What is Localized Neuropathic Pain? A First Proposal to Characterize and Define a Widely Used Term

Abstract

SUMMARY According to several guidelines, topical agents should be considered for the pharmacological management of localized neuropathic pain. As a definition for the term ‘localized neuropathic pain‘ that might facilitate easier identification of patients who are putatively responsive to topical treatments could not be found in the literature, six pain specialists met in 2010 to address this challenging issue. The following nucleus of a definition that is based on the International Association for the Study of Pain (IASP) definition of neuropathic pain, is the most detailed that can currently be proposed: ‘Localized neuropathic pain is a type of neuropathic pain that is characterized by consistent and circumscribed area(s) of maximum pain‘. An extended version of this core definition and the difficulties in covering all aspects of localized neuropathic pain are presented, and discussions within the scientific community are encouraged to develop a definition that might help to identify patients who could benefit most from topical treatment.

Acknowledgements

The consensus meeting on which this article is based was sponsored by Grünenthal GmbH, Germany.

Financial & competing interests disclosure

G Mick has received in the past 3 years support for clinical research and educational programs from Grünenthal and Menarini, and compensation for consulting from AFSSAPS, Boehringer-Ingelheim, Grünenthal, Janssen-Cilag, Lilly, Menarini, Mundipharma, Pfizer and Sanofi-Pasteur-MSD.

R Baron has received in the past 3 years honoraria from Allergan, Pfizer, Grünenthal, Medtronic, Mundipharma, Eisai, Sanofi-Pasteur, UCB Pharma, Lilly, Astellas, Böhringer-Ingelheim and Genzyme and received research funding from Pfizer, Grünenthal and Genzyme.

NB Finnerup has received in the past 3 years research support and honoraria from Grünenthal.

G Hans has received in the past 3 years research funding from Grünenthal, as well as consultancy honoraria from Grünenthal.

K-U Kern has received in the past 3 years consultancy honoraria from Astellas, Berlin Chemie, Eisai, Grünenthal, Lilly and Medi Bayreuth.

B Brett has received in the past 3 years honoraria for writing and editorial assistance, publication coordination and translation services from Bayer Health Care, Grünenthal, Janssen-Cilag, Merz Pharmaceuticals and UCB Pharma.

RH Dworkin has received in the past 3 years research support from the Montel Williams Foundation, Serono, US FDA and US NIH, and compensation for consulting from Acura, Adynxx, Allergan, Analgesic Solutions, Astellas, Avanir, Bayer, Biogen, Cardiome, Dainippon Sumitomo, Depomed, Endo, Epicept, Flexion, Glenmark, Grünenthal, Infinity, Inhibitex, Jazz, Johnson & Johnson, King, Lilly, McNeil, MediciNova, Merck, MMS Holdings, NeurogesX, Ono, Seikagaku, Smith & Nephew, Spinifex, Pfizer, Phillips Respironics, RCT Logic, Sanofi-Aventis, Theravance and the US Department of Veterans Affairs.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. B Brett received honoraia from Grünenthal for providing writing and editorial assistence.

Additional information

Funding

G Mick has received in the past 3 years support for clinical research and educational programs from Grünenthal and Menarini, and compensation for consulting from AFSSAPS, Boehringer-Ingelheim, Grünenthal, Janssen-Cilag, Lilly, Menarini, Mundipharma, Pfizer and Sanofi-Pasteur-MSD. R Baron has received in the past 3 years honoraria from Allergan, Pfizer, Grünenthal, Medtronic, Mundipharma, Eisai, Sanofi-Pasteur, UCB Pharma, Lilly, Astellas, Böhringer-Ingelheim and Genzyme and received research funding from Pfizer, Grünenthal and Genzyme. NB Finnerup has received in the past 3 years research support and honoraria from Grünenthal. G Hans has received in the past 3 years research funding from Grünenthal, as well as consultancy honoraria from Grünenthal. K-U Kern has received in the past 3 years consultancy honoraria from Astellas, Berlin Chemie, Eisai, Grünenthal, Lilly and Medi Bayreuth. B Brett has received in the past 3 years honoraria for writing and editorial assistance, publication coordination and translation services from Bayer Health Care, Grünenthal, Janssen-Cilag, Merz Pharmaceuticals and UCB Pharma. RH Dworkin has received in the past 3 years research support from the Montel Williams Foundation, Serono, US FDA and US NIH, and compensation for consulting from Acura, Adynxx, Allergan, Analgesic Solutions, Astellas, Avanir, Bayer, Biogen, Cardiome, Dainippon Sumitomo, Depomed, Endo, Epicept, Flexion, Glenmark, Grünenthal, Infinity, Inhibitex, Jazz, Johnson & Johnson, King, Lilly, McNeil, MediciNova, Merck, MMS Holdings, NeurogesX, Ono, Seikagaku, Smith & Nephew, Spinifex, Pfizer, Phillips Respironics, RCT Logic, Sanofi-Aventis, Theravance and the US Department of Veterans Affairs. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Writing assistance was utilized in the production of this manuscript. B Brett received honoraia from Grünenthal for providing writing and editorial assistence.