Total Knee Athroplasty Neuropathic Pain: Difference between revisions
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== '''UNDER CONSTRUCTION 3.4.2024 '''Introduction == | == '''UNDER CONSTRUCTION 3.4.2024 '''Introduction == | ||
Knee Replacement (KR) procedures are regularly performed now. However up to 1/5 of these replacements | Knee Replacement (KR) procedures are regularly performed now. However up to 1/5 of these replacements cause patients to have a degree of long-term pain or are not satisfied with their surgery. | ||
cause patients to have a degree of long-term pain or are not satisfied with their surgery. | |||
== Sub Heading 2 == | == Sub Heading 2 == | ||
Neuropathic pain rates post KJA reach their max at six to twelve weeks after surgery, and approximately 6% patients will go on to have | [[Neuropathic Pain|Neuropathic pain]] rates post KJA reach their max at six to twelve weeks after surgery, and approximately 6% patients will go on to have long term neuropathic pain. | ||
Patients with a pre existing neuropathic pain elsewhere have a greater potential for chronic nociceptor stimulation and central pain transmission. | * Post-surgical pain with a neuropathic component is likely to be greater than pure nociceptive pain, affecting QOL. | ||
* Neuropathic pain may stem from sensitisation of peripheral nociceptors many sources eg inflamed synovium, damaged subchondral bone, surgery trauma. | |||
* Patients with a pre existing neuropathic pain elsewhere have a greater potential for chronic nociceptor stimulation and central pain transmission. | |||
== Features == | == Features == | ||
Neuropathic pain is distinguished by the following features: pain not relieved by rest | Neuropathic pain is distinguished by the following features: pain not relieved by rest and analgesia; diffuse and difficult to localise pain; pain that radiates towards or away from the knee; pain associated with feelings of pressure, numbness, sensitivity, burning, stinging, electric shocks or rigidity. | ||
and analgesia; diffuse and difficult to localise pain; pain that radiates towards or away from the knee; pain associated with feelings of pressure, numbness, sensitivity, burning, stinging, electric shocks or rigidity. | |||
== Assessing == | == Assessing == | ||
Neuropathic pain can be assessed by various validated scoring systems, the most commonly used is the | Neuropathic pain can be assessed by various validated scoring systems, the most commonly used is the [[PainDETECT]], a helpful assessment tool in this patient group. | ||
PainDETECT, a helpful assessment tool in this patient group. | |||
Various guidelines exist for the assessment and treatment of neuropathic pain. These include offering a choice of | |||
for | * Amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment. | ||
* Capsaicin cream or topical lidocaine is an option for localised neuropathic pain or neuroma | |||
== Sub Heading 3 == | == Sub Heading 3 == | ||
Revision as of 03:05, 4 April 2024
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton
UNDER CONSTRUCTION 3.4.2024 Introduction[edit | edit source]
Knee Replacement (KR) procedures are regularly performed now. However up to 1/5 of these replacements cause patients to have a degree of long-term pain or are not satisfied with their surgery.
Sub Heading 2[edit | edit source]
Neuropathic pain rates post KJA reach their max at six to twelve weeks after surgery, and approximately 6% patients will go on to have long term neuropathic pain.
- Post-surgical pain with a neuropathic component is likely to be greater than pure nociceptive pain, affecting QOL.
- Neuropathic pain may stem from sensitisation of peripheral nociceptors many sources eg inflamed synovium, damaged subchondral bone, surgery trauma.
- Patients with a pre existing neuropathic pain elsewhere have a greater potential for chronic nociceptor stimulation and central pain transmission.
Features[edit | edit source]
Neuropathic pain is distinguished by the following features: pain not relieved by rest and analgesia; diffuse and difficult to localise pain; pain that radiates towards or away from the knee; pain associated with feelings of pressure, numbness, sensitivity, burning, stinging, electric shocks or rigidity.
Assessing[edit | edit source]
Neuropathic pain can be assessed by various validated scoring systems, the most commonly used is the PainDETECT, a helpful assessment tool in this patient group.
Various guidelines exist for the assessment and treatment of neuropathic pain. These include offering a choice of
- Amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment.
- Capsaicin cream or topical lidocaine is an option for localised neuropathic pain or neuroma
Sub Heading 3[edit | edit source]
Resources[edit | edit source]
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