NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Neuropathic Pain Guidelines Updated

Neuropathic pain has many causes and is defined as “Pain initiated or caused by a primary lesion or dysfunction of the nervous system”. The signs and symptoms include feelings of:

  • Burning
  • Electric shocks
  • Numbness
  • Tingling
  • Shooting/stabbing

It is important to establish a diagnosis and explain implications and chronicity to the patient and the value of compliance with treatment. Healthcare professionals should encourage self-management and provide education to the patient, including coping strategies for flare up. Patients should understand that effective treatment is considered as 30% reduction in pain score and / or improved function. The benefits and possible adverse effects of pharmacological treatment should be discussed, including the importance of titration and review.

Regular assessment of effectiveness of treatment is needed, particularly during the titration period. Assessment of pain control includes the impact on daily activities and lifestyle. Prescribers should also consider the patient’s physical and psychological well being including adverse effects of therapy and the continued need for treatment.

The updated NHSGGC Chronic Non-Malignant Pain Neuropathic Pain Guideline is now available on StaffNet. The guideline contains information on:

  • Assessing neuropathic pain with link to sLANSS tool
  • Need for regular assessment and review
  • More detailed information on stepwise treatment of neuropathic pain and titration schedules
  • Links to Patient Information Leaflets
  • When to consider referral to pain clinic