Treating Refractory Pain in Neurological Disease: Interventional Approaches and Real-World Outcomes

Pain remains one of the most prevalent and disabling non-motor consequences of neurological disease, yet it continues to be systematically undertreated. Central post-stroke pain, spinal cord injury-related pain, painful peripheral neuropathies, multiple sclerosis-associated pain syndromes, Parkinson’s disease-related pain, and refractory cranial neuralgias collectively affect millions of patients worldwide. These conditions are frequently resistant to first- and second-line pharmacotherapy, leaving many individuals with substantial residual pain, polypharmacy risks, and diminished quality of life. Interventional approaches – including image-guided nerve blocks, radiofrequency ablation, intrathecal drug delivery, neuromodulation, and emerging regenerative procedures – represent an expanding therapeutic arsenal. However, the evidence base in neurologically defined populations remains fragmented, with the majority of trials conducted in musculoskeletal or mixed chronic pain cohorts.This Research Topic aims to consolidate clinical, translational, and methodological advances in interventional pain management for patients with primary neurological disorders, with a focus on procedural technique, analgesic mechanisms, and patient selection. It complements parallel work on spasticity and neurorehabilitation; manuscripts focused primarily on spasticity management, chemodenervation, or rehabilitation protocols are outside the scope of this collection. We particularly welcome work addressing procedural safety in neurologically vulnerable populations, comparative effectiveness against pharmacological standards, and long-term functional and patient-reported outcomes. Contributions leveraging real-world data, registries, and federated health networks, as well as rigorous evidence syntheses, are encouraged to clarify where interventional approaches add measurable value and where evidence gaps persist.Themes of interest include the interventional management of central neuropathic pain in stroke, spinal cord injury, and multiple sclerosis, where the focus is on procedural selection and outcomes rather than broad rehabilitation planning; procedural approaches to cranial and cervical neuralgias; pain interventions in movement disorders and neurodegenerative disease, including Parkinson’s disease; perioperative and post-neurosurgical pain syndromes, including post-craniotomy pain and failed back surgery syndrome; intrathecal and neuromodulatory therapies; ultrasound- and fluoroscopy-guided techniques in patients with altered neuroanatomy; safety and outcomes in anticoagulated or immunocompromised neurological patients; health equity and access considerations in low- and middle-income settings; and methodological advances in trial design, core outcome sets, and real-world evidence for interventional pain research.We invite original research, systematic reviews and meta-analyses, clinical trials, cohort and database studies, case series with critical appraisal, methods papers, and perspective or mini-review articles. By bringing together neurologists, interventional pain physicians, neurosurgeons, anesthesiologists, and methodologists, this collection seeks to define the current state of evidence, foster cross-disciplinary dialogue, and chart a pragmatic research agenda for precision interventional pain care in neurological disease. Topic editors: Saurabh Kataria, Jeremiah Hilkiah Wijaya Source: https://www.frontiersin.org/research-topics/82579/treating-refractory-pain-in-neurological-disease-interventional-approaches-and-real-world-outcomes