How to treat NFCI?
Acute Management
- Initial management should focus on preventing further cooling. Replace wet/cold clothing with warm/dry layers.
- Rewarm the affected area slowly, avoiding immersing it in warm water or direct exposure to a radiator or fire.
- Robust, multimodal acute pain management is important.
Chronic Management
- Re-exposure to cold should be avoided or exposure time should be reduced with additional protection (insulation and wind-proof layers or heated garments).
- No good evidence exists for any single intervention.
- A holistic approach that recognises the significance of the “biopsychosocial” components of pain is important.
Prognosis
- Most individuals who develop NFCI will recover.
- A small proportion of individuals with severe NFCI will be left with chronic neuropathic pain needing the full support of an interdisciplinary chronic pain service.