What is Neuropathic Pain?
The International Association for the Study of Pain (2011) defines neuropathic pain as ‘pain caused by a lesion or disease of the somatosensory nervous system’. It can result from damage anywhere along the neuroaxis: peripheral nervous system, spinal or supraspinal nervous system.
- Central neuropathic pain is defined as ‘pain caused by a lesion or disease of the central somatosensory nervous system’.
- Peripheral neuropathic pain is defined as ‘pain caused by a lesion or disease of the peripheral somatosensory nervous system’.
Neuropathic pain is very challenging to manage because of the heterogeneity of its etiologies, symptoms and underlying mechanisms.
What Causes Neuropathic Pain?
Conditions frequently associated with neuropathic pain can be categorized into two major groups, pain due to damage in the central nervous system and pain due to damage to the peripheral nervous system.
Central nervous system causes include:
- Cortical and sub-cortical strokes, traumatic spinal cord injuries, syringomyelia and syringobulbia, trigeminal and glossopharyngeal neuralgias, neoplastic and other space-occupying lesions.
Peripheral nervous system causes include:
- Nerve compression/ entrapment neuropathies (eg carpal tunnel syndrome, thoracic outlet syndrome or piriformis syndrome) , ischemic neuropathy, nerve root compression
post traumatic neuropathy (occurs after injury or medical procedures, such as surgery or injection), post-amputation stump and phantom limb pain (the exact cause of phantom limb pain is unknown, it appears to result when the nerves and the brain send faulty signals to the limb as the circuitry attempts to “rewire” itself), postherpetic neuralgia (can occur following a viral infection of herpes zoster (aka shingles”)
- Complex Regional Pain Syndrome
- Diabetic neuropathy
- Cancer-related neuropathies