Pain is a major health care problem. Pain is regarded as a symptom of underlying condition.  Good pain management involves assessing the pain, followed by control of pain through pharmacological management and resolving underlying cause. Neuropathic pain is intractable pain caused by damage to nervous system. Peripheral neuropathy affects most people with Diabetes. HIV associated sensory peripheralneuropathy is the most prevalent neurological complication associated with HIV. According to Canadian guidelines Tri Cyclic Anti-depressants and Anticonvulsants are used as first line therapy for treating neuropathic pain. Cancer pain remains a clinical problem worldwide. Cancer therapy causes pain in patients receiving chemotherapy. Opioids remain the most effective pharmaceuticals in treatment of cancer pain. The goal of pain therapy for patients receiving chemotherapy is to provide them sufficient relief to tolerate the diagnostic and therapeutic approaches required to treat their Cancer.

1. Diane Glowacki- Effective pain management- critical care nurse 2015; 35 (3): 33-43.
2. The principles of managing acute pain in primary care- February 2018
3. WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses.
4. Vargas- schaffer G.cogan J.patient therapeutic education placing patient at centre of the WHO analgesic ladder can Fam physician. 2014;60:235-41.
5. Richard D. Blondell, MD; Mohammadreza azadfard et al Pharmacological Therapy for Acute Pain June 1,2013 volume 87, Number  11
6. Mara Lambert ICSI Releases guideline on chronic pain assessment and Management August 15, 2010 Volume 82, Number 4.
7. Dr Lesley Colvin, Dr Rachel Atherton, Dr Jonathan et al, Management of chronic pain A national clinical guideline 2013 December.
8.  Loesera JD, Treedeb RD. The Kyoto protocol of IASP Basic Pain Terminology Pain. 2008;137:473–7. [PubMed]
9. Colloca L, Ludman T, Bouhassira D et al. Neuropathic pain. Nat Rev Dis Primers 2017;(3):17002. doi: 10.1038/nrdp.2017.2
10. Pop-Busui R, Boulton A, Feldman E et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care 40(1):136–154. doi: 10.2337/dc16-2042
11. Meacham K, Shepherd A, Mohapatra D et al. Neuropathic pain: central vs peripheral mechanisms. Curr Pain Headache Rep  2017;21(6):28. doi: 10.1007/s11916-017-0629-5
12. Torrance N, Smith BH, Bennett MI et al. The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain 2006;7(4):281–289. doi: 10.1016/j.jpain.2005.11.008
13. Bouhassira D, Lantéri‐Minet M, Attal N, et al. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain. 2008;136:380–7. [PubMed]Top of Form
14. Toth C, Lander J & Wiebe S. The prevalence and impact of chronic pain with neuropathic pain symptoms in the general population. Pain Med 2009;10(5):918–929. doi: 10.1111/j.1526-4637.2009.00655.x

15. VanDenKerkhof E, Mann E, Torrance N et al. An epidemiological study of neuropathic pain symptoms in Canadian adults. Pain Res Manag 2016; 2016:9815750. doi: 10.1155/2016/9815750

1. Smith BH & Torrance N. Epidemiology of neuropathic pain and its impact on quality of life. Curr Pain Headache Rep. 2012; 16:191–198. doi: 107/s11916-012-0256-00.10
2. Bennett GJ. Neuropathic pain: new insights, new interventions. Hosp Pract (Off Ed). October 15, 1998;33(10):95-98, 101-104, 107-110 passim
3. Zilliox LA. Neuropathic pain. Continuum (Minneap Minn) 2017;23(2):512–532. doi: 10.1212/CON.0000000000000462
4. Katherine E Galluzzi management of neuropathic pain The Journal of the American Osteopathic Association,  September 2005, Vol. 105, S12-S19.
5. International association for study of pain. Epidemiology of neuropathic pain: how common is neuropathic pain, and what is impact? Washington: IASP; 2014.
6. Tesfaye S, Boulton AJ, Dickenson AH. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care. 2013;36:2456–2465. [PMC free article] [PubMed].
7. Boulton AJ, Kirsner RS, Vileikyte L. Clinical practice. Neuropathic diabetic foot ulcers. N Engl J Med. 2004;351:48–55. [PubMed]
8. Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006;82:95–100. [PMC free article] [PubMed]
9. Quattrini C, Tesfaye S. Understanding the impact of painful diabetic neuropathy. Diabetes Metab Res Rev. 2003;19 Suppl 1:S2–S8. [PubMed]

25. Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai KS, Stacey B. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage. 2005;30:374–385. [PubMed]

1. Freeman R. New and developing drugs for the treatment of neuropathic pain in diabetes. Curr Diab Rep. 2013;13:500–508. [PubMed]
2. Hurley R, Adams M & Benzon H. Neuropathic pain: treatment guidelines and updates. Curr Opin Anaesthesiol  2013; 26(5):580–587. doi: 10.1097/ACO.0b013e328363b4bf
3. Kamerman P, Wadley A & Cherry C. HIV-associated sensory neuropathy: risk factors and genetics Curr Pain Headache Rep  2012;16(3):226–236. doi: 10.1007/s11916-012-0257-z
4. Peripheral Neuropathy  primary care of veterans with hiv Neurology, Psychiatry, and Pain April 2009; Last reviewed/updated: October 2011
5. Daniela Amorim Pharmacological treatment of neuropathic pain: review of oral and topical therapy recommendations. International journal of clinical neuosciences and mental health July 2015 DOI: 10.21035/IJCNMH.2015;2:4.
6. Cavaletti G, Marmiroli P. Chemotherapy-induced peripheral neurotoxicity. Nat Rev Neurol. 2010;6(12):657-666
7. Miltenburg NC, Boogerd W. Chemotherapy-induced neuropathy: a comprehensive survey. Cancer Treat Rev. 2014;40(7):872-882.
8. Gupta R & Bhaskar A. Chemotherapy-induced peripheral neuropathic pain. BJA Educ  2016;16(4):115–119. doi: 10.1093/bjaed/mkv044
9. Argyriou AA, Bruna J, Marmiroli P, Cavaletti G. Chemotherapy-induced peripheral neurotoxicity (CIPN): an update. Crit Rev Oncol Hematol. 2012;82(1):51-77
10. Graham R. Hadley1 & Julie A. Gayle1 & Juan Ripoll 1 & Mark R. Jones1 & Charles E. Argoff2 & Rachel J. Kaye3 & Alan D. Kaye1Post-herpetic Neuralgia: a ReviewCurr Pain Headache Rep (2016) 20:17 DOI 10.1007/s11916-016-0548-x
11. Hall G, Carroll D & McQuay HJ. Primary car incidence and treatment of four neuropathic pain conditions: a descriptive study, 2002-2005. BMC Fam Pract 2008;9(26). doi: 10.1186/1471-2296-9-26
12. Kumar S, Rastogi S, Kumar S et al. Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review. J Med Life 2 013;6(4):383–388. PMID: 24701256
13. Krista G Brooks Tiffany L Kessler Treatments for neuropathic pain1 DEC 2017.
14. Stuart A . Grossman, MD Erin M. Dunbar, MD and Suzzcane A. Nesbit, pharm D Cancer pain management in 21 centuryoct 1 2006 vol-20 issue 11.
15. Deepak Thapa, V. Rastogi and Vanitha AhujaCancer pain management current status Journal of Anaesthesiology, Clinical Pharmacology 2011 Apr-Jun; 27(2): 162-168
16. M Fallon, R Giusti, F Aieli, P Hoskin et al, Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines Annals of oncology 29 (supplement 4): iv 166-iv 191, 2018.
17. C. I. Ripamonti, E. Bandieri & F. Roila Management of Cancer pain: ESMO Clinical Practice Guidelines Annals of Oncology Volume 22 (Supplement 6) September 2011.

Dr P. Kishore

Head, Department of Pharmacy Practice, Care College of Pharmacy, Oglapur (v), Damera (m), Warangal Rural, Telangana, India – 506006

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone: 9100576492