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Update on Managing Neuropathic Pain

Author(s):  McNulty Jack P, Muller George

Issue:  May/Jun 2009 - Pain Management
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Abstract:  Severe chronic neuropathic pain, which can profoundly and negatively affect quality of life, is usually caused by damage to peripheral nerve tissue from various physical, thermal, or chemical agents and is diffi cult to relieve. Commonly used opioids are quite effective in relieving nociceptive pain, but nerves that are damaged send pain-sensing fibers into an area of the spinal cord in which there are no mu or kappa receptors to receive opioids or the endogenous endorphins that relieve pain. Clinicians who treat neuropathic pain face daunting therapeutic challenges, but specifi c analgesic agents have proven effective in relieving that excruciating discomfort. In this article, drugs that target neuropathic pain are discussed, and case reports of patients who have overcome nerve-related pain are presented. Formulations for effective analgesic preparations useful in treating neuropathic pain are included.

Related Keywords: Jack P. McNulty, MD, FACP, FAAHPM, George Muller, RPh, neuropathic pain, neuropathy, neuralgia, pain relief, pain control, analgesic, analgesia, ketamine, gabapentin, clonidine, lidocaine, methadone, Pluronic Lecithin Organogel, topical preparations, transdermal administration, formulations, opioid conversion, levorphanol, NMDA receptors, morphine, case series, lorazepam, case reports, ketoprofen, nonsteroidal anti-inflammatory drugs, NSAIDs


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