Neuropathic Pain: An Evidence-Based Update (Invited Clinical Commentary) (Report‪)‬

BACKGROUND Neuropathic pain (NeP) is defined by the International Association for the Study of Pain (IASP) as pain arising as a direct consequence of a lesion or disease affecting the somatosensory system (Loeser and Treede, 2008). Symptoms of NeP often include a reported lack of sensation in the area and pain, with the pain being described as electric-like or lancinating. Common conditions such as diabetes, stroke, multiple sclerosis and cancer can cause NeP (Table 1). The World Health Organisation indicates that chronic or long term conditions including diabetes, cardiovascular disease and cancer, are the leading cause of preventable morbidity and mortality in New Zealand (WHO, 2008). The New Zealand Health Strategy (2000) prioritizes the reduction, impact and incidence of these conditions, and has targeted primary care as a service delivery area. It is however, anticipated that NeP may become more prevalent in years to come due to: an aging population, increased survival rates of conditions such as diabetes and cancer, and use of treatment strategies (for example medical and surgical management of cancer) which can cause NeP (Dworkin, 2002). This clinical commentary provides a critique of recent literature in response to key questions health care consumers and providers, such as physiotherapists, may have as regards NeP.