Neuropathic Pain centre NL.m4v
From the centre for the treatment of neuropathy and neuropathic pain, Soest, NL: info@ores.nl www.neuropathie.nu Neuropathic pain is a complex, chronic pain state and the nerve fibers themselves are either damaged, dysfunctional, or injured. Unfortunately, neuropathic pain responds poorly to standard pain treatment and may get worse instead of better over time. The discomfort for patients is significant and is often described as a burning sensation, a sharp, stabbing or shooting pain. Neuropathic pain has a devastating effect onquality of life. Indeed, the quality of treatment is poor, only few patients receiving recommended medications in efficacious dosages. Currently there is no treatment to prevent or cure neuropathic pain, and very often this pain transforms into an intractable chronic painstate. The two major pharmacological treatment options are antidepressants such as the tricyclic antidepressants (tcas, amitriptyline and nortriptiline) and anticonvulsants such as carbamazepine, gabapentin and its derivative pregabelin. Numbers needed to treat are 3-6 and many patients seem to be refractory to these classical analgesics. In order to help patients one needs to be brave and forget about the much trodden path described above. If patients do not respond satisfactory on antidepressants and anticonvulsants new inroads into other treatment modalities are necessary. As clinicians we are conditioned to think in oral pharmacological interventions only. And we do not often …
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