9th September 2020

A-54-year old patient with a history of poorly controlled type 2 diabetes presents to the GP

A-54-year old patient with a history of poorly controlled type 2 diabetes presents to the GP with pain that she describes as “like toothache in her legs”. She says it is starting to become unbearable and is stopping her from sleeping at night. On examination she has loss of sensation up to the knee and Charcot’s arthropathy of the ankle. She has a history of substance misuse with heroin, alcohol and benzodiazepines but is no longer using any of these substances.

Which of the following is the most appropriate therapy for her neuropathic pain?

Select the SINGLE most appropriate option from the list below. Select ONE option only.