Prevalence and Characterization of Neuropathic Pain in a Primary-Care Setting in Spain

Abstract

The results of the present study show the high prevalence of neuropathic pain at the primary-care level in Spain. In addition, the data presented here point to a need to improve the management of outpatients with neuropathic pain in the Spanish primary-care setting, particularly in relation to the higher than recommended use of NSAIDs (which are not indicated for neuropathic pain) and the lower than recommended use of antiepileptic drugs with an analgesic indication for pain with a neuropathic component.

Clinical Characteristics, Patient-Reported Outcomes, and Previous Therapeutic Management of Patients with Uncontrolled Neuropathic Pain Referred to Pain Clinics

“…Neuropathic pain is common among the general population, with prevalence rates of 7-8% [2, 3]. Neuropathic pain, which is also a common occurrence (12%) among patients who are managed by primary care physicians [4], accounts for a high proportion (20%) of the patients who are referred to specialized pain units [5]. The causes of neuropathic pain comprise a wide and heterogeneous number of clinical conditions, such as diabetic neuropathy, complex regional pain syndrome, spinal cord injury pain, postherpetic neuralgia, postoperative pain, trigeminal neuralgia, drug-induced polyneuropathies, HIV-associated neuropathy, multiple sclerosis, and central pain syndromes secondary to vascular lesions [6, 7].…”

“…Despite the availability of several effective drugs, neuropathic pain treatment is challenging: response to treatment is unpredictable; despite the fact that the patients may receive several drugs for pain treatment, moderate-to-severe levels of pain are common; suboptimal treatment is also common with patients who receive ineffective treatments, such as nonsteroidal anti-inflammatory drugs or lower-than-recommended doses of the prescribed treatment; and delayed referral to pain clinics is also common [4, 8, 16–18]. …”

Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: better pain relief, sleep and physical health

“…First-line treatment includes anticonvulsants and tricyclic antidepressants [4,13], usually in conjunction with opioids [14][15][16]. Anticonvulsants are the most frequent pharmacological NP treatment used [17,18] and pregabalin (PGB), specifi cally, is not only effective for NP relief [19][20][21][22] but also improves disturbed sleep and anxiety, and shows some antidepressant properties [22][23][24][25]. Additional analgesic techniques, such as radiotherapy (RT), are sometimes used.…”

A Review of Pregabalin for the Treatment of Peripheral and Central Neuropathic Pain and Its Place in the Treatment of Chronic Pain

“…[10][11][12] Neuropathic pain is difficult to treat because the patients are frequently resistant to treatment and/or unable to tolerate the medications. 13 Furthermore, patients with neuropathic pain often receive suboptimal treatment (ie, inappropriate drug therapy and/or use of subtherapeutic doses), 7,14,15 which increases the disease burden. [16][17][18] Although there are several treatments available for the management of neuropathic pain, 13 only the tricyclic antidepressants and calcium channel α 2 -δ ligands (gabapentin and pregabalin) are considered for first-line treatment by most clinical guidelines.…”