neuropathic olours: a rapid treatment can reduce the risk of chronicity

Neuropathic pain must be supported as soon as possible, because any loss of time corresponds to a loss of opportunities, increasing the risk that these pains become chronic, pleaded Dr. Francine Hirszowski, general practitioner in Paris, in a debate organized as part of the annual convention of the Study and Treatment of Pain Society (TDCS), which was held in Montpellier (Hérault).
Neuropathic pain speak after injury to the nervous system to cause a malfunction of the nerve transmission. Besides abnormal electrical activity, nerve fibers also tend to overreact to stimuli. It is to avoid this sensitivity to pain becomes exaggerated, while promoting chronicity of pain, that support should be as early as possible.

Pathologies such as diabetes, shingles, cancer or AIDS may be at the origin of neuropathic pain, which may also occur in multiple sclerosis, following a cerebrovascular accident (CVA) after amputation , on scars from surgery, or result from a rheumatic disease leading to nerve compression (osteoarthritis, herniated disc).

Neuropathic pain combine two types of pain sensation: a constant background pain (sensory disorders such tingling, tingling, numbness) and paroxysmal shooting pains (electric shock or stabbing).

Because neuropathic pain arising from nerve conduction problems, the "classic" analgesics are commonly found little or no effective to relieve, and treatment is usually based on the use of antidepressants (to treat painful background) or antiepileptic drugs (to treat breakthrough pain).

But these drugs are then not used "in their first indication," said Dr. Bernard Lawrence, neurology department of Bellevue Hospital (CHU of Saint-Etienne, Loire). So if your doctor prescribes these products, it is because their action on nerve transmission properties will allow to correct the shortcomings of the nervous system causing the pain, and it does not mean that you are depression or epilepsy, said Dr. Loïc Rambaud, a neurologist at Saint-Genis-Laval (Rhône).

In fact, for the treatment of neuropathic pain, these drugs are generally used below those at which their antidepressant or antiepileptic properties exerted doses.

The definition of the dosage is then very gradually, said Dr. Francine Hirszowski. This initial phase of implementation of the treatment, the experts call "titration" is to slowly increase the amount of product consumed to find the dosage for which establishes a compromise between the efficiency of the molecule to relieve pain and adverse effects (dizziness, drowsiness) that its use entails.

If this first attempt at treatment fails, the doctor will then try another molecule (or combination therapy, a combination of two drugs), using the same process, explained Dr. Loïc Rambaud.

In cases where the pain persists after this second phase, it will direct you to a central management of pain will be considered where other therapeutic approaches, such as nerve blocks (injection of an anesthetic local near a nerve preventing the transmission of nerve messages painful) or transcutaneous electrical nerve stimulation (application of an electric current of low intensity that blocks the transmission of pain messages).