Pain Medicine Specialist: Championing High-Quality Development for Neuromodulation Technology

Ming Chen , Yang-jia Shi , Kun Chen , Hong-bing Xiang

Current Medical Science ›› : 1 -11.

PDF
Current Medical Science ›› :1 -11. DOI: 10.1007/s11596-026-00209-5
Review
review-article
Pain Medicine Specialist: Championing High-Quality Development for Neuromodulation Technology
Author information +
History +
PDF

Abstract

Neuromodulation technology, an interdisciplinary field integrating neuroscience, engineering, and clinical medicine, offers novel therapeutic paradigms for numerous intractable diseases. In pain medicine, it modulates nervous system function through electrical or chemical signals, emerging as a core approach for managing refractory pain. However, the rapid advancement of this technology has coincided with a persistent underappreciation of the core value and multidimensional roles of pain physicians. This paper systematically elucidates the essence and scope of neuromodulation technology, analyzes its unique advantages in addressing the diagnostic and therapeutic challenges of refractory pain, and reviews its rapid developmental trajectory. It critically highlights the indispensable, yet often underestimated, role of pain physicians in driving the high-quality advancement of this field. Furthermore, this paper explores safety concerns in clinical applications and highlights the need to establish robust monitoring, evaluation, and education systems. Finally, future directions for pain specialists in leading the evolution of neuromodulation are outlined.

Graphical Abstract

Keywords

Neuromodulation technology / Pain medicine / High-quality development / Pain physicians / Nervous system modulation / Refractory pain

Cite this article

Download citation ▾
Ming Chen, Yang-jia Shi, Kun Chen, Hong-bing Xiang. Pain Medicine Specialist: Championing High-Quality Development for Neuromodulation Technology. Current Medical Science 1-11 DOI:10.1007/s11596-026-00209-5

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Sivanesan E, North RB, Russo MA, et al.. A definition of neuromodulation and classification of implantable electrical modulation for chronic pain. Neuromodulation., 2024, 27(1): 1-12

[2]

Velasco F. Neuromodulation an overview. Arch Med Res., 2000, 31(3): 232-236

[3]

Kumar K, Rizvi S. Historical and present state of neuromodulation in chronic pain. Curr Pain Headache Rep., 2013, 18(1): 387

[4]

Davidson B, Bhattacharya A, Sarica C, et al.. Neuromodulation techniques–from non-invasive brain stimulation to deep brain stimulation. Neurotherapeutics., 2024, 21(3 ArticleID: e00330

[5]

Matt E, Radjenovic S, Mitterwallner M, et al.. Current state of clinical ultrasound neuromodulation. Front Neurosci., 2024, 18: 1420255

[6]

Moisset X, Lanteri-Minet M, Fontaine D. Neurostimulation methods in the treatment of chronic pain. J Neural Transm., 2020, 127(4): 673-686

[7]

Barros AMSP, Santos Pereira G, da Silva JRT, et al.. The effectiveness of spinal cord stimulation combined with physiotherapy in the management of chronic pain in adults: a systematic review. Front Pain Res., 2025, 6: 1620289

[8]

Zhang T, Pan N, Wang Y, et al.. Transcranial focused ultrasound neuromodulation: a review of the excitatory and inhibitory effects on brain activity in human and animals. Front Hum Neurosci., 2021, 15 ArticleID: 749162

[9]

Ramos-Fresnedo A, Perez-Vega C, Domingo RA, et al.. Motor cortex stimulation for pain: a narrative review of indications, techniques, and outcomes. Neuromodulation., 2022, 25(2): 211-221

[10]

Kaye AD, Ridgell S, Alpaugh ES, et al.. Peripheral nerve stimulation: a review of techniques and clinical efficacy. Pain Ther., 2021, 10(2): 961-972

[11]

Zanos S. Closed-loop neuromodulation in physiological and translational research. Cold Spring Harb Perspect Med., 2019, 9(11 ArticleID: a034314

[12]

Zhang H, Jiao L, Yang S, et al.. Brain-computer interfaces: the innovative key to unlocking neurological conditions. Int J Surg., 2024, 110(9): 5745-5762

[13]

Pridmore S, Erger S, Rybak M, et al.. Early relapse (ER) transcranial magnetic stimulation (TMS) in treatment resistant major depression. Brain Stimul., 2018, 11(5): 1098-1102

[14]

Beisteiner R, Matt E, Fan C, et al.. Transcranial pulse stimulation with ultrasound in Alzheimer’s disease—a new navigated focal brain therapy. Adv Sci., 2020, 7(3): 1902583

[15]

Murphy C, Matikainen-Ankney B, Chang YH, et al. Optogenetically-inspired neuromodulation: Translating basic discoveries into therapeutic strategies. Emerging Horizons in Neuromodulation: New Frontiers in Brain and Spine Stimulation. Amsterdam: Elsevier; 2021:187–219.

