Effectiveness of Multimodal Treatment Strategies for Neuropathic Pain: A Retrospective Study from a Moroccan Rheumatology Centre

Background: Neuropathic pain (NP) is a common and challenging clinical entity in rheumatology, necessitating an integrated therapeutic approach. Despite established guidelines, real-world data on multimodal management strategies in North African rheumatology settings remain scarce. Methods: This retrospective study included patients with neuropathic pain (NP) who were treated at the Rheumatology Department of Ibn Rochd University Hospital, Casablanca, between October 2020 and April 2022. Inclusion was based on a DN4 score of ≥4. Both pharmacological and non-pharmacological treatment modalities were assessed. Outcome measures comprised pain intensity (VAS), sleep quality, functional status, and emotional well-being, as evaluated by the Hospital Anxiety and Depression Scale (HADS). Results: The most frequently prescribed medications were pregabalin (52%), amitriptyline (36%), tramadol (22%), gabapentin (4.4%), and duloxetine (2%). A significant improvement in pain (VAS <3/10), sleep, and functional status was observed. Non-pharmacological approaches (physical therapy, TENS, and infiltrations) were implemented in 40% of patients and resulted in functional and emotional benefits. Etiological surgery was performed in 6.5% of cases and led to significant clinical improvement. Conclusion: This study highlights the effectiveness of a multimodal, patient-centred approach in managing NP within a rheumatologic context. Integration of pharmacological and non-pharmacological modalities contributed to comprehensive clinical improvement, supporting the biopsychosocial model in chronic pain management.