Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Assessment of neuropathic pain in primary care.
AU - Haanpää, Maija L.
AU - Backonja, Misha-Miroslav
AU - Bennett, Michael I.
AU - Bouhassira, Didier
AU - Cruccu, Giorgio
AU - Hansson, Per T.
AU - Jensen, Troels Staehelin
AU - Kauppila, Timo
AU - Rice, Andrew S. C.
AU - Smith, Blair H.
AU - Treede, Rolf-Detlef
AU - Baron, Ralf
PY - 2009/10
Y1 - 2009/10
N2 - Management of patients presenting with chronic pain is a common problem in primary care. Essentially, the classification of chronic pain falls into 3 broad categories: (1) pain owing to tissue disease or damage (nociceptive pain), (2) pain caused by somatosensory system disease or damage (neuropathic pain), and (3) pain without a known somatic background. Key challenges in developing a targeted holistic approach to treatment include appropriate diagnosis of the cause or causes of pain; identifying the type of pain and assessing the relative importance of its various components; and determining appropriate treatment. In clinical examination, sensory abnormalities are the crucial findings leading to a diagnosis of neuropathic pain, for which pharmacotherapy with antidepressants and anticonvulsants represents the cornerstone of medical treatment. Chronic neuropathic pain is underrecognized and undertreated, yet primary care physicians are uniquely placed on the frontlines of patient management, where they can play a pivotal role in treatment and prevention through diagnosis, therapy, follow-up, and referral. This review provides guidance in understanding and identifying the neuropathic contribution to pain presenting in primary care; assessing its severity through patient history, physical examination, and appropriate diagnostic tests; and establishing a rational treatment plan.
AB - Management of patients presenting with chronic pain is a common problem in primary care. Essentially, the classification of chronic pain falls into 3 broad categories: (1) pain owing to tissue disease or damage (nociceptive pain), (2) pain caused by somatosensory system disease or damage (neuropathic pain), and (3) pain without a known somatic background. Key challenges in developing a targeted holistic approach to treatment include appropriate diagnosis of the cause or causes of pain; identifying the type of pain and assessing the relative importance of its various components; and determining appropriate treatment. In clinical examination, sensory abnormalities are the crucial findings leading to a diagnosis of neuropathic pain, for which pharmacotherapy with antidepressants and anticonvulsants represents the cornerstone of medical treatment. Chronic neuropathic pain is underrecognized and undertreated, yet primary care physicians are uniquely placed on the frontlines of patient management, where they can play a pivotal role in treatment and prevention through diagnosis, therapy, follow-up, and referral. This review provides guidance in understanding and identifying the neuropathic contribution to pain presenting in primary care; assessing its severity through patient history, physical examination, and appropriate diagnostic tests; and establishing a rational treatment plan.
KW - Allodynia
KW - Assessment
KW - Neurological testing
KW - Neuropathic pain
KW - Pain measurement
KW - Somatosensory testing
U2 - 10.1016/j.amjmed.2009.04.006
DO - 10.1016/j.amjmed.2009.04.006
M3 - Journal article
VL - 122
SP - S13-S21
JO - The American Journal of Medicine
JF - The American Journal of Medicine
SN - 0002-9343
IS - 10 (Su
ER -