Managing Chronic Pain: Practical Considerations to Improve Treatment Outcomes - Episode 17

Complementary and Alternative Treatment Options for Managing Neuropathic Pain

The panelists discuss the benefits of integrative and/or complementary options to bolster the treatment they provide to patients who are suffering from chronic pain.

Charles Argoff, MD, points out that some studies of supplements have shown good results. He mentions a German study of the antioxidant alpha-lipoic acid that found it to have some benefit in the treatment of diabetic neuropathy, as well as a B vitamin product that has also shown some early success in trials in patients with diabetic neuropathy.

Joseph Pergolizzi, MD, agrees that there have been some interesting studies of antioxidants and other options, including for prevention and treatment of chemotherapy-induced peripheral neuropathy.

Pergolizzi also notes that researchers have found new data on the pathways and mechanisms by which some of these complementary treatments function. He says that often “the more that we go back and revisit these [types of treatments], the more potential they have.”

He says that nearly all pain clinicians rely on multimodal treatment strategies, meaning that they’re all practicing integrative pain medicine so some extent. “The bottom line is that integrative medicine is where we take complementary alternative medicine and marry it with allopathic traditional medicine,” he says.

Moderator Jeffrey Gudin, MD, asks the panelists to also talk about nerve blocks, epidurals, and other interventional therapies, particularly the use of corticosteroids to “calm down the inflamed nerve roots from the Zoster virus.”

Chris Gharibo, MD, responds that when it comes to interventional pain medicine, “it really depends on the type of neuropathic pain that we’re talking about, and that he while he doesn’t think “interventions are well indicated for postherpetic neuralgia or peripheral neuropathy, there is “a subset of neuropathic pain that could respond well.”