Neuropathic Pain

Definition

Neuropathic pain is a common component of pain states, is complex condition and often has profound negative physical, psychological and social impacts.

Causes of neuropathic pain

Central Disorders: 

  1. Post Stroke Pain
  2. Spinal Cord Injury
  3. Multiple Sclerosis

 

Peripheral Disorders: 

  1. Painful polyneuropathies (Diabetic and non-diabetic)
  2. Post Herpetic Neurlagia
  3. Trigeminal Neuralgia
  4. Brachial Plexus Injury
  5. Limp Amputations (Phantom pain)
  6. Post Surgical neuralgia
  7. Post-injury neuralgia
  8. Complex Reginal Pain Syndrome
  9. Radiculopathy

Assessment

Assessment of neuropathic pain should ascertain:

  1. Underlying causes of pain
  2. Assess pain severity
  3. Assess functional limitations
  4. identify coexisting depression, anxiety, insomnia, diabetes, or other health problems
  5. Assess the impact of the condition on work, family, social life, income, …

Symptoms of neuropathic pain

Allodynia

  • Pain initiation or worsening with minor touch

Hyperalgesia

  • Pain severity is higher than expected for such stimulus

Hypoalgesia

  • Reduced pain or feeling numb after painful stimulus

Paresthesia

  • Pain or discomfort without any stimulus
  • Can be spontaneous or evoked

Hyposthesia

  • Altered tactile or thermal sensitivity
  • Decreased sensitivity to warm or cold objects

Dysesthesia 

  • A spontaneous or evoked abnormal unpleasant sensation

Management

Management of neuropathic pain is extremely challenging and depends on the underlying pathology and also individuals psychological state.

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