Neuropathic pain presents a therapeutic challenge because patients cannot be relieved from it, even when all known medical options have been tried. Several treatment guidelines have been provided, and several pharmacotherapies have been proposed with non-pharmacological treatments. This study aimed to present the current pharmacological and non-pharmacological treatments used to treat patients with neuropathic pain. Furthermore, several treatment guidelines for neuropathic pain are compared.Current Concepts: Tricyclic antidepressants, gabapentinoids, and serotonin-norepinephrine reuptake inhibitors are the first-line agents recommended by clinical guidelines in several countries. Tramadol and topical agents are recommended as second-line agents. Opioids and cannabinoids are recommended as third-line agents; cannabinoids are recommended by Canadian treatment guidelines. Combination therapy may be more effective because it results in synergistic pain-relieving effects, and the individual drug dose may be lower. Non-pharmacologic treatment is recommended as third-line or supplementary management because of the lack of evidence.Discussion and Conclusion: Several guidelines have recommended similar drugs; however, it is impossible to completely cure neuropathic pain. Therefore, therapeutic goals must be realistically discussed to improve patient compliance. In addition, additional studies based on pathophysiological mechanisms should be conducted to improve the management of neuropathic pain.

Neuropathic pain presents a therapeutic challenge because patients cannot be relieved from it, even when all known medical options have been tried. Several treatment guidelines have been provided, and several pharmacotherapies have been proposed with non-pharmacological treatments. This study aimed to present the current pharmacological and non-pharmacological treatments used to treat patients with neuropathic pain. Furthermore, several treatment guidelines for neuropathic pain are compared.Current Concepts: Tricyclic antidepressants, gabapentinoids, and serotonin-norepinephrine reuptake inhibitors are the first-line agents recommended by clinical guidelines in several countries. Tramadol and topical agents are recommended as second-line agents. Opioids and cannabinoids are recommended as third-line agents; cannabinoids are recommended by Canadian treatment guidelines. Combination therapy may be more effective because it results in synergistic pain-relieving effects, and the individual drug dose may be lower. Non-pharmacologic treatment is recommended as third-line or supplementary management because of the lack of evidence.Discussion and Conclusion: Several guidelines have recommended similar drugs; however, it is impossible to completely cure neuropathic pain. Therefore, therapeutic goals must be realistically discussed to improve patient compliance. In addition, additional studies based on pathophysiological mechanisms should be conducted to improve the management of neuropathic pain.

Progressive spastic weakness of the lower limbs is a major feature of hereditary spastic paraplegia (HSP) and primary lateral sclerosis (PLS). The motor band sign (MBS) is characterized by a band-like hypointensity along the precentral gyrus in susceptibility-weighted image of brain magnetic resonance imaging. This sign has been reported in amyotrophic lateral sclerosis and is recognized as an indirect marker of upper motor neuron degeneration. The presence of MBS could serve as a marker for PLS but not for HSP.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic autoimmune disease of the peripheral nervous system, primarily treated with corticosteroids and intravenous immunoglobulin as first-line therapies. Early treatment yields better outcome before nerve damage caused by the immune response. Once axonal damage has progressed, immunotherapy becomes ineffective, making early intervention crucial. Additionally, as treatment responses vary among patients, it is essential to assess treatment efficacy objectively and tailor therapy accordingly. Since there are currently no biomarkers that accurately reflect disease status, regular physical examinations are necessary to evaluate treatment effectiveness and adjust maintenance therapy. This review outlines the current clinical guidelines for the treatment of CIDP and explores emerging therapeutic options, including neonatal Fc receptor inhibitors and complement pathway inhibitors.

Progressive spastic weakness of the lower limbs is a major feature of hereditary spastic paraplegia (HSP) and primary lateral sclerosis (PLS). The motor band sign (MBS) is characterized by a band-like hypointensity along the precentral gyrus in susceptibility-weighted image of brain magnetic resonance imaging. This sign has been reported in amyotrophic lateral sclerosis and is recognized as an indirect marker of upper motor neuron degeneration. The presence of MBS could serve as a marker for PLS but not for HSP.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic autoimmune disease of the peripheral nervous system, primarily treated with corticosteroids and intravenous immunoglobulin as first-line therapies. Early treatment yields better outcome before nerve damage caused by the immune response. Once axonal damage has progressed, immunotherapy becomes ineffective, making early intervention crucial. Additionally, as treatment responses vary among patients, it is essential to assess treatment efficacy objectively and tailor therapy accordingly. Since there are currently no biomarkers that accurately reflect disease status, regular physical examinations are necessary to evaluate treatment effectiveness and adjust maintenance therapy. This review outlines the current clinical guidelines for the treatment of CIDP and explores emerging therapeutic options, including neonatal Fc receptor inhibitors and complement pathway inhibitors.

Progressive spastic weakness of the lower limbs is a major feature of hereditary spastic paraplegia (HSP) and primary lateral sclerosis (PLS). The motor band sign (MBS) is characterized by a band-like hypointensity along the precentral gyrus in susceptibility-weighted image of brain magnetic resonance imaging. This sign has been reported in amyotrophic lateral sclerosis and is recognized as an indirect marker of upper motor neuron degeneration. The presence of MBS could serve as a marker for PLS but not for HSP.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic autoimmune disease of the peripheral nervous system, primarily treated with corticosteroids and intravenous immunoglobulin as first-line therapies. Early treatment yields better outcome before nerve damage caused by the immune response. Once axonal damage has progressed, immunotherapy becomes ineffective, making early intervention crucial. Additionally, as treatment responses vary among patients, it is essential to assess treatment efficacy objectively and tailor therapy accordingly. Since there are currently no biomarkers that accurately reflect disease status, regular physical examinations are necessary to evaluate treatment effectiveness and adjust maintenance therapy. This review outlines the current clinical guidelines for the treatment of CIDP and explores emerging therapeutic options, including neonatal Fc receptor inhibitors and complement pathway inhibitors.