Apr 1, 2007 Issue
Are Opioids Effective in the Treatment of Neuropathic Pain? [Cochrane for Clinicians]

Eight to 60 days of opioid therapy for the treatment of neuropathic pain effectively reduces pain scores as measured by a visual analog scale. A lack of response to opioids in the first 24 hours should not be used to predict whether longer-term opioid therapy might be beneficial. There are no contro...

Jul 1, 2006 Issue
Systemic Lidocaine or Mexiletine for Neuropathic Pain [Cochrane for Clinicians]

Intravenous lidocaine and oral mexiletine provide a modest reduction in neuropathic pain with no indication of serious adverse effects. However, safety data are limited because most studies were of relatively short duration and fewer than 400 patients have been studied in total for each drug. Intrav...

Jun 1, 2006 Issue
Antidepressants for the Treatment of Neuropathic Pain [Cochrane for Clinicians]

Tricyclic antidepressants, particularly amitriptyline, are effective for the treatment of painful diabetic neuropathy and post herpetic neuralgia, and may be beneficial in other neuropathic pain syndromes, but they should be used with caution in patients at increased risk of adverse events.

Feb 1, 2006 Issue
Gabapentin for Pain: Balancing Benefit and Harm [Cochrane for Clinicians]

At high dosages, gabapentin is moderately effective for neuropathic pain, although adverse effects are experienced as often as benefit.

Jun 1, 2005 Issue
Evaluation and Prevention of Diabetic Neuropathy [Article]

Diabetic neuropathy is a debilitating disorder that occurs in nearly 50 percent of patients with diabetes. It is a late finding in type 1 diabetes but can be an early finding in type 2 diabetes. The primary types of diabetic neuropathy are sensorimotor and autonomic. Patients may present with only o...

Jul 15, 2003 Issue
Management of Carpal Tunnel Syndrome [Article]

Carpal tunnel syndrome affects approximately 3 percent of adults in the United States. Pain and paresthesias in the distribution of the median nerve are the classic symptoms. While Tinel's sign and a positive Phalen's maneuver are classic clinical signs of the syndrome, hypalgesia and weak thumb abd...

Nov 1, 2001 Issue
Charcot Foot: The Diagnostic Dilemma [Article]

Primary care physicians involved in the management of patients with diabetes are likely to encounter the diagnostic and treatment challenges of pedal neuropathic joint disease, also known as Charcot foot. The acute Charcot foot is characterized by erythema, edema and elevated temperature of the foot...

Jun 1, 1998 Issue
The Charcot Foot in Diabetes: Six Key Points [Article]

The Charcot foot commonly goes unrecognized, particularly in the acute phase, until severe complications occur. Early recognition and diagnosis, immediate immobilization and a lifelong program of preventive care can minimize the morbidity associated with this potentially devastating complication of ...

Feb 15, 1998 Issue
An Algorithm for the Evaluation of Peripheral Neuropathy [Article]

The diagnosis of peripheral neuropathies can be frustrating, time consuming and costly. Careful clinical and electrodiagnostic assessment, with attention to the pattern of involvement and the types of nerve fibers most affected, narrows the differential diagnosis and helps to focus the laboratory ev...

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