Neuropathic Pain

Neuropathic pain is a type of pain that develops when the nerves or other parts of the nervous system involved in sensing and processing pain are affected by injury or disease. It may arise from problems involving peripheral nerves, nerve roots, the spinal cord or, less commonly, the brain. Neuropathic pain can occur on its own or alongside other forms of pain, including musculoskeletal or inflammatory pain. Identifying the underlying cause and understanding how the nervous system is contributing to the symptoms are important steps in assessment and treatment.

People with neuropathic pain often describe their symptoms differently from ordinary aches or soreness. Common descriptions include burning, shooting, stabbing, piercing or electric-shock-like pain, as well as tingling, prickling, numbness or pins and needles. Some patients develop increased sensitivity, where a normally harmless stimulus such as light touch, clothing or bedsheets can provoke pain. Others may find that an ordinarily painful stimulus feels much more intense than expected. Symptoms can be constant or occur in brief episodes and may have a substantial effect on sleep, physical activity, work and quality of life.

A wide range of conditions can have a neuropathic pain component. Examples include diabetic peripheral neuropathy, sciatica and nerve-root disorders, post-herpetic neuralgia following shingles, trigeminal neuralgia, nerve injuries and entrapment syndromes such as carpal tunnel syndrome. Neuropathic symptoms may also develop after surgery or trauma, with conditions such as multiple sclerosis or stroke, or following some cancer treatments. Diabetes is an important cause of peripheral nerve damage, although nutritional deficiencies, autoimmune conditions, infections, certain medications and other disorders can also affect the nerves. Because neuropathic pain has many possible causes and presentations, a comprehensive assessment can help determine the underlying pain mechanism and inform an individualised treatment approach.