What a pain! Managing it through the continuum
ROGER GOUCKE, MARK SCHUTZE
There is increasing evidence that chronic or persistent pain can be classified as a disease in its own right. Managing pain can be challenging for both the GP and patient, and the use of medications alone cannot be relied on.
Treatment of neuropathic pain
Neuropathic pain is under-recognised and therefore undertreated. Most patients require a meticulous history and detailed examination so that a cause can be sought. Treatment is relatively straightforward and includes regular analgesics and adjuvant agents.
Peripheral nerve conditions in diabetes
STEPHEN M TWIGG, LEA SORENSEN
Tight glycaemic control can prevent diabetic peripheral neuropathy from worsening. If insensate peripheral neuropathy occurs, the patient is at risk of foot ulceration and preventive podiatric care is required. Painful peripheral neuropathy is managed pharmacologically.
Management of trigeminal neuralgia and its atypical variant
HELEN BOOCOCK, E RUSSELL VICKERS
The characteristic symptom of trigeminal neuralgia is sharp paroxysmal pain that radiates through the teeth and jaw. In patients with the classic form of the condition, the pain lasts seconds to minutes; however, the pain is persistent in patients with the atypical variant.