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The following is a summary of “A Review of Nonsurgical Neurolytic Procedures for Neuropathic Pain,” published in the February 2025 issue of Journal of Pain Research by Gupta et al.
Researchers conducted a retrospective study to review 5 well-documented nonsurgical neurolytic procedures for managing refractory neuropathic pain and peripheral neuropathies.
They conducted a focused literature search in the PubMed database for English-language human studies published through July 2024, using terms such as “neuropathic pain” AND “cryoablation,” “cryoneurolysis,” “radiofrequency ablation,” “alcohol neurolysis,” “alcohol injection,” “phenol neurolysis,” “phenol injection,” “chemoneurolysis,” “topical capsaicin,” and “TRPV1.” While clinical trials were sought for each neurolytic procedure, available data on safety and efficacy were primarily derived from case studies and anecdotal evidence.
The results showed that the risk-benefit profile of each technique was analyzed, and recommendations for appropriate use were summarized based on the literature. Most procedures require ultrasound or fluoroscopy guidance for accurate application. Pain relief duration typically ranges from 3 to 12 months, with repeated neurolytic interventions often necessary to sustain effective pain management.
Investigators concluded that various nonsurgical physical and chemoneurolytic procedures offer diverse and effective options for treating refractory neuropathic pain across different patient populations based on targeted neural pathways.