[16]

Grossman N, Okun MS, Boyden ES. Translating temporal interference brain stimulation to treat neurological and psychiatric conditions. JAMA Neurol., 2018, 75(11): 1307-1308

[17]

Fayaz A, Croft P, Langford RM, et al.. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open., 2016, 6(6 ArticleID: e010364

[18]

Jiang Y, Xu T, Mao F, et al.. The prevalence and management of chronic pain in the Chinese population: findings from the China pain health index (2020). Popul Health Metr., 2022, 20(1): 20

[19]

Todd J, Austin H, Clarke P, et al.. Chronic pain, insomnia and their mutual maintenance: a call for cognitive bias research. J Pain., 2022, 23(9): 1530-1542

[20]

Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain., 2009, 10(9): 895-926

[21]

Eldabe S, Obara I, Panwar C, et al.. Biomarkers for chronic pain: significance and summary of recent advances. Pain Res Manag., 2022, 2022: 1940906

[22]

Kaczyńska K, Wojciechowski P. Non-opioid peptides targeting opioid effects. Int J Mol Sci., 2021, 22(24 ArticleID: 13619

[23]

Laughey W, Lodhi I, Pennick G, et al.. Ibuprofen, other NSAIDs and COVID-19: a narrative review. Inflammopharmacology., 2023, 31(5): 2147-2159

[24]

Theriault CB, Burns T, Goldschneider K, et al.. Pediatric pain physician workforce: an assessment of supply and demand. Front Pain Res., 2024, 5: 1390736

[25]

Hagedorn JM, Gunn J, Budwany R, et al.. How well do current laboratory biomarkers inform clinical decision-making in chronic pain management?. J Pain Res., 2021, 14: 3695-3710

[26]

Chou R, Deyo R, Devine B, et al.. The effectiveness and risks of long-term opioid treatment of chronic pain. Evid Rep Technol Assess., 2014, 218: 1-219

[27]

Brewer NJ, Turrise SL, Kim-Godwin YS, et al.. Nurses’ knowledge and treatment beliefs: use of complementary and alternative medicine for pain management. J Holist Nurs., 2019, 37(3): 248-259

[28]

Di Stefano G, Di Lionardo A, Di Pietro G, et al.. Pharmacotherapeutic options for managing neuropathic pain: a systematic review and meta-analysis. Pain Res Manag., 2021, 2021(1): 6656863

[29]

Huang L, Liu J. Da-ying Zhang: enabling pain medicine to continuously demonstrate its value. Chin Hosp CEO (in Chinese)., 2025, 21(18): 22-25

[30]

Kapural L, Peterson E, Provenzano DA, et al.. Clinical evidence for spinal cord stimulation for failed back surgery syndrome (FBSS): systematic review. Spine., 2017, 42(Suppl 14): S61-S66

[31]

Dones I, Levi V. Spinal cord stimulation for neuropathic pain: current trends and future applications. Brain Sci., 2018, 8(8): 138

[32]

Fontaine D, Hamani C, Lozano A. Efficacy and safety of motor cortex stimulation for chronic neuropathic pain: critical review of the literature: Clinical article. J Neurosurg., 2009, 110(2): 251-256

[33]

Wan S, Liu K, Zhao J, et al.. Case report: multidimensional analgesia via asymmetric dual-target deep brain stimulation of the periaqueductal gray and ventral posterior thalamus in central post-stroke pain. Neurol Ther., 2025, 14(6): 2751-2764

[34]

Hamid P, Malik BH, Hussain ML. Noninvasive transcranial magnetic stimulation (TMS) in chronic refractory pain: a systematic review. Cureus., 2019, 11(10e6019

[35]

Arendsen LJ, Hugh-Jones S, Lloyd DM. Transcranial alternating current stimulation at alpha frequency reduces pain when the intensity of pain is uncertain. J Pain., 2018, 19(7): 807-818

[36]

Xiong HY, Zheng JJ, Wang XQ. Non-invasive brain stimulation for chronic pain: state of the art and future directions. Front Mol Neurosci., 2022, 15 ArticleID: 888716

[37]

New Oxford-led project aims to revolutionise chronic pain treatment. Oxford: University of Oxford; 2025 Oct 17 [cited 2026 May 7]. Available from: https://www.ox.ac.uk/news/2025-10-17-new-oxford-led-project-aims-revolutionise-chronic-pain-treatment.

