• Curr Opin Anaesthesiol · Oct 2013

    Review

    Neuropathic pain: treatment guidelines and updates.

    • Robert W Hurley, Meredith C B Adams, and Honorio T Benzon.
    • aDivision of Pain Medicine, Department of Anesthesiology, Psychiatry, Neurology, Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida bDepartment of Anesthesiology, North Florida/South Georgia Veterans Administration Hospital, University of Florida, Gainesville, Florida cDepartment of Anesthesiology, Northwestern University, Chicago, Illinois, USA *Robert W. Hurley and Meredith C.B. Adams contributed equally to the writing of this article.
    • Curr Opin Anaesthesiol. 2013 Oct 1; 26 (5): 580-7.

    Purpose Of ReviewThe purpose of this review is to provide an update on the diagnosis, treatment, and prevention of neuropathic pain.Recent FindingsNeuropathic pain can be debilitating, leading to poor quality of life and functional status. Neuropathic pain results from numerous mechanisms of nerve injury including infectious diseases, complication of medical diseases, and mechanical damage. As a result of the lack of class I evidence for the treatment of numerous neuropathic pain conditions, those diseases without such evidence are often managed, as though neuropathic pain is a singular condition. In diseases such as diabetes, HIV, and herpes infections, the resultant neuropathic pain is often modifiable with prevention strategies. In one of the more prevalent neuropathic pain conditions, radiculopathy, the commonly used treatments lack sufficient evidence to explain their widespread use.SummaryThe literature reveals that neuropathic pain is underdiagnosed and often undertreated or treated with ineffective or untested modalities. Evolving definitions of neuropathic pain has broadened the range of therapeutic approaches and brought current treatment paradigms under increased scrutiny. The lack of a mechanism-based approach to treatment may be responsible for the lackluster responses seen in most neuropathic pain conditions.

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