Neuropathic Pain News Archive
Reviewing the Efficacy, Safety, and Tolerability of Cannabis-Based Medicines for Chronic Neuropathic Pain
The effectiveness of cannabis-based products for chronic neuropathic pain is not supported by high-quality evidence.
The type of sciatic nerve lesions observed in patients with diabetic peripheral neuropathy was found to differ in type 1 and type 2 diabetes.
ZTlido is comprised of a non-aqueous adhesive material containing 1.8% lidocaine.
Cotargeting of peripheral μ-opioid and cannabinoid receptors was found to have a synergistic effect in reducing mechanical allodynia in a mouse model of neuropathic pain.
Resilience may mediate the relationships between positive affect and pain interference and depression in patients with multiple sclerosis.
A bedside quantitative sensory testing using inexpensive handheld devices indicates that this test may reliably be used to assess sensory profiles in patients with neuropathic pain.
Although peripheral neuropathy is one of the most common neurologic problems seen in the primary care setting, recognizing and evaluating peripheral neuropathy in a patient can be challenging due to its diverse presentations.
Investigators sought to determine whether repeated intravenous low-dose lidocaine could provide prolonged pain relief in patients with refractory neuropathic pain.
For patients with gluten neuropathy, following a strict gluten-free diet is associated with significantly reduced odds of peripheral neuropathic pain.
Substantial evidence suggests a close connection between neuropathic pain and mood disorders.
Researchers have developed a weighted score that may be useful in the differential diagnosis of complex regional pain syndrome.
Analgesics may be more effective in alleviating pain associated with postherpetic neuralgia compared with topical therapies, antivirals, antidepressants, and antiepileptics.
Ketamine infusion may provide short-term pain relief for patients with complex regional pain syndrome.
Depending on the extent of the injury, pain due to burns can range from mild to severe to excruciating.
Oral vitamin E supplementation consisting of 400 mg/day mixed tocotrienols for 1 year may not result in improved neuropathic pain symptoms in patients with diabetic peripheral neuropathy.
Systemic lidocaine administered via IV or patch has consistently shown effectiveness for the treatment and prevention of chronic pain.
An examination of treatment patterns among patients with trigeminal neuralgia suggests that this orofacial disorder appears to be significantly burdensome.
Microvascular decompression for trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia was found to be a largely safe procedure.
Patients with end-stage knee or hip osteoarthritis were found to often experience possible neuropathic pain - particularly pain at rest vs on activity, and in men.
Use of the 2006 vs 2007 criteria for the diagnosis of complex regional pain syndrome may lead to the misdiagnosis of patients experiencing unexplained excessive pain after total knee arthroplasty.
Opioids may be "life-transforming" for patients with refractory restless legs syndrome when taken in relatively low total daily doses, according to new guidelines.
Patients who are obese and experience knee pain were found to have improved pressure pain threshold at the patella and the wrist after weight loss associated with bariatric surgery vs medical management.
Evidence for the effectiveness of oxcarbazepine in painful diabetic neuropathy and other forms of neuropathic pain is limited.
Increasing evidence suggests a relationship between migraine and multiple sclerosis that is beyond comorbidity and may help clarify the pathophysiology of both disorders.
Online Cognitive Behavioral Therapy May Provide Pain Relief in Chemotherapy-Induced Peripheral Neuropathy
Self-guided online cognitive behavioral pain management may result in improved "worst" pain but not "average" pain compared with usual care for the treatment of painful chemotherapy-induced peripheral neuropathy.
Neuromodulation techniques have been explored as alternative treatment options in patients with trigeminal neuralgia who do not achieve adequate pain relief with pharmacologic therapies and surgical interventions.
Treatment with the capsaicin 8% patch Qutenza may be more effective than pregabalin for reducing the intensity and area of dynamic mechanical allodynia and for complete resolution of the disorder.
From 2002 to 2015, the percentage of individuals in the United States who used gabapentin and/or pregabalin increased in 1.2% to 3.9%.
Chronic pain experienced by patients with pachyonychia congenita may be caused by damage to the peripheral nerve fibers, with the hyperalgesia and allodynia observed in affected regions likely to be manifestations of peripheral sensitization.
Peripheral nerve stimulation may provide long-term pain relief in patients with painful mononeuropathy secondary to leprosy.
After 5 years, 55% of patients had experienced treatment success and 80% of patients with a permanent implant still used their SCS device.
The use of pregabalin alone vs pregabalin plus opioids or opioids alone may result in more favorable outcomes in terms of pain interference and pain severity in patients with fibromyalgia.
Acupuncture may reduce pain intensity and mechanical thresholds in patients with idiopathic trigeminal neuralgia.
