Advances in Neuropathic Pain

Dworkin, Robert H.; Bačkonja, Miroslav; Rowbotham, Michael C.; Allen, Robert R.; Argoff, Charles; Bennett, Gary J.; Bushnell, M. Catherine; Farrar, John T.; Galer, Bradley S.; Haythornthwaite, Jennifer A.; Hewitt, David; Loeser, John D.; Max, Mitchell B.; Saltarelli, Mario; Schmader, Kenneth E.; Stein, Christoph; Thompson, David C.; Turk, Dennis C.; Wallace, Mark; Watkins, Linda R.; Weinstein, Sharon M.

doi:10.1001/archneur.60.11.1524

Cited by 1,078 publications

(217 citation statements)

References 68 publications

(107 reference statements)

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“…However, the results of our study also suggest that infiltrations for PN due to PNE are only moderately effective, as only 26% of patients experienced a greater than 30% reduction in their pain. In studies on the treatment of chronic pain, this improvement is usually considered to indicate clinical efficacy 18. However, it is not clear if this improvement rate simply reflects a placebo effect or is due to a specific effect of local anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

Riant

Lassaux

et al. 2016

BJOG

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ObjectiveTo compare the effect of corticosteroids combined with local anaesthetic versus local anaesthetic alone during infiltrations of the pudendal nerve for pudendal nerve entrapment.DesignRandomised, double‐blind, controlled trial.SettingMulticentre study.Population201 patients were included in the study, with a subgroup of 122 women.Methods CT‐guided pudendal nerve infiltrations were performed in the sacrospinous ligament and Alcock's canal. There were three study arms: patients in Arm A (n = 68) had local anaesthetic alone, those in Arm B (n = 66) had local anaesthetic plus corticosteroid and those in Arm C (n = 67) local anaesthetic plus corticosteroid with a large volume of normal saline.Main outcome measuresThe primary end‐point was the pain intensity score at 3 months. Patients were regarded as responders (at least a 30‐point improvement on a 100‐point visual analogue scale of mean maximum pain over a 2‐week period) or nonresponders.ResultsThree months’ postinfiltration, 11.8% of patients in the local anaesthetic only arm (Arm A) were responders versus 14.3% in the local anaesthetic plus corticosteroid arms (Arms B and C). This difference was not statistically significant (P = 0.62). No statistically significant difference was observed in the female subgroup between Arm A and Arms B and C (P = 0.09). No significant difference was detected for the various pain assessment procedures, functional criteria or quality‐of‐life criteria.ConclusionsCorticosteroids provide no additional therapeutic benefits compared with local anaesthetic and should therefore no longer be used.Tweetable abstractSteroid infiltrations do not improve the results of local anaesthetic infiltrations in pudendal neuralgia.

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Section: Discussionmentioning

confidence: 99%

Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

Riant

Lassaux

et al. 2016

BJOG

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“…11 The role that central sensitization and the NMDA receptor have in pathological pain is highlighted by studies that show that the blocking of central sensitization with NMDA antagonists abolishes pain hypersensitivity in patients with neuropathic pain. 31 In conclusion, the efficacy of indomethacin, alone and combined with prochlorperazine and caffeine, in abolishing peripheral and central sensitization in in vivo models of hyperalgesia is a further explanation of the clinical efficacy of IndoProCaf in the treatment of migraine.…”

Section: Discussionmentioning

confidence: 99%

Indomethacin, alone and combined with prochlorperazine and caffeine, but not sumatriptan, abolishes peripheral and central sensitization in in vivo models of migraine

Ghelardini

Galeotti

Grazioli

et al. 2004

The Journal of Pain

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M igraine is a common, multifactorial, neurovascular disorder, characterized by recurrent disabling attacks of moderate to severe headache, nausea, vomiting, photophobia, and phonophobia, and also, in up to one third of patients, neurologic aura symptoms. 12 It is known that migraine is characterized by a state of central neuronal hyperexcitability, 30 which involves overactivity of the excitatory amino acids. Higher concentrations of excitatory amino acids (mainly glutamic and aspartic acid) were observed in the cerebrospinal fluid, 23 in the saliva, 26 in the plasma, 2,13 and in the platelets 9 of patients with migraine.Recently it has been proposed that the throbbing pain of migraine, which is the pulsating pain aggravated by routine physical activities, is mediated by sensitization of peripheral trigeminovascular neurons, and that cutaneous allodynia (CA) of migraine, which means pain resulting from a non-noxious stimulus to normal skin, is mediated by sensitization of central trigeminovascular neurons. 4,22 The development of hyperalgesia has been shown after the injection of kainic acid. The hyperalgesic effect of kainic acid appears to be mediated by activity at aminomethylisoxazole-propionic acid/kainate receptors that are located outside the spinal cord, perhaps on primary afferents in trigeminal ganglia. 27 Intraperitoneal injection of kainic acid induces a persistent hyperalgesia in mice and rats. 18 Glutamate, an excitatory neurotransmitter, produces

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“…About 74% of neuropathic pain cases present with moderate-to-severe intensity. Neuropathic pain comprises more than 17% of patients' pain complaint (3,4,(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

“…In a few scenarios, non-steroidal anti-inflammatory drugs are used. Furthermore, occupational therapies can be conducted (1,4,9,10).…”

Section: Introductionmentioning

confidence: 99%

Spinal cord stimulation in the treatment of neuropathic pain: Current perspectives of indications, cost-effectiveness, complications and results

Camporeze

Simm

Estevão

et al. 2017

JHSCI

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Introduction:The spinal cord stimulation (SCS) has been described as a valuable neuromodulating procedure in the management of chronic and medically untreated neuropathic pain. Although many studies have discussed the use of this technique, a question still remains regarding its efficacy in different medical conditions with different etiology in the long term. The aim of this paper is to discuss the risks, complications, cost-effectiveness, and results of SCS in patients affected by chronic neuropathic pain based on the comprehensive literature review.

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Advances in Neuropathic Pain

Cited by 1,078 publications

References 68 publications

Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

Indomethacin, alone and combined with prochlorperazine and caffeine, but not sumatriptan, abolishes peripheral and central sensitization in in vivo models of migraine

Spinal cord stimulation in the treatment of neuropathic pain: Current perspectives of indications, cost-effectiveness, complications and results

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