Assessment and Management of Neuropathic Pain in Primary Care

Abstract

SUMMARY Most patients with neuropathic pain present and are managed in primary care. It is generally a long-term condition associated with poor physical, psychological and social health. Assessment and pharmacological treatment algorithms, specifically designed for primary care, are now available. The focus should be on taking a good medical history and clinical examination, and with the knowledge of the patient‘s current and past medical history, the general practitioner can diagnose possible neuropathic pain and initiate treatment while awaiting specialist assessment (if required). Specific nonpharmaceutical interventions, though popular with patients, have thus far demonstrated limited effectiveness. General practitioners, with their long-term relationship with patients, have a central role in improving the diagnosis and management of neuropathic pain.

Financial & competing interests disclosure

BH Smith has received occasional lecture fees, on behalf of his Institution, from companies involved in the manufacture of drugs used in treating neuropathic pain. BH Smith and N Torrance have received unrestricted educational grants from Pfizer UK for research into neuropathic pain epidemiology. M Johnson has received lecture fees and attended advisory boards from the companies involved in the manufacture of drugs used in treating neuropathic pain. The authors assert no personal pecuniary or other conflict of interest in the writing of this article. 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.

No writing assistance was utilized in the production of this manuscript.

Notes

† This clinical guideline will be revised during 2012 and 2013.

Data taken from [30].