Modern Approaches to the Diagnosis, Treatment, and Prevention of Neuralgias in Military Personnel: Clinical Experience and Prospects for Enhancing Medical Support in the Armed Forces

Introduction. Neuralgias in military personnel represent a pressing medical and social issue, as chronic neuropathic pain significantly reduces combat readiness, physical performance, and the quality of life of service members. The aim of this study was to examine the clinical characteristics, diagnostic methods, treatment, and prevention of various types of neuralgias (trigeminal, postherpetic, occipital, intercostal, sciatica, and others) in military personnel. The study included one hundred twenty cases recorded at the Military Educational and Scientific Center of the Air Force from 2018 to 2023. Materials and methods. A retrospective analysis was conducted to assess clinical manifestations, etiology, diagnostic procedures (neurological examination, MRI, CT, electroneuromyography, diagnostic nerve blocks), as well as treatment outcomes and preventive measures. Results. The most frequently diagnosed types were sciatica (33.3%) and occipital neuralgia (20.8%). Chronic pain lasting more than 3 months was observed in 30% of patients. Standard first-line therapies (carbamazepine, gabapentin, pregabalin, amitriptyline, duloxetine) led to complete remission in 67% of cases and partial improvement in 29%. In treatment-resistant cases, physiotherapy, botulinum toxin injections, and neurosurgical interventions were employed. Preventive measures included Varicella Zoster virus vaccination, regular medical check-ups, health education, and improvements in the ergonomic design of military equipment. Conclusion. The implementation of modern approaches to the diagnosis and treatment of neuralgias at the Military Educational and Scientific Center of the Air Force ensures high effectiveness of medical care: over 90% of servicemen returned to duty after treatment. Prospects for improvement include the establishment of specialized centers in military hospitals, the development of departmental clinical guidelines for neuropathic pain treatment, training of medical personnel in early detection and multidisciplinary management of patients with neuralgia, as well as further exploration of new methods (gene therapy, neuromodulation) for patients with refractory pain.