Clinical Management of Neuropathic Low Back and Neck Pain

Neuropathic neck and back pain often requires a multidisciplinary approach to management in hopes of alleviating the associated economic, humanistic, and societal burdens. While nonpharmacologic and interventional therapies play a role in the treatment of these patients, pharmacologic therapy is often required. Evidence-based recommendations suggest that tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, pregabalin, and gabapentin are first-line in neuropathic pain management, while other agents such as lidocaine patches, capsaicin patches, and tramadol may be considered alternative agents. With the many complexities associated with neuropathic pain management, it is essential that practitioners monitor for safety and efficacy of treatment.