Abstract

One of the most frequent problems in medical care is the management of patient presenting with chronic pain. Neuropathic pain is related to the injury or disorders affecting peripheral and central nervous systems and is resistant to over-the-counter analgesics and conventional treatment methods. The estimated prevalence for patients presenting classical symptoms of neuropathic pain is eventually reported to be 6%–8%. Several mechanisms have been considered and proposed for this disorder. The involvement of small and large sensory fibers as well as motor fibers is a reason for the presence of neuropathic pain. In addition to the lifestyle modification, a number of different therapeutic approaches and treatment protocols have been applied to control the neuropathic pain. However, management is still unsatisfactory. Comorbidities such as depression, anxiety, and sleep disorders are associated with this disorder and should be previously considered and eliminated. Analgesics, tricyclic antidepressants, anticonvulsant, serotonin– norepinephrine reuptake inhibitors, and local anesthetic agent as well as opioid analgesics and herbal medicaments such as capsaicin are known treatment lines for the management of neuropathic pain. Regarding the unsuccessfulness of single therapy, poly-pharmacy or combination therapy of two or more agents with synergistic mechanisms and different modes of action seems necessary.