Neuropathic pain: diagnosing and treating


  • R. V. Sulik P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv


Neuropathic pain (NP) is caused by a damage or dysfunction of the system that normally carries pain signals. Diseases followed by NP are of heterogeneous group of pathologies with the peripheral and central nervous system lesions. Pathophysiological basis of neuropathic pain is excessive excitability of neurons arising from plastic changes in the structures related to the conduction and processing of nociceptive signals. A typical example is pain in diabetic neuropathy, postherpetic neuralgia and trigeminal neuralgia. NP can significantly affect the life quality. Often it is difficult to treat NP because of its resistance to many drugs, and it is accompanied by side effects against effective pharmacotherapy.


Download data is not yet available.


Баринов А. Н. Лечение нейропатических болевых синдромов // Укр. мед. часопис. – 2007. – № 2(58). – С. 91–96.

Данилов А. Б. Использование габагамма в лечении болевой формы диабетической невропатии // Міжнар. неврологічний журн. – 2008. – № 3(19). – С. 111–114.

Данилов А. Б. Применение витаминов группы В при болях в спине: новые анальгетики? // РМЖ. 2008; 16: Специальный выпуск. Болевой синдром: 35–39.

Данилов А.Б., Давыдов О. С. Нейропатическая боль. Москва : Боргес, 2007. — 198 с.

Данилов А.Б., Давыдов О. С. Диагностические шкалы для оценки нейропатической боли // Боль. – 2007. – № 3(16). – С. 11–14.

Лысенко Г.И., Ткаченко В. И. Проблема боли в общеврачебной практике: Уч.-метод. пособие для семейных врачей. – К. : Медкнига, 2007. – 196 с.

Маньковський Б. М. Симптоматичне лікування больового синдрому при діабетичній нейропатії // Укр. мед. газета. – 2006. – № 10. – С. 15.

Маньковський Б. М., Жердьова Н. М., Пхакадзе О. Г., Бабіна Г. В., Юзвенко Т. Ю. Терапія діабетичної полінейропатії за допомогою тіогами // Клінічна ендокринологія та ендокринна хірургія. – 2003. – № 4(5). – С. 50–53.

Новикова О. В. Невропатическая боль: основные аспекты ее патогенеза и лечения (обзор) // Международный неврологический журнал. – 2006. – № 5. – С. 120–123.

Ang C.D., Alviar M.J., Dans A.L., Bautista-Velez G.G., Villaruz-Sulit M.V., Tan J.J., Co H.U., Bautista M.R., Roxas A. A. Vitamin B for treating peripheral neuropathy. Cochrane Database Syst Rev. 2008 Jul 16; 3:CD004573.

Attal N., Cruccu G., Haanpaa M., Hansson P., Jensen T. S., Nurmikko T., Sampaio C., Sindrup S., Wiffen P. EFNS guidelines on pharmacological treatment of neuropathic pain. European Journal of Neurology, 2006, 13:1153–1169.

Aufiero E., Stitik T.P., Foye P.M., Chen B. Pyridoxine hydrochloride treatment of carpal tunnel syndrome: a review. Nutr Rev. 2004 Mar; 62: 3: 96–104.

Bromm K., Herrmann W.M., Schulz H. Do the B-vitamins exhibit antinociceptive efficacy in men? Results of a placebo-controlled repeated-measures double-blind study. Neuropsychobiology. 1995; 31: 3: 156–65.

Finnerup N.B., Otto M., McQuay H. J., Jensen T. S., Sindrup S. H. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain, 2005 Dec 5;118(3):289–305.

Freynhagen R., Strojek K., Griesing T., Whalen E., Balkenohl M. Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of fable- and fixeddose regimens. Pain, 2005 Jun;115(3):254–63.

Galer B.S., Jensen M. P., Ma T., Davies P. S., Rowbotham M. C. The lidocaine patch 5 % effectively treats all neuropathic pain qualities: results of a randomized, double-blind, vehicle-controlled, 3-week efficacy study with use of the neuropathic pain scale. Clin J Pain, 2002;18:297–301.

Gilron I., Bailey J. M., Tu D., Holden R. R., Weaver D. F., Houlden R. L. Morphine, gabapentin, or their combination for neuropathic pain. N Engl J Med, 2005 Mar 31;352(13):1324–34.

Goldstein D.J., Lu Y., Detke M. J., Lee T. C., Iyengar S. Duloxetine vs. placebo in patients with painful diabetic neuropathy. Pain, 2005; 116:109–118.

Harati Y., Gooch C., Swenson M. et al. Double-blind randomized trial of tramadol for the treatment of the pain of diabetic neuropathy. Neurology, 1998 ;50:1842–1846.

