Activity 2: Tailoring the Treatment of Neuropathic Pain: Case Studies

Program Overview

In this second activity, Tailoring the Treatment of Neuropathic Pain: Case Studies, faculty build on material discussed in the first activity, Principles of Neuropathic Pain Assessment and Management. Principles of diagnosis, assessment and management are reinforced using patient cases. The program focuses on the two most common forms of neuropathic pain: postherpetic neuralgia and painful diabetic neuropathy. In addition, the faculty members discuss a case of idiopathic neuropathic pain and how to approach diagnosis and management in complex situations. The final part of this program focuses on how to optimize patient outcomes. Topics discussed include the role of the multidisciplinary team, the importance of patient education, long-term treatment monitoring and practical advice on the use of opioids in neuropathic pain. 

Intended Audience

This continuing medical education program is intended for family physicians and other primary care providers who care for patients with neuropathic pain.  

Learning Objectives

After completing this activity, family physicians will be better able to:

  • Apply evidence-based recommendations for assessment and management of neuropathic pain in clinical practice.
  • Recognize signs and symptoms of neuropathic pain to facilitate timely diagnosis and management.
  • Differentiate among commonly encountered neuropathic pain conditions and their various causes in order to select appropriate treatments.
  • Improve assessment of neuropathic pain in clinical practice, including assessment of comorbidities.
  • Apply evidence-based strategies in the selection and use of first-, second- and third-line pharmacotherapy for patients with common neuropathic pain syndromes.
  • Develop tailored treatment plans that address common and potentially debilitating comorbidities, such as depression and sleep disturbances.
  • Implement practical approaches to monitoring treatment response, managing adverse effects and optimizing outcomes.


Dawn Marcus, MD
Professor of Anesthesiology and Neurology
University of Pittsburgh Medical Center
Pittsburgh, PA

Penny Tenzer, MD
Vice Chair and Director of the Family Medicine Residency Program
University of Miami Miller School of Medicine
Chief of Service for Family Medicine
University of Miami Hospital
Miami, FL 

Matthew Schocket, MD
Anesthesiologist and Pain Management Specialist
Capitol Pain Institute
Austin, TX

CME Accreditation

This enduring material activity, Tailoring the Treatment of Neuropathic Pain: Case Studies, (the second activity in the Neuropathic Pain series), has been reviewed and is acceptable for up to 1 Prescribed credit(s) by the American Academy of Family Physicians. This activity conforms to the AAFP criteria for evidence-based CME clinical content. AAFP accreditation begins November 15, 2011.  Term of approval is for two year(s) from this date with the option of yearly renewal.

The Evidence-Based CME clinical content designated for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since some clinical research is ongoing, the American Academy of Family Physicians recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Family Physicians designates this Enduring material for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.



Introduction and Opening Remarks
Module 1. Case One: Postherpetic Neuralgia
Module 2. Case Two: Diabetic Neuropathy
Module 3. Case Three: Idiopathic Neuropathic Pain
Module 4. Implementing Management Strategies
Closing Remarks


It is the policy of the AAFP that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, they are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity.

The AAFP and MedEd Architects, LLC staffs have indicated that they have no relationships to disclose relating to the subject matter of the activity. Drs. Marcus and Schocket returned disclosure forms indicating that they have no financial interest in or affiliation with any commercial supporter or providers of any commercial services discussed in this educational material. Dr. Tenzer returned a disclosure form indicating that she has served as a consultant to Forest Pharmaceuticals, Inc., on the topic of fibromyalgia and to Zogenix on the topic of pain.


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