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Neuropathic pain
Eric Kerstman1, Sangmin Ahn, Sree Battu
1Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
Handbook of Clinical Neurology
|January 15, 2013
Summary
Neuropathic pain, distinct from nociceptive pain, poses diagnostic and treatment challenges. Effective management often requires a multimodal approach combining pharmacological and non-pharmacological therapies for optimal patient outcomes.
Area of Science:
- Neurology
- Pain Medicine
- Clinical Neuroscience
Background:
- Neuropathic pain presents significant diagnostic and therapeutic challenges.
- It imposes a substantial burden on individuals and society, necessitating better resource assessment for healthcare policy.
- The pathophysiology of neuropathic pain remains incompletely understood, with several proposed mechanisms.
Purpose of the Study:
- To provide a comprehensive overview of neuropathic pain syndrome.
- To discuss its classification, epidemiology, pathophysiology, diagnosis, and treatment.
- To highlight the need for evidence-based approaches in managing this condition.
Main Methods:
- Systematic clinical assessment including detailed history, physical examination, and diagnostic testing.
- Review of proposed pathophysiological mechanisms (e.g., central/peripheral sensitization, deafferentation, neurogenic inflammation).
- Evaluation of pharmacological (antidepressants, antiepileptics, topical anesthetics, opioids) and non-pharmacological treatments (psychological, physical therapy, interventional, surgical).
Main Results:
- Neuropathic pain can be differentiated from nociceptive pain through clinical presentation.
- Pharmacological and non-pharmacological treatment modalities exist, with combination therapy potentially offering superior efficacy.
- Clinical practice guidelines offer an evidence-based framework for treatment.
Conclusions:
- Neuropathic pain requires a systematic diagnostic and therapeutic approach.
- Multimodal treatment strategies, combining various therapies, are often necessary for effective management.
- Further research into pathophysiology and resource utilization is warranted to improve patient care and healthcare policy.
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