Shoulder Arthroplasty, Rotator Cuff Repair, Postoperative Complications, Arthrofibrosis, Periprosthetic Infection, Implant Loosening, Arthroscopic Surgery, Integrative Review

Pain is a complex and multidimensional biological experience with sensory, emotional, and neurophysiological aspects, which can be categorized into nociceptive, neuropathic, and nociplastic (depending on the underlying mechanisms and not on the symptoms) in general. This review paper is a unanimous synthesis of experimental results of validated animal models to explain the molecular, inflammatory, oxidative, and neuroplastic pathways involved in such categories of pains. Paradigms of carrageenan-induced inflammation, chronic constriction injury, spared nerve injury and fibromyalgia-like models have identified important biological targets in NF- B, COX-2, 5-LOX, TRPV1 channels, NMDA receptors, ERK/MAPK signaling cascades, and glial activation markers. Preclinical studies have shown that herbal bioactives, including curcumin, resveratrol, boswellic acids, withanolides, and quercetin, among other phytochemicals, have a multimodal analgesic mechanism involving inhibition of pro-inflammatory cytokines, inhibition of oxidative stress, ion channel modulators and ion channel regulation. The review also highlights the significance of a pharmacokinetic profiling, safety and toxicity assessment, dose translation plans, and phytochemical standardization to improve the translational reliability. This paper combines mechanistic knowledge with methodological adequacy and suggests a more systematic herbal supervision model to promote the evidence-based, integrative, and mechanism-centred approaches to holistic and precision-focused pain management