[38]

Taylor RS. Spinal cord stimulation in complex regional pain syndrome and refractory neuropathic back and leg pain/failed back surgery syndrome: results of a systematic review and meta-analysis. J Pain Symptom Manag., 2006, 31(4): S13-S19

[39]

Qian W, Xu X, Wu Y, et al.. Altered white matter microstructural integrity in patients with postherpetic neuralgia: a combined DTI and DTI-NODDI study. Front Neurosci., 2025, 19: 1552961

[40]

North J, Calodney A, Trainor D, et al. Spinal cord stimulation plus conventional medical management versus conventional medical management alone for severe, non-surgical, refractory back pain: a randomized clinical trial followed by crossover. Reg Anesth Pain Med. 2025:rapm–2024–106335.

[41]

Sokal P, Harat M, Zieliński P, et al.. Motor cortex stimulation in patients with chronic central pain. Adv Clin Exp Med., 2015, 24(2): 289-296

[42]

Kannan S, Gillespie CS, Hanemaaijer J, et al.. Deep brain stimulation and motor cortex stimulation for central post-stroke pain: a systematic review and meta-analysis. Pain Med., 2025, 26(5): 269-278

[43]

DeLisio K, Miller J, Sweet J. Long-term pain control and reduced opioid use through novel selection criteria for peripheral nerve and motor cortex stimulation. J Neurosurg., 2025, 143(6): 1626-1633

[44]

Shaheen N, Shaheen A, Elgendy A, et al.. Deep brain stimulation for chronic pain: a systematic review and meta-analysis. Front Hum Neurosci., 2023, 17: 1297894

[45]

Sun P, Fang L, Zhang J, et al.. Repetitive transcranial magnetic stimulation for patients with fibromyalgia: a systematic review with meta-analysis. Pain Med., 2022, 23(3): 499-514

[46]

Mangano N, Torpey A, Devitt C, et al. Closed-loop spinal cord stimulation in chronic pain management: mechanisms, clinical evidence, and emerging perspectives. Biomedicines. 2025;13(5).

[47]

Steigerwald F, Müller L, Johannes S, et al.. Directional deep brain stimulation of the subthalamic nucleus: a pilot study using a novel neurostimulation device. Mov Disord., 2016, 31(8): 1240-1243

[48]

Costigan M, Scholz J, Woolf CJ. Neuropathic pain: a maladaptive response of the nervous system to damage. Annu Rev Neurosci., 2009, 32: 1-32

[49]

Treede RD. The role of quantitative sensory testing in the prediction of chronic pain. Pain., 2019, 160(Suppl 1): S66-S69

[50]

Thomson S, Helsen N, Prangnell S, et al.. Patient selection for spinal cord stimulation: the importance of an integrated assessment of clinical and psychosocial factors. Eur J Pain., 2022, 26(9): 1873-1881

[51]

Lempka SF, Patil PG. Innovations in spinal cord stimulation for pain. Curr Opin Biomed Eng., 2018, 8: 51-60

[52]

Frizon LA, Yamamoto EA, Nagel SJ, et al.. Deep brain stimulation for pain in the modern era: a systematic review. Neurosurgery., 2020, 86(2): 191-202

[53]

Pope JE, Smith GL, Goree JA, et al. Clinical utility of ECAP dosing in a real-world population delivered via EVOKE therapy: the ECAP study. Reg Anesth Pain Med. 2025:rapm–2025–107051.

