Damage to one or both parts of the peripheral or central nervous system can result in neuropathic pain and the pain is often not well localised.
There are numerous diagnoses for neuropathic pain which can have 'neuralgia or neuropathy' in the title of the condition. These conditions will be diagnosed following a full assessment by a neurologist, neurosurgeon or pain specialist. Diagnostic tools may include imaging, neurophysiological examination or lab tests.
Some diseases can result in nerve pain, including diabetes, stroke and shingles. A diagnosis of post-herpetic neuralgia is normally based upon the history of having shingles. Other diseases, such as trigeminal neuralgia are currently investigated based on their clinical presentation rather than by objective lab testing. Injuries such as spinal cord injuries also can result in neuropathic pain.
Symptoms or signs
As medical scientists learn more about the nervous systems, nerves and neuropathic pain, the terms and their meanings evolve further.
Some terms associated with neuropathic pain include:
• Allodynia refers to touch that doesn't usually cause pain eg a sheet or a breeze, causing pain
• Hyperalgesia is when there is an exaggerated pain response to a stimulus which generally causes pain
• Hypoalgesia covers feeling less pain to a usually painful event
• Sensory loss may accompany the pain
Describing the neuropathic pain may be difficult or include unusual sensations such as burning or electric shock type pain. For example, knocking your funny bone (ulnar nerve) is a neuropathic pain experience and this pain is qualitatively different to the pain felt from a bump to the hand.
The neuropathic pain may be present all of the time and then different pain sensations may occur spontaneously and not ascribe to a specific pattern.
There are some medications available that can help reduce the neuropathic pain in some people. The type of medications prescribed will vary depending on the diagnosis for the neuropathic pain. Your treating doctor will discuss specific medications for your particular condition.
Generally speaking, a combination of medications including tricyclic antidepressants and anti-epileptic medication may work best for neuropathic pain.
As for other pain conditions, it is vitally important for patients to be able to learn about their particular pain condition and include cognitive and physical therapies to retrain the nervous system as well as to keep the body as healthy and active as possible.