Neuropathic pain is a debilitating and very difficult type of pain to diagnose and treat. It robs sufferers from their sleep, enjoyment of life, work and role within the family and it costs millions of dollars to the health care system.
Neuropathic pain can be the result of numerous conditions such as:
- Trauma to the spinal cord – a devastating injury that leaves the patient paralyzed
- Multiple Sclerosis – a disease that causes inflammation to the nerves, spinal cord and brain
- Syringomyelia – a condition caused by cavities (holes) in the spinal cord
- Damage to the nerve roots after a herniated disc (not treated for long time) or after unsuccessful back surgery
- Brachial plexus injury – a serious injury that may leave the patient with extremely painful but weak or paralyzed and insensitive arm
- Pain after amputation – when the patient complains bitterly of pain in the amputated “ghost” arm
- Diabetic neuropathy
- Other neuropathies due to AIDS or treatment with cancer medications
- Complex regional pain syndrome, a difficult condition affecting a limb even after minor injuries
- Post-herpetic neuralgia – the painful condition that follows an attack of shingles
- Trigeminal neuralgia
- Injuries to the nerves of the arms, legs or body after trauma
- Surgery that damages nerves, such as mastectomies, cardiac bypass surgery, surgery to repair abdominal hernias or inguinal hernia
In many of the conditions listed above, pain is affecting a large number of patients. For example, pain affects 6-8% of the patients after stroke, 70% or more of the patients after spinal cord injury, 7-54% of patients with AIDS, up to 65% of patients with Multiple Sclerosis, up to 90% of patients with syringomyelia, 50-75% of patients with amputation, most patients with nerve injury after trauma, almost half of the patients with shingles who are 70 years or older, up to 25% of the women after mastectomy, and 15% of patients after cardiac bypass surgery.
Common Symptoms and Signs of Neuropathic Pain
Typical neuropathic symptoms include pain (burning, shooting, stabbing, shock-like etc.), occurring spontaneously or generated by touch, pin prick, pressure or movement; paresthesiae and dysesthesiae, numbness, pins and needles sensations and motor dysfunction (weakness, difficulty starting or performing movements etc).
Neuropathic signs may include abnormal sensations, weakness, atrophy, changes in colour, temperature or sweating patterns and flickering of the muscles, stiffness or bizarre posturing.