Unmet needs in the management of neuropathic pain.
Neuropathic pain is a challenging condition to treat. It is heterogeneous in nature and largely resistant to treatment with commonly prescribed analgesics. Current management strategies fail to achieve adequate or satisfactory pain relief in a high proportion of patients. The four main reasons that treatments for neuropathic pain fail are: inadequate diagnosis and a lack of appreciation of the mechanisms involved; insufficient management of comorbid conditions; incorrect understanding or selection of treatment options; and the use of inappropriate outcomes measures. These unmet needs in the current management of neuropathic pain are reviewed in this article. The review focuses on the need for a methodical and mechanistic approach to diagnosis, and a flexible, interdisciplinary approach to treatment of neuropathic pain conditions, in order to improve pain relief and quality of life in patients with neuropathic pain.
Harden
Norman
N
Rehabilitation Institute of Chicago, Chicago, IL 60677, USA.
Cohen
Mitchell
M
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000150:complications*; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination; D006801:Humans; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D019635:Neurosurgical Procedures / Q000379:methods; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods*; D010348:Patient Care Team; D017060:Patient Satisfaction; D010523:Peripheral Nervous System Diseases / Q000150:complications*; D017410:Practice Guidelines as Topic; D011786:Quality Control; D016032:Randomized Controlled Trials as Topic; D017211:Treatment Failure
D000889:Anti-Arrhythmia Agents; D000927:Anticonvulsants; D000928:Antidepressive Agents