NeuPSIG guidelines on neuropathic pain assessment
Abstract
This is a revision of guidelines, originally published in 2004, for the assessment of patients with neuropathic pain. Neuropathic pain is defined as pain arising as a direct consequence of a lesion or disease affecting the somatosensory system either at peripheral or central level. Screening questionnaires are suitable for identifying potential patients with neuropathic pain, but further validation of them is needed for epidemiological purposes. Clinical examination, including accurate sensory examination, is the basis of neuropathic pain diagnosis. For more accurate sensory profiling, quantitative sensory testing is recommended for selected cases in clinic, including the diagnosis of small fiber neuropathies and for research purposes. Measurement of trigeminal reflexes mediated by A-beta fibers can be used to differentiate symptomatic trigeminal neuralgia from classical trigeminal neuralgia. Measurement of laser-evoked potentials is useful for assessing function of the A-delta fiber pathways in patients with neuropathic pain. Functional brain imaging is not currently useful for individual patients in clinical practice, but is an interesting research tool. Skin biopsy to measure the intraepidermal nerve fiber density should be performed in patients with clinical signs of small fiber dysfunction. The intensity of pain and treatment effect (both in clinic and trials) should be assessed with numerical rating scale or visual analog scale. For future neuropathic pain trials, pain…
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The results may also reflect insufficient assay sensitivity of clinical trials in neuropathic pain.
“However these results may also reflect insuffficient assay sensitivity of clinical trials of neuropathic pain50 (Table 4).”
From Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis (2015) · cites this paper as [50]
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Self-citationA Comprehensive Algorithm for Management of Neuropathic Pain
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Self-citationClinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews
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Self-citationA new look at painful diabetic neuropathy
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Self-citationPsychological therapies for the management of chronic neuropathic pain in adults
Eccleston, C., Hearn, L., & Williams, A. C. D. C. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011259.pub2 · Cited by 102 · see citing works
Sensitization of the Nociceptive System in Complex Regional Pain Syndrome
Reimer, M., Rempe, T., Diedrichs, C., Baron, R., & Gierthmühlen, J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0154553 · Cited by 101 · see citing works
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- Authors
- Haanpää, M., Attal, N., Backonja, M., Baron, R., Bennett, M., Bouhassira, D., Cruccu, G., Hansson, P., Haythornthwaite, J. A., Iannetti, G. D., Jensen, T. S., Kauppila, T., Nurmikko, T. J., Rice, A. S. C., Rowbotham, M., Serra, J., Sommer, C., Smith, B. H., & Treede, R.-D.
- Affiliations
- University of Wisconsin–Madison (US)
- Inserm (FR)
- University Hospital Schleswig-Holstein (DE)
- Sapienza University of Rome (IT)
- Karolinska University Hospital (SE)
- Johns Hopkins University (US)
- University College London (GB)
- Aarhus University Hospital (DK)
- University of Helsinki (FI)
- University of Liverpool (GB)
- University of California, San Francisco (US)
- Parc Científic de Barcelona (ES)
- University of Würzburg (DE)
- University of Aberdeen (GB)
- Heidelberg University (DE)
- Corresponding author
- Haanpää, Maija
- ORCID
- Venue
- Pain
- Published
- 2011-01
- Volume
- 152
- Issue
- 1
- Pages
- 14-27
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2026423509
- Cited by
- 1,060
- References
- 104
- Citations by year
- 2026: 30 · 2025: 37 · 2024: 39 · 2023: 53 · 2022: 67 · 2021: 80 · 2020: 74 · 2019: 81 · 2018: 65 · 2017: 78 · 2016: 97 · 2015: 84 · 2014: 92 · 2013: 76 · 2012: 62
- FWCI
- 5.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Funders
- NeuPSIG
- Special Interest Group on Neuropathic Pain of the International Association for the Study of Pain (IASP®)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- neuropathic pain, pain assessment, screening questionnaire, sensory examination, quantitative sensory testing, small fiber neuropathy, trigeminal neuralgia, laser-evoked potentials, functional neuroimaging, skin biopsy, intraepidermal nerve fiber density, pain intensity assessment, quality of life, sleep and mood
- MeSH terms
- Autonomic Nervous System, Diagnostic Imaging, Disability Evaluation, Evoked Potentials, Humans, Mass Screening, Neuralgia, Pain Measurement, Psychological Tests, Psychophysiologic Disorders, Quality of Life, Surveys and Questionnaires, Time Factors, Databases, Factual, Guidelines as Topic
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