Dr. Muhammad Aasam Masoom Maan is a Consultant in Anesthesia at King Salman Bin Abdulaziz Medical City, Madina, Saudi Arabia. He holds FCPS qualifications in Anesthesia and Pain Medicine from the College of Physicians and Surgeons Pakistan. Previously, he served as Assistant Professor in the Department of Anesthesia, Pain and ICU at Faisalabad Medical University and undertook fellowship training in algology at Akdeniz University Hospital, Turkey.

His clinical and research work spans chronic pain management, regional anesthesia, interventional pain therapies, and perioperative care. He has contributed to scientific publications, authored books on anesthesia and pain medicine, and presented at international conferences. His achievements include first prize for a paper presentation at the 2019 ESRA World Congress in Bilbao, Spain. He has also contributed to medical education, conference organization, and community pain management services.

From Neuronal Mechanisms to Precision Intervention: Redefining Neuropathic Pain Management Through DRG-Targeted Therapies and Personalized Care

Background: Neuropathic pain remains a major therapeutic challenge because of its heterogeneous mechanisms, variable treatment responses, and substantial impact on quality of life. Conventional diagnosis-based treatment strategies often fail to account for individual differences in sensory phenotypes, neuronal excitability, and underlying pathophysiology.

Objective: To explore how advances in dorsal root ganglion (DRG) neuroscience, precision phenotyping, and targeted interventions may inform a more individualized approach to neuropathic pain management.

Methods: This narrative review synthesizes contemporary evidence on DRG-mediated pain mechanisms, including ectopic neuronal firing, peripheral sensitization, altered sensory processing, and neuroimmune interactions. It examines the clinical relevance of sensory phenotyping and evaluates the therapeutic roles of mechanism-informed pharmacotherapy, DRG-targeted procedures, and neuromodulation, particularly DRG stimulation in selected patients with refractory neuropathic pain.

Discussion: The DRG represents a critical interface between peripheral nerve injury and persistent neuropathic pain, offering opportunities for targeted therapeutic intervention. Integrating clinical assessment with sensory phenotyping and mechanism-based treatment selection may improve patient stratification and support more rational therapeutic decisions. DRG stimulation offers a targeted neuromodulation option for selected refractory conditions, although outcomes depend on patient selection, pain etiology, and procedural considerations. Important challenges include the limited availability of validated biomarkers, variability in treatment response, procedural costs, and unequal access to advanced therapies.

Conclusion: Translating neuronal mechanisms into personalized interventions may help advance neuropathic pain care beyond conventional symptom-based approaches. A precision-oriented framework integrating phenotype-guided pharmacotherapy, appropriately selected DRG-targeted interventions, and longitudinal outcome assessment offers a promising direction toward more effective, patient-centered pain management.

Keywords: Neuropathic pain; dorsal root ganglion; precision medicine; sensory phenotyping; neuromodulation; personalized pain management.