Allodynia: pain produced by an innocuous stimulus e.g. touch, pressure
Hyperaesthesia: increased sensitivity to touch
Hyperalgesia: increased response to stimulus which is normally painful
Dysaesthesia: an unpleasant abnormal sensation
Pathway for managing Neuropathic pain in primary care
This is a new guideline with resources for both patient and clinician to manage long term neuropathic pain. It covers both post herpetic neuralgia and neuropathic pain.
Use this treatment guidance and the resources before considering referral.
If complex regional pain syndrome is suspected, refer early to pain specialist team. (see guidance)
The Neuropathic pain diagnostic DN4 tool is useful to aid diagnosis and for detecting change in pain after treatment. (see patient clinical resources on pathway)
All of the drugs in the guideline can cause significant adverse effects in some patients. If this occurs, try an alternative from the same therapeutic group. For example, with tricyclic antidepressants (TCA) try nortriptyline or imipramine instead of amitriptyline. Use patient leaflets provided to guide patients in their effective use.