{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:29:36Z","timestamp":1785403776954,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2022-NR071976"],"award-info":[{"award-number":["RS-2022-NR071976"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"award":["RS-2022-NR071976"],"award-info":[{"award-number":["RS-2022-NR071976"]}],"id":[{"id":"https:\/\/ror.org\/013aysd81","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: In zoster-associated pain (ZAP), earlier epidural steroid injection (ESI) has been associated with better outcomes, but optimal timing remains unclear, and prior studies have largely relied on pain reduction alone. Methods: In this multicenter retrospective cohort, 215 patients with ZAP who completed a three-session ESI course were classified into early (&lt;30 days) and delayed (\u226530\u2013\u2264180 days) groups. The primary endpoint was complete remission at 12 weeks (\u226550% visual analog scale [VAS] reduction, VAS \u2264 2, and sensory normalization); successful response (\u226550% VAS reduction) served as the secondary endpoint. An ordered three-category framework and an exploratory generalized Youden index threshold analysis were applied. Results: Complete remission occurred in 82.1% versus 39.0% and successful response in 91.7% versus 67.8%. Each additional day of delay was associated with lower odds of complete remission (adjusted odds ratio [aOR], 0.957; p &lt; 0.001) and higher odds of a worse outcome category (aOR, 1.030; p &lt; 0.001). Exploratory candidate boundaries were 22 and 42 days. Conclusions: Earlier ESI initiation was associated with a higher likelihood of complete remission incorporating pain reduction, low residual pain intensity, and sensory normalization. These findings highlight the clinical relevance of treatment timing and recovery assessment beyond pain reduction alone in ZAP.<\/jats:p>","DOI":"10.3390\/life16060869","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:42:18Z","timestamp":1779691338000},"page":"869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Time to Epidural Steroid Injection and Complete Remission in Zoster-Associated Pain: A Multicenter Retrospective Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Yongsoo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Hee","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7506-1375","authenticated-orcid":false,"given":"Hee Yong","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harin","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeji","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6328-6948","authenticated-orcid":false,"given":"Hye Sun","family":"Lee","sequence":"additional","affiliation":[{"name":"Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5125-3129","authenticated-orcid":false,"given":"Jung Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e004833","DOI":"10.1136\/bmjopen-2014-004833","article-title":"Systematic review of incidence and complications of herpes zoster: Towards a global perspective","volume":"4","author":"Kawai","year":"2014","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1503\/cmaj.091711","article-title":"The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: A prospective study","volume":"182","author":"Drolet","year":"2010","journal-title":"CMAJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/0304-3959(96)03122-3","article-title":"Pain and its persistence in herpes zoster","volume":"67","author":"Dworkin","year":"1996","journal-title":"Pain"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1056\/NEJMcp1403062","article-title":"Postherpetic neuralgia","volume":"371","author":"Johnson","year":"2014","journal-title":"N. 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