Neuropathic Pain

Neuropathic pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves might be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of a nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.

What causes neuropathic pain? Neuropathic pain often seems to have no obvious cause. It responds poorly to standard pain treatment and occasionally might get worse instead of better over time. For some people, it can lead to serious disability. 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 seem to misfire and cause pain. Some common causes of neuropathic pain include:

Alcoholism * Amputation * Back, leg, and hip problems * Cancer chemotherapy * Diabetes Facial nerve problems * HIV infection or AIDS * Multiple sclerosis * Shingles * Spine surgery

What are the symptoms of neuropathic pain? Some symptoms of neuropathic pain include shooting pain, burning pain, tingling, and numbness.

How is neuropathic pain diagnosed? A doctor will conduct an interview and physical exam. He or she might 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? In most cases, neuropathic problems are not fully reversible. Partial to marked improvement is often possible with proper treatment. Some neuropathic pain studies suggest the use of NSAIDs or an analgesic with morphine. Anticonvulsant and antidepressant drugs and various pain relievers seem to work in some cases. If another condition, such as diabetes, is involved, better management of that disorder might alleviate the neuropathic pain. In cases that are difficult to treat, a pain specialist might use invasive or implantable device therapies to effectively manage the pain. It is worth noting that electrical stimulation of the nerves involved in neuropathic pain generation might significantly control the pain symptoms.

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