Neuropathic pain occurs as a result of injury or disease of nerve fibers. Generally, it is extremely painful and very difficult to treat. Neuropathic pain occurs in various forms and may result from damage or injury of central neural regions or peripheral nerves. More severe cases may take on characteristics of Complex Regional Pain Syndrome.
Peripheral Nerve Pain
Painful states that fall into this category are usually related to disease or injury of the peripheral nerves. Peripheral neuropathies that are often painful include those caused by diabetes, polyarteritis, alcohol-related nutritional deficiencies, and nerve entrapment.
Central Neurogenic Pain
Central pain refers to pain that is produced due to damage of central neural matter (such as the brain or spinal cord). For example, in patients who have had spinal cord damage, there may be severe pain in regions supplied by nerves below the level of the spinal cord lesion.
Complex Regional Pain Syndrome
Complex regional pain syndrome is a rare disorder of the extremities characterized by widespread pain (usually in an arm or hand, leg or foot), swelling of the extremity, color and temperature changes in the affected limb, weakening, degeneration, and/or abnormal development of the skin and nails overlying the affected area. Most cases occur after relatively minor trauma to bone, soft tissues, and/or nerves. It is believed that the pain results from dysfunction of the sympathetic division of the nervous system but the exact mechanism has yet to be elucidated.
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Symptoms of Neuropathic Pain
Neuropathic pain often has burning, gnawing, aching, shooting or stabbing characteristics. The pain is often associated with increased sensitivity, particularly to painful stimuli. In addition, individuals will experience pain in response to stimuli that are normally not painful. There may also be additional coexistent neurological deficits.
Treatment of Neuropathic Pain
Treating neuropathic pain can be very challenging and thus requires various approaches. Some pharmacological options for treating neuropathic pain include antiepileptics, antidepressants, topical analgesics, topical anesthetics, antiarrhythmic drugs, and opioid medications. Electrical stimulation of the nerve(s) involved may also be utilized for pain management.
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