Neuropathic Pain: An Introduction

Neuropathic pain arises directly from irritated or injured nerve cells.

Neuropathic pain is one of the two basic functional pain types. It is far less common and less well understood than nociceptive pain. It is defined as pain, which arises directly from an injured or irritated nerve. There is usually little or no tissue injury.


While it may occasionally seem to settle in a particular area, nociceptive pain is more often migratory along the course of the nerve involved, appearing in the knee one day, the hip the next and the ankle on the third day. The character of nociceptive pain is usually described as burning, lancinating or electrical. Yet another distinguishing character of nociceptive pain is its temporal variability. The pain often comes in waves and may vary greatly from minute-to-minute, hour-to-hour and day-to-day.


Some examples of neuropathic pain are the sciatica resulting from lumbar disc herniation, acute shingles and diabetic neuropathy. This type of pain characteristically shows little or no response to anti-inflammatory agents or narcotics, but anti-epileptic agents such gabapentin and pregabalin are often surprisingly effective. When neuromodulation is used, stimulation tends to be more effective than pain pumps, although the introduction of Prialt is slowly changing this.



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