Recommendations for neuropathic pain treatment.
Damage to the somatosensory nervous system poses a risk for the development of neuropathic pain. Such an injury to the nervous system results in a series of neurobiological events resulting in sensitization of both the peripheral and central nervous system. The symptoms include continuous background pain (often burning or crushing in nature) and spasmodic pain (shooting, stabbing or "electrical"). The diagnosis of neuropathic pain is based primarily on the history and physical examination finding. Although monotherapy is the ideal approach, rational polypharmacy is often pragmatically used. Several classes of drugs are moderately effective, but complete or near-complete relief is unlikely. Antidepressants and anticonvulsants are most commonly used. Opioid analgesics can provide some relief but are less effective than for nociceptive pain; adverse effects may prevent adequate analgesia. Topical drugs and a lidocaine-containing patch may be effective for peripheral syndromes. Sympathetic blockade is usually ineffective except for some patients with complex regional pain syndrome.
Demarin
Vida
V
University Department of Neurology, Sestre milosrdnice University Hospital, Zagreb, Croatia.
Basić-Kes
Vanja
V
Zavoreo
Iris
I
Bosnar-Puretić
Marijana
M
Rotim
Kresimir
K
Lupret
Velimir
V
Perić
Mladen
M
Ivanec
Zeljko
Z
Fumić
Lidija
L
Lusić
Ivo
I
Aleksić-Shihabis
Anka
A
Kovac
Biserka
B
Ivanković
Mira
M
Skobić
Helena
H
Maslov
Boris
B
Bornstein
Natan
N
Niederkorn
Kurt
K
Sinanović
Osman
O
Rundek
Tanja
T
D015670:Acupuncture Therapy; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation