How effective are opioids in relieving neuropathic pain?

Schmidt, André; Schmidt, Sérgio Renato Guimarães

doi:10.1163/156856902320761360

Cited by 4 publications

(3 citation statements)

References 79 publications

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“…In many cases, chronic pain is understood as persistent pain that is not amenable to routine pain control methods. Pain is a highly disagreeable sensation that results from an extraordinarily complex and interactive series of mechanisms integrated at all levels of neuraxis, from the periphery to higher cerebral structures (73). Pain is usually elicited by the activation of specifi c nociceptors, either by two types of peripheral nociceptors connected with C-and A-delta fibers in the case of nociceptive pain, (74) or from injury to sensory fi bers or from damage to the CNS in the case of neuropathic pain (75).…”

Section: Defi Nitionmentioning

confidence: 99%

Evidence-Based Practice Guidelines for Interventional Techniques in the Management of Chronic Spinal Pain

Manchikanti

2003

Pain Phys

106

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diagnosis of sacroiliac joint pain, and for transforaminal epidural injections in the preoperative evaluation of patients with negative or inconclusive imaging studies, but with clinical fi ndings of nerve root irritation.Moderate to strong evidence was shown for multiple therapeutic interventional techniques including medial branch blocks and medial branch neurotomy; caudal epidural steroid injections and transforaminal epidural steroid injections; lumbar percutaneous adhesiolysis; and implantable therapies.These guidelines do not constitute infl exible treatment recommendations. It is expected that a provider will establish a plan of care on a case-by-case basis, taking into account an individual patient's medical condition, personal needs, and preferences, and the physician's experience. Based on an individual patient's needs, treatment different from that outlined here could be warranted. These guidelines do not represent "standard of care."

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Section: Defi Nitionmentioning

confidence: 99%

Evidence-Based Practice Guidelines for Interventional Techniques in the Management of Chronic Spinal Pain

Manchikanti

2003

Pain Phys

106

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“…The others listed have the promise of potential benefit with case reports or a single randomized, controlled trial to support their use [32•,36]. A thorough discussion of the use of opioids for neuropathic pain can be found elsewhere [37][38][39]40•].…”

Section: Treatment Of Neuropathic Low Back Painmentioning

confidence: 99%

Neuropathic low back pain

Audette

Emenike²,

Meleger³

2005

Current Science Inc

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In this discussion, we hope to advance a clinical approach to low back pain that is more in line with our modern understanding of neuropathic pain. We review the current understanding of normal and pathologic neuroanatomy of the lumbar spine and then outline how pathology in the different structures can lead to neuropathic pain and cause common pain patterns seen in clinical practice. We also detail the available treatments for neuropathic low back pain.

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“…13 In previous reports, benzodiazepines, opioids, barbiturates, calcitonin, neuroleptics, sodium channel blockers, volatile anesthetics, and N-methyl-D-aspartate (NMDA)-receptor antagonists have been tried with variable results. 4,7,14,15 Generally, drugs that suppress the central nervous system are thought to provide pain relief against newly developed pain after regional anesthesia.…”

mentioning

confidence: 99%