Current Therapeutic Strategies for Neuropathic Pain: Mechanisms, Drug Options, and Interventional Approaches

Neuropathic pain is a chronic condition resulting from a lesion or disease of the somatosensory nervous system. Despite diverse etiologies, neuropathic pain involves shared mechanisms such as neuronal hyperexcitability, central sensitization, and impaired inhibitory pathways. Neuropathic pain substantially limits mobility and leads to a general decline in overall health and quality of life. A wide array of therapeutic approaches is used in patients care, ranging from systemic pharmacologic agents to localized and minimally invasive interventions. This review summarizes recent approvals on treatments for neuropathic pain and evaluates the benefits, risks, and appropriate clinical contexts for oral, topical, and interventional modalities. Systemic pharmacologic therapeutic drugs, such as serotoninnorepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, gabapentinoids, nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, are widely used, although the efficacy varies based on the underlying mechanisms and patient-specific factors. Topical formulations, such as lidocaine and capsaicin, provide targeted analgesia with minimal systemic exposure and are suitable therapy for localized peripheral neuropathic syndromes. Minimally invasive procedures, including corticosteroid injections, nerve blocks, and radiofrequency ablation, offer additional choices for pain relief. Overall, optimal neuropathic pain management includes stepped, multimodal and individualized strategies that integrates systemic pharmacologic, topical, and interventional approaches. Ongoing research advances in mechanism-based and minimally invasive therapies hold promises for improving long-term outcomes in patients with neuropathic pain.