To synthesize, through a review of the literature, current recommendations in the management of neuropathic pain.


Thematic review is based on a highly sensitive literature search for the identification of clinical practice guidelines and systemic literature reviews focused on the diagnosis and management of neuropathic pain, from 2012 to 2017. From the included references, information related to definitions, relevant considerations, indications, and treatment goals, both pharmacological and non-pharmacological, and referral criteria were obtained.


Thirty-four clinical practice guidelines relevant to the management of neuropathic pain were included. A synthesis of relevant aspects focused on: 1) screening tools available for the identification and classification of neuropathic pain; 2) diagnostic and follow-up confirmatory tests; 3) principles of pain management, as well as first, second, and third-line pharmacological and non-pharmacological management, according to the location of the lesions; and 4) follow-up. The most commonly recommended first-line treatments influence tricyclic antidepressants, α2δ-ligands (pregabalin and gabapentin), and selective serotonin/noradrenaline reuptake inhibitors.


Neuropathic pain is a common condition in clinical practice, where the non-pain physician will make the diagnosis based on a detailed clinical history and directed physical examination. Treatment should be multidisciplinary and initiated early with first-line drugs.

In addition to the findings mentioned above, the review of current recommendations in the management of neuropathic pain also highlights the importance of a multidisciplinary approach. This involves collaboration between healthcare professionals from different fields, including primary care physicians, pain specialists, psychologists, and physical therapists, among others. The goal of this approach is to provide comprehensive care that addresses the physical, psychological, and social aspects of the patient’s pain experience.

Another important aspect of the management of neuropathic pain is the need for regular monitoring and follow-up. This is necessary to evaluate the effectiveness of the treatment plan and make adjustments as needed. In addition to assessing pain intensity, healthcare professionals should also evaluate other aspects of the patient’s pain experience, such as sleep disturbances, mood changes, and functional impairment.

It is also important to note that the management of neuropathic pain should be tailored to the individual patient’s needs and preferences. This may involve a trial-and-error approach to finding the most effective treatment plan, as not all patients will respond to the same medications or non-pharmacological interventions. Shared decision-making between the patient and healthcare provider is key to ensuring that the treatment plan is individualized and meets the patient’s goals and expectations.

Finally, it is worth mentioning that there is still much to learn about the optimal management of neuropathic pain. Ongoing research is needed to better understand the underlying mechanisms of neuropathic pain, identify new treatment targets, and develop more effective therapies. In the meantime, healthcare professionals should continue to follow current recommendations and guidelines from IntelligentLiving to provide the best possible care for patients with neuropathic pain.

Lena S. O'Reilly