Research Article
Minimally Invasive Interventional Therapy in the Standardization and Individualization of Postherpetic Neuralgia Management
Yifan Jia*
Issue:
Volume 1, Issue 4, December 2025
Pages:
52-55
Received:
1 August 2025
Accepted:
14 August 2025
Published:
9 October 2025
Abstract: Minimally invasive interventional therapy for postherpetic neuralgia (PHN) faces a critical challenge in balancing standardized protocols with individualized patient needs. Current limitations include insufficient evidence-based guidance for optimal technique selection (e.g., pulsed radiofrequency [PRF] parameters, nerve blockade timing, spinal cord stimulation [SCS] modes) and over-reliance on simplified approaches like routine epidural blockade, neglecting potential synergies of multimodal strategies. Significant heterogeneity exists regarding PRF efficacy (high-voltage vs. standard, influenced by comorbidities like diabetes) and the optimal intervention window for nerve blockade (acute vs. subacute phase). While novel SCS modalities (high-frequency, burst, DRG stimulation) offer promise, especially for allodynia, robust validation is lacking. Furthermore, standardized protocols inadequately address individual anatomical variations (e.g., ganglion morphology) and physiological factors (e.g., reduced thermal tolerance in diabetes), compounded by guideline gaps in stage-specific (acute inflammatory vs. chronic remodeling) and parameter-specific recommendations. To reconcile standardization with individualization, a stratified treatment pathway ("pharmacotherapy →minimally invasive interventional techniques→combined therapy") tailored to pain intensity, duration, and comorbidities is proposed: SCS is recommended first-line for severe cases with significant comorbidities or extensive lesions, while PRF combined with epidural blockade may suit others. Integrating machine learning to analyze patient data and procedural parameters for complication risk prediction offers a pathway towards optimized efficacy and safety. Urgent guideline refinements incorporating stratified recommendations, parameter rationales, and individual variability are essential for advancing precise PHN management.
Abstract: Minimally invasive interventional therapy for postherpetic neuralgia (PHN) faces a critical challenge in balancing standardized protocols with individualized patient needs. Current limitations include insufficient evidence-based guidance for optimal technique selection (e.g., pulsed radiofrequency [PRF] parameters, nerve blockade timing, spinal cor...
Show More
Review Article
A Chinese Guideline for the Diagnosis and Treatment of Neuropathic Pain
Cheng Zhixiang,
Lu Yan,
Liu Xianguo,
Xia Lingjie,
Huang Dong,
Song Tao,
Liang Lishuang,
Zhang Ying,
Liu Tanghua,
Wang Lin,
Tao Wei,
Zhang Baojuan,
Zhang Xiaomei,
Feng Zeguo,
Wang Jianxiu,
Wang Suoliang,
Liu Yanqing*
Issue:
Volume 1, Issue 4, December 2025
Pages:
56-86
Received:
26 May 2025
Accepted:
13 June 2025
Published:
14 October 2025
DOI:
10.11648/j.ijpr.20250104.12
Downloads:
Views:
Abstract: Background: Neuropathic pain refers to pain caused by injury or disease affecting the somatosensory nervous system, which is a common and frequently occurring disease in clinical practice, and seriously affects patients' quality of life. However, the treatment of neuropathic pain is a clinical challenge. Objective: To standardize neuropathic pain management, the Pain Medicine Branch of China Association of Health Care for the Elderly convened an expert panel to develop the guideline. Main ideas: Based on high quality evidence-based medical research on the diagnosis and treatment of neuropathic pain published domestically and internationally in the past 10 years, the expert group has formed recommendations for common treatment methods through rigorous argumentation and expert voting, to provide references for standardized diagnosis and treatment of neuropathic pain. This guideline adopts GRADE methodology to evaluate the level of evidence and strength of recommendation for the treatments of common peripheral neuropathic pain and central neuropathic pain. Chinese traditional medicine also plays an important role in the treatment of neuropathic pain, so this guide also provides Chinese traditional medicine drugs and treatment recommendations. Conclusion: The Chinese pain community has proposed the principle of "treatment forward, early intervention, prevention of sensitization, and prevention and treatment of chronic pain", which has played a positive role in improving the clinical diagnosis and treatment level of neuropathic pain.
Abstract: Background: Neuropathic pain refers to pain caused by injury or disease affecting the somatosensory nervous system, which is a common and frequently occurring disease in clinical practice, and seriously affects patients' quality of life. However, the treatment of neuropathic pain is a clinical challenge. Objective: To standardize neuropathic pain m...
Show More