[54]

Krauss JK, Lipsman N, Aziz T, et al.. Technology of deep brain stimulation: current status and future directions. Nat Rev Neurol., 2021, 17(2): 75-87

[55]

Smith V, Warty R, Nair A, et al.. Defining the clinician’s role in early health technology assessment during medical device innovation–a systematic review. BMC Health Serv Res., 2019, 19(1): 514

[56]

Kelly ML, Malone D, Okun MS, et al.. Barriers to investigator-initiated deep brain stimulation and device research. Neurology., 2014, 82(16): 1465-1473

[57]

Harnik MA, Kesselring P, Ott A, et al.. Complex regional pain syndrome (CRPS) and the value of early detection. Curr Pain Headache Rep., 2023, 27(9): 417-427

[58]

Mohabbati V, Sullivan R, Yu J, et al.. Early outcomes with a flexible ECAP based closed loop using multiplexed spinal cord stimulation waveforms—single-arm study with in-clinic randomized crossover testing. Pain Med., 2025, 26(11): 773-782

[59]

Staudt MD. The multidisciplinary team in pain management. Neurosurg Clin N Am., 2022, 33(3): 241-249

[60]

Oganesian LL, Shanechi MM. Brain–computer interfaces for neuropsychiatric disorders. Nat Rev Bioeng., 2024, 2(8): 653-670

[61]

Johnson A, Booker SQ. Population-focused approaches for proactive chronic pain management in older adults. Pain Manag Nurs., 2021, 22(6): 694-701

[62]

Bennett J, MacGuire J, Novakovic E, et al.. Characterizing complications of deep brain stimulation devices for the treatment of Parkinsonian symptoms without tremor: a federal MAUDE database analysis. Cureus., 2021, 13(6e15539

[63]

Eldabe S, Buchser E, Duarte RV. Complications of spinal cord stimulation and peripheral nerve stimulation techniques: a review of the literature. Pain Med., 2016, 17(2): 325-336

[64]

Krishnan C, Santos L, Peterson MD, et al.. Safety of noninvasive brain stimulation in children and adolescents. Brain Stimul., 2015, 8(1): 76-87

[65]

Fama CA, Chen N, Prusik J, et al.. The use of preoperative psychological evaluations to predict spinal cord stimulation success: our experience and a review of the literature. Neuromodulation Technol Neural Interface., 2016, 19(4): 429-436

[66]

Izzo A, Piano C, D’Ercole M, et al.. Intraoperative microelectrode recording during asleep deep brain stimulation of subthalamic nucleus for Parkinson disease. A case series with systematic review of the literature. Neurosurg Rev., 2024, 47(1): 342

[67]

Zhong T, William HM, Jin MY, et al.. A review of remote monitoring in neuromodulation for chronic pain management. Curr Pain Headache Rep., 2024, 28(12): 1225-1233

[68]

Ho T, O’Brien M, Sullivan R, et al.. Best practice guidelines for neuromodulation in pain management: insight from the neuromodulation society of Australia and New Zealand. Neuromodulation., 2026, 29(1): 1-14

[69]

Pilitsis JG, Fahey M, Custozzo A, et al.. Composite score is a better reflection of patient response to chronic pain therapy compared with pain intensity alone. Neuromodulation Technol Neural Interface., 2021, 24(1): 68-75

[70]

Komssi S, Kähkönen S. The novelty value of the combined use of electroencephalography and transcranial magnetic stimulation for neuroscience research. Brain Res Rev., 2006, 52(1): 183-192

[71]

Jiang R, Li H, Peng Z, et al.. A cross-sectional survey unveiling the imperatives for continuing education and discipline development in pain medicine. Front Med., 2025, 12: 1541403

[72]

Bendersky D, Yampolsky C. Is spinal cord stimulation safe? A review of its complications. World Neurosurg., 2014, 82(6): 1359-1368

[73]

Hasoon J, Vu PD, Mousa B, et al.. Device-related complications associated with cylindrical lead spinal cord stimulator implants: a comprehensive review. Curr Pain Headache Rep., 2024, 28(9): 941-947

[74]

Patil AS, Levasseur B, Gupta M. Neuromodulation and habituation: a literature review and conceptional analysis of sustaining therapeutic efficacy and mitigating habituation. Biomedicines., 2024, 12(5): 930

[75]

Duarte RV. Analysis of psychological characteristics impacting spinal cord stimulation treatment outcomes: a prospective assessment. Pain Phys., 2015, 18(3;5): E369-E377

[76]

Rossi S, Antal A, Bestmann S, et al.. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: expert Guidelines. Clin Neurophysiol., 2021, 132(1): 269-306

