American Board of Internal Medicine (ABIM) Certification Practice Exam

Which medication might be effective for patients suffering from chronic neurogenic neck pain?

1. Ibuprofen

2. Gabapentin

3. Prednisone

4. Aspirin

The correct answer is: Gabapentin

Gabapentin is recognized as an effective medication for patients suffering from chronic neurogenic neck pain due to its mechanism of action that specifically targets neuropathic pain pathways. It is an anticonvulsant that works by inhibiting certain neurotransmitters, thereby reducing the excitability of neurons associated with pain transmission. Chronic neurogenic pain often arises from conditions affecting the nervous system, such as nerve compression or nerve damage, which makes traditional analgesics like ibuprofen or aspirin less effective, as they primarily address inflammatory or musculoskeletal pain rather than neuropathic pain. While prednisone can reduce inflammation and may benefit conditions that have a significant inflammatory component, it does not target neuropathic pain specifically and comes with a range of potential side effects associated with long-term use. Gabapentin, however, has been shown through research to provide relief for patients with neuropathic pain and can be particularly beneficial for those whose pain is not adequately controlled with over-the-counter analgesics. Its favorable side effect profile in the context of chronic use further supports its use as a first-line treatment option for managing chronic neurogenic neck pain.