Needle-Related Procedural Pain: An Integrated Nervous-System Framework from Tissue Mechanics to Central Processing—A Systematic Review

Background/Objectives: Needle procedures cause acute pain through mechanical, chemical, sensory, and affective processes. We synthesized human and animal evidence and developed a framework spanning peripheral nociception, spinal/trigeminal modulation, central processing, and clinical outcomes.

Methods

This PRISMA 2020 review was registered in PROSPERO (CRD420261477391). PubMed/MEDLINE, Embase, and Web of Science were searched from inception through June 2026. Eligible studies examined pain or mechanistic outcomes during needle procedures. Evidence was classified as peripheral, central, or mixed. Human comparisons were pooled as Hedges’ g using random-effects models.