[77]

Allen CH, Kluger BM, Buard I. Safety of transcranial magnetic stimulation in children: a systematic review of the literature. Pediatr Neurol., 2017, 68: 3-17

[78]

Pritzlaff SG, Goree JH, Hagedorn JM, et al.. Pain education and knowledge (PEAK) consensus guidelines for neuromodulation: a proposal for standardization in fellowship and training programs. J Pain Res., 2023, 16: 3101-3117

[79]

Abd-Elsayed A, Abdallah R, Falowski S, et al.. Development of an educational curriculum for spinal cord stimulation. Neuromodulation., 2020, 23(5): 555-561

[80]

Johnson M. Transcutaneous electrical nerve stimulation: mechanisms, clinical application and evidence. Rev Pain., 2007, 1(1): 7-11

[81]

Knotkova H, Hamani C, Sivanesan E, et al.. Neuromodulation for chronic pain. Lancet., 2021, 397(10289): 2111-2124

[82]

Ciampi de Andrade D, Shirvalkar P. The future of pain research: neuromodulation and surgery. Pain., 2025, 166(11S): S116-S120

[83]

Al-Faraj K, Hanel PHP, Valentini E. Brain responses during provoked pain in patients with chronic primary pain: a systematic review and meta-analysis of fMRI studies. J Pain. 2026:106218.

[84]

Zhang J, Wang N, Ren LM, et al.. Application of functional magnetic resonance imaging in identifying responsible brain regions associated with spinal diseases related pain. Front Med., 2025, 12: 1585799

[85]

Cannistra M, Sacca V, Hodges S, et al.. Thalamocortical and corticostriatal pathways in the progression from acute to chronic musculoskeletal pain: an fMRI study. J Pain., 2026, 43 ArticleID: 106213

[86]

Shah JV, Quinkert CJ, Collar BJ, et al.. A highly miniaturized, chronically implanted ASIC for electrical nerve stimulation. IEEE Trans Biomed Circuits Syst., 2022, 16(2): 233-243

[87]

Tian H, Xu K, Zou L, et al.. Multimodal neural probes for combined optogenetics and electrophysiology. iScience., 2022, 25(1 ArticleID: 103612

[88]

Sun FT, Morrell MJ. Closed-loop neurostimulation: the clinical experience. Neurotherapeutics., 2014, 11(3): 553-563

[89]

Bi Y, Liu X, Zhao X, et al.. Enhancing pain modulation: the efficacy of synchronous combination of virtual reality and transcutaneous electrical nerve stimulation. Gen Psychiatr., 2023, 36(6 ArticleID: e101164

[90]

Hadanny A, Harland T, Khazen O, et al.. Development of machine learning–based models to predict treatment response to spinal cord stimulation. Neurosurgery., 2022, 90(5): 523-532

[91]

Pathak YJ, Greenleaf W, VerhagenMetman L, et al.. Digital health integration with neuromodulation therapies: the future of patient-centric innovation in neuromodulation. Front Digit Health., 2021, 3 ArticleID: 618959

[92]

Yang S, Qiao X, Ma J, et al.. Recent advances in flexible sensors for neural interfaces: multimodal sensing, signal integration, and closed-loop feedback. Biosensors., 2025, 15(7 ArticleID: 424

[93]

Zheng Y, Zhang T, Yang X, et al.. A survey of chronic pain in China. Libyan J Med., 2020, 15(1): 1730550

[94]

Mouraux A, Bannister K, Becker S, et al.. Challenges and opportunities in translational pain research–An opinion paper of the working group on translational pain research of the European pain federation (EFIC). Eur J Pain., 2021, 25(4): 731-756

[95]

Lerman I, Bu Y, Singh R, et al.. Next generation bioelectronic medicine: making the case for non-invasive closed-loop autonomic neuromodulation. Bioelectron Med., 2025, 11(1): 1

[96]

Long J, Zhu J, Ma D. Research progress and future perspective in anaesthesiology. Anesthesiol Perioper Sci., 2025, 3(4): 66

Funding

Natural Science Foundation of Hainan Province(No. 825MS198)

RIGHTS & PERMISSIONS

The Author(s), under exclusive licence to the Huazhong University of Science and Technology

PDF

2

Accesses

0

Citation

Detail

Sections
Recommended

/