Treatment options expand for patients with neuropathic pain

Treatment options for people who suffer from severe pain caused by damage to nerves have expanded dramatically in just the past five years, say scientists and physicians who have published the first-ever guidelines for treating such pain. The guidelines for treating neuropathic pain appear in the November issue of the Archives of Neurology.

Though we may not appreciate it, much of the pain we feel every day is normal and healthy. The intense pain we feel after putting a hand on a hot stove, for instance, tells you that you're doing damage to your body and to move your hand immediately. But neuropathic pain serves no useful purpose it's the result of damage to nerves that transmit pain signals. And so the nerves send errant, unnecessary pain signals that can put a person in constant, pointless, agonizing pain.

"This type of pain is very abnormal," says Robert Dworkin, Ph.D., the lead author of the guidelines and director of the Anesthesiology Clinical Research Center at the University of Rochester Medical Center. "Many patients worry about how to describe their pain, because it can be so unusual. It seems to come out of nowhere, and it can be excruciating."

Shingles is one of the most common causes of neuropathic pain. For most shingles patients, the painful rash heals in two to three weeks, and the pain is gone permanently. But one in four patients suffers from tremendous pain months or even years after the skin rash heals, because of damage to the nerves, a condition known as post-herpetic neuralgia.

"For many patients who had shingles, just the touch of a shirt or a blouse lightly brushing against the skin can be excruciatingly painful, for years. And so what happens? They stay home, topless. It's hard to go to work, hold a job, or see family and friends if you're sitting home unable to wear a shirt or a blouse. It can truly be disabling," says Dworkin.

Such patients are among the 4 to 6 million people in the United St

Contact: Tom Rickey
University of Rochester Medical Center

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