Pain management in athletes requires a clear understanding of the different types of pain and various factors that can contribute to pain in this population.
The use of virtual reality (VR) and multisensory stimulation in patients with spinal cord injury promotes mild relief from chronic neuropathic pain and represents a potentially helpful addition to SCI neurorehabilitation management.
Pregabalin, but not duloxetine, was shown to improve pain and function scores in patients with hand osteoarthritis.
In patients with multiple sclerosis, lesions in the right dorsolateral prefrontal cortex and posterior periventricular area may be associated with hypo and hyperalgesia.
Dronabinol provides a safe and effective treatment option for patients with symptoms of neuropathic pain associated with multiple sclerosis.
Patients with a diagnosis of HIV and peripheral neuropathy often have ≥1 additional pain disorders.
As survival rates for patients with burns have improved, the need for effective treatments for chronic pain in this population has become more pressing.
The researchers found that paclitaxel triggers CIPN by altering IP3 receptor phosphorylation and intracellular calcium flux and activating calcium-dependent calpain proteases.
A recent study evaluated the efficacy of cryotherapy for chemo-induced peripheral neuropathy; study participants wore frozen gloves and socks on the dominant side for 90 minutes, including the entire duration of drug infusion.
Radiofrequency rhizotomy and the more expensive stereotactic radio surgery provide immediate pain relief from trigeminal neuralgia associated with multiple sclerosis.
Electrical stimulation and a higher baseline pain score were shown to be associated with a higher chance of improved pain relief with acupuncture.
Chronic pain following adjuvant chemotherapy with docetaxel or oxaliplatin may be solely account for by pure sensory neuropathy.
Neuroinflammation in Neuropathic Pain Indicated by Elevated Levels of Proinflammatory Chemokines in CSF
Patients with neuropathic pain have elevated levels of a set of pro-inflammatory chemokines compared with healthy individuals, suggesting ongoing neuroinflammation.
The FDA has approved Lyrica CR, a once-daily treatment for the management of neuropathic pain associated with diabetic peripheral neuropathy and the management of postherpetic neuralgia.
Both gabapentin and opioids are commonly prescribed for the treatment of pain, making the likelihood of these two agents being prescribed together high.
The dopaminergic medication rotigotine and the α-2-δ ligands gabapentin enacarbil and pregabalin provide similar treatment effects for patients with restless leg syndrome.
Privigen is stabilized with proline, which has been shown to reduce IgG aggregation and dimer formation.
The use of capsaicin 8% patch repeat treatment is well tolerated and may provide effective long-term benefit in patients with peripheral neuropathic pain.
Gabapentinoid use presents significant risk for adverse events and provides few benefits for patients with chronic low back pain.
Multivitamin use before diagnosis of breast cancer is associated with reduced risk of symptoms of chemotherapy-induced peripheral neuropathy.
There is currently little conclusive evidence to suggest a benefit of cannabis use for the management of neuropathic pain.
The use of gabapentin, pregabalin, or both is effective for reducing pruritus and neuropathic pain in burn survivors.
Patients with neuropathic pain are more likely to achieve effective therapeutic dose when treated with pregabalin compared with gabapentin.
In patients with rheumatoid arthritis, vitamin D deficiency was shown to be associated with increased neuropathic pain.
In patients with concomitant fibromyalgia and PTSD, opioid therapy was shown to improve quality of life and help patients return to a greater sense of "normalcy."
Dr Cuevas-Trisan covered the evaluation and management of diabetic peripheral neuropathic pain during his presentation at PAINWeek 2017.
Preemptive analgesia seeks to prevent central sensitization and ensuing chronic pain, a concept that has shown promising results in preliminary studies.
Nerve decompression used to treat peripheral neuropathy may improve symptoms of restless leg syndrome.
Clinicians may be overprescribing gabapentinoids, in part as a response to the opioid epidemic, and prescribing them for almost any type of pain.
Lidocaine infusions were shown to provide long-lasting and adequate analgesia in 41% of patients with chronic pain.
Patients with neuropathic pain who do not respond to a low dose of pregabalin can benefit from a higher dose.
Long-term treatment with opioids is associated with more adverse outcomes in patients with polyneuropathy, including depression, overdose, and opioid dependence.
For patients with chronic fatigue syndrome/fibromyalgia or rheumatoid arthritis, morphine has anti-hyperalgesic effects comparable with placebo.
The diagnostic criteria formulated by the ACTTION-APS Pain Taxonomy working group focus on neuropathic pain from SCI, stroke, and MS.
Filorexant is not effective in relieving painful diabetic neuropathy-related pain.
A systematic review points to a dearth of evidence regarding the neuropathic etiology of low back-related leg pain.
