Do you think there are any effective treatments for people with neuropathic pain due to syringomyelia?
G: Very difficult disorder to treat. I want to underscore the importance of the correct diagnosis. There may be secondary issues in the spine, such as cysts, so its important to have a clear and specific diagnosis. Once that is made, the neuropathic nature of the pain is difficult, because were looking at central and peripheral mechanisms. Some medicines, such as anti-seizure drugs like Neurontin have been helpful as well as some anti-depressants. Local anesthetics and narcotic spinal infusions have been helpful in severe cases. Even some electro-stimulating procedures have been helpful. All have been used, but none have been 100% effective in this difficult disorder. What are your views on the use of narcotics to treat pain? Should patients and/or doctors be concerned about addiction? G: The use of narcotics is quite controversial but does have a role in pain management. Overall, narcotic analgesics are quite safe. Thousands upon thousands of patients die every year with non-steroidal
