Neuropathic pain

Neuropathic pain
SpecialtyNeurology and psychiatry
DurationVariable
CausesDamage to the nervous system resulting from diabetes mellitus, multiple sclerosis, infection, injury, and stroke, among others
Risk factorsDiabetes mellitus; multiple sclerosis; exposure to neurotoxicants; alcoholism; history of chemo- and/or radiotherapy; & nutritional deficiencies, among others
Diagnostic methodClinical interview; quantitative sensory testing; electroneuromyography; nerve stimulation; biopsy; imaging, & patient self-rating of symptoms
Differential diagnosisDiabetic 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
TreatmentPhysical therapy; exercise; psychotherapy; antidepressants; gabapentinoids; anticonvulsants; Tramadol; neuromodulation, and topical agents, among others
Frequency4.1%-12.4% (12-month prevalence, US adults)[1]

Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system.[2][3] 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.[3]

Up to 7–8% of the European population is affected by neuropathic pain,[4] and in 5% of persons it may be severe.[5][6] The pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord). 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 peripheral neuropathy, the pain may progress to insensitivity.

  1. ^ DiBonaventura, Marco D.; Sadosky, Alesia; Concialdi, Kristen; Hopps, Markay; Kudel, Ian; Parsons, Bruce; Cappelleri, Joseph C.; Hlavacek, Patrick; Alexander, Andrea H.; Stacey, Brett R.; Markman, John D.; Farrar, John T. (2017). "The prevalence of probable neuropathic pain in the US: results from a multimodal general-population health survey". Journal of Pain Research. 10: 2525–2538. doi:10.2147/JPR.S127014. PMC 5677393. PMID 29138590.
  2. ^ "Terminology Pain terms and definitions". Archived from the original on 13 January 2015. Retrieved 15 Nov 2023.
  3. ^ a b Kaur, Jaskirat; Ghosh, Shampa; Sahani, Asish Kumar; Sinha, Jitendra Kumar (June 2019). "Mental imagery training for treatment of central neuropathic pain: a narrative review". Acta Neurologica Belgica. 119 (2): 175–186. doi:10.1007/s13760-019-01139-x. PMID 30989503. S2CID 115153320.
  4. ^ De Courcy, Jonathan; Liedgens, Hiltrud; Obradovic, Marko; Holbrook, Tim; Jakubanis, Rafal (April 2016). "A burden of illness study for neuropathic pain in Europe". ClinicoEconomics and Outcomes Research. 8: 113–126. doi:10.2147/CEOR.S81396. PMC 4853004. PMID 27217785.
  5. ^ Torrance N, Smith BH, Bennett MI, Lee AJ (April 2006). "The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey". J Pain. 7 (4): 281–9. doi:10.1016/j.jpain.2005.11.008. PMID 16618472.
  6. ^ Bouhassira, Didier; Lantéri-Minet, Michel; Attal, Nadine; Laurent, Bernard; Touboul, Chantal (June 2008). "Prevalence of chronic pain with neuropathic characteristics in the general population" (PDF). Pain. 136 (3): 380–387. doi:10.1016/j.pain.2007.08.013. PMID 17888574. S2CID 599627.