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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...
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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
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...
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Research/Technical Note
Development and Validation of a Chinese Assessment Scale for the Primary Trigeminal Neuralgia Based on the Delphi Method
Issue:
Volume 1, Issue 4, December 2025
Pages:
87-106
Received:
10 September 2025
Accepted:
23 September 2025
Published:
29 October 2025
DOI:
10.11648/j.ijpr.20250104.13
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Abstract: Objective: To develop and validate an assessment scale for primary trigeminal neuralgia (PTN) that is suitable for Chinese patients’ clinical requirements and cultural background. Methods: Descriptive study. (1) Construction of pre-scales: A pool of scale entries was prepared based on the common clinical features of PTN, the consensus of domestic experts, clinical diagnosis and treatment guidelines, and the reference of the international scale production process. Based on the Delphi method, 21 experts were invited to participate in two rounds of correspondence and pre-test revisions to develop the pre-scales. (2) Formation and validation of the preliminary version of the scale: A clinical investigation was conducted on 157 patients with PTN in the Pain Department of Shandong Provincial Hospital from March 20, 2024 to January 1, 2025. The entries were screened to form a preliminary version of the scale using the critical ratio method, correlation coefficient method, and discrete trend method. The scientific validity and feasibility of the scale were then assessed through reliability and validity tests, satisfaction measurements, and reflective tests. Results: 147 patients with PTN completed the study. The positive coefficient of two rounds of expert correspondence was 100.0%, the authoritative coefficient was 0.927 and 0.957 (>0.900), the Kendall's W coefficient was 0.227 and 0.421, respectively (all P<0.001). The validity and reliability of the scale were positive, with Cronbach's α 0.870 (>0.700), the content validity index 0.935 (>0.900) for S-CVI and 0.810-1.000 (all≥0.780) for I-CVI respectively, the Kaiser-Meyer-Olkin (KMO) value 0.858 (>0.600), and χ2=1 220.060 (P<0.001) of Bartlett spherical test. The exploratory factor analysis extracted 3 common factors, with a cumulative variance contribution rate of 63.880% (＞50.000%) and factor loadings ranging between 0.533 and 0.905 for each entry. The correlation coefficient (r) between satisfaction and change before and after the treatment was 0.903. The scale demonstrated excellent responsiveness, as evidenced by a standardized response median (SRMed) of 2.71 and an effect size (ES) of 3.17 (both substantially exceeding the established benchmark of >0.80). The final scale consisted of 4 parts: the first part with 6 non-quantitative entries, the second part contained 4 dimensions and 20 quantitative entries, the third part contained 5 entries related to post-treatment evaluation, the fourth part was the overall satisfaction evaluation with 5 entries, and the third and fourth parts were for post-treatment only. Conclusion: The primary trigeminal neuralgia assessment scale has good reliability, validity, and applicability.
Abstract: Objective: To develop and validate an assessment scale for primary trigeminal neuralgia (PTN) that is suitable for Chinese patients’ clinical requirements and cultural background. Methods: Descriptive study. (1) Construction of pre-scales: A pool of scale entries was prepared based on the common clinical features of PTN, the consensus of domestic e...
