title: Diagnosis and management of neuropathic pain: review of literature and recommendations of the Polish Association for the study of pain and the Polish Neurological Society - part one.
abstract: Neuropathic pain still present a major diagnostic and therapeutic challenge despite considerable progress in understanding of its mechanisms and publication of number of studies which assessed the efficacy and safety of drugs used in the symptomatic treatment. In practice, it is diagnosed less frequently than recognised in the epidemiological studies, and many patients do not achieve satisfactory outcomes of treatment. A multidisciplinary team of Polish experts, commissioned by the Polish Association for the Study of Pain and the Polish Neurological Society, has reviewed the literature on neuropathic pain, with special focus on the published international recommendations, and formulated recommendations on neuropathic pain diagnosis and treatment, in accordance with the principles of evidence-based medicine. The paper presents also background information on the neuropathic pain definition, epidemiology, pathomechanism and method of assessment. The diagnosis of neuropathic pain may be established based on medical history and physical examination including special assessment of the somatosensory system. First-line drugs used in pharmacological management of neuropathic pain are: tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin, opioids and lidocaine patches.
authors.affiliation: Department of Neurology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szczudlik
authors.affiliation: Department of Pain Research and Treatment, Chair of Anaesthesiology and Intensive Care, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Dobrogowski
authors.affiliation: Department of Pain Treatment and Palliative Care, Chair of Internal Diseases and Gerontology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Wordliczek
authors.affiliation: Department of Neurology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Stępień
authors.affiliation: Department of Palliative Care, Nicolaus Copernicus University - Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Krajnik
authors.affiliation: Department of Palliative Care, Karol Marcinkowski University School of Medical Sciences, Poznań, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Leppert
authors.affiliation: Department of Pain Treatment and Palliative Care, Chair of Internal Diseases and Gerontology, Jagiellonian University Medical College, Cracow, Poland; Department of Clinical Pharmacology, Chair of Pharmacology, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Woroń
authors.affiliation: Department of Pain Research and Treatment, Chair of Anaesthesiology and Intensive Care, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Przeklasa-Muszyńska
authors.affiliation: Department of Pain Research and Treatment, Chair of Anaesthesiology and Intensive Care, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kocot-Kępska
authors.affiliation: Department of Pain Research and Treatment, Chair of Anaesthesiology and Intensive Care, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Renata
authors.initials: R
authors.lastname: Zajączkowska
authors.affiliation: Department of Palliative Care and Medicine, Division of Nursing, School of Health Care, Medical University of Silesia, Katowice, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Janecki
authors.affiliation: Department of Palliative Care, Nicolaus Copernicus University - Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Adamczyk
authors.affiliation: Department of Anaesthesiology and Intensive Care, Medical Centre for Postgraduate Education, Warsaw, Poland. Electronic address: lmilewski@post.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Malec-Milewska
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D006801:Humans; D009437:Neuralgia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D059408:Pain Management / Q000379:methods*; D011044:Poland / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012955:Societies, Medical
chemical_list: D000700:Analgesics
keywords: Assessment of neuropathic pain; Diagnosis of neuropathic pain; Evidence-based recommendations; Neuropathic pain; Pharmacological treatment of neuropathic pain