Diagnosis and treatment of pain in plexopathy, radiculopathy, peripheral neuropathy and phantom limb pain. Evidence and recommendations from the Italian Consensus Conference on Pain on Neurorehabilitation.
Pain may affect all aspects of social life and reduce the quality of life. Neuropathic pain (NP) is common in patients affected by plexopathy, radiculopathy, mononeuropathy, peripheral neuropathy. Phantom limb pain (PLP) is a painful sensation that is common after amputation, and its pathophysiological mechanisms involve changes in the peripheral and central nervous system. Given the lack of conclusive evidence and specific guidelines on these topics, the aim of the Italian Consensus Conference on Pain on Neurorehabilitation (ICCPN) was to collect evidence and offer recommendations to answer currently open questions on the assessment and treatment of NP associated with the above conditions and PLP. When no evidence was available, recommendations were based on consensus between expert opinions. Current guidelines on the assessment and pharmacological treatment of NP can be applied to plexopathy, radiculopathy, mononeuropathy, peripheral neuropathy, while evidence for invasive treatments and physical therapy is generally poor because of the low quality of studies. Treatment of PLP is still unsatisfactory. Data on the functional outcome and impact of pain on neurorehabilitation outcome in these conditions are lacking. In most cases, a multidisciplinary approach is recommended to offer a better outcome and reduce side effects. High quality studies are requested to address the unmet needs in this field.
Section of Neuromotor Rehabilitation, Department of Neuroscience, ASST Carlo Poma, Mantova, Italy - francesco.ferraro@asst-mantova.it.
Francesco
F
Ferraro
University of Parma, Parma, Italy.
Marco
M
Jacopetti
Department of Systems Medicine, University of Tor Vergata, Rome, Italy.
Vincenza
V
Spallone
Department of Geriatrics, Neurosciences and Orthopaedics, Catholic University, Rome, Italy.|Don Carlo Gnocchi Foundation, Milan, Italy.
Luca
L
Padua
IRCCS Santa Lucia Foundation, Rome, Italy.
Marco
M
Traballesi
IRCCS Santa Lucia Foundation, Rome, Italy.
Stefano
S
Brunelli
Physical and Rehabilitation Medicine Unit, University of Tor Vergata, Rome, Italy.
Cristina
C
Cantarella
Physical and Rehabilitation Medicine Unit, University of Tor Vergata, Rome, Italy.
Cristina
C
Ciotti
Department of Orthopedics, Sapienza University, Rome, Italy.
Daniele
D
Coraci
Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.|Physical Medicine and Rehabilitation Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Elena
E
Dalla Toffola
Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Silvia
S
Mandrini
IRCCS Santa Lucia Foundation, Rome, Italy.
Giovanni
G
Morone
Don Carlo Gnocchi Foundation, Milan, Italy.
Costanza
C
Pazzaglia
Neurology Unit, Villa Sofia Cervello Hospitals, Palermo, Italy.
Marcello
M
Romano
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, DiNOGMI, University of Genoa, Genoa, Italy.
Angelo
A
Schenone
Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Rossella
R
Togni
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Stefano
S
Tamburin
D020516:Brachial Plexus Neuropathies / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D006801:Humans; D007558:Italy; D009437:Neuralgia / Q000209:etiology* / Q000534:rehabilitation*; D000066530:Neurological Rehabilitation / Q000379:methods*; D017063:Outcome Assessment, Health Care; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010591:Phantom Limb / Q000534:rehabilitation*; D011843:Radiculopathy / Q000534:rehabilitation*; D057170:Translational Research, Biomedical