A Treatment Guideline for Neuropathic Pain.
10.4184/jkss.2011.18.4.246
- Author:
Kook Jin CHUNG
1
;
Jae Hyup LEE
;
Changju HWANG
;
Myun Whan AHN
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Hallym University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Neuropathic pain;
Definition;
Diagnosis;
Treatment guideline
- MeSH:
Amines;
Analgesics, Opioid;
Anticonvulsants;
Antidepressive Agents, Tricyclic;
Cyclohexanecarboxylic Acids;
gamma-Aminobutyric Acid;
Humans;
Neuralgia;
Norepinephrine;
Peripheral Nervous System;
Serotonin;
Spinal Cord;
Tramadol
- From:Journal of Korean Society of Spine Surgery
2011;18(4):246-253
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: A review of literature including definition, diagnosis and treatment of neuropathic pain. OBJECTIVES: To review and discuss the treatment guideline for neuropathic pain. SUMMARY OF LITERATURE REVIEW: Neuropathic pains are characterized by partial or complete somatosensory change caused by various disorders affecting central and peripheral nervous system, and are especially problematic because of their severity, chronicity and resistance to simple analgesics. MATERIALS AND METHODS: Review of literature. RESULTS: Tricyclic antidepressants and the anticonvulsants gabapentin and pregablin were recommended as first-line treatments for neuropathic pain. Opioid analgesics and tramadol were recommended as second-line treatments that can be considered for first-line use in selected clinical circumstances. Other medications such as dual reuptake inhibitors of both serotonin and norepinephrine would be used in severe cases. More invasive interventions (e.g., spinal cord stimulation) may sometimes be helpful. CONCLUSIONS: Treatment must be individualized for each patient and aggressive, combinatory pharmacotherapy and multidisciplinary approach are recommended for the treatment of neuropathic pain.