Jolivalt C.G., Mizisin L.M., Nelson A., Cunha J.M., Ramos K.M., Bonke D., Calcutt N.A. B vitamins alleviate indices of neuropathic pain in diabetic rats. Eur J Pharmacol. 2009 Jun 10; 612: 1–3: 41–7.

Jurna I., Carlsson K.H., Komen W., Bonke D. Acute effects of vitamin B6 and fixed combinations of vitamin B1, B6 and B12 on nociceptive activity evoked in the rat thalamus: dose-response relationship and combinations with morphine and paracetamol. Klin Wochenschr. 1990 Jan 19; 68: 2: 129–35.

Jurna I., Reeh P. W. How useful is the combination of B vitamins and analgesic agents?. Schmerz. 1992 Sep; 6: 3: 224–6.

Jurna I. Analgesic and analgesia-potentiating action of B vitamins. Schmerz. 1998 Apr 20; 12: 2: 136–41.

Mauro G.L., Martorana U., Cataldo P., Brancato G., Letizia G. Vitamin B12 in low back pain: a randomised, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci. 2000 May–Jun; 4: 3: 53–58.

Mixcoatl-Zecuatl T., Quinonez-Bastidas G.N., Caram-Salas N.L., Ambriz-Tututi M., Araiza-Saldana C.I., Rocha-Gonzalez H.I., Medina-Santillan R., Reyes-Garcia G., Granados-Soto V. Synergistic antiallodynic interaction between gabapentin or carbamazepine and either benfotiamine or cyanocobalamin in neuropathic rats. Methods Find Exp Clin Pharmacol. 2008 Jul–Aug; 30: 6: 431–41.

Ryan-Harshman M., Aldoori W. Carpal tunnel syndrome and vitamin B6. Can Fam Physician. 2007 Jul; 53: 7: 1161–2.

Saarto T., Wiffen P. Antidepressants for neuropathic pain. Cochrane Database of Systemic Reviews 2005; 20:CD005454.

Schwieger G. Zur Frage der Rezidivprophylaxe von schmerzhaften. Wirbewlsaulensyndromen durch B-Vitamine. Ergebnisse einer randomisierten Doppelblindstudie, Neurobion forte (Vitamin B1, B6, B12) gegen Placebo. In: Klinische Bedeutung von Vitamin Bl, B6, B12 in der Schmerztherapie / N Zollner et al (Edtr). Steinkopff Verlag, Darmstadt, 1988;169–181.

Siddall P. J., Cousins M. J., Otte A., Griesing T., Chambers R., Murphy T. K. Pregabalin in central neuropathic pain associated with spinal cord injury: a placebo-controlled trial. Neurology, 2006 Nov 28;67(10):1792–800.

Song X.S., Huang Z.J., Song X. J. Thiamine suppresses thermal hyperalgesia, inhibits hyperexcitability, and lessens alterations of sodium currents in injured, dorsal root ganglion neurons in rats. Anesthesiology. 2009 Feb; 110: 2:387–400.

Stracke H., Gaus W., Achenbach U., Federlin K., Bretzel R. G. Benfotiamine in diabetic polyneuropathy (BENDIP): results of a randomised, double blind, placebo controlled clinical study. Exp Clin Endocrinol Diabetes. 2008 Nov; 116: 10: 600–5.

Sindrup S.H., Otto M., Finnerup N. B. et al. Antidepressants in the treatment of neuropathic pain. Basic and Clinical Pharmacology and Therapy, 2005; 9 6:399–409.

Talaei A., Siavash M., Majidi H., Chehrei A. Vitamin B(12) may be more effective than nortriptyline in improving painful diabetic neuropathy. Int J Food Sci Nutr. 2009 Feb; 12:1–6.30.

van Seventer R., Feister H. A., Young J. P. Jr., Stoker M., Versavel M., Rigaudy L. Efficacy and tolerability of twice-daily pregabalin for treating pain and related sleep interference in postherpetic neuralgia: a 13-week, randomized trial.Curr Med Res Opin, 2006 Feb;22(2):375–84.

Wiffen P., McQuay H., Edwards J. et al. Gabapentin for acute and chronic pain. Cochrane Database Systematic Reviews, 2005a; 20:CD005452. 36. Wiffen P., Collins S., McQuay H. et al. Anticonvulsant drugs for acute and chronic pain. Cochrane Database Systematic Reviews 2005c; 20:CD001133.




How to Cite

Sulik RV. Neuropathic pain: diagnosing and treating. PMJUA [Internet]. 2016Mar.1 [cited 2020Oct.25];1(1). Available from: