Consider the many different ways to manage neuropathic pain in patients with multiple sclerosis, but more evidence is needed

Neuropathic pain in patients with multiple sclerosis (MS) can be debilitating and require a multimodal management strategy. Of the pharmacological treatment options, first line are antidepressants (e.g. amitriptyline, duloxetine), and other considerations include anticonvulsants, opioids and muscle relaxants, and even nanomedicine as an emerging strategy. However, the evidence for many of these therapies are scarce or from small studies; therefore, further investigation is required to elucidate the optimal therapies for neuropathic pain in patients with MS. Non-pharmacological options are also important and various (including non-invasive brain stimulation techniques, neurological methods, psychotherapy, physical rehabilitation); however, current evidence is of low quality and further data are needed.