Came across this well written paper that I thought some of you might find interesting. It's long, below is the abstract only. It looks like it was first published 10 years ago. Interestingly - and frustratingly - it seems not much has changed in terms of drug options. Go to the URL for the entire document.
Treating Neuropathic Pain And The Neuropathic Pain Patient
John T. Farrar, MD, MSCE
Departments of Anesthesiology, Neurology, and Epidemiology, the Center for Clinical Epidemiology and Biostatistics, the University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania.
Correspondence: John T. Farrar, MD, MSCE Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 423 Guardian Drive, Blockley Hall, Room 816, Philadelphia, Pennsylvania.
Neurologists have the option of choosing from among numerous drugs and drug classes when treating neuropathic pain. The challenge, therefore, lies not in having limited options for treatment, but in the art of practicing medicine, i.e., of identifying neuropathic pain and empathizing with the patient without the benefit of either an objective test or a complete understanding of pain pathophysiology, and providing the best evidence-based options for therapy. The International Association for the Study of Pain definition of pain - a sensory and emotional experience, signaling actual or potential tissue damage - illustrates the dual nature, both objective and subjective, of this condition. The neurologist's unique understanding of the complex interactions that occur in the nervous system can provide a significant contribution to the care of patients with pain.
Additionally, we must remember that many patients, unable to quantitatively describe their pain and witnessing the medical community's lack of codified remedies, leave the physician's office thinking that the practitioner views their pain, even when incapacitating, as psychosomatic. An equally important role of the practicing neurologist, therefore, is to acknowledge the patient's experience of pain without attempting to validate its source. This article includes strategies for approaching a neuropathic pain patient, useful methods to treat the whole patient, and a discussion of why a holistic approach is important. An overview of the pharmacotherapies available for the treatment of neuropathic pain and their role in treating the whole patient is also provided.
Copyright 2001 Galen Publishing, LLC. First published in the September 2001 issue of Advanced Studies in Medicine, New Developments in the Management of Migraine and Neuropathic Pain (Volume 1, Number 6: 241-247), www.ASIMCME.com.
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