Neuropathic Pain - A Guide Part 2

Today's post is part 2 of a two-part, general information post about neuropathic pain. Many people who have lived with neuropathy for some time, will already be aware of most of the things mentioned here but for those who are looking for general information, the posts from yesterday and today are an excellent 'guide' to the disease. They come from howstuffworks.com (see link below) and the section is Discovery: fit and health. Useful for people new to neuropathy and to their friends and relatives who also want to know more.

Treatments for Neuropathic Pain - Part Two
by Gerlinda Grimes

Medical Marijuana for Neuropathic Pain

Television shows like "Weeds" poke fun at so-called "medical" marijuana, inferring that it has more in common with reefer madness than real medicine. Nevertheless, as of this writing, medical marijuana is legal in 16 U.S. states as well as Washington, D.C., and six more states have pending legislation for the legalization of medical marijuana.

The reported benefits of cannabinoids, of which THC (the main psychoactive compound in marijuana) is one, have been confirmed in multiple randomized trials. A recent review concluded that 15 out of 18 trials showed that cannabinoids provided a significant pain-relieving effect when compared with a placebo. Cannabinoids were also shown to improve sleep [source: Lynch and Campbell].

The study of cannabinoids and why they work on chronic pain, including the neuropathic variety, is a hot topic among today's pharmacological researchers. Current studies are looking at cannabinoid receptors and ligands in the human body to try and provide a scientific explanation for why medical marijuana is effective in reducing pain.

Like all the other treatments for neuropathic pain, however, medical marijuana may only partially relieve the pain. In one Canadian study, patients who smoked medical marijuana reported their neuropathic pain level at 5.4, whereas patients who were given the placebo reported pain levels of 6.1 [source: Lowry]. If medical marijuana doesn't provide the necessary relief, more traditional analgesics may be indicated. We discuss the pros and cons of painkillers next.

The Pros and Cons of Using Painkillers to Treat Neuropathic Pain

There is no doubt that opiates will reduce almost most any kind of pain, including neuropathic pain. However, drugs like oxycodone, oxycontin and morphine carry risks that make some patients reluctant to use them and some doctors reluctant to prescribe them.

In general, opiates are considered a second or third-line treatment for neuropathic pain. Sometimes doctors will issue a short-term prescription for opiates in conjunction with first-line treatments since drugs like tricyclics, SNRIs and anticonvulsants can take several days to become effective. In cases where first-line treatments are ineffective, scheduled long-acting opioids like fentanyl patches or extended-release oxycodone are preferred over shorter acting agents [source: Jeffries]. This is because with any chronic pain, it is best to stay on top of the pain rather than to try and tough it out and only take medication when the pain gets really bad.

Side effects of opiates include drowsiness, constipation, nausea and, with elderly patients, an increased risk of falls or cognitive problems. Some studies have shown the risk of misuse or addiction to be as high as 50 percent [source: Jeffries]. Opiate alternatives such as methadone and tramadol have also been shown to work in treating neuropathic pain; both are thought to carry a lower risk of dependence than traditional opioids.

If opiates don't work for you, or if you're dubious about using addictive medication long-term, there are also alternative therapies to consider. We talk about acupuncture and other alternative treatments next.

Alternative Treatments for Neuropathic Pain

number of alternative treatments and non-Western healing practices are currently being evaluated to objectively gauge their effectiveness in treating many conditions including neuropathy. One of the most promising is acupuncture. Acupuncturists believe that vital energy ("Qi") traverses the nervous system along specific pathways called meridians and channels. By inserting thin needles into specific areas of the body, acupuncturists seek to stimulate qi and bring vital energy back into balance. The Chinese have practiced acupuncture for thousands of years. Although Western researchers can't yet explain how it works, studies have shown that it can be effective in relieving some types of pain. One 2010 study showed acupuncture to be more effective than traditional medication in relieving peripheral neuropathy pain induced by chemotherapy drugs [source: Zhongguo].

The Northern California Chapter of the Neuropathy Association has published a guide to complementary and alternative treatments for neuropathy. Among the treatments listed are alpha-lipoic acid (a universal antioxidant), Bowen therapy (a type of massage) and IVIG (intravenous immunoglobulin therapy), as well as many folk remedies such as borage oil, primrose oil and nettle footbaths. Though there is little scientific evidence supporting these treatments, they are recommended anecdotally by members of NCCNA support groups. Be sure to always discuss alternative treatments with your doctor before experimenting with complementary therapies.

Neuropathy is a big subject, with multiple possible causes and treatments. Find additional information and more great links on the next page.

http://health.howstuffworks.com/medicine/modern-treatments/5-treatments-for-neuropathic-pain3.htm