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Neuropathic Pain leaflet

We are delight­ed to announce that our pop­u­lar book­let on neu­ro­path­ic pain has been revised and reprint­ed, thanks to an award from Foun­da­tion Scotland.

The book­let, orig­i­nal­ly writ­ten by Dr John Lee, has been revised and updat­ed by Dr Alan Fayaz, Con­sul­tant in Chron­ic Pain Med­i­cine, Anaes­the­sia and Peri­op­er­a­tive Care at the Uni­ver­si­ty Col­lege Lon­don Hos­pi­tals NHS Trust.

This book­let starts by address­ing the caus­es of neu­ro­path­ic pain, from the more com­mon caus­es, such as nerve dam­age and entrap­ment, dia­betes or post-her­pet­ic neu­ral­gia (pain after shin­gles); to less com­mon caus­es, such as trigem­i­nal neu­ral­gia (a form of facial pain), mul­ti­ple scle­ro­sis, phan­tom limb pain or pain relat­ed to can­cer or can­cer treatment.

There is an exten­sive sec­tion on the drug treat­ments avail­able for peo­ple with neu­ro­path­ic pain, and why stan­dard painkillers, such as parac­eta­mol, non-steroidal anti-inflam­ma­to­ry drugs (NSAIDs) (e.g. ibupro­fen) and sim­ple opi­oid drugs (e.g. codeine) are often not effec­tive in treat­ing neu­ro­path­ic pain. In some cas­es, anti­de­pres­sants like amitripty­line and antiepilep­tics like those in the gabapenti­noid fam­i­ly (such as gabapentin and pre­ga­balin) are pre­scribed instead, as they are found to be more effec­tive in a lot of cas­es. This revised book­let does, how­ev­er, men­tion the recent law clas­si­fi­ca­tion changes to gabapentin and pre­ga­balin, which are a com­mon treat­ment for peo­ple with neu­ro­path­ic pain, and how these changes might affect the peo­ple who find these drugs effec­tive. This was a sub­ject Pain Con­cern delved into more deeply in pro­gramme 114 of Air­ing Pain, ‘You, Your Drugs, and the Law: Gabapenti­noids & Med­i­c­i­nal Cannabis’, also fund­ed by the Foun­da­tion Scot­land grant.

The final sec­tion of the book­let stud­ies non-drug treat­ments for neu­ro­path­ic pain. Many peo­ple with neu­ro­path­ic pain find stan­dard pain man­age­ment tech­niques are not as applic­a­ble to their pain (a sub­ject which Tina from livingwellpain.net goes into in a lot of detail in the issue 73 of Pain Mat­ters mag­a­zine). Drs Lee and Fayaz look at pain self-man­age­ment tech­niques for peo­ple with neu­ro­path­ic pain, as well as oth­er non-drug treat­ments such as phys­io­ther­a­py, pain man­age­ment pro­grammes and stim­u­la­tion pro­ce­dures like TENS (tran­scu­ta­neous elec­tri­cal nerve stim­u­la­tion) and PENS (per­cu­ta­neous elec­tri­cal nerve stim­u­la­tion), where an elec­tri­cal sig­nal is used to stim­u­late the nerves.

The revised leaflet has been pub­lished on our web­site and we wel­come your com­ments. We are extreme­ly grate­ful to the Trigem­i­nal Neu­ral­gia Asso­ci­a­tion UK and the Shin­gles Sup­port Soci­ety for their sup­port and col­lab­o­ra­tion in the pub­li­ca­tion of this leaflet.

You can read the full leaflet here.

Comments

I’ve tried all the anti-epilep­tic drugs but they just make me a zom­bie in day. My PN has moved through from cramps, spasms in both low­er legs to acute “sun­burn” pain when lay­ing down. Inter­rupt­ing sleep. I am on 20mg Flu­ox­e­tine which has helped with cold hands & feet. I should be on hyper­ten­sion meds but every­thing tried by my GP has an adverse effect. So co-codamol, Voltarol, Deep Heat & in mid­dle of night Deep Freeze cream, sun­burn lotion & more co-codol. But even­tu­al­ly burn­ing pain in legs main­ly to front & side wake me up. I’ve a refer­ral let­ter to see a Spe­cial­ist pri­vate­ly but have no idea where to go. NY I am going for walk every day.

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