Understanding peripheral neuropathic pain in primary care: diagnosis and management.

OBJECTIVE To describe an approach that allows for a dedicated clinical assessment and accurate recognition of peripheral neuropathic pain in primary care and to provide an update on the available pharmacologic therapies MATERIALS AND METHODS: Medline was searched using the key word "neuropathic pain". Searches were refined for each pathophysiological mechanism, diagnosis and treatment by adding appropriate key words. RESULTS The distinction between neuropathic and nociceptive pain is essential for an adequate treatment because these forms of pain differ in their underlying mechanisms and therefore in their response to different drugs. CONCLUSIONS Chronic pain with neuropathic characteristics presents a significant challenge as it is often unresponsive to conventional analgesics. The correct diagnosis and early management of peripheral neuropathic pain not only improve health-related outcomes, but also yield significant cost benefit to society.