Translating Classical Sinew Diagnostics into Standardized Geriatric Pain Care

Abstract

Chronic musculoskeletal pain in geriatric cohorts demands interventions that move beyond empirical, unstandardized modalities. Integrating traditional sinew pathology with modern trial design, this investigation introduces a protocolized combined external therapy targeting the pathological interplay between tendon degeneration and microcirculatory stagnation. The intervention standardizes a structured clinical pipeline that diagnoses and manages three distinct patterns: cold-induced stasis, damp-heat infiltration, and microvascular stagnation, delivering customized multi-technique interventions. To validate efficacy, an assessor-blinded, three-arm randomized trial is framed to benchmark the protocol against standard point-based care and non-intervention controls, tracking subjective pain intensity, objective nociceptive thresholds, and systemic inflammatory mediators. Community pilot insights confirm procedural viability while highlighting practical hurdles in practitioner concordance and patient heterogeneity. Overall, this work bridges traditional diagnostic principles with contemporary trial methodology, outlining a scalable framework for future large-scale, multicenter therapeutic evaluations.