Pain Management: Neuropathic Pain

Neuropathic pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.
One example of neuropathic pain is called phantom limb syndrome. This occurs when an arm or a leg has been removed because of illness or injury, but the brain still gets pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.
What Causes Neuropathic Pain?
Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include:
Alcoholism
Amputation
Back, leg, and hip problems
Chemotherapy
Diabetes
Facial nerve problems
HIV infection or AIDS
Multiple sclerosis
Shingles
Spine surgery
What Are the Symptoms of Neuropathic Pain?
Symptoms may include:
Shooting and burning pain
Tingling and numbness
How Is Neuropathic Pain Diagnosed?
A doctor will conduct an interview and physical exam. He or she may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain.
How Is Neuropathic Pain Treated?
Some neuropathic pain studies suggest the use of non-steroidal anti-inflammatory drugs, such as Aleve or Motrin, may ease pain. Some people may require a stronger painkiller, such as those containing morphine. Anticonvulsant and antidepressant drugs seem to work in some cases.
If another condition, such as diabetes, is involved, better management of that disorder may alleviate the pain.
In cases that are difficult to treat, a pain specialist may use invasive or implantable device therapies to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain generation may significantly control the pain symptoms.
Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability.
Reviewed by the doctors at The Cleveland Clinic Pain Management Department. Edited by Charlotte E. Grayson, MD, WebMD, June 2004.
http://www.medicinenet.com/neuropathic_pain/article.htm