Tapentadol treatment results in long-term pain relief in patients with chronic low back pain and associates with reduced segmental sensitization

Donk, Tine van de; Cosburgh, Jurjan van; Dasselaar, Tom van; Velzen, Monique van; Drewes, Asbjørn Mohr; Dahan, Albert

doi:10.1097/pr9.0000000000000877

Cited by 11 publications

(2 citation statements)

References 42 publications

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“…25 A site-specific impairment of OA was also shown in chronic low back pain, with an OA effect which was lower at the back than at the arm. 26 This may be explained by a somatotopic descending pain modulation in specific areas of the brain, such as the periaqueductal grey as a potential underlying mechanism. 27 To investigate potential influences and underlying mechanisms of OA, studies on healthy pain-free participants are often conducted.…”

Section: Discussionmentioning

confidence: 99%

Offset analgesia is increased intra‐orally

Szikszay

Lévénez

Adamczyk

et al. 2022

J of Oral Rehabilitation

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Offset analgesia (OA) is defined as robust analgesia evoked by a small decrease in noxious stimulation via temporal filtering of noxious information. 1,2 This test procedure is considered to reflect the efficiency of descending pain inhibition and thus to play a crucial role in the pathological processes of chronic pain. 3,4 Although OA has high clinical relevance, its underlying mechanisms still need to be determined.Previous research suggests that OA may be the result of a complex interaction of multiple interdependent systems, including supra-spinal, spinal and peripheral processes. Functional magnetic

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Section: Discussionmentioning

confidence: 99%

Offset analgesia is increased intra‐orally

Szikszay

Lévénez

Adamczyk

et al. 2022

J of Oral Rehabilitation

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“…Somnolence and confusion may occur during treatment with tramadol, however, the risk of abuse is lower than other opioids [ 130 ]. Tapentadol, another µ-opioid agonist, has shown beneficial outcomes in the management of diabetic neuropathy and low back pain with a neuropathic component [ 174 , 175 , 176 , 177 ]. Other strong opioids such as oxycodone or morphine are recommended in the third-line treatment of neuropathic pain, but these agents are rarely utilized due to their high addiction potential [ 112 ].…”

Section: Treatment Strategies For Neuropathic Painmentioning

confidence: 99%

Diagnosis and Management of Neuropathic Pain in Spine Diseases

Bielewicz

Kamieniak

Szymoniuk

et al. 2023

JCM

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Neuropathic pain is generally defined as a non-physiological pain experience caused by damage to the nervous system. It can occur spontaneously, as a reaction to a given stimulus, or independently of its action, leading to unusual pain sensations usually referred to as firing, burning or throbbing. In the course of spine disorders, pain symptoms commonly occur. According to available epidemiological studies, a neuropathic component of pain is often present in patients with spinal diseases, with a frequency ranging from 36% to 55% of patients. Distinguishing between chronic nociceptive pain and neuropathic pain very often remains a challenge. Consequently, neuropathic pain is often underdiagnosed in patients with spinal diseases. In reference to current guidelines for the treatment of neuropathic pain, gabapentin, serotonin and norepinephrine reuptake inhibitors and tricyclic antidepressants constitute first-line therapeutic agents. However, long-term pharmacologic treatment often leads to developing tolerance and resistance to used medications. Therefore, in recent years, a plethora of therapeutic methods for neuropathic pain have been developed and investigated to improve clinical outcomes. In this review, we briefly summarized current knowledge about the pathophysiology and diagnosis of neuropathic pain. Moreover, we described the most effective treatment approaches for neuropathic pain and discussed their relevance in the treatment of spinal pain.

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