Europathic Pain Syndromes

Nonopioid analgesics such as acetaminophen can be used as adjuncts. EUROPATHIC PAIN SYNDROMES are challenging to treat. New drugs aim at the mechanisms of the pain, but results are still less than desirable. Newer antidepressants and anticonvulsive drugs are becoming first-line treatments in many patients. And we now know that, contrary to conventional wisdom, opioids do have a role in treating neuropathic pain. Still, there is no definitive algorithm for treatment. Rather, physicians often will have to combine agents in order to provide patients with relief from their pain. This article reviews how to classify a patient’s pain on the basis of the clinical picture, discusses the physiology of pain, and provides several approaches to managing common neuropathic pain syndromes, with two cases to illustrate the art and the science of treatment.