A GLOBAL research initiative looking at new evidence and emerging technologies has led to a revision of neuropathic pain treatment recommendations.
Three medication classes are recommended for first line use: alpha-2 delta ligands (gabapentin, pregabalin); serotonin-norepinephrine reuptake inhibitors; and tricyclic antidepressants.
While only demonstrating small benefits, capsaicin and lidocaine patches and capsaicin creams are recommended as second-line treatments due to their high safety and tolerability.
Evidence was inconclusive for spinal cord stimulation, selective serotonin reuptake inhibitors and ketamine.
The team recommended against cannabis-based products, which were found to be ineffective.
Up to 10% of Australians have neuropathic pain - or nerve pain - caused by damage to nerves due to disease, surgery or trauma.
"Neuropathic pain affects people differently, so the guideline supports the provision of high-quality patient-centred care, that considers needs, values and preferences," said Michael Ferraro of Neuroscience Research Australia (NeuRA), who was involved in the international team.
"Treatment choices depend on potential effectiveness, safety, accessibility, comorbidities and use of other medicines," Ferraro added.
Future revisions may include a focus on other non-drug, non-surgical interventions, such as exercise, which are currently lacking, and should be prioritised for future research.
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