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Management of neuropathic pain

Created: 7/9/2005
Updated: 12/1/2009
Early recognition and aggressive management of neuropathic pain is critical to successful outcome. Multiple treatment modalities are provided by an interdisciplinary management team. Numerous treatment modalities are available and include systemic medication, physical modalities (e.g. physical rehabilitation), psychological modalities (e.g. behaviour modification, relaxation training), invasive procedures (e.g. trigger-point injections, epidural steroids, sympathetic blocks), spinal cord stimulators, intrathecal morphine pump systems and various surgical techniques (e.g. dorsal root entry zone lesions, cordotomy and sympathectomy).

Pharmacological treatments for chronic pain

The mainstays of treatment are predominantly the tricyclic antidepressants, anticonvulsants, systemic local anaesthetics and opioids. Other pharmacological agents that have proven efficacious include corticosteroids, topical therapy with substance P depletors, autonomic drugs and NMDA receptor antagonists.

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