[Types of topical treatment for peripheral neuropathic pain : Mechanism of action and indications].

Der Schmerz
Ralf Baron, F Mahn

Abstract

The term "peripheral neuropathic pain syndromes" summarizes several chronic pain syndromes, which can occur focally or generalized in the peripheral nervous system in the course of an impairment of afferent neurons. Controlled clinical trials gave distinct indications for systemic treatments with antidepressants, anticonvulsants and opioid analgesics in several neuropathic pain syndromes. In addition to these systemic therapies, there are also two topical treatment options: topical application of lidocaine and capsaicin. An important cause of sensitization phenomena of afferent nociceptors is the upregulation of sodium channels and thermosensor channels. In the context of a partial nerve lesion that leaves behind partially preserved or regenerated afferent nerve fibres, just these channels could be used as target structures for topical medications. Topically applied drugs are absorbed systemically only in minute quantities, so systemic side effects are negligible. Pharmacological interactions with systematically acting substances are also virtually absent; thus, topically applied substances are especially appropriate for add-on therapy in addition to systemic pain medication.

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Citations

Jun 29, 2012·Der Schmerz·J LoeserO Dagtekin
Nov 29, 2015·The Medical Clinics of North America·Robert Carter Wellford JonesMiroslav Backonja
May 2, 2017·Journal of Cellular Biochemistry·Yang ZhangCheng-Cai Wen
Nov 20, 2020·International Journal of Molecular Sciences·Markus LeoTim Hagenacker

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