Abstract
Introduction: Neuropathic pain may develop after injury to the central nervous system, peripheral or both, when deleterious changes occur along the nociceptive modulatory pathways of the central nervous system. Proper management requires an interdisciplinary approach, as it can impact quality of life. Objectives: This review of the literature aims to assess the impact of pharmacological and non-pharmacological factors in the quality of life of patients with chronic neuropathic pain. Methodology: A systematized virtual search was carried out in PubMed®, collected articles between January 2010 and May 2020 using the terms “neuropathic pain”, “treatment”, “human” and “systematic review” using the filters of “systematic reviews ”E“ published in the last 10 years ”. All articles were formed by two independent reviewers and tabulated in a spreadsheet using Microsoft Excel® software. Results: Non-pharmacological interventions were addressed by most articles. Some articles addressed pharmacological interventions, with painful diabetic peripheral neuropathy being the main etiology. The most used quality of life measurement tools were: Medical Outcomes Study 36 (SF-36); EuroQol-5 Dimension (EQ-5D) and Beck Depression Inventory Score (BDI). Conclusion: The scarcity of high-quality studies that measure quality of life through validated tools is an obstacle to credible analysis of the impact of interventions on the life of chronic pain patients, however, in a preliminary way, cognitive behavioral therapy and the use of Spray THC/CBD oromucous has the potential to have a beneficial impact on quality of life.
Highlights
Neuropathic pain may develop after injury to the central nervous system, peripheral or both, when deleterious changes occur along the nociceptive modulatory pathways of the central nervous system
The remaining articles were submitted to the following criteria to be included in this review: [1] the article studies humans as a target population; [2] the article refers to neuropathic pain; [3] the article refers to ‘quality of life’ as a studied result; [4] the article refers to any type of intervention as treatment; [5] the article is a systematic review
Another study showed an improvement when using Nabilone 1 to 4 mg daily for 5 weeks compared to the placebo group according to the EuroQol-5 Dimension (EQ-5D) and the use of Nabilone 2 mg daily for 6 weeks compared to the use of Dihydrocodeine 240 mg/day showed an improvement in Physical Function domain of the SF-36, Dihydrocodeine has been shown to be superior in the Bodily Pain domain (Meng et al, 2017)
Summary
Neuropathic pain may develop after injury to the central nervous system, peripheral or both, when deleterious changes occur along the nociceptive modulatory pathways of the central nervous system. Objectives: This review of the literature aims to assess the impact of pharmacological and non-pharmacological factors in the quality of life of patients with chronic neuropathic pain. Some articles addressed pharmacological interventions, with painful diabetic peripheral neuropathy being the main etiology. The term was traced back three centuries later (5 BC), when Hippocrates and his followers published 'The Hippocratic Collection' (Perl, 2007). In another aspect, the relation of the brain as the seat of the sensation of pain was only described in the Renaissance period by Andreas Vesalius (1514-1564). None fully explains all aspects of pain perception (Collier, 2018; Moayedi & Davis, 2013)
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