WHAT IS NEUROPATHIC PAIN?
Neuropathic pain (sometimes referred to as nerve pain) is a long-term or chronic pain condition that results from nerve damage.1 When a nerve is damaged, this can disrupt how nerves communicate with each other in your body, spinal cord or brain, meaning signals may be sent incorrectly or become exaggerated.1,3 Although nerve damage can cause neuropathic pain, not everyone with nerve damage develops painful symptoms.3 It is estimated that approximately 7–10% of the world population have some kind of chronic neuropathic pain.4
Just as the nervous system is made up of two parts, the central nervous system (i.e. the nerves in the brain and spinal cord) and the peripheral nervous system (all other nerves in the body),2 so there is central neuropathic pain (where the spinal cord and/or brain is affected) and peripheral neuropathic pain (where nerves in other parts of body are affected).1 In addition, neuropathic pain may affect large areas of the body or it can be restricted to a small area; when it is restricted to smaller areas, it is called localised neuropathic pain.5
WHAT CAUSES NEUROPATHIC PAIN?
There are multiple types of events or conditions that cause nerve damage or dysfunction, which affects how pain signals are transmitted.1 Neuropathic pain may occur due to a trauma, such as surgery or an accident, a stroke (i.e. where the blood supply to part of the brain is cut off or starts to bleed into the brain), an injury (e.g. a spinal cord injury) or a chemical burn. These events can cause direct damage to nerves, or impair the way they function, and lead to neuropathic pain (e.g. phantom pain following an amputation or scar pain).1 This damage may be in the form of nerve crushing or bruising.6
Neuropathic pain is also a common complication of other diseases, including nerve damage:1
- after shingles or herpes zoster infection (post-herpetic neuralgia)
- after human immunodeficiency virus (HIV) infection
- resulting from diabetes (painful diabetic polyneuropathy)
- resulting from multiple sclerosis in the spine or lower back (low back pain)
- because of cancer (e.g. a tumour in the spinal cord or brain)
It might also be a side effect from medication, such as chemotherapy used to treat various cancers.1
WHAT ARE THE TYPICAL SYMPTOMS OF NEUROPATHIC PAIN?
People with neuropathic pain often described it as ‘shooting pain’, ‘burning pain’ or ‘stabbing pain’. It can also feel like ‘pins and needles’. In addition, people with neuropathic pain can suffer from symptoms such as allodynia (when a normally non-painful stimulus, such as a light touch or clothing, becomes painful) and hyperalgesia (when a mild or moderate stimulus causes severe pain).3
HOW IS NEUROPATHIC PAIN DIAGNOSED?
Neuropathic pain can be difficult to diagnose and is often under- or misdiagnosed.7 This can lead to people with neuropathic pain being ineffectively treated on a ‘trial and error’ basis that may persist over many months or even years.3
It is therefore important that people describe their symptoms in as much detail as possible to their doctor, including the history of the symptoms and how they may have changed over time.8 The doctor may conduct a physical examination and, if they suspect neuropathic pain, conduct some relevant tests.3
WHAT CAN YOU DO?
There are treatment options available.3 However, it is important to see your healthcare professional for advice regarding your condition.
If you have chronic pain please fill out the My Pain Questionnaire and make an appointment to see a doctor. The My Pain Questionnaire is a useful tool to help with communicating pain more effectively with a doctor and supports them in making an accurate diagnosis of the cause of chronic pain. It will help with describing chronic pain, where it occurs on the body and if it is triggered by anything in particular. Once completed online, print out the results of the questionnaire and discuss them with a doctor.
In addition, the Pain Diary can be used to help document and keep track of a person’s pain condition; how they feel each day, whether they are coping, their current level of pain and any side effects of the treatment(s) prescribed/recommended.
It is also important to be realistic about the expectations of any treatment. Although most would like to completely eliminate their pain, reducing pain to a level that is manageable to enable a person to (re-)start activities that will lead a fulfilling life is perhaps a more achievable goal for many patients.
1. Scholz J et al. Pain 2019;160:53–9.
2. Institute for Quality and Efficiency in Health Care (IQWiG). How does the nervous system work? Available at: https://www.ncbi.nlm.nih.gov/books/NBK279390/ Accessed June 2021.
3. Colloca L et al. Nat Rev Dis Primers. 2017;3:17002.
4. van Hecke O et al. Pain. 2014;155:654–62.
5. Mick G et al. Pain Manag 2012;2:71–7.
6. The British Society for Surgery of the Hand. Nerve injury. Available at: https://www.bssh.ac.uk/patients/conditions/35/nerve_injury. Accessed June 2021.
7. May S & Serpell M. F1000 Med Rep. 2009;1.
8. Morlion B et al. Curr Med Res Opin 2018;34:1169–78.