Overview of the Pharmacological Management of Neuropathic Pain

Neuropathic pain refers lesions or disease affecting the somatosensory nervous system either in the periphery or centrally. Examples of neuropathic pain include painful polyneuropathy, postherpetic neuralgia, trigeminal neuralgia, and post-stroke pain. Clinically, neuropathic pain is characterized by spontaneous ongoing or shooting pain and evoked amplified pain responses after noxious or non-noxious stimuli. Neuropathic pain is treated as a ‘blanket condition’ in this guideline regardless of its aetiologies, unless there is valid and robust clinical and health economics evidence that shows the clinical efficacy and cost effectiveness of a particular treatment for a specific neuropathic pain condition. Management of neuropathic pain requires an interdisciplinary approach, centered around pharmacological treatment. A better understanding of neuropathic pain and in particular of the translation of pathophysiological mechanisms into sensory signs will lead to a more effective and specific mechanism-based treatment approach.