Invited Review: An overview of the non-procedural treatment options for peripheral neuropathic pain
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Abstract
Peripheral neuropathic pain is common in patients with peripheral nerve injury and can significantly impact both their function and quality of life. There is a wide variety of non-interventional treatment approaches, including pharmacologic therapy, physical/occupational therapy, modalities (therapeutic, mechanical, thermal, etc.), psychology, and lifestyle modification. First line pharmacologic therapy for peripheral neuropathic pain includes gabapentinoids, tricyclic antidepressants, and serotoninnorepinephrine reuptake inhibitors. Other classes of medications, such as topical
treatments, opioids, and cannabinoids, have more limited usefulness in treatment but remain part of a treatment regimen. Physical and occupational therapy, psychological interventions, and lifestyle medicine are important adjuncts in the treatment and prevention of future peripheral neuropathic pain. The strength of the evidence supporting each intervention varies, with that for pharmacologic intervention being the strongest. A combination of these options tailored to the individual needs of the patient likely will result in the best treatment outcome for peripheral neuropathic pain.
Objectives:The objectives of this activity are to: 1) Understand and be able to appropriately prescribe medications for peripheral neuropathic pain; 2) Understand and be able to appropriately order therapy interventions for peripheral neuropathic pain; 3) Understand and be able to appropriately refer patients for lifestyle psychological therapies and lifestyle modifications for peripheral neuropathic pain.
ACCREDITATION STATEMENT The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
CREDIT DESIGNATION The AANEM designates this enduring material for a maximum of 1
AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
DISCLOSURE INFORMATION
Dr. Zach Simmons (editor) has no conflicts of interest. Relevant financial relationships of the article’s authors have been disclosed and managed through the journal’s editorial review process.
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Evan R. Zeldin MD; Adam R. Goddard MD; Maxwell S. Boyle MD; Renee L. Madathil PhD; Erick Rosenvall MD; Kajri A. Majithia DO; Eric J. Morrison MD