10
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Outcome predictors for treatment success with 5% lidocaine medicated plaster in low back pain with neuropathic components and neuropathic pain after surgical and nonsurgical trauma

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Five percent lidocaine medicated plaster has been proven efficacious for the symptomatic relief of neuropathic pain in diverse pain conditions which might be attributed to a common localized symptomatology in these indications, possibly with common predictors of treatment success. To discuss potential symptoms and other factors predicting response to treatment with lidocaine plaster for the indications of low back pain with neuropathic components and neuropathic pain after surgical and nonsurgical trauma, 44 pain specialists from 17 countries attended a two-day conference meeting in December 2009. Discussions were based on the retrospective analysis of case reports (sent in by participants in the four weeks prior to the meeting) and the practical experience of the participants. The results indicate some predictors for success with 5% lidocaine medicated plaster for the two indications. Localized pain, hyperalgesia and/or allodynia, and other positive sensory symptoms, such as dysesthesia, were considered positive predictors, whereas widespread pain and negative sensory symptoms were regarded as negative predictors. Paresthesia, diagnosis, and site of pain were considered to be of no predictive value. Common symptomatology with other neurologic pathologies suggests that treatment of localized neuropathic pain symptoms with the plaster can be considered across different neuropathic pain indications.

          Related collections

          Most cited references 19

          • Record: found
          • Abstract: found
          • Article: not found

          Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment.

          Neuropathic pain develops as a result of lesions or disease affecting the somatosensory nervous system either in the periphery or centrally. Examples of neuropathic pain include painful polyneuropathy, postherpetic neuralgia, trigeminal neuralgia, and post-stroke pain. Clinically, neuropathic pain is characterised by spontaneous ongoing or shooting pain and evoked amplified pain responses after noxious or non-noxious stimuli. Methods such as questionnaires for screening and assessment focus on the presence and quality of neuropathic pain. Basic research is enabling the identification of different pathophysiological mechanisms, and clinical assessment of symptoms and signs can help to determine which mechanisms are involved in specific neuropathic pain disorders. Management of neuropathic pain requires an interdisciplinary approach, centred around pharmacological treatment. A better understanding of neuropathic pain and, in particular, of the translation of pathophysiological mechanisms into sensory signs will lead to a more effective and specific mechanism-based treatment approach. Copyright 2010 Elsevier Ltd. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Pathology and pathogenesis of lumbar spondylosis and stenosis.

            Study of autopsy specimens of the lumbar spine makes it possible to construct a spectrum of pathologic change. Progressive degenerative changes in the posterior joints lead to marked destruction and instability. Similar changes in the disc result in herniation, internal disruption, and resorption. Combined changes in posterior joint and disc sometimes produce entrapment of a spinal nerve in the lateral recess, central stenosis at one level, or both of these conditions. Changes at one level often lead, over a period of years, to multilevel spondylosis and/or stenosis. Developmental stenosis is an enhancing factor in the presence of a small herniation or moderate degenerative stenosis. Lesions such as major trauma, spondylolisthesis, those following spinal fusion, Paget's disease, and fluorosis, on occasion act directly to produce central or lateral stenosis.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The evaluation of neuropathic components in low back pain.

              Chronic low back pain is highly prevalent in Western societies. Large epidemiological studies show that 20% to 35% of patients with back pain suffer from a neuropathic pain component. Presently, chronic lumbar radicular pain is the most common neuropathic pain syndrome. The pathophysiology of back pain is complex and nociceptive, and neuropathic pain-generating mechanisms are thought to be involved, which established the term mixed pain syndrome. Neuropathic pain may be caused by lesions of nociceptive sprouts within the degenerated disc (local neuropathic), mechanical compression of the nerve root (mechanical neuropathic root pain), or by action of inflammatory mediators (inflammatory neuropathic root pain) originating from the degenerative disc even without any mechanical compression. Its diagnosis and management remain an enigma, mainly because there is no gold standard for either. Accuracy of diagnostic tests used to identify the source of back pain and their usefulness in clinical practice, particularly for guiding treatment selection, is unclear. In connection with the specific instance of back pain (one of the single most costly disorders in many industrialized nations), neuropathic pain components are a significant cost factor.
                Bookmark

                Author and article information

                Journal
                J Pain Res
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2011
                11 January 2011
                : 4
                : 25-38
                Affiliations
                [1 ] St Georges Hospital, London, UK
                [2 ] Allentown, Pennsylvania, USA
                [3 ] Antwerp University Hospital, Edegem, Belgium
                [4 ] Institut Curie, Saint Cloud, France
                Author notes
                Correspondence: Guy Hans, Multidisciplinary Pain Center, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium, Tel +323 821 4945, Fax +323 821 4586, Email guy.hans@ 123456uza.be
                Article
                jpr-4-025
                10.2147/JPR.S15534
                3048580
                21386952
                © 2011 Nicolaou et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                Categories
                Original Research

                Comments

                Comment on this article