Management of neuropathic pain: a survey of the Italian Association for the Study of Pain

BACKGROUND: Neuropathic pain significantly impacts the quality of life. This study explores neuropathic pain management practices among members of the Italian Association for the Study of Pain (AISD). METHODS: During the 46th National Congress, 240 physicians affiliated with AISD were surveyed. The data included demographics, clinical settings, diagnostic procedures, treatment approaches, and preferences. The analysis utilized descriptive statistics, treatment rankings, and consensus evaluations. RESULTS: Respondents practicing in pain medicine reported the numbers of cases managed monthly. Neuropathic pain diagnoses relied on clinical findings corroborated by diagnostic tools. Treatment typically commenced within one to two weeks, emphasizing pharmacological interventions, which were often combined with invasive procedures. The leading pharmacological choices included gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors. Varied rankings were noted for invasive procedures, with nerve and neuraxial blocks particularly favored. Nutraceuticals such as palmitoylethanolamide, alpha-lipoic acid, and vitamin B complex were commonly prescribed, reflecting differences based on the physician's age and specialty. CONCLUSIONS: Generally, practices aligned with guidelines, showing a strong consensus on specific pharmacological treatments. Discrepancies in the rankings of invasive procedures, particularly among specialists, have led to questions regarding their perceived efficacy. These inconsistencies may indicate varying levels of expertise in interventional management, differences in the availability of these techniques, or different views on the current evidence supporting these procedures. The use of nutraceuticals indicated potential gaps in the guidelines.