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Review Article
A Chinese Guideline for the Diagnosis and Treatment of Chronic LOW Back Pain (2024 Edition)
Zhi-Xiang Cheng,
Xian-Guo Liu,
Yan Lu,
Ke Ma,
Dong Huang,
Qing Liu,
Xiao-Qiu Yang,
Li-Juan Lu,
Tang-Hua Liu,
Lin Wang,
Jin-Feng Liu,
Bao-Juan Zhang,
Yan-Qing Liu*
Issue:
Volume 1, Issue 4, December 2025
Pages:
107-131
Received:
12 June 2025
Accepted:
22 September 2025
Published:
29 October 2025
DOI:
10.11648/j.ijpr.20250104.14
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Views:
Abstract: Background: Low back pain (LBP) is the leading cause of disability worldwide, severely impairing patients' quality of life, consuming substantial healthcare resources, and increasing medical costs while reducing productivity. Low back pain has become the leading cause of disability worldwide and a major global public health issue. Objective: To enhance the ability of diagnosis and treatment for LBP to meet the needs of clinical diagnosis and treatment. Main ideas: Based on high quality evidence based medical research on the diagnosis and treatment of LBP published domestically and internationally between January 2010 and December 2023, the expert group of the Pain Disease Diagnosis and Treatment Special Capacity Enhancement Project of the National Health Commission of China's Capacity Building and Continuing Education Centerhas formed recommendations for common treatment methods through rigorous argumentation and expert voting, to provide references for standardized diagnosis and treatment of LBP. This guideline adopts GRADE methodology to evaluate the level of evidence and strength of recommendation for the treatments of common chronic specific low back pain (cSLBP) and chronic non-specific low back pain (cNSLBP). Conclusion: LBP is characterized by high prevalence, significant disability rates, and frequent recurrence, imposing substantial burdens on individuals, families, and society. For patients, improving understanding of cLBP, practicing effective self-management, and actively cooperating with treatment are crucial for disease prognosis. Healthcare providers must enhance patient education and clinical competencies while strictly adhering to diagnostic and therapeutic guidelines for comprehensive cLBP management. Policymakers and academic organizations should focus on developing evidence-based clinical guidelines, strengthening healthcare system oversight, and promoting widespread implementation of standardized cLBP care protocols.
Abstract: Background: Low back pain (LBP) is the leading cause of disability worldwide, severely impairing patients' quality of life, consuming substantial healthcare resources, and increasing medical costs while reducing productivity. Low back pain has become the leading cause of disability worldwide and a major global public health issue. Objective: To enh...
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Research/Technical Note
Development and Validation of Chinese Assessment Scale for Zoster-Associated Pain
Issue:
Volume 1, Issue 4, December 2025
Pages:
132-149
Received:
10 September 2025
Accepted:
23 September 2025
Published:
29 October 2025
DOI:
10.11648/j.ijpr.20250104.15
Downloads:
Views:
Abstract: Objective: To develop and validate a Chinese assessment scale for patients with zoster-associated pain (ZAP) that is tailored to China's national conditions. Methods: A descriptive study was conducted to formulate the preliminary scale items based on the common clinical features of ZAP, incorporating consensus from domestic herpes zoster experts, clinical guidelines, and international scale development procedures. The pre-scale was refined through review by pain specialists and pre-testing. From March 20 to November 21, 2024, a clinical investigation involving 145 ZAP patients from the Pain Department of Shandong Provincial Hospital was carried out. The pre-scale questionnaire was administered and item analysis—including the critical ratio method, correlation coefficients, and discrete trend analysis—was performed to screen items and form a preliminary version. Reliability and validity were further assessed. Results: The scale demonstrated strong validity and reliability, with a standardized Cronbach’s α of 0.857 (>0.7), a KMO value of 0.781 (>0.6), and a Bartlett’s sphericity test result of χ2 = 914.521 (p < 0.001). Exploratory factor analysis extracted five common factors with a cumulative variance contribution of 70.169% (>50%) and factor loadings between 0.529 and 0.920. Confirmatory factor analysis indicated good model fit: χ2/df = 1.902, RMSEA = 0.079 (<0.08), CFI = 0.915 (>0.90), and IFI = 0.917 (>0.90). The final ZAP assessment scale comprises three sections: 15 non-quantitative items, 17 quantitative items across 5 dimensions, and 3 additional quantitative items specific to acute-phase patients. Conclusion: The developed Chinese assessment scale for ZAP exhibits good reliability, validity, and applicability, making it a suitable tool for clinical use in China.
Abstract: Objective: To develop and validate a Chinese assessment scale for patients with zoster-associated pain (ZAP) that is tailored to China's national conditions. Methods: A descriptive study was conducted to formulate the preliminary scale items based on the common clinical features of ZAP, incorporating consensus from domestic herpes zoster experts, c...
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