What is neuropathy

Neuropathic pain is a complex, chronic pain state that is usually accompanied by tissue injury. With neuropathic pain, the nerve fibres themselves may be damaged or dysfunctional. These damaged nerve fibres send incorrect signals to other pain centres. The impact of nerve fibre injury includes a change in nerve function, both at the site of injury and in areas around the injury.

One example of neuropathic pain is phantom limb syndrome. This occurs when an arm or a leg has been removed due to illness or injury, but the brain still receives pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.

Causes of neuropathic pain

Neuropathic pain often seems to have no obvious cause. However, some common sources include:

• Alcoholism
• Amputation
• Back, leg and hip problems
• Chemotherapy
• Diabetes
• Facial nerve problems
• HIV infection or AIDS
• Multiple sclerosis
• Shingles
• Spinal surgery

Symptoms of neuropathic pain

Neuropathic pain symptoms may include:

• Shooting and burning pain
• Tingling and numbness

Diagnosing neuropathic pain

Your doctor will conduct an interview and a physical examination. He or she may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain.

Neuropathic pain treatment

Some studies suggest the use of non-steroidal anti-inflammatory drugs may ease neuropathic pain. Other people may need a stronger painkiller, such as one containing morphine. Anticonvulsant and antidepressant drugs seem to work in some cases.

If another condition is involved, such as diabetes, better management of that disorder may alleviate the pain.

In cases that are difficult to treat, a pain specialist may use invasive or implantable devices to manage the pain effectively. Electrical stimulation of the nerves involved in neuropathic pain generation may significantly control the pain symptoms.

Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally it may get worse instead of better over time. For some people, it can lead to serious disability.