Dfinition
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:
- Post Stroke Pain
- Spinal Cord Injury
- Multiple Sclerosis
Peripheral Disorders:
- Painful polyneuropathies (Diabetic and non-diabetic)
- Post Herpetic Neurlagia
- Trigeminal Neuralgia
- Brachial Plexus Injury
- Limp Amputations (Phantom pain)
- Post Surgical neuralgia
- Post-injury neuralgia
- Complex Reginal Pain Syndrome
- Radiculopathy
Assessment
Assessment of neuropathic pain should ascertain:
- Underlying causes of pain
- Assess pain severity
- Assess functional limitations
- identify coexisting depression, anxiety, insomnia, diabetes, or other health problems
- 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.