How do you approach pain management in patients with idiopathic polyneuropathy?

There are a few different guidelines/recommendations depending on which professional society you search. However, I tend to adhere most closely to the table cited below, with an approach that looks something like:

First line:

• Gabapentin 300mg TID titrating up to 1000mg TID
• Pregabalin 75mg BID titra...

Painful neuropathy is typically most symptomatic when disrupting sleep and TCA HS promotes sleep onset while moderating dysesthesias.

Gabapentin