Tapentadol prolonged release for managing moderate to severe chronic neck pain with or without a neuropathic component

Background: Despite the high prevalence of neck pain, few studies have addressed the pharmacological treatment of this condition. Purpose: We evaluated the effectiveness of tapentadol prolonged-release (PR) in patients with or without a neuropathic pain component, with a focus on functional movements, disability and Quality of Life (QoL). Study design/setting: Observational, retrospective study. Patient sample: Ninety-four adult patients with severe neck pain not responsive to opioid step III treatment. Outcome measures: The primary endpoint was a ≥ 30% improvement of pain intensity at 4 weeks (W4). Several secondary outcomes were evaluated, including neck disability index (NDI), range of motion (ROM), and QoL. Methods: Patients received tapentadol PR at the starting dose of 100 mg/day. Dose titration was allowed in 50 mg increments, up to 500 mg daily. Results: At W4, the primary endpoint of ≥30% improvement of pain was reported in 70% (n = 35; 95% confidence interval [CI]: 55–82%) of patients with a neuropathic pain component and in 69% (n = 20; 95% CI: 49–85%) of those without a neuropathic component. The percentage of patients reporting a neuropathic pain component significantly decreased from baseline (64.2%) to W4 (27.8%). NDI significantly improved in both groups at W12. ROM significantly improved in all three planes of motion (p <.01), with no difference between the two groups. Interference of pain with sleep and QoL also improved. Conclusions: The reduction in pain provided by tapentadol is associated with functional recovery, which may in turn be linked to an improvement in QoL.