Ketamine was found to alleviate several pain modalities, and a number of clinical trials investigating its efficacy are ongoing.
Gabapentin, at doses of 1800 mg to 3600 mg can provide "good levels of pain relief" to some individuals suffering from postherpetic neuralgia and peripheral diabetic neuropathy.
Symptoms associated with central sensitization are common in children and adolescents with migraine.
Researchers identified characteristics associated with pain improvement in patients with fibromyalgia who take antidepressant medications.
Selective cannabinoids may provide limited relief from chronic neuropathic pain and improvements in quality of life and sleep.
Patients with multiple sclerosis (MS) have lower bone mineral density and greater rates of osteoporosis than healthy controls.
Polyneuropathy may increase the likelihood of patients receiving long-term opioid therapy.
A genetic variant that is associated with both multiple sclerosis and systemic lupus erythematosus has been identified.
Trauma exposure plays a significant role in both pain response and development of chronic pain.
In a 3-year period, 45% of patients with trigeminal neuralgia received at least 3 unique treatments.
Cibinetide, an innate repair receptor agonist, was shown to exert disease-modifying effects by reversing sarcoidosis-related nerve loss in the cornea and skin.
Bortezomib-induced peripheral neuropathy does not worsen between initial treatment and retreatment in patients with multiple myeloma.
Greater pain extent of chronic tension-type headaches correlates with older age and with greater emotional and physical burdens in patients.
A randomized trial found that pregabalin is not more effective than placebo in treating sciatica, and resulted in more adverse effects.
Results from the ASCEND study recently published in BioMed Central Neurology indicate that an 8% capsaicin patch is effective in relieving peripheral neuropathic pain resulting from a wide range of etiologies.
Serum concentration levels of several antidepressants were lower in cigarette smokers vs non-smokers.
The effects of central sensitization extend beyond nociceptive pathways to other sensory modalities.
Pain is far more common and widespread in ALS than previously suspected, and initial pain symptoms may predate the clinical onset of the disease's hallmark motor dysfunction by as much as 2 years.
A ketamine regimen is superior to methadone, or ketamine combined with methadone, in alleviating neuropathic pain and associated sensory changes.
A number of shortcomings are associated with systematic reviews and meta-analyses of postoperative care.
Changes in several measures of pain in patients suspected of opioid-induced hyperalgesia were observed after transitioning from opioids to buprenorphine.
Several classes of drugs reduce neuropathy-related pain better than placebo.
Dorsal root ganglion stimulation is more likely than spinal cord stimulation to provide pain relief in patients with neuropathic pain conditions affecting the lower extremities.
In patients with sciatica pain, treatment with pregabalin did not significantly reduce pain intensity compared with placebo.
The wide range of etiologies underlying neuropathic pain render it a particularly challenging condition to manage.
Differentiating central neuropathic pain from musculoskeletal or peripheral neuropathic pain can be challenging.
The American Diabetes Association released an updated position statement on the prevention, detection, and management of diabetic neuropathies.
The human monoclonal antibody opicinumab may potentially enhance spontaneous remyelination after acute optic neuritis.
Patients in the neurofeedback group reported significant declines in CIPN symptoms, compared with patients who did not get neurofeedback training.
Limited data suggest antidepressants, topical capsaicin, and fat grafting may reduce pain associated with post-mastectomy pain syndrome, but more and better studies are needed to determine optimal management for this debilitating condition.
Death and serious outcomes resulting from overdose or poisoning from drugs used to treat depression more than doubled during the last decade and a half, found a recent study, with amitriptyline topping the list.
Clinical Pain Advisor Articles
- Reviewing the Use of Buprenorphine in Perioperative Pain Management
- IASP Updates Classification of Chronic Pain
- CBT Program Effective for Chronic Pain and Opioid Use Disorder
- Galcanezumab Provides Persistent Preventive Effects in Episodic, Chronic Migraine
- Large Survey Evaluates Effects of Chronic Migraine on Life Domains
- Reviewing the Use of Buprenorphine in Perioperative Pain Management
- External Trigeminal Nerve Stimulation May Alleviate Migraine Pain
- Galcanezumab Provides Persistent Preventive Effects in Episodic, Chronic Migraine
- Pulsed Ultrasound May Be Effective for the Treatment of Rib Fractures
- Greater Walking Frequency, Duration May Reduce Risk for Low Back Pain
- Chronic Secondary Headache or Orofacial Pain IASP Classification
- Ultrasound-Guided C2 Coblation May Be Effective for Cervicogenic Headache
- Case Study: Fever and Headache in an Adolescent Boy
- Racial Disparities May Have Widened After Hospital Readmissions Reduction Program Implementation
- Cervical Dysfunction Needs Clarification to Identify Link With Headache