Neuropathic pain in orthopedic conditions: a comprehensive review

Abstract

Neuropathic pain (NP) is a complex and disabling condition frequently associated with orthopedic disorders such as radiculopathies, entrapment syndromes, postoperative pain, and complex regional pain syndrome. This narrative review aims to summarize current scientific evidence regarding the pathophysiology, diagnosis, and treatment of NP within the orthopedic context. Databases such as PubMed, Cochrane, and Embase were searched for clinical trials, meta-analyses, and guidelines published up to 2024. The review presents updated pharmacological recommendations, including firstline agents such as antidepressants and gabapentinoids, as well as topical therapies, opioids, cannabinoids, and interventional procedures. Special attention is given to the role of ultrasound guided blocks and neuromodulation techniques like spinal cord stimulation. Evidence supports a multidisciplinary and individualized approach, particularly in cases refractory to conventional therapy. This review reinforces the need for early recognition of NP components in musculoskeletal pain syndromes to improve functional outcomes and quality of life.