Progress in Radiofrequency Therapy for Zoster-Associated Pain About Parameters, Modes, Targets, and Combined Therapy: A Narrative Review

Abstract

Zoster-associated pain (ZAP) is a painful condition that significantly impacts a patient's quality of life, often leading to postherpetic neuralgia (PHN). Over 30% of patients with herpes probably experience PHN. However, the understanding and treatment of ZAP remain inadequate. Common interventional treatments include radiofrequency therapy, nerve blocks, epidural block, and spinal cord electrical stimulation. Among these, radiofrequency therapy is widely used for pain control in ZAP, but the standard pulsed radiofrequency technique can still be improved. Researchers have

Central and peripheral dual neuromodulation strategy in pain management of zoster-associated pain：a retrospective cohort study

“…Moreover, among patients with subacute pain, the dual stimulation protocol effectively prevented the progression to PHN compared to single central stimulation alone. This nding aligns with current trends in pain management, suggesting that multimodal and multitarget therapeutic approaches often yield better outcomes [27] . The multifaceted pathogenesis of ZAP involves sensitization of central and peripheral nerves and abnormal ion channel expression [20,21] .…”

“…This dual stimulation strategy addresses pain signal processing at both central and peripheral levels, enhancing therapeutic effects. ZAP originates from VZV latent in peripheral ganglia, evolving from peripheral sensitization to central sensitization over time, with the two mechanisms in uencing each other [27,29,30] . We describe this phenomenon of layered and integrated sensitization as the "layerintegrate" sensitization theory (LIST).…”

Development of a Prediction Model and Corresponding Scoring Table for Postherpetic Neuralgia Using Six Machine Learning Algorithms: A Retrospective Study

“…Management of PHN involves analgesic therapy and interventional approaches. Early pain interventions such as epidural and paravertebral blocks, percutaneous electrical nerve stimulation, and stellate ganglion blocks in herpes zoster patients can effectively reduce the occurrence of PHN [ 17 , 20 , 21 ]. However, treatment outcomes for established PHN are often unsatisfactory [ 18 ], and, consequently, the prediction of PHN holds significant clinical relevance, prompting global medical attention towards prognostication and early intervention strategies [ 19 ].…”