Andrew SC Rice
Professor of Pain Research, Faculty of Medicine, Imperial College, London, United Kingdom
This presentation will take as its basis the current International Association for the Study of Pain mechanistic definition of neuropathic pain: “Pain caused by a lesion or disease of the somatosensory nervous system”.
The speaker will describe a clinical algorithm which uses this definition as the basis of a step wise approach for increasing the diagnostic certainty (possible, probable, definite) of a case of neuropathic pain. This algorithm is structured to be compatible with the familiar sequential steps of a clinical consultation – history, physical examination and diagnostic tests. The use of symptom screening questionnaires will be discussed.
He will then present the new European Academy of Neurology, European Pain Federation and IASP Special Interest Group on Neuropathic Pain joint guidelines on neuropathic pain assessment. These were compiled using a comprehensive evidence appraisal process.
Finally, the speaker will argue that perhaps, in contrast to other areas of chronic pain management, the neuropathic pain field has overly concentrated on biological/pharmacological aspects of the neuropathic pain syndrome and that clinical management might be further improved by enhanced assessment of the psychological and social aspects of the biopsychosocial model.
- Jensen TS et al. A new definition of neuropathic pain. Pain 2011;152(10):2204-2205.
- Finnerup NB et al. Neuropathic pain: an updated grading system for research and clinical practice. Pain 2016;157(8):1599-1606.
- Truini A et al. Joint European Academy of Neurology-European Pain Federation-Neuropathic Pain Special Interest Group of the International Association for the Study of Pain guidelines on neuropathic pain assessment. Eur J Neurol 2023;30(8):2177-2196.