Why aren’t there better treatments for neuropathic pain?

Neuropathic pain is pain that serves no purpose: You keep feeling pain even when an injured part of your body has already healed. It’s caused by a problem with the body’s pain system. Like a broken alarm clock, this faulty system broadcasts non-stop, incorrect, and annoying signals that can’t be turned off.

Research is shedding new light on this disease, but new treatments are slow in coming. And even when new treatments are available, it takes time for them to be widely accepted and prescribed.

No magic bullet

Some people think that healthcare providers have a “magic bullet” medication that’s able to stop neuropathic pain. In reality, no such magic bullet exists. There is no single treatment that can totally relieve neuropathic pain over a long period of time. Even though some people are helped at first by using prescription opioids (the strongest pain medicines available), these drugs may not work as well – or at all – after a few weeks or months; they may even produce more pain with continued use. In addition, the use of these medications might cause new health, psychological, social, or legal problems for the person with neuropathic pain. The safest treatment for neuropathic pain is actually a mix of drug and non-drug methods that is occasionally fine-tuned by the person’s healthcare provider. Just as the feeling of neuropathic pain is unique to the person, so is the combination of things that can help to make it better.

Ten years and a billion dollars

Current pain relievers don’t always help because they rely on working, healthy nerves to have an effect. With neuropathic pain, though, damaged, misfiring nerves may not be able to respond the right way to these treatments. Since researchers have found dozens of ways that nerves can misfire, dozens of new drugs and devices are being developed to ease this type of pain.

Unfortunately, it takes scientists a billion dollars, 10 years, and many failures to create one new drug. Making drugs for neuropathic pain has an extra challenge because human nerves aren’t the same as the test-tube and animal nerves that researchers use to test many new drugs. In spite of these challenges, a few new drugs are in the final stages of testing. These drugs promise to stop nerve inflammation, keep pain signals from being garbled, prevent the pain from spreading, and boost production of the body’s natural pain relievers.

Roadblocks to treatment

Most health professionals have never been trained to diagnose and treat neuropathic pain. Even those who understand it struggle to find the best way to manage it. One reason is that the source of pain may change over time, while treatments are ongoing. This makes it unclear what symptoms are related to the disease itself, to the side effects of therapy, or to the effect that pain and its treatment has on daily life.

And even when professionals use the best ways of evaluating and treating neuropathic pain, insurers may undermine the treatment plan by refusing to pay for needed medicines and services. As a result, fewer of the medicines and treatments that help people with neuropathic pain are widely available. People without access to informed specialists, and those without insurance are at particularly high risk of not getting the help they need.

Without one standard treatment or adjustment in daily living that works for everyone, a partnership is needed between the patient, healthcare provider, and other professionals in order to find the combination that works best.

The future looks brighter

In spite of these issues, there are many reasons to hope for a better future:

  • Groups of pain experts have created guidelines for treating neuropathic pain
  • New and different treatments will be available every year for the foreseeable future
  • Healthcare reform may make it easier to get proper care for neuropathic pain, with treatment decisions coming from medical experts instead of health insurance companies
  • Electronic devices, including on-line services, will be used more often to teach healthcare providers about treatments
  • These devices will also help people with pain to keep track of different therapies and make it easier to communicate with healthcare professionals

Neuropathic pain resources and support groups will continue to grow. With better understanding of the condition, both professionals and people with neuropathic pain will team up to find the best possible treatments.