Summary
Published online by Cambridge University Press: 19 October 2021
Summary
• Pain disorders affect patients, families, friends, and society as a whole. Neuropathic pain can be a great financial and emotional burden. Recognizing the variety of neuropathic pain disorders, and their common comorbidities and concomitant symptoms, is the first step in mitigating the profound impact that pain has on our patients and their families and our society as a whole.
• Pain disorders, even more than most other ailments, require careful attention to patient rapport, communication, and the optimum alleviation of symptoms so that activities of daily living can be maximized.
• The neurobiology of neuropathic pain disorders is complicated, including disorders that derive from precipitating factors and those that result from no apparent injury.
• Pain disorders appear to be progressive in nature. This calls to light the importance of recognizing and treating pain early in its course so as to avoid the use of disabling drugs and to avoid the deterioration of the patient.
• Several classes of pharmacoloy options for neuropathic pain exist with varying mechanisms. TCAs and SNRIs are hypothesized to work via dual norepinephrine and serotonin reuptake inhibition, hypothetically increasing nociceptive inhibition. Alpha 2 delta ligands are thought to effectively block pain associated with central sensitization by binding selectively to VSCCs. Anticonvulsants are thought to be effective in the management of neuropathic pain associated with peripheral sensitization by reducing ionic flow in VSSCs.
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- Publisher: Cambridge University PressPrint publication year: 2009