International Journal of Clinical Research

Objective Low back pain is one of the most common chronic pain disorders. This article reviews the literature on the role of neuropathological mechanisms in chronic low back pain and discusses advances in its pharmacological treatment. Methods: A literature search was performed in literature databases for published literature on neuropathic low back pain. All relevant literature was evaluated. Results: Chronic low back pain included traumatic and neuropathic pain. However, neuropathic pain is difficult to manage. Many people with chronic low back pain have pain that is not responsive to existing treatments. Less than half of patients achieved clinical remission with oral drug therapy. Paracetamol and NSAIDs, although widely used for low back pain, are unlikely to improve neuropathy components and data on the use of neuropathic low back pain antidepressants and drugs such as gabapentin/pregabalin are limited. Although there is an unmet need for improved treatment options, recent data suggest that tapentadol is effective against the neuropathic component of low back pain. The 8% capsaicin patch and 5% lidocaine ointment are topical analgesics that can be used to treat peripheral disease and may be an effective treatment for neuropathic low back pain. Conclusions: Chronic low back pain often has an underrecognized neuropathic component that is difficult to manage and requires more detailed investigation, diagnosis and treatment.

low back pain; neuropathic pain; pain management; non-steroidal anti-inflammatory drugs; capsaicin