Introduction

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

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

What Causes Neuropathic Pain?

Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include:

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

What Are the Symptoms of Neuropathic Pain?

Symptoms may include:

		Shooting and burning pain
		Tingling and numbness

How Is Neuropathic Pain Diagnosed?

A physiatrist will conduct an interview and physical exam. He may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain.

How Is Neuropathic Pain Treated?

While the first goal of therapy is to relieve pain, goals should be realistic. Patients often hope for a “cure,” but this is not always possible. Complete pain relief may not be achieved with treatment. A more realistic goal is to decrease pain to a tolerable level. Successful treatment should improve Activities of Daily Living. This includes improved ability for patient self-care, and increased ability to socialize. Specific goals should include activities the patient wishes to resume with pain relief. Effective treatment usually combines nonpharmacologic methods with medication.

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

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

At our facility we may use invasive or implantable device therapies to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain generation may significantly control the pain symptoms.