Abstract
Dear Editor, Neuropathic incisional pain is difficult to treat effectively and is probably mechanistically due to microneuroma formation and sensitization at the site of the incision. First-line pharmacological treatments for neuropathic pain include selective serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants calcium channel α2δ-subunit ligands (gabapentin and pregabalin), and topical lidocaine. The role of nonsteroidal anti-inflammatory drugs (NSAIDs) in treating neuropathic pain is unclear. Application of topical NSAIDs in the peripheral tissue is demonstrated to be efficacious in the treatment of acute and chronic nociceptive pain. NSAIDs may decrease inflammation of the peripheral nerves and the supporting structures that can cause neuropathic pain. Even so, NSAIDs are excluded from most treatment guidelines for any role in treating neuropathic pain, although a significant number of patients with neuropathic pain receive prescriptions for NSAIDs. We report a case of headaches and incisional pain treated with topical NSAID. To our knowledge, this is the first reported case of incisional pain treated with topical diclofenac plus dimethyl sulfoxide (DMSO). A 46-year-old gentleman with …
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