Neuropathic pain is a debilitating condition that affects up to 10% of the global population, with conditions such as diabetic peripheral neuropathy, postherpetic neuralgia, and chemotherapy-induced nerve pain causing significant impacts on quality of life. A recent international study conducted by the International Association for the Study of Pain Neuropathic Pain Special Interest Group has provided the most comprehensive evidence to date on treatments for neuropathic pain.
Doctoral researcher Michael Ferraro, from the Center for Pain IMPACT at NeuRA and the School of Health Sciences UNSW, was involved in the study. The research focused on evaluating the effectiveness, safety, cost, accessibility, and patient perspectives of various drug and nerve stimulation treatments for neuropathic pain. Published in The Lancet Neurology, the systematic review and meta-analysis included data from 313 randomized controlled trials involving nearly 50,000 adult participants.
The study made recommendations for first-, second-, and third-line treatments for neuropathic pain. First-line treatments included alpha-2 delta ligands (e.g., pregabalin, gabapentin), serotonin and norepinephrine reuptake inhibitors (e.g., duloxetine), and tricyclic antidepressants (e.g., amitriptyline). Second-line therapies included capsaicin and lidocaine patches, capsaicin cream, and for the first time, repetitive transcranial magnetic stimulation. The research also found inconclusive evidence for certain treatments and recommended against the use of cannabis-based products.
Ferraro emphasized the importance of patient-centered care in the management of neuropathic pain, highlighting the need for individualized treatment plans that consider the unique needs, values, and preferences of each patient. The guidelines are intended for use by a wide range of healthcare professionals, including those in specialist and primary care settings.
Future revisions of the guidelines may focus on non-drug, non-surgical interventions for neuropathic pain, such as exercise. The goal is to prioritize research in these areas to provide more comprehensive treatment options for patients. The recommendations aim to improve the quality of care for individuals living with neuropathic pain and reduce the social and economic burden associated with the condition.
In conclusion, the recent study provides evidence-based recommendations for the management of neuropathic pain, offering valuable insights into effective treatments and highlighting the importance of personalized care for individuals with this condition. By following the guidelines outlined in the study, healthcare professionals can better support patients in managing neuropathic pain and improving their quality of life.
