Evidence map›Paper›PMID 42700197›Full record

ReviewCurrent pain and headache reports2026

Neuroimmune Phenotyping as the Next Frontier in Chronic Pain Medicine for Musculoskeletal Back Pain.

Samer G Salman, Rohan A Phadke, Adithya Nair, Rahul Kumar, Arbaz Momin, Alireza Tavakkoli, James Rizkalla

Abstract readReview
In one paragraph

Review in Current pain and headache reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Samer G SalmanSchool of Medicine, Baylor College of Medicine, Houston, TX, USA. samer.salman@bcm.edu.ORCID https://orcid.org/0009-0007-9897-4071
Rohan A PhadkeSchool of Medicine, Baylor College of Medicine, Houston, TX, USA.
Adithya NairSchool of Medicine, Baylor College of Medicine, Houston, TX, USA.
Rahul KumarT.H. Chan School of Medicine, UMass Chan Medical School, Worcester, MA, USA.
Arbaz MominDepartment of Neurosurgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Alireza TavakkoliHuman-Machine Perception Laboratory, Department of Computer Science, University of Nevada, Reno, NV, USA.
James RizkallaDepartment of Orthopaedic Surgery, Baylor University Medical Center, Dallas, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic low back pain encompasses heterogeneous mechanical, neuropathic, nociplastic, and myofascial presentations that may reflect distinct neuroimmune mechanisms. We synthesized evidence linking these phenotypes to measurable biological features and clinically relevant treatment strategies.

methodsWe conducted a structured literature search of MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials for studies published from January 2005 through January 2025. Systematic reviews, randomized controlled trials, and mechanistic studies addressing neuroinflammation, glial activation, central sensitization, biomarkers, or imaging were organized according to four clinically relevant pain phenotypes and translational readiness.

resultsNeuroimmune findings differed across axial mechanical, radicular neuropathic, nociplastic, and myofascial pain. Imaging of the 18-kDa translocator protein demonstrated phenotype-associated neuroinflammatory patterns, whereas shear wave elastography provided an objective measure of myofascial trigger-point stiffness. Combining inflammatory biomarkers with psychosocial characteristics improved chronic pain prediction, with reported areas under the receiver operating characteristic curve ranging from 0.69 to 0.92. Evidence also supported phenotype-aligned approaches including targeted rehabilitation, ultrasound-guided dry needling, dorsal root ganglion stimulation, and spinal cord stimulation. However, biomarker validation, imaging standardization, and clinical availability varied substantially.

conclusionNeuroimmune phenotyping provides a framework for connecting pain mechanisms with diagnostic and therapeutic strategies in chronic low back pain. Shear wave elastography and selected inflammatory measures appear closest to clinical implementation, while advanced neuroimaging and multi-omic approaches remain investigational. Phenotype-enriched prospective trials are needed before routine precision-guided management can be established.

Indexed as

Chronic PainLow Back PainMusculoskeletal PainNeuroimmunomodulationBiomarkersHumansPhenotypeBiomarkersChronic low back painImaging biomarkersNeuroimmune mechanismsNeuroinflammationPain phenotypingPrecision rehabilitation

Identifiers

PMID42700197
PMCPMC13546305

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.