Phenol Neurolysis for Refractory Non-Cancer Chronic Pain: Re-Evaluating an Established Technique in Modern Pain Practice.

PURPOSE OF REVIEW: To critically reevaluate the role of phenol neurolysis in the management of refractory chronic non-cancer pain, focusing on mechanisms of action, formulations, clinical indications, procedural techniques, therapeutic efficacy, safety profile, economic considerations, and its relevance in the era of modern interventional pain therapies.

RECENT FINDINGS: Emerging evidence suggests that phenol neurolysis may provide meaningful analgesia and functional improvement in selected patients with refractory non-cancer pain, including spasticity, trigeminal neuralgia, osteoarthritis, coccydynia, and sympathetically maintained pain. However, available studies remain limited, heterogeneous, and largely observational, with substantial variability in concentrations, indications, and techniques. The overall quality of evidence is predominantly low to moderate. Despite declining use in contemporary practice, phenol neurolysis remains a potentially valuable option in selected clinical scenarios, particularly in resource-constrained settings. Significant knowledge gaps and lack of procedural standardization underscore the need for high-quality prospective research to better define its role in modern pain management.