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Case Report

EJMCR. 2018; 2(3): 91-94

Three case reports of chronic pain with neuropathic component - the importance of individualized therapy

Filipa Ferreira Pereira, Sergio Azevedo, Helena Magalhaes, Claudia Vieira, Deolinda Pereira, Maria Fragoso.

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Background: Pain is the most common symptom present at any stage of life. The pain can be divided into acute or chronic considering the duration of symptoms. Chronic pain approach is complex and it is a clinical challenge. Two main mechanisms are traditionally described: pain nociceptive (caused by ongoing tissue damage, somatic, or visceral) or neuropathic (damage or dysfunction in the nervous system). For the treatment of chronic moderate-severe pain, opioids are the standard treatment but the undesirable side effects cause a high discontinuation rate. Tapentadol was developed to improve the therapeutic range of opioids by adding two complementary mechanisms of action which seem to contribute to the reduction of side effects.
Case Presentation: The authors describe three cases of neuropathic chronic pain. One case describes neuropathic pain caused by degenerative changes and osteoporotic fracture, the second case was a woman with an important renal impairment, who complained of generalized arthralgia (under cancer treatment), and a third case of a man presented with diminished muscle strength in the lower right limb, most probably due to chemotherapy-induced peripheral neuropathy.
Conclusion: The management of chronic pain requires a multimodal approach, that is part of the individual as a whole, and a multidisciplinary approach is needed to relieve chronic pain with minimal side effects.

Key words: Pain, neuropathic pain, cancer, analgesics, opioid, case report

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