Current pharmacologic and alternative treatments for the prevention of neuropathic pain
OA Version
Citation
Abstract
Neuropathic pain is a type of pain experienced in response to damage to the somatosensory nervous system, either through physical trauma, such as lesions directly to the nerves, or as part of an illness or disease. Although neuropathic pain can occur in response to many different conditions, the painful sensations experienced by those with this condition are quite similar and include symptoms such as burning, tingling, or pricking. Oftentimes, extremely hot or cold temperatures or even light touch sensations, which normally do not evoke pain, can exacerbate nociceptive, or painful, sensations in those with neuropathic pain. Neuropathic pain can be a significant burden to individuals as it affects many aspects of everyday life. It can negatively impact sleep, quality of life, and can lead to comorbid associations of neuropathic disease, including anxiety and depression. Different types of pharmacologic and non-pharmacologic treatments exist for neuropathic pain. This review summarizes the effective treatments for neuropathic pain caused by diabetes, chemotherapeutic agents, as well as phantom limb pain. Diabetic neuropathy may be caused by several different mechanisms, but the hyperglycemia that is characteristic of both Type I and Type II diabetes is the main contributing factor to nerve damage and the perception of pain. Several pharmacologic agents have proven to be successful in terminating the perception of pain caused by diabetes.
Patients with cancer being treated with various chemotherapeutic agents may experience chemotherapy-induced peripheral neuropathy, as different types of chemotherapeutics have been found to damage nerves, despite their ability to effectively eliminate cancerous cells. However, a number of pharmacological agents have been found to effectively relieve the neuropathic pain experienced by those taking various chemotherapeutics.
Lastly, phantom limb pain, which occurs when nerves are lacerated through amputations or physical trauma, can be treated with several types of drugs which are further reviewed in this paper.
Suggestions for future research and treatment options that aim to prevent nerve damage, thus preventing neuropathic pain itself, are also reviewed in this paper. Although there is limited research on non-pharmacologic treatments for neuropathic pain, several mechanisms have shown encouraging results in reducing pain by targeting the root cause for the pain itself, although these procedures may be invasive and can possess numerous risks. Additional research is required in order to determine future treatment options that prevent nerve damage and therefore prevent the perception of pain.
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2024