open access
Diagnosis and management of neuropathic pain: Review of literature and recommendations of the Polish Association for the Study of Pain and the Polish Neurological Society – Part one
Affiliations- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
- Department of Pain Research and Treatment, Chair of Anaesthesiology and Intensive Care, Jagiellonian University Medical College, Cracow, Poland
- Department of Pain Treatment and Palliative Care, Chair of Internal Diseases and Gerontology, Jagiellonian University Medical College, Cracow, Poland
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
- Department of Palliative Care, Nicolaus Copernicus University – Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
- Department of Palliative Care, Karol Marcinkowski University School of Medical Sciences, Poznań, Poland
- Department of Clinical Pharmacology, Chair of Pharmacology, Jagiellonian University Medical College, Cracow, Poland
- Department of Palliative Care and Medicine, Division of Nursing, School of Health Care, Medical University of Silesia, Katowice, Poland
- Department of Anaesthesiology and Intensive Care, Medical Centre for Postgraduate Education, Warsaw, Poland
open access
Abstract
Neuropathic pain still present a major diagnostic and therapeutic challenge despite considerable progress in understanding of its mechanisms and publication of number of studies which assessed the efficacy and safety of drugs used in the symptomatic treatment. In practice, it is diagnosed less frequently than recognised in the epidemiological studies, and many patients do not achieve satisfactory outcomes of treatment. A multidisciplinary team of Polish experts, commissioned by the Polish Association for the Study of Pain and the Polish Neurological Society, has reviewed the literature on neuropathic pain, with special focus on the published international recommendations, and formulated recommendations on neuropathic pain diagnosis and treatment, in accordance with the principles of evidence-based medicine. The paper presents also background information on the neuropathic pain definition, epidemiology, pathomechanism and method of assessment. The diagnosis of neuropathic pain may be established based on medical history and physical examination including special assessment of the somatosensory system. First-line drugs used in pharmacological management of neuropathic pain are: tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin, opioids and lidocaine patches.
Abstract
Neuropathic pain still present a major diagnostic and therapeutic challenge despite considerable progress in understanding of its mechanisms and publication of number of studies which assessed the efficacy and safety of drugs used in the symptomatic treatment. In practice, it is diagnosed less frequently than recognised in the epidemiological studies, and many patients do not achieve satisfactory outcomes of treatment. A multidisciplinary team of Polish experts, commissioned by the Polish Association for the Study of Pain and the Polish Neurological Society, has reviewed the literature on neuropathic pain, with special focus on the published international recommendations, and formulated recommendations on neuropathic pain diagnosis and treatment, in accordance with the principles of evidence-based medicine. The paper presents also background information on the neuropathic pain definition, epidemiology, pathomechanism and method of assessment. The diagnosis of neuropathic pain may be established based on medical history and physical examination including special assessment of the somatosensory system. First-line drugs used in pharmacological management of neuropathic pain are: tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin, opioids and lidocaine patches.
Keywords
Neuropathic pain, Diagnosis of neuropathic pain, Assessment of neuropathic pain, Pharmacological treatment of neuropathic pain, Evidence-based recommendations
About this articleTitle
Diagnosis and management of neuropathic pain: Review of literature and recommendations of the Polish Association for the Study of Pain and the Polish Neurological Society – Part one
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Review Article
Pages
262-271
Page views
254
Article views/downloads
402
DOI
10.1016/j.pjnns.2014.07.011
Bibliographic record
Neurol Neurochir Pol 2014;48(4):262-271.
Keywords
Neuropathic pain
Diagnosis of neuropathic pain
Assessment of neuropathic pain
Pharmacological treatment of neuropathic pain
Evidence-based recommendations
Authors
Andrzej Szczudlik
Jan Dobrogowski
Jerzy Wordliczek
Adam Stępień
Małgorzata Krajnik
Wojciech Leppert
Jarosław Woroń
Anna Przeklasa-Muszyńska
Magdalena Kocot-Kępska
Renata Zajączkowska
Marcin Janecki
Anna Adamczyk
Małgorzata Malec-Milewska
