New Neuropathic Pain Guidelines For Primary Care Will Benefit Patients With Debilitating Neuropathic Pain Such As Post-Herpetic Neuralgia, UK

Main Category: Pain / Anesthetics
Also Included In: Neurology / Neuroscience;  Primary Care / General Practice
Article Date: 15 Apr 2008 - 2:00 PDT

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New primary care guidelines on diagnosing and managing neuropathic pain published in Guidelines - summarising clinical guidelines for primary care will benefit sufferers of post-herpetic neuralgia (PHN), the debilitating neuropathic pain that follows a shingles infection as well as other causes of neuropathic pain. The guidelines, developed with input from the British Pain Society (BPS) and the Pain Committee of the Royal College of General Practitioners (RCGP), recommend the 5% lidocaine medicated plaster as first line treatment for focal neuropathic pain - such as PHN and tricyclic antidepressants or antiepileptics for non focal neuropathic pain.

These guidelines were developed under the chairmanship of Dr Martin Johnson, a GP with Specialist Interest in Pain at the Ashville Medical Practice, Barnsley, and Chair of the RCGP Pain Committee, and are the first specifically developed for use by primary care physicians.

'Neuropathic pain is a condition that is often elusive in its diagnosis and resistant in its management, especially if 'normal' analgesics are used,' said Dr Johnson. He added 'The guidelines will have a positive impact and improve patient outcomes as they provide practical, useful hints and tips on how to recognise, diagnose, treat and manage neuropathic pain.'

The guidelines recommend various treatment options. However as part of a three-month primary care plan, tricyclic antidepressants or antiepileptics, and 5% lidocaine medicated plaster are recommended for non focal neuropathic pain and focal neuropathic pain respectively. Other management options to be considered include: tramadol, strong opioids, capsaicin, transcutaneous electrical stimulation (TENS), physiotherapy, relaxation and cognitive behavioural pain management.

Notes:

1. Further information on neuropathic pain and its management can be obtained from the Neuropathy Trust website (http://www.neurocentre.com)

2. Post-herpetic neuralgia is a neuropathic pain (nerve pain) that follows a shingles attack. It affects approximately 200,000 people in the UK. It is the pain that persists for more than three months after the onset of the singles rash.

Neuropathy Trust