Neuropathic pain: current definition and review of drug treatment

Neuropathic pain is relatively common and often poorly treated. Management options include tricyclic antidepressants or serotonin and noradrenaline reuptake inhibitors in the first instance, followed by pregabalin or gabapentin. Tramadol or topical lidocaine (lignocaine) could be considered as second line. Stronger opioids have been relegated to third line. It is important to remember that opioids and gabapentinoids have abuse potential. Fibromyalgia and chronic low back pain without radiculopathy do not meet the current criteria for the definition of neuropathic pain.