| One-Minute Clinician

Going Beyond the Usual Neuropathic Pain Conditions

I’m not sure if odd is necessarily the right word. They’re odd in the sense that not everyone gets them after these certain types of surgeries. It’s only a subset of patients that tend to get long sequelae of pain after these surgeries. So I guess in that way, it’s odd, but they are actually pretty prevalent for people that experience it.

We try to emphasize a multimodal approach; medical treatment, procedural interventions, psychological interventions like cognitive-behavioral therapy, graded motor imagery. These therapies benefit patients the most when they’re used in conjunction with each another. Some of the non-pharmacological therapies for these neuropathic pain syndromes would be preemptive modalities, meaning targeting pain before a noxious stimuli happens. In a lot of these cases, it will be surgery. So preemptive procedures - like a thoracic epidural or a paravertebral catheter, different types of PEC blocks for mastectomy. Those types of procedures would be alternatives to medications.

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