac.ir/index.php/fem/article/view/1703 https://fem.tums.ac.ir/index.php/fem/article/download/1703/551