Ravi Mirpuri’s scientific contributions

Neuropathic pain is a category of chronic pain disorders that are most common, debilitating, costly, and difficult to treat. It is a significant challenge to individuals suffering from it, healthcare providers, and society at large. This book is written by expert clinicians and investigators from multiple disciplines to provide the most comprehensive and updated information on neuropathic pain disorders that are commonly encountered in clinical practice. It strives to reflect the current understanding of the concepts, classification, mechanisms, assessment, diagnosis, and treatment of neuropathic pain. Following chapters addressing these topics in general terms are chapters devoted to specific neuropathic pain disorders consequent to lesions or diseases of the central and peripheral nervous systems. These chapters take a case-based format to stimulate situation-guided thinking, predicting, and learning. The textbook serves to inform best practices and stimulate innovative investigations to advance patient care, as well as the science behind it.

This chapter discusses various nonpharmacological treatments for neuropathic pain. Physiotherapy, tai chi, and yoga are all methods that incorporate movement exercise to treat biomechanical imbalances and reduce kinesiophobia, or “fear of movement.” Additionally, this chapter discusses treatments targeted at the peripheral nervous system, such as structured graded desensitization, heat/cold physical modalities, transcutaneous electrical nerve stimulation, and acupuncture, all of which have varying levels of efficacy. The chapter reviews the different psychotherapy approaches to treating neuropathic pain: cognitive-behavioral therapy (CBT), operant-behavioral therapy, mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT). It is important to note that many of the therapies discussed are intended to be incorporated with other pharmacological or interventional approaches to provide a multimodal level of care and increase chances of outcome success. Other treatments discussed include orthotics, mirror therapy, and transcranial magnetic stimulation for a variety of neuropathic conditions.