Neuropathic pain
Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system. Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli (allodynia). It may have continuous and/or episodic (paroxysmal) components. The latter resemble stabbings or electric shocks. Common qualities include burning or coldness, "pins and needles" sensations, numbness and itching.
| Neuropathic pain | |
|---|---|
| Specialty | Neurology and psychiatry |
| Duration | Variable |
| Causes | Damage to the nervous system resulting from diabetes mellitus, multiple sclerosis, infection, injury, and stroke, among others |
| Risk factors | Diabetes mellitus; multiple sclerosis; exposure to neurotoxicants; alcoholism; history of chemo- and/or radiotherapy; & nutritional deficiencies, among others |
| Diagnostic method | Clinical interview; quantitative sensory testing; electroneuromyography; nerve stimulation; biopsy; imaging, & patient self-rating of symptoms |
| Differential diagnosis | Diabetic and metabolic neuropathy; demyelinating disease (e.g., multiple sclerosis); malignancy; spinal cord injury; primary neuralgia; mononeuritis multiplex; sciatica; pruritic processes; fibromyalgia; and functional pain syndrome, among others |
| Treatment | Physical therapy; exercise; psychotherapy; antidepressants; gabapentinoids; anticonvulsants; Tramadol; neuromodulation, and topical agents, among others |
| Frequency | 4.1%-12.4% (12-month prevalence, US adults) |
Up to 7-8% of the European population is affected, and in 5% of persons it may be severe. Neuropathic pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord). Thus, neuropathic pain may be divided into peripheral neuropathic pain, central neuropathic pain, or mixed (peripheral and central) neuropathic pain. Neuropathic pain may occur in isolation or in combination with other forms of pain. Medical treatments focus on identifying the underlying cause and relieving pain. In cases of neuropathy, the pain may progress to insensitivity.