The management of neuropathic pain or chronic pain with neuropathic component is based on a multi-specialty approach. In fact, at the moment it is prevalently treated with a multimodal therapy. In general, pharmacological therapy is based on the use of antidepressant, anticonvulsant drugs and/or cannabinoids. This is frequently associated to supportive therapies like acupuncture, mesotherapy and reflexology. Even if their use is largely diffuse all over the world, supporting data for their efficacy are weak. This poster will present the results of a huge clinical experience.
The author has retrospectively analysed the results obtained in a case series affected by neuropathic pain or chronic pain with a neuropathic component. The evaluation of pain was done with the visual analog scale (VAS). The inclusion criteria were chronic pain in different locations for over 6 months, with a clear neuropathic origin, already in treatment with pharmacological therapy for at least 3 months without a significant reduction of pain. VAS <2 was deemed as a satisfactory result. A reduction of VAS less than 2 point was deemed as a failure.
The clinical records of 137 patients, treated between January 1, 2018, and December 31, 2019, were analysed. Their age was comprised between 31 and 78 years old. Eighty were females and 53 males. All of them were enclosed in the study because of the clear origin of the pain syndrome. All of them were treated with acupuncture and related techniques (electro-acupuncture, moxibustion, auriculotherapy). The best results were obtained in the trigeminal neuralgia with 65% of complete remission at the end of the treatment. In 12& of those patients the supplemental therapy resulted completely useless. Good results were also obtained in post-herpetic neuralgia (57.1% complete remission of pain, 14,4% no effects). Diabetic neuropathy has resulted as the less sensitive to the supplemental therapies (37.5% remission, 62.5% insufficient improvement).
This study suggests that neuropathic pain is sensible to the treatment with acupuncture and associate techniques. The "complementary" treatment is efficacious both alone or as support of the pharmacological therapy. It may also prevent the necessity of invasive therapies, like infiltration with local anesthetics. In any case, considering the limitations of the study, other experiences with prospective and randomised protocols would be necessary.