Feldman Andrew, Weaver Joshua
Department of Neurology, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, New York.
Semin Neurol. 2025 Feb;45(1):145-156. doi: 10.1055/s-0044-1791770. Epub 2024 Oct 11.
Disorders of the somatosensory nervous system that cause neuropathic pain are treated in a variety of ways. Herein, we introduce a stepwise approach to treating neuropathic pain. We then summarize the available data and guidelines for treating neuropathic pain, both with pharmacologic and nonpharmacologic methods, and provide a synthesized algorithm highlighting the similarities and differences between recent guidelines on the management of neuropathic pain. Pharmacologic treatments are primarily antiseizure medications (e.g., gabapentinoids, sodium channel blockers) and antidepressant medications (e.g., tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors), though other medications and interventional pharmacologic therapies can also be considered. There are a wide variety of nonpharmacologic treatments for neuropathic pain including neuromodulation, nerve stimulation, physiotherapy, movement therapies, lifestyle modification, nutritional supplements, acupuncture, and mind-body techniques.
导致神经性疼痛的躯体感觉神经系统疾病有多种治疗方法。在此，我们介绍一种治疗神经性疼痛的逐步方法。然后，我们总结了治疗神经性疼痛的现有数据和指南，包括药物和非药物方法，并提供了一个综合算法，突出了近期神经性疼痛管理指南之间的异同。药物治疗主要是抗癫痫药物（如加巴喷丁类、钠通道阻滞剂）和抗抑郁药物（如三环类抗抑郁药、5-羟色胺-去甲肾上腺素再摄取抑制剂），不过也可考虑其他药物和介入性药物疗法。对于神经性疼痛有各种各样的非药物治疗方法，包括神经调节、神经刺激、物理治疗、运动疗法、生活方式改变、营养补充剂、针灸和身心技巧。
