Activity 1: Principles of Neuropathic Pain Assessment and Management

Algorithm for the Treatment of Painful Diabetic Neuropathy: Download PDF

Algorithm for the Treatment of Postherpetic Neuralgia: Download PDF

Diagnostic Algorithm for Neuropathic Pain: Download PDF

Recommendation #1: The use of numerical rating or visual analog scales is recommended to assess pain intensity and the effects of treatment on neuropathic pain intensity.
Source: Guidelines on neuropathic pain assessment. Pain 2011;152:14-27.
Website: http://www.painjournalonline.com/article/S0304-3959(10)00453-7/fulltext
Strength of Evidence: A

Recommendation #2: Tricyclic antidepressants or gabapentin/pregabalin are recommended as first-line treatment in postherpetic neuralgia.
Source: Guidelines on pharmacological treatment of neuropathic pain: 2010 revision. European Journal of Neurology 2010;17:1113-23.
Website: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2010.02999.x/abstract
Strength of Evidence: A

Recommendation #3: Topical lidocaine, with its excellent tolerability, may be considered first line in the elderly with postherpetic neuralgia, especially if there are concerns regarding the central nervous system side effects of oral medications.
Source: Guidelines on pharmacological treatment of neuropathic pain: 2010 revision. European Journal of Neurology 2010;17:1113-23.
Website: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2010.02999.x/abstract
Strength of Evidence: A

Recommendation #4: Strong opioids and capsaicin cream are recommended as second-line choices for postherpetic neuralgia. Capsaicin patches are promising, but the long-term effects of repeated applications are not clear.
Source: Guidelines on pharmacological treatment of neuropathic pain: 2010 revision. European Journal of Neurology 2010;17:1113-23.
Website: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2010.02999.x/abstract
Strength of Evidence: A

Recommendation #5: Tricyclic antidepressants, gabapentin, pregabalin and serotonin-norepinephrine reuptake inhibitors (duloxetine, venlafaxine) are recommended as first-line treatment in painful polyneuropathy (notably related to diabetes).
Source: Guidelines on pharmacological treatment of neuropathic pain: 2010 revision. European Journal of Neurology 2010;17:1113-23.
Website: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2010.02999.x/abstract
Strength of Evidence: A

Download PDF of EB Recs

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Common Adverse Effects from Drugs Used to Treat Neuropathic Pain: Download PDF

Drug Interactions in the Treatment of Neuropathic Pain: Download PDF

Effect of Comorbidities on Choice of Agent for Neuropathic Pain: Download PDF

Patient Health Questionnaire for Anxiety and Depression (PHQ-4): Download PDF

Pharmacologic Agents for Neuropathic Pain Classified by Evidence Level: Download PDF

Neuropathic Pain Screening Tool (DN4): Download PDF

Neuropathic Pain Screening Tool (LANSS): Download PDF

 

 

 

 

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